644-40204-4900-0499

Since FY25, IDoA has placed special emphasis on the use of ESS funds to assist older adults at risk of homelessness and those experiencing homelessness to provide supports and services aimed at ending homelessness and facilitating access to a permanent and secure housing solution. Recent trends suggest the number of older adults experiencing homelessness has not only increased but is expected to continue to rise owing to factors such as rising costs, fixed income, complex medical needs, and lack of homelessness assistance. Illinois is experiencing a similar increase in older adults experiencing homelessness that presents an opportunity for IDoA and the Aging Network to assist the Illinois Office of Homelessness by ensuring these vital resources are utilized to help some of our most vulnerable older adults. The ESS 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 prevent homelessness and enable seniors to continue to reside in their home and community-based settings. These funds are being appropriated to assist seniors who have exhausted all other resources and have limited income and assets to address these needs. Funds are meant to provide short-term assistance and 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 term “at risk of homelessness” means, with respect to an individual or family, that the individual or family— (A) has income below 30 percent of median income for the geographic area; (B) has insufficient resources immediately available to attain housing stability; and (C) (i) has moved frequently because of economic reasons; (ii) is living in the home of another because of economic hardship; (iii) has been notified that their right to occupy their current housing or living situation will be terminated; (iv) lives in a hotel or motel; (v) lives in severely overcrowded housing; (vi) is exiting an institution; or (vii) otherwise lives in housing that has characteristics associated with instability and an increased risk of homelessness (Source: 42 USC § 11360(1)). ESS Eligibility Guidelines The goods and services purchased under ESS are available to assist with the unanticipated needs of any senior (age 60+) or APS participant (age 18-59) who is a U.S. citizen or legal alien residing in Illinois and meets the following income criteria: Demonstrate an urgent financial need that is significantly affecting the participant’s ability to remain in their current HCBS place of residence. Special emphasis on the use of ESS funds needs to be directed to the prevention of homelessness and assisting older adults who are homeless to access a permanent and secure housing solution. Have readily accessible liquid assets no greater than $17,500 (e.g. – Savings, Checking, Insured Money Market Accounts, Certificates of Deposit, Stocks, Bonds, Cash Value Life Insurance, etc.). Receive modified adjusted gross income in line with 200% of the 2025 Federal Poverty Level (FPL) being no greater than $2608/month ($31,300/year) for a single participant or $3,525/month ($42,300/year) for a married couple. Requests for Exceptional Payment Requests (EPRs) for participants who do not meet the above citizenship and/or financial criteria should be submitted via an online EPR form for consideration utilizing the following web link - ESS Exceptional Payment Request Online Form.

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 who are a U.S. citizen or legal alien residing in Illinois 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 achieve housing stability in their home and community-based placements.

Yes

Care Coordination Unit (CCU) staff must keep a record in the participant file to document that the participant’s current monthly income and available liquid asset information was verified, and the participant meets IDoA’s specified income requirements. If a participant requesting ESS assistance has an active CCP, Medicaid or SNAP case, no further income verification for the participant is necessary. CCUs should document in the referral documentation that the participant’s current active CCP, Medicaid or SNAP status was verified to support income eligibility. If the participant does not have an active CCP, Medicaid or SNAP case, the CCU must obtain the participant’s income and asset information, as well as copies of supporting income and asset documentation. Additionally, the CCUs should obtain a signed statement from the participant attesting that the participant has no other income and assets other than what has been reported to the CCU. If a CCU has reason to believe the participant may not be reporting all existing income and assets based on an assessment of the participant’s current home or rental property, the CCU should request a copy of the participant’s latest tax documents for income verification purposes. 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 IDoA, 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. CCUs should document, either on the referral form or in the case notes, what actions were taken to ensure ESS funds are being utilized as a payor of last resort. 