DRS

The Home Services Program is a 1915C Waiver Program providing a myriad of services to people with severe disabilities under the age 60 who need help with daily living activities in their homes. Many of these people are at risk of moving into a nursing home or other facility. The program also provides specialized waiver services for people with HIV/AIDS and/or traumatic brain injuries (TBI). Services include, but are not limited to the following: •Personal Assistant (PA): Provides assistance with household tasks, personal care and, with permission of a doctor, certain health care procedures. PAs are selected, employed, and supervised by individual customers. •Homemaker Services: Personal care provided by trained and professionally supervised personnel for customers who are unable to direct the services of a PA. Instruction and assistance in household management and self-care are also available. •Maintenance Home Health: Services provided through a treatment plan prescribed by a physician or other health care professional. Other services include nursing care and physical, occupational, and speech therapy. •Electronic Home Response: Emergency response system offered by hospitals and community service organizations. This rented signaling device provides 24-hour emergency coverage, permitting the individual to alert trained professionals at hospitals, fire departments, or police departments. •Home Delivered Meals: Provided to individuals who can feed themselves but are unable to prepare food. •Adult Day Care: The direct care and supervision of customers in a community-based setting to promote their social, physical, and emotional well-being. •Assistive Equipment: Devices or equipment either purchased or rented to increase an individual's independence and capability to perform household and personal care tasks at home. •Environmental Modification: Modifications in the home that help compensate for loss of ability, strength, mobility or sensation; increase safety in the home, and decrease dependence on direct assistance from others. •Respite Services: Temporary care for adults and children with disabilities aimed at relieving stress to families. Respite services may be provided for vacation, rest, errands, family crisis or emergency. Services may include personal assistant, homemaker or home health.

The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in §1915(c) of the Social Security Act - 42 CFR 440.180

Implementing Section 3 of the Disabled Persons Rehabilitation Act [20 ILCS 2405/3].

Illinois Administrative Code Title 89, Sub-Chapter D, Home Services Program

The Home Services Program is a 1915C Waiver Program providing a myriad of services to people with severe disabilities under the age 60 who need help with daily living activities in their homes. Many of these people are at risk of moving into a nursing home or other facility. The program also provides specialized waiver services for people with HIV/AIDS and/or traumatic brain injuries (TBI).

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None, State Agency Use;

The Department of Human Services' (DHS) Home Services Program (HSP) is a Medicaid Waiver Program (42 CFR 440.180) designed to prevent the unnecessary institutionalization of individuals who may instead be satisfactorily maintained at home at a lesser cost to the State. The Medicaid Waiver for the State of Illinois is administered by the Illinois Department of Healthcare and Family Services, as the State's approved Medicaid agency. The operational responsibility for HSP, with the exception of hearings on customer appeals (see 89 Ill. Adm. Code 510), rests with the Department of Human Services.

In order to receive services through the Home Services Program (HSP) a customer must: a) be a citizen of the United States, or be an individual who is living permanently in the United States after having been legally admitted; b) have applied for, be a recipient of, or be found eligible for Medicaid benefits through HFS and within 60 days after the date of application for HSP provide verification to the HSP counselor of the aforementioned. Customers may be found eligible for Medicaid and be placed on Spend Down. However, a customer is not required to meet the eligibility criteria for Medicaid to receive benefits, nor is Medicaid eligibility or verification of application required to receive Interim Services (see 89 Ill. Adm. Code 682). The customer must agree to apply for Medicaid, and cooperate with HFS, to receive Interim Services. Customers having applied for HSP services prior to October 1, 1991 may choose to apply for Medicaid; c) be a resident of the State of Illinois; d) be under the age of 60 at the time of application for HSP services, unless the individual is applying for services under the HSP AIDS Medicaid Waiver or under the HSP Brain Injury Medicaid Waiver, in which case there is no age criteria for application; e) have a severe disability that is expected to last for at least 12 months or for the duration of life; f) be an individual with a disability who is in need of long-term care, as determined by the DON score completed as a result of a prescreening (89 Ill. Adm. Code 679) or application for HSP services. In order to be determined to have met this criteria, the individual must receive a DON score of at least 15 points on part A, which includes, if applicable, the 10 points from the Mini-Mental Examination, with a total DON score of at least 29 points; and g) not require in-home services that are expected to cost more than the cost the State would pay for institutional care for an individual with a similar DON score.

