HOME SERVICES
PROGRAM
Waiver Overview,
Eligibility Criteria
and Services
What is the Home Services Program
(HSP)?
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Illinois Department of Human Services
Division of Rehabilitation Services
History:
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1979 inception, 1982 waiver written
35K customers
Purpose
HSP consists of 3 different waivers:
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Persons with Disabilities
Persons with Brain Injuries
Persons with HIV or AIDS
What is a Home and Community
Based (HCBS) Waiver?
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Waivers provide alternatives to nursing home
placement for Medicaid recipients
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The Department of Healthcare and Family
Services (HFS) monitors all of the HCBS
waivers in Illinois
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Waivers allows Illinois to recoup a portion of
the money spent on direct services to
Medicaid recipients
What is a Home and Community
Based Waiver? (continued)
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Illinois waiver agencies pay for the services up
front and then request reimbursement.
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Crucial for customers to be Medicaid eligible
whenever possible, but not mandatory.
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80% of HSP customers are Medicaid recipients,
and the state receives 50% reimbursement for
waiver expenditures for these individuals.
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The remaining 20% receive services that are
funded directly through state GRF, which are
not reimbursed.
Limitation
Applicants cannot receive services through two
waiver program simultaneously.
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•
Other Illinois Waivers:
DSCC- Division of Specialized Care for
Children
DoA- Department on Aging
DDD - Division of Developmental
Disabilities
HFS – Supported Living Facilities
Eligibility Criteria
United States citizen or lawful permanent
resident status
Illinois Resident
Applicants must be under the age of 60
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o
o
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AIDS/BI no age limit
Services are reassessed at minimum 1x/year.
Severe disability which lasts 12 months or
duration of life
Eligibility Criteria (cont.)
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Need for long term care based on scoring of
the Determination of Need [DON].
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Physician or Neuropsychologist must
approve plan of care.
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Service plan costs must be at or below the
Service Cost Maximum.
Eligibility Criteria (cont.)
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Assets cannot exceed $17,500 for a
customer over 18 or total family assets
cannot exceed $35,000 for a customer
under the age of 18.
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Customer must apply and cooperate with
Medicaid application process until an
eligibility decision has been reached.
Aging Customers in HSP
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The following chart indicates actual experience of
an individual who was served by the Home
Services Program over a period of several years.
In addition to changes due to aging, this customer
also experienced significant decline in her
physical functioning due to muscular dystrophy.
The chart highlights HSP’s flexibility in meeting
the ongoing needs of our customers.
1987
Age 45
1997
Age 55
2007
Age 65
2011
Age 69
MD, poor
vision, poor
ambulation
MD, history of
UTI and
blurred vision,
poor
ambulation
DON/Plan:
41/68 hours
DON/Plan:
42/77 hours
MD, anxiety,
pneumonia,
cataracts,
decreased
ambulation,
heart attack
DON/Plan:
49/113 hours
MD, another
heart attack
2011,
oxygen 24/7,
W/C
dependent
DON/Plan:
54/140 hours
Cane
Cane
Cane, W/C
ramp
EHRS
W/C lift, ramp,
EHRS
HSP Statistics
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Nyle’s chart goes here.
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1200 kids
Services Overview
Personal Assistant
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Chosen by the customer or representative; not
employed by an agency
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Customer/representative must be able to direct
care
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Non-skilled care and skilled care
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Teach, supervise, physically provide services
Homemaker
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Used for customers unable to locate or
unable to manage a PA.
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Worker is assigned to a customer, but is
supervised by an agency.
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Less flexibility in scheduling.
Home Health (HH)
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Types of HH:
 Certified Nurses Aide [CNA]
 Licensed Practical Nurse [LPN]
 Registered Nurse [RN]
 Physical Therapist [PT]
 Occupational Therapist [OT]
 Speech Therapist [OT]
Adult Day Care [ADC]
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Community based setting outside of the
home
Typically used when a
customer’s primary
caregiver works during
the day and the customer
need supervision.
Home Delivered Meals [HDM]
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Meals that are delivered to the customer’s
home when the individual is unable to prepare
meals, but can feed him/herself.
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Various community
organizations are
contracted to
provide these
meals.
Emergency Home Response [EHR]
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Device rented by the month to enhance
customer safety in the home should there
be an emergency situation.
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Can purchase modification/device to enable
customer to use EHR system
Assistive Equipment
Purchase, repair or rental of equipment that is
medically necessary and not covered by other
insurance:
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the safety of the customer or caregiver,
enables customers to perform activities of daily
living independently
reduces the cost of HSP services in the home
Assistive Equipment
Environmental Modifications
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Structurally changing the home environment for
accessibility
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Enhance independence in ADLs, prevent
anticipated increase, reduce services, or health
& safety issue for customer or caregivers.
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$25K limit for a 5 year period (includes assistive
equipment purchases)
Environmental Modifications
Special Populations
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AIDS and Brain Injury waiver customers have
higher SCMs and utilize case managers.
Special Brain Injury waiver services include:
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Habilitation
Pre-Vocational
Supported Employment
Counseling/Psychotherapy
Respite
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Relief for primary caretaker.
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Can be used all at once or spread out.
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Up to 240 hour per calendar year.
Community Reintegration Program
and Money Follows the Person
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What is CRP? MFP?
Program enhancements.
Work with local Centers for Independent Living
to assist eligible individuals to move out of
nursing homes.
445 customers presently served.
DoA, DD, DMH also have MFP programs, which
are part of the Federal Rebalancing
Demonstration for Long Term Care.
Referral Process
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Contact your local DHS/DRS office and make a
phone referral.
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Visit your local DHS/DRS office in person.
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Have your medical doctor/therapist make a
referral.
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Make a referral on-line at www.dhs.state.il.us