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 provider, and Emergency Home Response Service/Automated Medication Dispenser providers. If another funding source is available such as Early Intervention Services (EIS) for Adult Protective Services (APS) cases, CCUs should attempt to utilize those funds or request the cost be split between ESS and the other possible funding source. CCUs should document these efforts in the case notes and/or EPR request. Basic Referral Info: • 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 receiving assistance should be obtained on the referral form. o In cases where the participant signature can’t be obtained due to extenuating circumstances or health risks; it is imperative that the CCU document the reason participant signature was unattainable, as well as the date the participant’s verbal consent for the request was received on the referral form. Following receipt of a request, CCUs will: • Initiate contact with the participant. • Make purchases and ensure goods and services are delivered/set up, work with the referring agency as needed, as well as notify the referring agency once the request has been fulfilled. • Adhere to all IDoA grant guidance and utilization requirements. CCUs are required to keep all processed referral request forms received, including approved forms that contain the participant signature, as well as copies of ESS invoices and paid 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. Approved referral requests must contain the participant’s signature. • CCUs must possess and retain copies of paid receipts and invoices for billed ESS goods and services provided to participants and reported in the CCUs monthly detailed expense reports. Under no circumstances will a CCU attempt to bill IDoA for donated goods or charitable services that were provided to participants free of charge or items donated to the CCU at no cost. ESS participant costs should be reported in the month the CCU releases funds and has a paid receipt on file for the goods or services being billed to IDoA. • CCUs cannot use gift cards to fulfill participant requests without IDoA prior approval. If IDoA approves the use of a gift card to fulfill an ESS request, 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 recommends CCUs develop a process for prioritizing and managing ESS requests based on risk (with priority given to the most at-risk participants presenting with the most urgent needs), request type (with priority status given to homeless participants, as well as our existing CCP participants and new intakes), as well as consideration of the number of requests received, current cash flow, and available grant funds remaining. IDoA is permitting a maximum total spend of $500.00 per participant in a fiscal year with the following exceptions: Exceptional Payment Requests: CCUs should complete an online Exceptional Payment Request (EPR) form for consideration utilizing the following web link - ESS Exceptional Payment Request Online Form for any of the following reasons: • If the participant has time-sensitive expenses that need paid to avoid eviction, is at risk of homelessness, or needs to move to a new, more affordable location to remain in a home or community-based residence. • If the participant is homeless and needs ESS funds to secure and furnish a home or community-based residence. • Any request which totals over $500 in total assistance for a participant in a fiscal year will require IDoA prior approval. o A minimum of two estimates should be included when submitting an EPR for any single ticket item or service totaling $500 or more. Random audits will be conducted on all CCUs throughout the year to ensure compliance and program integrity. IDoA will conduct audits on CCUs that routinely submit payment requests at or near the $500 threshold for participants. o EPR requests for home modifications (e.g. ramps) should include information in the email and/or EPR form stating the proposed contractor is licensed and insured, and any necessary permits (if required) have been obtained. o EPR requests to assist with overdue rent, mortgage, or utility bills should provide a detailed explanation that supports what mitigating circumstance or event caused the participant to become delinquent on their payments and whether the participant made any sort of payments on these accounts during the months they were in arrears. Additionally, the CCU should explain what services and supports will be put in place to ensure the participant will be able to manage these expenses moving forward. Copies of the mortgage or rental agreement and payment history, as well as copies of overdue utility statements which show the payment history, should be included when submitting an EPR to cover these expenses. Any payment assistance request should be under the requesting participant and/or spouse’s name. In situations where the participant is living with other household members and the bill is not in the participant’s name, the amount of ESS assistance will be limited to the participant’s percentage of the total number of persons living in the home (e.g. - older adult living with adult child and 3 grandchildren, the total maximum percentage of assistance for the bill would be 20%). o CCUs must include copies of the income and asset verification documents, which support the participant meets ESS income and asset eligibility guidelines, when submitting EPR requests for participants who do not currently have an active CCP, Medicaid, or SNAP case. • Any ESS request for participants enrolled in a Managed Care Organization (MCO), regardless of the dollar amount of the request and/or whether the participant is enrolled in the CCP program, requires prior approval via an EPR form. If the participant is enrolled in the CCP program, CCUs should contact the participant’s CCP MCO case manager to provide notification of the request for follow up