644-40204-4900-0499

Considering the public health emergencies (PHE) ending on May 11, 2023, the Illinois Department on Aging (IDoA or Department) has evaluated and recognized the continued critical role the Emergency Senior Services (ESS) grant program has filled in providing participants with necessary gap-filling support services since inception in 2020. IDoA Care Coordination Units (CCUs) serve as grantees, as well as the primary gate keepers for receiving and processing referrals and ensuring the appropriate utilization of these funds to qualifying participants. The Department has prepared this updated guidance to assist Care Coordinators, Area Agencies on Aging, and Community Care Program (CCP) providers in continuing to utilize these critical services. The Emergency Senior Services grant serves as a stabilization mechanism to assist seniors having limited resources to handle unexpected expenses and emergencies, as well as providing necessary gap-filling support to help seniors continue to reside in their homes and community-based settings. These funds exist to assist seniors who have exhausted all other resources and have limited income and assets to address these needs. Funds are not meant to be utilized on an ongoing basis to provide support to participants or as a one-time yearly charitable gift. Examples of appropriate utilization scenarios include unexpected illness and health-related expenses, home repairs, maintenance, and modifications; as well as other unforeseen and necessary gap-filling expenses (i.e., non-covered medical and dental expenses, real estate assessments). The goods and services purchased under ESS are available to assist with the unanticipated needs of any senior (age 60+) or APS client (age 18-59) who meets the following income criteria: • Demonstrate an urgent financial need that is affecting the participant’s ability to remain in their current HCBS placement. • Have readily accessible emergency funds no greater than $17,500 (e.g. – Savings, Checking, Insured Money Market Accounts, Certificates of Deposit, Stocks, and Bonds). • Receive monthly income no greater than $3,500 for a single participant or $4,700 for a married couple. • Requests for Exceptional Payment Requests (EPRs) for individuals that do not meet the above financial criteria should be sent via email to ESS.Aging@Illinois.gov for review and c consideration.

N/A

Public Act 81-202, Community Care Program

•CODE of FEDERAL REGULATIONS Title 2: Grants and Agreements PART 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR 200) •Grant Accountability and Transparency Act (GATA), 30 ILCS 708/1 •Illinois Administrative Code

The goal of this grant funding is to provide as many qualifying seniors aged 60 and over (as well as APS clients ages 18-59), having limited financial resources and living in home and community settings, with funding to handle unexpected expenses and emergencies, as well as provide gap-filling supportive funds, in an effort to assist individuals to continue residing in their home and community-based placements.