Direct Payments for Specific Use

Human Services

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The following is a listing of the services available through the Home Services Program. The service level, combination of services, and amount of services for which a customer is eligible is dependent upon the needs of the customer as identified during the determination of eligibility (see 89 Ill. Adm. Code 682). a) Personal Assistant (PA) Services – services provided by an individual employed by the customer. b) Adult Day Care (ADC) Services – direct care and monitoring of customers in a community-based setting for any portion of a 24-hour day for the purpose of promoting social, physical, and emotional health and well-being and offering an alternative to an institutional setting. ADC services are provided only when the social, emotional, and physical needs of the customer cannot be met in the home through other available services. c) Homemaker Services – general support provided by trained and professionally supervised individuals to maintain, strengthen, and safeguard the functioning of an individual in his/her home when no responsible person is available or capable of monitoring those services. Homemaker services include the actual completion of, and the training in, completion of ADLs. d) Maintenance Home Health Services – services provided for a customer, in his/her home, that are prescribed or recommended by a physician or other health care professional. These services include three basic categories of care, which are: 1) direct health care provided by a registered nurse (RN) and/or a licensed practical nurse (LPN); 2) direct health care provided by a Certified Nurse Aid (CNA) who is supervised by an RN or LPN; and 3) in-home therapy, including the areas of physical, occupational and speech therapy. e) Home Delivered Meals – prepared food brought to the customer's home. Usually, home delivered meals consist of a hot lunch and a smaller dinner meal that may be refrigerated and eaten later. These services are provided when available and when they are more cost effective than PA services for an eligible individual who has a need for care in the area of meal preparation but who can adequately feed him/herself. f) Electronic Home Response Services (EHRS) – a 24-hour per day emergency communication link to assistance outside the customer's home for customers who have no other persons available for assistance should an emergency arise. g) Assistive Equipment – items necessary to accommodate the customer's loss of function in the completion of his/her Activities of Daily Living (ADLs). This does not include medical supplies, disposable personal hygiene items, or items necessary for medical treatment. (See 89 Ill. Adm. Code 686, Subpart H.) h) Environmental Modification – services to physically modify the customer's home to accommodate the customer's loss of function in the completion of his/her ADLs. (See 89 Ill. Adm. Code 686, Subpart G.) i) Respite Services – limited PA, Homemaker, and Maintenance Home Health services provided to a customer to provide for the customer's ADLs during periods of time it is necessary for the family/primary care giver to be absent. Respite services are provided to a customer to allow the family/primary care giver relief for vacations, rest, errands, family crises and emergency situations. Respite services are provided in the maximum amount of 240 hours per calendar year and are provided regardless of financial need. During the COVID-19 Gubernatorial Disaster Proclamations, and subject to federal approval, customers who exhaust 240 hours as a direct result of the COVID-19 pandemic may have additional respite hours added to the Service Plan, dependent upon the customer's needs and availability of customer's unpaid caregiver, up to a maximum of 240 additional hours per calendar year. Any additional Service Plan hours under this subsection are subject to the advance approval of the Counselor or Managed Care Organization Care Coordinator. j) Day Habilitation Services – assistance provided to a person with a brain injury to assist with the acquisition, retention and improvement in self-help, socialization and adaptive skills. These services are provided in a setting separate from the residence in which the customer is residing. k) Pre-Vocational Services – services provided to a person with a brain injury that are aimed at preparing the individual for paid or unpaid employment but are not job task oriented. Specific services include teaching concepts such as compliance, attendance, task completion, problem solving and safety. l) Supported Employment Services – services provided to a customer with a brain injury that consist of paid employment for persons for whom competitive employment is unlikely, when the customer, because of his/her disabilities, needs intensive, ongoing support to perform in a work setting. Supported employment includes, but is not limited to, activities needed to sustain the customer in supported employment (i.e., supervision and training). m) Behavioral Services – remedial therapies provided to a person with a brain injury to decrease the individual's severe maladaptive behaviors. These services are intended to enable the customer to better manage his or her behavior and to make the customer more capable of living independently.

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A total of 37,595 persons were served by the Home Services Program in FY2019 which saw an increase of 4.6 percent compared to the prior year. The number served in the General waiver program increased by 5.2 percent to 32,481 individuals. The number of persons served in the AIDS waiver decreased by 3.5 percent to 1,539, while the number served in the Brain Injury waiver increased by 1.9 percent to 3,575. Some of this reduction is due to continued transfer of cases to the General waiver based on reduced need for specialized services. A total of 113 individuals were moved from nursing homes into the community through reintegration efforts of DRS contractors in FY2019. This number is 62 percent more than the 70 from FY2018,marking a significant increase.

https://www.law.cornell.edu/cfr/text/42/440.180 https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=333 https://www.ilga.gov/commission/jcar/admincode/089/08900676sections.html

Individuals with severe disabilities under the age 60 who need help with daily living activities in their homes may find the nearest IDHS DRS local Office here: https://www.dhs.state.il.us/page.aspx?module=12

100 South Grand Ave E 1st Floor Springfield, Illinois 62794-9429

https://www.dhs.state.il.us/page.aspx?item=67182

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7/1/2021

FY 2021 : $843,673,900
FY 2022 : $909,999,600
FY 2023 : $1,038,772,400
FY 2024 : $1,141,572,400
FY 2025 : $1,271,272,400