purposes by the MCO and to inquire if the MCO may be able to assist. If the CCU has difficulty obtaining proper contact information to reach the MCO case manager, please contact IDoA via email at Aging.ESS@Illinois.gov and share all available participant and case manager information to request assistance in routing the ESS request information to the assigned MCO case manager. o If the CCU is unable to reach the CCP MCO case manager, please ensure an email notification or voicemail message was left for the case manager and allow 2 business days from the date of notification for the case manager to respond. If the MCO fails to respond after 2 business days from date of notification, please document the date and details of the notification attempt in the participant’s file and proceed with submitting the EPR request. Please include the notification attempt information in the email correspondence submitted with the EPR request to IDoA. o For non-CCP MCO participants, contacting the MCO is not required unless the CCU believes the MCO may be able to provide medical care coordination support to the participant based on a medical need that was brought to the CCU’s attention while providing ESS assistance to the participant. • Any ESS item not identified on IDoA’s Approved ESS Reference Guide (see Grant Agreement – Exhibit A on pages 10-12), regardless of the dollar amount of the request, requires prior approval via an EPR form. • Certain specified medical and transportation assistance requests (such as medical care, incontinence supplies, rollators, canes, hearing aids, glasses, medical transportation assistance, etc.) regardless of the dollar amount, will require approval by IDoA via an EPR request (see ESS reference guide for specific medical items requiring IDoA prior approval). Please include copies of the Explanation of Benefits (EOB) letter from the insurance provider, as well as any correspondence received from the Third-Party Liability (TPL) insurance provider supporting the denial, and/or any other documentation justifying the use of ESS funds to cover the requested item. o For transportation-related assistance: CCUs must ensure the participant is using an appropriate transportation provider (public transportation, taxi, Uber/Lyft) and they are retaining copies of receipts that support payment for the transportation expenses incurred. IDoA does not approve CCUs paying family members or friends to provide transportation or providing gas cards to participants. If the participant is facing hardship due to having to cover unexpected transportation-related expenses, the CCUs can provide other types of ESS-approved assistance to the participant. • The use of a gift card to fulfill an ESS request regardless of the dollar amount of the request. o If IDoA gives prior approval for the use of a gift card to fulfill an ESS request, 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. • If an ESS requestor is a friend or relative of a CCU staff person and the request would be a conflict of interest, another CCU staff person should review and process the ESS request and complete an EPR to obtain Department approval. Medical/Durable Medical Equipment (DME) Related EPR Requests: 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 could be used to repair or provide a replacement wheelchair for the participant). 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. Additionally, if ESS is requesting to be utilized for DME purchases due to no local Medicaid-enrolled DME provider being found in the participant’s area, please include this information in the EPR request. 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. If a participant requires electronic technology and/or assistive devices, CCUs should first reach out to IDoA’s Illinois Care Connections (ICC) Program (https://ilaging.illinois.gov/programs/illinois-care-connections.html) to request this type of assistance for the participant (see page 8 for additional information on the ICC program). For basic incontinence supplies, nutritional supplements, rollators, wheelchairs, and other general mobility items such as canes, if these items are billable to the participant’s insurance, the CCU must direct the participant to contact their primary care physician and/or insurance provider for assistance in obtaining these items. ESS funds could be utilized to assist the participant in covering any deductibles or cost-sharing associated with obtaining these items. If there are urgent mitigating circumstances involving the participant’s safety or overall health that may justify the use of ESS funds to cover billable DME items, the CCUs must document this information in the submitted EPR request. The use of ESS funds must not serve to circumvent established protocols (e.g. - obtaining a doctor’s order, receiving prior authorization, locating an enrolled medical provider) put in place for the provision of medical goods and services payable by the participant’s Medicaid, Medicare or TPL insurance provider for the sake of convenience. The CCU must obtain documentation of the denial for these services by the insurance provider and submit this documentation with the EPR request, including a copy of the supporting physician order for medically necessary DME items. Examples of such items that must be routed through the proper funding channels include: o Covered DME o Medical transportation for Medicaid-eligible participants o Medical expenses for Medicaid-eligible participants o Covered prescription expenses (this includes non-covered medication if a similar drug could be obtained through the participant's health insurance) For EPR requests to assist with medical bills, the CCU should include a copy of the detailed billing statement, along with a copy of the Explanation of Benefits (EOB) indicating what services and costs were not covered by the participant’s insurance provider. Any participant covered by a full-coverage Medicaid medical program should not be receiving bills for the remainder of the cost to the provider after billing Medicaid. All providers enrolled in the Medicaid program must sign an agreement stating they will accept Medicaid rates and agree not to attempt to bill the participant for any fees priced higher than the accepted Medicaid rate for the service or good. 