Yes

Care Coordination Unit (CCU) staff should keep a record in the participant file to document that the participant’s current monthly income and available emergency fund information was verified, and the participant meets the Department’s specified income requirements. CCU staff must document in the case notes of the participant file the urgent financial need being demonstrated and how one-time ESS funds could appropriately assist the participant to meet those needs and remain in the home (e.g. – participant’s refrigerator broke, participant meets financial guidelines specified by the Department, and a working refrigerator is necessary to continue residing in the home). CCUs must document in the case notes of the participant file that the participant’s current Medicaid, Medicare, and third-party insurance information was requested and obtained. CCUs shall utilize all other types and forms of available assistance (including third-party insurance) prior to utilizing ESS funds to assist participants with an emergent need, including any funds the CCU may have or other gap-filling funds to address such participant needs. It is the responsibility of the CCUs to receive and process referral request forms for ESS from Area Agencies on Aging, Adult Protective Services providers, Adult Day Services providers, In-Home providers; and Emergency Home Response Service/Automated Medication Dispenser providers. • All referral requests will be emailed to the CCU’s general mailbox. • Requests made to the Senior HelpLine will be routed to the CCUs for specific follow up. • The signature of the participant/individual receiving assistance should be obtained on the referral form. • In cases where the signature can’t be obtained due to extenuating circumstances or health risks; it is imperative that the CCU document receipt of verbal consent accordingly in their notation. Following receipt of a request, CCUs will: • Initiate contact with the individual. • Make purchases and ensure goods and services are delivered/set up, and work with the referring agency as needed, as well as notify the referring agency once the request has been fulfilled. • Adhere to all Department grant guidance and utilization requirements. CCUs are required to keep all processed (approved) referral request forms and ESS invoices and receipts in the participant’s file for monitoring purposes. This includes: • Receipts of purchases made in advance by APSPAs and are reimbursed by the CCU. • Electronic storage or hard-copy filing of the one-page referral form received (whether approved or denied) coming from the AAAs, APSPAs and CCP providers (INH, ADS and EHRS/AMD) and all associated invoices and receipts on file. • Gift cards may be utilized to assist participants. A receipt shall be kept in the participant’s file showing the specific approved items that were purchased using the gift card. These items must equal or exceed the total amount of the gift card and the receipt must be dated within 30 days of the date the gift card was issued to the participant. The CCU is responsible to keep these receipts on file for auditing and compliance purposes. IDoA is permitting a maximum total spend of $500.00 per individual in a fiscal year with the following exceptions: Exceptional Payment Exceptions: • Any request which totals over $500 in total assistance for a participant in a fiscal year will require Department prior approval. The CCU should submit an Exceptional Payment Request (EPR) form via email to Aging.ESS@illinois.gov for consideration. • Any ESS request for individuals enrolled in an MCO (regardless of the dollar amount of the request) requires prior approval via an Exceptional Payment Request form. • Any ESS item not identified on the Department Approved ESS Reference Guide (see Grant Agreement - Exhibit A on pages 5-7), regardless of the dollar amount of the request, requires prior approval via an Exceptional Payment Request form. • Certain specified medical and transportation assistance requests (such as medical care, hearing aids, glasses, transportation assistance, etc.) regardless of the dollar amount, will require approval by the Department via an EPR request (see ESS reference guide for specific medical items requiring Department prior approval). CCUs should verify the participant’s current Medicaid, Medicare, and all third-party insurance coverage status and document this information in the participant’s case notes, as well as EPR requests. CCUs are responsible for ensuring that ESS is used only as a payor of last resort when no other form of insurance will cover the required medical expense (including medical transports if the participant is Medicaid eligible) unless there is an urgent need and/or a need for specialized non-covered or medically-urgent covered equipment (e.g., Medicare purchases a wheelchair for an eligible participant every 5 years, in instances where a wheelchair is damaged and needs replacement prior to this time frame, ESS funds would repair or provide a replacement wheelchair for the participant). CCUs can reach out to IDoA via email at Aging.ESS@Illinois.gov if they have questions or concerns regarding medical and/or transportation assistance requests. For durable medical equipment (DME) for a Medicaid and/or Medicare-eligible participant, CCUs should refer to the Illinois Medicaid DME fee schedule (https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/dme.html) and the Federal CMS Medicare DME Site (https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule) to download the most current Medicare DME fee schedule available via zip file, which includes information for both rural and non-rural locations in Illinois (see further guidance on pages 5 and 6 to assist with using these documents and understanding the process for utilizing Medicare and/or Medicaid to cover these items). When utilizing ESS funds, the highest priority should be the identification of the most cost-effective goods and services without overlooking the quality and durability of the items. If a request for home modification, install, or repair is received and a landlord or mortgage holder is involved with the property site, the CCU shall complete the Landlord or Mortgage Holder Approval Form (IL 402-1333) and will retain a copy of the completed form in the participant’s file. IDoA requires CCUs to initially determine if appliances can be repaired (IDoA will pay for an estimate if necessary). If this is not possible, IDoA requests 2 or 3 estimates for any replacement equipment. Additionally, any home maintenance, repair, or modification requests (if total assistance for the participant in the fiscal year is over $500) also require 2 or 3 estimates, if possible, for the work being completed. If a participant requires electronic technology and/or assistive devices, CCUs should first reach out to the Department’s Illinois Care Connections Program (https://ilaging.illinois.gov/programs/illinois-care-connections.html) to request this type of assistance for the participant. Illinois Care Connections is a state funded grant program with the Illinois Assistive