Illinois Department of Human Services

Division of Rehabilitation Services

Home Services Program (HSP)

Home Services Program

Goal: to prevent unnecessary institutionalization by providing in-home care support to people with disabilities who can safely and cost effectively live in the community

Home and Community Based Services Waiver (1915c) Center for Medicare and Medicaid (CMS) Alternative to institutional care States identify core services to be offered Individuals can be served through only

one 1915C waiver Federal reimbursement for services

available

HSP: Three Medicaid Waivers

Persons with Disabilities (PD) Persons with Brain Injuries (BI) Persons with HIV/AIDS

Eligibility for Services

Identical criteria for all 3 waivers Waiver specific to type of disability Services identical among waivers BI Waiver has four additional services

Eligibility For Brain Injury Waiver Medical diagnosis of an acquired brain injury

Traumatic Brain Injury (TBI)Brain Infection (Encephalitis)Lack of Oxygen (Anoxia/Hypoxia)Stroke (Cerebral Vascular Accident)Brain Bleeds (Aneurysm)Electric Shock (TBI)Brain Tumor (Malignant or Benign)Poisoning (Toxic Encephalopathy)  

Eligibility For Brain Injury Waiver (continued)

Functional limitations resulting from the brain injury

Required criteria to be eligible for HSP

US citizen or legal alien status Illinois resident Applicants must be under age 60

BI and HIV/AIDS (no age limit)

Required criteria to be eligible for HSP (continued)

Severe disability last 12 months or more or duration of life

Scores on Determination of Need (DON) reflect risk of nursing faculty placement

Physicians approval for planned services

Required criteria to be eligible for HSP (continued)

Services must be within Service Cost Maximums (SCM)PD Waiver $1,593 - $3,329 per month

Assets can not exceed $17,500 for an individual over age 18 or total family assets can not exceed $35,000 for customers under age 18

Required criteria to be eligible for HSP (continued)

Must apply and cooperate with Medicaid application processPersons deemed ineligible may or may not be

served through HSPEx: Person with spinal cord injury resulting in

quadriplegia who is employed

Services through HSP

Customer driven by choice within scope of services offered

Personalized planning and coordination Services address the unmet needs

(Medicaid, Insurance, Medicare, other social/familial resources)

Multiple types of services (combined)

Personal Assistant (PA)

Selected, hired, fired, trained and supervised by the customer

$9.85 per hour paid twice monthly by HSP Representative/guardian may assist in

directing care by PA’s Tasks vary according to customer need

and physician approval

Who cannot be a paid PA?

Legally responsible relatives cannot be paid caregiversSpouse for spouseParent for minor (under 18) childMinor child for parentGuardian of minor childStep-parent for minor childFoster-parent for minor child

Criteria to work as a PA

Photo ID or Drivers License Valid social security card Must be able to complete tasks on the

service plan Complete 1413B to enroll as a Medicaid

Waiver Provider

Homemaker Services

Agency based with rate agreements $15.32 per hour Designed to provide backups Hours of availability and task completion

vary

Home Health Services

Agency and Private dutyCertified Nurse Aid (CNA)Licensed Practical Nurse (LPN)Registered Nurse (RN)

Home Health Services (continued)

Physical, Occupational and Speech Therapy Designed to evaluate then train lower level care

providers Time limited Must use all other resources (Medicaid, Insurance,

Medicare, etc.)

Home Health Rates

Agency BasedCNA - $13.75 per hourLPN - $25.47 per hourRN - $29.55 per hour

Home Health Rates (Continued)

Private DutyCNA - $10.00 - $13.00 per hourLPN - $20.00 (max) per hourRN - $26.00 (max) per hourMust have current license/certification

Adult Day Care

Agency based with rate agreement $7.02 per hour Reimburse for transportation when agency

sponsored

Home Delivered Meals

Licensed entities who bring one or more meals to the home

Customer must be able to eat independently

Typically, eliminates the need for PA’s to complete task

Cost varies (Maximum $15 per day)

Emergency Home Response

Rate agreement with five providers Rented units $28.00 per month Can purchase adaptive technology Requires a land line

Respite Services

240 hours maximum per calendar year Other respite programs may affect

eligibility “Stand alone” service Level of providers/service: PA,

Homemaker, CNA, LPN, RN or ADC

Assistive Equipment $25,000 over 5 years Must be denied by Medicaid, Medicare,

insurance, etc. Must meet one of the four reasons of

justification:Eliminate a need or servicesReduce servicesPrevent an increase in servicesSafety of customer during performance of

ADL’s

Assistive Equipment (continued)

No medical supplies No medical treatment devices Buy, rent or repair No van modifications/vehicle purchases

Environmental Modifications

$25,000 over 5 years Must be denied by all other known sources Structurally change environment for

accessibility No additions to homes and cannot add

square footage

Environmental Modifications (Continued)

Must meet one of the four reason of justifications:Eliminate a need or servicesReduce servicesPrevent an increase in servicesSafety of customer during performance of

ADL’s Landlord agreement for rental property Vendor requirements

Services Available Only to Customers of BI Waiver

BI Behavioral/Cognitive BI Habilitation BI Pre-Vocational Services BI Supported Employment

Contacting an HSP Office Office Locator (for Cook County per zip code)

http://www.dhs.state.il.us/page.aspx?module=12

Contacting an HSP Office (Continued)

Phone or fax request Web referral link-

https://drs.dhs.state.il.us/owr/setReferral.do