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 9 and 10 to assist with using these documents and understanding the process for utilizing Medicare and/or Medicaid to cover these items). General EPR Guidance: CCU’s will adhere to the intent of the ESS grant, which is to provide urgent gap filling funds to low-income older adults to assist in stabilizing participants in a home or community-based living arrangement. ESS funds would not be appropriate for participants who have adequate income, assets, or other supportive means to cover costs. ESS funds are not intended as a charitable funding source for participants who have no urgent mitigating circumstance or event that has occurred to put the participant at risk for homelessness aside from the participant’s own mishandling of funds or decision not to pay their expenses. Additionally, ESS is not intended to provide ongoing supplemental assistance to participants who cannot cover their ongoing basic living expenses or nutritional needs. Other budgetary services and supports should be investigated to assist participants in these types of situations. CCUs should demonstrate good stewardship principles when processing ESS requests (e.g. repair versus replace, price shop, obtain multiple estimates). CCUs should utilize common sense principles when vetting ESS requests. If a participant is living in a home with an exceptionally high mortgage payment due to the value of the home and/or the participant is renting an exceptionally high-cost unit, it may be time for the participant to downsize if they are having trouble covering their basic living expenses. Additionally, during home assessments, if a participant appears to have more income than they are reporting, CCUs should request copies of the participant’s most recent tax return document to fully assess the participant’s income. ESS funds should be used to cover necessities – not wish list items such as a new furnace or A/C unit that could be repaired or new windows, gutters, etc. IDoA requires CCUs to initially determine if appliances can be repaired (ESS funds can be used to pay for a repair 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 the CCU is unable to attain a minimum of 2 estimates, they must provide documentation of the contacts they attempted to make or the responses they received indicating a contractor wasn’t interested in the project or willing to provide a cost estimate. 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. Assistive Technology: If a participant requires electronic technology and/or assistive devices, CCUs should first reach out to IDoA’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 (ICC) is a state funded grant program with the Illinois Assistive Technology Program (IATP) 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 and lift chairs; 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 (ICC) 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. For lift chair requests that are not able to be provided through the ICC program due to timeliness or funding issues, CCUs should include a physician statement supporting the need for the request. Bulk Purchases: Bulk purchases for the CCU’s intent to have routinely requested items on hand to fulfill multiple (more than one) participant requests require prior approval by IDoA prior to purchase. Examples of bulk purchase requests include, but are not limited to, grab bars, cleaning supplies, and incontinence supplies. To request approval for a one-time bulk purchase request, please email IDoA at Aging.ESS@illinois.gov and include the following information: Description of bulk item, quantity and cost per item being purchased, the name of the supplier the CCU will be purchasing these items from (items and/or services donated to the CCU or provided directly to a participant by another charitable organization should not be billed to IDoA by the CCU), the anticipated number of participants assisted, and the total cost of bulk purchase. Please include at least 2-3 price estimates along with the bulk item request. The CCU must send IDoA a copy of the EPR-approved bulk purchase invoice and paid receipt in the billing quarter the CCU requests payment for the bulk item request. Additionally, the CCU must complete IDoA’s bulk purchase tracking document, which identifies and inventories each participant who received items from the bulk purchase order. There must also be a copy of the ESS referral form signed by the participant for the bulk item on file to support the CCU providing the participant with this item. Home Delivered Meals (HDM)/Ongoing Grocery Assistance (Discontinued): IDoA is no longer allowing the CCUs to utilize ESS funds to provide ongoing grocery or HDM assistance to participants. ESS is meant to provide urgent gap-filling funds to assist in stabilizing participants who are currently homeless or at risk of homelessness. ESS funds could be utilized to provide urgent pantry restocking assistance to a participant; however, this program is not intended to provide ongoing support to participants who cannot cover their routine expenses. Participants having difficulty handling their routine living costs should be referred to available community resource programs, as well as the Money Management Program or a similar no-cost financial counseling program available in the participant’s area to receive budgetary assistance. Please see page 17 for referral information to the Area Agencies on Aging (AAA) for congregate dining and HDM assistance. 