Technology program and is available to adults age 60+ to help them remain safely in the home by addressing independence or health welfare needs such as ADLs/IADLs, social isolation, and mobility issues, among others. Examples of this type of assistance include, but are not limited to: Tablet bundles (iPad or Android, case, keyboard, charger, headphones), screen protectors, mice, stylus pens, tablet stands, laptops, desktop computers, internet/Wi-Fi/hotspot access devices; hearing devices including speakers, soundboxes and sound amplifiers; vision devices such as magnifiers; mobility devices such as adaptive utensils; smart home technology including smart plugs, smart light bulbs, voice-activated home assistants, camera-enabled doorbells, memory loss calendars/clocks and talking clocks; animated companion stuffed animals; and 3D printed devices. If the Illinois Care Connections program is unable to assist with the participant’s assistive device or technology request, the CCU can utilize ESS funds to assist the participant. Requests for grab bars or other assistive devices requiring home modification for installation should be requested through the ESS program. Bulk Purchases: Bulk purchases for various items (e.g., groceries, reachers, cleaning supplies, incontinent supplies) require prior approval by IDoA prior to purchase. To request approval for one-time or ongoing bulk purchases, please email the Department at Aging.ESS@illinois.gov and include the following information: Description of bulk item, quantity of items being purchased, and number of participants assisted, cost of bulk purchase (or average cost if quantity will vary), and frequency of purchase (one time or monthly ongoing). Home Delivered Meals (HDM)/Ethnic Meals: During the height of the pandemic, IDoA allowed a few CCUs to utilize ESS funds to provide Home Delivered Meals (HDM)/Ethnic meals to participants. NOTE: The Department will not be approving any new HDM/Ethnic meal program agreements with CCUs. In addition, the Department is not allowing any existing HDM/Ethnic meal programs (approved in the most recent fiscal year) to add new participants to their current meal program rosters. IDoA’s objective is to utilize ESS funds for urgent gap-filling needs, therefore, the Department intends for existing HDM/Ethnic meal programs to eventually be discontinued due to attrition or by identifying another funding source independent of ESS funds. CCUs with existing HDM/Ethnic meal programs (approved in the most recent fiscal year) shall request prior approval to continue the HDM/Ethnic meal program in the new grant year. Please send these requests via email to Aging.ESS@Illinois and include the following information: The name of any external provider the CCU is working with and a description of the CCU’s relationship with this provider (i.e., external provider is handling the production of the meals, description of how CCU is working in conjunction with the external provider). Additionally, include the total number of monthly meals that will be provided and number of participants receiving these meals. CCU - ESS Program Administrative Requirements: Administrative expenses (including personnel salary/wages, fringe benefits, travel, supplies, telecommunications, equipment, and miscellaneous costs) in any given reporting month may not exceed 50% of the total direct ESS participant service expenses reported for the month (e.g., ESS expenses for July are $500 total – no more than $250 could be billed as direct administrative expense for that month). Additionally, administrative fees may not exceed over 20% of the total grant award amount for the fiscal year (i.e., grant award is for $50,000 – no more than $10,000 total shall be billed or paid for administrative fees). Any monthly administrative expense (excluding personnel-related expenses), which exceeds $500 in a reporting month, will require Department approval (send request via email to Aging.ESS@illinois.gov and include the following information: detailed description of items, cost, quantity, and summary of demonstration of need for requested items). Complete ESS Monthly Expenditure Tracking Sheet and ESS Administrative Tracking Sheet and send via email to Aging.ESS@illinois.gov. Under no circumstances should a CCU report administrative expenses (including travel for delivery of items) in the monthly service expenditure portion of the monthly expenditure tracking document. All administrative expenses should only be reported on the Administrative Tracking Sheet. This report is due by the 10th day of the following reporting month. Detailed monthly expense reports (including participant costs paid and administrative costs incurred in the reporting month) are due on the 10th day of the month following the reporting period. Quarterly Periodic Financial Reports (PFRs), as well as quarterly Periodic Performance Reports (PPRs), are due on the 10th day of the month following the end of a reporting quarter (Oct. 10th, Jan 10th, Apr 10th, July 10th) and should be submitted to the Aging.ESS@illinois.gov mailbox. Per GATA requirements, performance measures included in the PPR report are listed in the grant fund opportunity and are required to be met (not for informational purposes only). CCU - Medicaid/Medicare DME Billing Info: The following information is meant to serve as a general guide for CCUs to utilize when a participant needs basic durable medical equipment (DME) and the participant is covered under Medicare and/or Medicaid insurance. In instances where the participant is dual-eligible, Medicare is considered the primary insurance for billing purposes if the item is a Medicare-covered DME item. Medicaid is always considered the payor of last resort when a participant is covered by multiple insurances. Since DME coverage under Medicare and/or Medicaid can vary based on each program’s fee schedule, as well as a medical supply provider’s discretion (i.e., - a medical supply provider may choose not to accept Medicaid/Medicare for certain covered items such as bath items due to the Medicaid/Medicare reimbursement rates being too low), CCUs are encouraged to reach out to area medical suppliers to verify whether a provider is enrolled with Medicare and/or Medicaid and whether the provider accepts these insurance coverages for DME items included on the Medicaid and/or Medicare fee schedules (see page 3). DME Requirements and Fee Schedules: Medicare requirements for DME: Requires a prescription for the requested DME item(s) from a Medicare-enrolled physician provided in a secure format to the Medicare-enrolled medical supply provider, as well as the patient’s chart notes demonstrating medical necessity for the requested item. Medicaid requirements for DME: Requires a prescription for the requested DME item(s) from a Medicaid-enrolled physician provided in a secure format to the Medicaid-enrolled medical supply provider. Illinois Medicaid DME fee schedule: https://hfs.illinois.gov/medicalproviders/medicaidreimbursement/dme.html Federal CMS Medicare DME fee schedule: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule

