Regulatory Review of Adult Day Services: Final Report - Section 2. Illinois

08/26/2005

Overview

The State of Illinois does not require licensing or certification for adult day care providers. The Department on Aging Community Care Program (CCP) funded by state general revenue and the Medicaid Waiver provides services designed to prevent premature and unnecessary institutionalization to individuals over 60 years of age who are determined eligible to receive such services. The regulations for CCP, as stated in the Administrative Code, require all adult day service providers to comply with the applicable local and state building, fire, health, and safety codes and standards in addition to specific accessibility and environmental barrier codes, and food service sanitation and vehicle codes. There are no provisions for adult day care other than those stated in the Administrative Code for the CCP, which are detailed in this profile.

Licensure and Certification Requirements

Licensure and Certification Requirements
Licensure Only  ☐ 
Certification Only  ☐ 
Both Required  ☐ 
Other  ☒  CCP providers must follow CCP rules to offer adult day services

Definitions

Adult day service is the direct care and supervision of adults 60 years of age and over in a community-based setting for the purpose of providing personal attention and promoting social, physical, and emotional well-being in a structured setting.

Parameters for Who Can Be Served

Other than the general parameters included in the definition (above), none are specified.

Inspection and Monitoring

Inspection and Monitoring
Yes  ☒ 
No  ☐ 

The Department shall have the authority to conduct performance reviews of a contracted provider agency at any time during the course of the provider's contract period. The Provider Performance Review consists of reviewing a sample of client and employee files to: evaluate provider compliance with administrative rules; ensure adherence to the policies and procedures established by the Department and the adult day service provider; and ensure that Request for Proposal (RFP) provider requirements are met or exceeded.

Required and Optional Services

  Adult Day Services
Required Optional
Activities of Daily Living (ADL) Assistance  ☒   ☐ 
Health Education and Counseling  ☒   ☐ 
Health Monitoring/Health-Related Services  ☒   ☐ 
Medication Administration  ☒   ☐ 
Nursing Services  ☒   ☐ 
Physical Therapy, Occupational Therapy, or Speech Therapy  ☐   ☒ 
Skilled Nursing Services  ☐   ☒ 
Social Services  ☒   ☐ 
Transportation  ☒   ☐ 

Provisions Regarding Medications

An adult day service provider shall have on file and utilize written procedures to manage storage and administration of medications, including ensuring that prescribed medication is administered by an appropriately licensed professional to those adult day service clients who are determined unable to self-administer medications; and that judgment of a client's inability to self-administer medications shall be documented by a physician's order or the Case Coordination Unit plan of care and/or the adult day service plan of care by the program nurse.

Provisions for Groups with Special Needs

Provisions for Groups with Special Needs
Dementia  ☐ 
Mental Retardation/Developmental Disabilities  ☐ 
Other  ☐ 

Staffing Requirements

Type of staff. A separate and identifiable staff person must be designated for sole use by the adult day service program. Each adult day service provider shall have adequate personnel in number and skill (a minimum of two staff persons) at the adult day service site to provide for program and fiscal administration; nursing and personal care services; nutritional services; planned therapeutic/recreational activities; and provision or arrangement of transportation to and from the adult day service site.

The program coordinator/director may perform the responsibilities of an adult day service program administrator; and must be on duty full-time when clients are in attendance or have a qualified substitute.

program nurse must be on duty at least one-half of a full-time (FTE) work period when clients are in attendance, either as staff or on a contractual basis. With written Department approval, the responsibilities of a program nurse may be performed by the program coordinator/director or administrator, in which case that person must be full-time and must meet the qualifications for a program nurse and fulfill responsibilities for all assigned positions.

Nutrition staff shall include: (1) at least one staff person who meets the food service sanitation guidelines issued by the Department of Public Health; and (2) a nutrition consultant/dietitian, either paid or in-kind, who shall be a registered member of the American Dietetic Association with experience in an agency setting.

Drivers of adult day service vehicles that transport clients, and at least two program adult day service staff, shall be certified in cardiopulmonary resuscitation (CPR) and trained in first aid, and at least one of such trained staff shall be on-site when clients are present.

The adult day service team consisting of program coordinator/director and program nurse may include other staff at the option of the program coordinator/director.

Staffing ratios. The minimum ratio of full-time staff (qualified adult day service staff, trained volunteers or substitutes) or full-time equivalent staff present at the adult day service site to clients, when clients are in attendance, shall be: two staff for every 1-12 clients; three staff for 13-20 clients; four staff for 21-28 clients; with one additional staff person for each seven additional clients. Fifty percent or more of a staff member's time shall be spent in on-site direct service or supervision on behalf of one or more clients in order to be considered in the ratio.

Training Requirements

Each adult day service employee shall have initial training totaling a minimum of 12 hours face-to-face training within the first week of employment (exclusive of orientation). A worker may be exempted from initial training by the provider if the worker has had previous documented training equivalent to 12 hours, with another CCP contracted agency, or in a related field, within the past 2 years prior to this employment or holds a CNA, RN, LPN, BA, BS, BSW, or higher degree. A minimum of 12 hours continuing education per year shall be mandatory for all adult day service employees.

Relevant Medicaid Contracting Requirements for Adult Day Services Providers

There are no additional Medicaid requirements for adult day services providers. The CCP requires all providers to adhere to the same rules and regulations irrespective of funding sources.

Location of Licensing, Certification, or Other Requirements

  1. http://www.ilga.gov/commission/jcar/admincode/089/08900240sections.html

Citations

  1. Administrative Code (Title 89: Social Services, Chapter II: Illinois Department on Aging, Part 240--Community Care). Joint Committee on Administrative Rules. [Effective 5/21/04]

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