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 incurred by the CCU (supported by billed invoices and paid receipts on file with the CCU) for the reporting month and/or reporting quarter (e.g., ESS participant expenses for July total $500, August participant expenses total $2,000 and Sept participant expenses total $500 – no more than $1500 total could be billed as direct administrative expenses incurred for the reporting quarter) unless approved by IDoA. Additionally, administrative fees may not exceed 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 IDoA 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). CCUs must complete all participant fields in the appropriate monthly ESS Service Expenditure Tracking Sheet, as well as the Cash Request/Admin Costs Sheet in the One Drive FY25 ESS Monthly Expenses and Cash Request report and notify IDoA that your monthly expenses have been entered 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 ESS participant service expenditure portion of the monthly expenditure tracking document. All administrative expenses should only be reported on the Cash Request/Admin Costs sheet in the report document. It is very important that grantees ensure all fields in the monthly detailed participant expenses included in the ESS expense tracking sheets are completed and accurate. Please ensure the participant’s name, DOB, Participant ID (even if participant is not currently receiving services), Medicaid RIN, and whether the participant is homeless or at risk of becoming homeless are included in the monthly ESS participant expense sheet. CCUs should enter participant expenses into the monthly expense report in the month the CCUs releases the funds to pay for the expense (e.g. participant requests utility assistance in March but the bill is not paid by the CCU until April, the CCU should list the expense in April’s expense sheet since the funds were dispersed by the CCU in that month). The only exception to this rule would be during a fiscal year grant close out period (e.g. if a participant requests utility assistance in June and it was paid July 5th, the CCU should list the expense in the June sheet and should hold their final 4th quarter PFR until all the June expenses listed in the report have been paid by the CCU). The detailed monthly expense report should be completed by the 10th day of the month following the reporting month. 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). PFR totals must reconcile back to aggregate totals represented for each quarter in the monthly report. If totals do not reconcile, the PFR will be sent back for correction. Additionally, if refunds or overages are discovered after a quarterly PFR has been submitted and paid, these changes need to be reported in the current reporting quarter with detailed information referencing the previous expense and notes to explain the overage or refund. If a refund/overage occurs following the processing of the grant’s close out Q4 payment processing, the CCU will need to complete a corrected final Q4 PFR report. 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 fee schedule websites below). DME Requirements and Fee Schedules: Medicare requirements for DME: Requires a physician statement/doctor order (DO) 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 physician statement/doctor order (DO) 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)

The goods and services purchased under ESS are available to assist with the unanticipated needs of any senior (age 60+) or APS participant (age 18-59) who is a U.S. citizen or legal alien residing in Illinois and meets the following income criteria: • Demonstrate an urgent financial need that is significantly affecting the participant’s ability to remain in their current HCBS place of residence. Special emphasis on the use of ESS funds needs to be directed to the prevention of homelessness and assisting older adults who are homeless to access a permanent and secure housing solution. • Have readily accessible liquid assets no greater than $17,500 (e.g. – Savings, Checking, Insured Money Market Accounts, Certificates of Deposit, Stocks, Bonds, Cash Value Life Insurance, etc.). • Receive modified adjusted gross income in line with 200% of the 2025 Federal Poverty Level (FPL) being no greater than $2608/month ($31,300/year) for a single participant or $3,525/month ($42,300/year) for a married couple. • Requests for Exceptional Payment Requests (EPRs) for participants who do not meet the above citizenship and/or financial criteria should be submitted via an online EPR form for consideration utilizing the following web link - ESS Exceptional Payment Request Online Form.

