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