Government Organizations; Nonprofit Organizations; For-Profit Organizations;

Illinois Care Coordination Units (CCUs)

Any senior (age 60+) or APS client (age 18-59) who meets the following income criteria: • Demonstrate an urgent financial need that is affecting the participant’s ability to remain in their current HCBS placement. • Have readily accessible emergency funds no greater than $17,500 (e.g. – Savings, Checking, Insured Money Market Accounts, Certificates of Deposit, Stocks, and Bonds). • Receive monthly income no greater than $3,500 for a single participant or $4,700 for a married couple. • Requests for Exceptional Payment Requests (EPRs) for individuals that do not meet the above financial criteria should be sent via email to ESS.Aging@Illinois.gov for review and consideration.

Non-competitive

Human Services

Current contract holder with Illinois Department of Aging as a Care Coordination Unit

The Illinois Department on Aging (IDoA) will be issuing Emergency Assistance Services (ESS) grants to Care Coordination Units (CCUs) to address emergency and supportive gap-filling needs for qualifying individuals aged 60 and over (as well as APS clients ages 18-59) having limited financial resources and living in home and community settings to assist with identified needs in an effort to stabilize the individual's home and community-based placement. Allocation levels are determined by the CCU with approval by the Department. CCUs must adhere to all IDoA grant guidance and utilization requirements.

Please copy and paste the URL:

Merit Criteria

Merit Based Review

March 29, 2024

30 business days

N/A

Renewal by application

No matching requirements.

ESS Grant funds may be used to purchase items/goods including, but not limited to: Nutritional needs: • Groceries/food -this includes coverage of delivery costs for older participants who are not able to purchase the items themselves • Access box stores (i.e., Walmart), Uber/Lyft, other pick-up & delivery services • Shelf stable meals for pantries, including non-perishable food items & bottled water Personal Care & Sanitation needs: • Personal hygiene items • Adult under garments & pads • Disposable hygiene wipes • Disposable gloves • Disinfectant items • Hand sanitizer & hand soap • Disposable disinfectant wipes • Disinfectant cleaning products Medical Care needs*: • Diabetes test strips, catheters, oxygen, glasses, etc. • Home First Aid kits (OHSA approved) • Incontinence products • Dentures and dental care assistance • Medical bill assistance • Medication assistance • Counseling services * = Denotes medical assistance category that requires Department approval via an EPR if the requested item or service is covered by the participant's insurance. Transportation services that may be covered through ESS funds include, but are not limited to: • Transportation to and from physician/medical* appointments • Transportation to and from pharmacy for medication pick-up • Transportation to and from medical supply providers • Costs associated with delivery of essential/necessary medications * = Denotes medical assistance category that requires Department approval via an EPR if the requested item or service is covered by the participant's insurance. Basic Home Furnishings, Supplies and Appliances • Bedframe/mattress, basic living room, bedroom, bath, and kitchen furnishings • Necessary appliances (stove, refrigerator, oven, water heater, etc.) • Vacuum and other various cleaning supplies • Telephone, clock, etc. Minor Home Modifications • Minor home modifications • Minor home repairs and weatherization • Ramps Utility and HVAC Assistance • Electric and gas/propane assistance • Other utility assistance (telephone, water, past due bills) • AC and furnace installation or repairs • Portable heaters and fans Moving and Housing Assistance • Transportation assistance to locate or move to new residence • Moving van or truck rental • Mortgage or Rental Assistance • Temporary hotel stay • Security deposit or housing application fees • Pest eradication, cleaning, and allergen control ADL & IADL Assistive Technology* such as: • Walker, wheelchair, rollator, scooter • Weighted utensils, shower chair, grooming aides • Commode, colostomy bag, elevated toilet seat • IPad, wireless hearing amplifier, WIFI booster • Grab bars, reaching devices *CCUs must initially seek assistance with ADL and IADL assistive technology requests from the IATP program prior to utilizing ESS funds for these types of requests. IDoA is permitting a maximum total spend of $500.00 per individual in a fiscal year with the following exceptions: Exceptional Payment Exceptions: • Any request which totals over $500 in total assistance for a participant in a fiscal year will require Department prior approval. The CCU should submit an Exceptional Payment Request (EPR) form via email to Aging.ESS@illinois.gov for consideration. • Any ESS request for individuals enrolled in an MCO (regardless of the dollar amount of the request) requires prior approval via an Exceptional Payment Request form. • Any ESS item not identified on the Department Approved ESS Reference Guide (see Grant Agreement - Exhibit A on pages 5-7), regardless of the dollar amount of the request, requires prior approval via an Exceptional Payment Request form. • Certain specified medical and transportation assistance requests (such as medical care, hearing aids, glasses, transportation assistance, etc.) regardless of the dollar amount, will require approval by the Department via an EPR request (see ESS reference guide for specific medical items requiring Department prior approval). Administrative expenses (including personnel salary/wages, fringe benefits, travel, supplies, telecommunications, equipment, and miscellaneous costs) in any given reporting month may not exceed 50% of the total direct ESS participant service expenses reported for the month (e.g., ESS expenses for July are $500 total – no more than $250 could be billed as direct administrative expense for that month). Additionally, administrative fees may not exceed over 20% of the total grant award amount for the fiscal year (i.e., grant award is for $50,000 – no more than $10,000 total shall be billed or paid for administrative fees). Any monthly administrative expense (excluding personnel-related expenses), which exceeds $500 in a reporting month, will require Department approval (send request via email to Aging.ESS@illinois.gov and include the following information: detailed description of items, cost, quantity, and summary of demonstration of need for requested items).