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 Senior Services (ESS) grants to Care Coordination Units (CCUs) to address emergency and supportive gap-filling needs for qualifying U.S. citizens or legal alien individuals residing in Illinois 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: https://il.amplifund.com/Public/Opportunities/Details/be02fd55-21c1-44db-a7fd-68a0bb7e0864

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 - one-time pantry restocking, this includes coverage of delivery costs if the grocer offers this service, for older participants who are not able to purchase the items themselves 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 IDoA 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 * = Medical transportation for a participant covered by Medicaid would require an EPR, as this type of transport is covered by Medicaid. Household Supplies & Furnishings • 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. • Household cleaning supplies and personal hygiene products Minor Home Modifications & Repairs • Minor home modifications • Minor home repairs and weatherization • Ramps Utility and HVAC Assistance • Electric and gas/propane assistance • Other utility assistance (phone, water, sewer, trash, Internet) • 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, shower chair • Weighted utensils, 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 Illinois Care Connections (ICC) grant program prior to utilizing ESS funds for these types of requests. **Any Durable Medical Equipment (DME) covered by Medicaid or TPL insurance requires an EPR. IDoA is permitting a maximum total spend of $500.00 per participant in a fiscal year with the following exceptions: Exceptional Payment Requests: CCUs should complete an online Exceptional Payment Request (EPR) form for consideration utilizing the following web link - ESS Exceptional Payment Request Online Form for any of the following reasons: • If the participant has time-sensitive expenses that need paid to avoid eviction, is at risk of homelessness, or needs to move to a new, more affordable location to remain in a home or community-based residence. • If the participant is homeless and needs ESS funds to secure and furnish a home or community-based residence. • Any request which totals over $500 in total assistance for a participant in a fiscal year will require IDoA prior approval. o A minimum of two estimates should be included when submitting an EPR for any single ticket item or service totaling $500 or more. Random audits will be conducted on all CCUs throughout the year to ensure compliance and program integrity. IDoA will conduct audits on CCUs that routinely submit payment requests at or near the $500 threshold for participants. o EPR requests for home modifications (e.g. ramps) should include information in the email and/or EPR form stating the proposed contractor is licensed and insured, and any necessary permits (if required) have been obtained. o EPR requests to assist with overdue rent, mortgage, or utility bills should provide a detailed explanation that supports what mitigating circumstance or event caused the participant to become delinquent on their payments and whether the participant made any sort of payments on these accounts during the months they were in arrears. Additionally, the CCU should explain what services and supports will be put in place to ensure the participant will be able to manage these expenses moving forward. Copies of the mortgage or rental agreement and payment history, as well as copies of overdue utility statements which show the payment history, should be included when submitting an EPR to cover these expenses. Any payment assistance request should be under the requesting participant and/or spouse’s name. In situations where the participant is living with other household members and the bill is not in the participant’s name, the amount of ESS assistance will be limited to the participant’s percentage of the total number of persons living in the home (e.g. - older adult living with adult child and 3 grandchildren, the total maximum percentage of assistance for the bill would be 20%). o CCUs must include copies of the income and asset verification documents, which support the participant meets ESS income and asset eligibility guidelines, when submitting EPR requests for participants who do not currently have an active CCP, Medicaid, or SNAP case. • Any ESS request for participants enrolled in a Managed Care Organization (MCO), regardless of the dollar amount of the request and/or whether the participant is enrolled in the CCP program, requires prior approval via an EPR form. If the participant is enrolled in the CCP program, CCUs should contact the participant’s CCP MCO case manager to provide notification of the request for follow up purposes by the MCO and to inquire if the MCO may be able to assist. If the CCU has difficulty obtaining proper contact information to reach the MCO case manager, please contact IDoA via email at Aging.ESS@Illinois.gov and share all available participant and case manager information to request assistance in routing the ESS request information to the assigned MCO case manager. o If the CCU is unable to reach the CCP MCO case manager, please ensure an email notification or voicemail message was left for the case manager and allow 2 business days from the date of notification for the case manager to respond. If the MCO fails to respond after 2 business days from date of notification, please document the date and details of the notification attempt in the participant’s file and proceed with submitting the EPR request. Please include the notification attempt information in the email correspondence submitted with the EPR request to IDoA. o For non-CCP MCO participants, contacting the MCO is not required unless the CCU believes the MCO may be able to provide medical care coordination support to the participant based on a medical need that was brought to the CCU’s attention while providing ESS assistance to the participant. • Any ESS item not identified on IDoA’s Approved ESS Reference Guide (see Grant Agreement – Exhibit A on pages 10-12), regardless of the dollar amount of the request, requires prior approval via an EPR form. • Certain specified medical and transportation assistance requests (such as medical care, incontinence supplies, rollators, canes, hearing aids, glasses, medical transportation assistance, etc.) regardless of the dollar amount, will require approval by IDoA via an EPR request (see ESS reference guide for specific medical items requiring IDoA prior approval). Please include copies of the Explanation of Benefits (EOB) letter from the insurance provider, as well as any correspondence received from the Third-Party Liability (TPL) insurance provider supporting the denial, and/or any other documentation justifying the use of ESS funds to cover the requested item. o For transportation-related assistance: CCUs must ensure the participant is using an appropriate transportation provider (public transportation, taxi, Uber/Lyft) and they are retaining copies of receipts that support payment for the transportation expenses incurred. IDoA does not approve CCUs paying family members or friends to provide transportation or providing gas cards to participants. If the participant is facing hardship due to having to cover unexpected transportation-related expenses, the CCUs can provide other types of ESS-approved assistance to the participant. • The use of a gift card to fulfill an ESS request regardless of the dollar amount of the request. o If IDoA gives prior approval for the use of a gift card to fulfill an ESS request, 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. • If an ESS requestor is a friend or relative of a CCU staff person and the request would be a conflict of interest, another CCU staff person should review and process the ESS request and complete an EPR to obtain Department 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 incurred by the CCU (supported by billed invoices and paid receipts on file with the CCU) for the reporting month and/or reporting quarter (e.g., ESS participant expenses for July total $500, August participant expenses total $2,000 and Sept participant expenses total $500 – no more than $1500 total could be billed as direct administrative expenses incurred for the reporting quarter) unless approved by IDoA. Additionally, administrative fees may not exceed 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 IDoA 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).

The Grantee shall deliver to the Department detailed financial and programmatic reports. 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. Notification of the completion of 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 FY25: • 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, 2025 - June 30, 2025) Reports for FY26: • October 10, 2025 (July 1, 2025 - September 30, 2025) • January 10, 2026 (October 1, 2025 - December 31, 2025) • April 10,2026 (January 1, 2026 - March 31, 2026) • July 10, 2026 (April 1, 2026 - June 30, 2026) Reports for FY27: • October 10, 2026 (July 1, 2026 - September 30, 2026) • January 10, 2027 (October 1, 2026 - December 31, 2026) • April 10,2027 (January 1, 2027 - March 31, 2027) • July 10, 2027 (April 1, 2027 - June 30, 2027) Notification of monthly report completion and completed quarterly PFR/PPR 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 ESS 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 prevent homelessness and enable seniors to continue to reside in their home and community-based settings. These funds are being appropriated to assist seniors who have exhausted all other resources and have limited income and assets to address these needs. Funds are meant to provide short-term assistance and 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).

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