Grantee agrees to submit financial reports as requested and in the format required by grantor. Grantee shall submit a close-out report within 10 calendar days following the end of the period of performance for this agreement. Grantee shall submit Consolidated Year-End Financial Reports, according to the required audit. Grantee agrees to submit Performance Reports as requested and in the format required by Grantor. Grantee shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 USC 7501-7507) and subpart F of 2 CFR Part 200, and the audit rules and policies set forth by the Governor's Office of Management and Budget. Reports shall be due to the Department as follows: In a format as prescribed by the Department, the Grantee shall submit detailed Monthly Expenditure and Administrative Reports due to the Department's program liaison (Melissa Schackel) by the 10th of each month for the preceding month. All monthly reports can be submitted to the general ESS mailbox at Aging.ESS@illinois.gov. The Grantee shall deliver to the Department Periodic Programmatic Report (PPR) and Periodic Financial Reports (PFR). These reports shall be inclusive of all expenses and activities for the reporting periods indicated. All funds shall be utilized as detailed on the Grantee's application and budget. Any variation from this use requires advanced approval by the Department. Per GATA requirements, performance measures included in the PPR report are listed in the grant agreement and are required to be met (not for informational purposes only). These reports shall be due on or before the following dates: Reports for FY24: • October 10, 2024 (July 1, 2024 - September 30, 2024) • January 10, 2025 (October 1, 2024 - December 31, 2024) • April 10,2025 (January 1, 2025 - March 31, 2025) • July 10, 2025 (April 1, 2024 - June 30, 2025) All above reports can be submitted to the general ESS mailbox at Aging.ESS@illinois.gov.

Aligned with Community Care Program audit requirements

Record retention in accordance to agency requirements

0644.40204.4900.0499

$5,000,000.00

$30,000.00 to $300,000.00

The Emergency Senior Services grant serves as a stabilization mechanism to assist seniors having limited resources to handle unexpected expenses and emergencies, as well as providing necessary gap-filling support to help seniors continue to reside in their homes and community-based settings. These funds exist to assist seniors who have exhausted all other resources and have limited income and assets to address these needs. Funds are not meant to be utilized on an ongoing basis to provide support to participants or as a one-time yearly charitable gift. Examples of appropriate utilization scenarios include unexpected illness and health-related expenses, home repairs, maintenance, and modifications; as well as other unforeseen and necessary gap-filling expenses (i.e. – non-covered medical and dental expenses, real estate assessments, etc.).

N/A

Aging.ESS@illinois.gov

Illinois Department on Aging One Natural Resources Way, Suite 100 Springfield, IL 62702-1271

https://ilaging.illinois.gov/

Illinois Care Connections

N/A

FY 2022 : $5,000,000
FY 2023 : $5,000,000
FY 2024 : $5,000,000
FY 2025 : $5,000,000