HOME SERVICES PROGRAM

1. HOME SERVICES PROGRAM Waiver Overview, Eligibility Criteria and Services

2. What is the Home Services Program (HSP)? • Illinois Department of Human Services • Division of Rehabilitation Services • History: • 1979 inception, 1982 waiver written • 35K customers • Purpose • HSP consists of 3 different waivers: • Persons with Disabilities • Persons with Brain Injuries • Persons with HIV or AIDS

3. What is a Home and Community Based (HCBS) Waiver? • Waivers provide alternatives to nursing home placement for Medicaid recipients • The Department of Healthcare and Family Services (HFS) monitors all of the HCBS waivers in Illinois • Waivers allows Illinois to recoup a portion of the money spent on direct services to Medicaid recipients

4. What is a Home and Community Based Waiver? (continued) • Illinois waiver agencies pay for the services up front and then request reimbursement. • Crucial for customers to be Medicaid eligible whenever possible, but not mandatory. • 80% of HSP customers are Medicaid recipients, and the state receives 50% reimbursement for waiver expenditures for these individuals. • The remaining 20% receive services that are funded directly through state GRF, which are not reimbursed.

5. Limitation • Applicants cannot receive services through two waiver program simultaneously. • Other Illinois Waivers: DSCC- Division of Specialized Care for Children DoA- Department on Aging DDD - Division of Developmental DisabilitiesHFS – Supported Living Facilities

6. Eligibility Criteria • United States citizen or lawful permanent resident status • Illinois Resident • Applicants must be under the age of 60 • AIDS/BI no age limit • Services are reassessed at minimum 1x/year. • Severe disability which lasts 12 months or duration of life

7. Eligibility Criteria (cont.) • Need for long term care based on scoring of the Determination of Need [DON]. • Physician or Neuropsychologist must approve plan of care. • Service plan costs must be at or below the Service Cost Maximum.

8. Eligibility Criteria (cont.) • 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. • Customer must apply and cooperate with Medicaid application process until an eligibility decision has been reached.

9. Aging Customers in HSP • 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.

11. HSP Statistics • Nyle’s chart goes here. • 1200 kids

12. Services Overview

13. Personal Assistant • Chosen by the customer or representative; not employed by an agency • Customer/representative must be able to direct care • Non-skilled care and skilled care • Teach, supervise, physically provide services

14. Homemaker • Used for customers unable to locate or unable to manage a PA. • Worker is assigned to a customer, but is supervised by an agency. • Less flexibility in scheduling.

15. Home Health (HH) • Types of HH: • Certified Nurses Aide [CNA] • Licensed Practical Nurse [LPN] • Registered Nurse [RN] • Physical Therapist [PT] • Occupational Therapist [OT] • Speech Therapist [OT]

16. Adult Day Care [ADC] • Community based setting outside of the home • Typically used when a customer’s primary caregiver works during the day and the customer need supervision.

17. Home Delivered Meals [HDM] • Meals that are delivered to the customer’s home when the individual is unable to prepare meals, but can feed him/herself. • Various community organizations are contracted to provide these meals.

18. Emergency Home Response [EHR] • Device rented by the month to enhance customer safety in the home should there be an emergency situation. • Can purchase modification/device to enable customer to use EHR system

19. Assistive Equipment • Purchase, repair or rental of equipment that is medically necessary and not covered by other insurance: • 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

20. Assistive Equipment

21. Environmental Modifications • Structurally changing the home environment for accessibility • Enhance independence in ADLs, prevent anticipated increase, reduce services, or health & safety issue for customer or caregivers. • $25K limit for a 5 year period (includes assistive equipment purchases)

22. Environmental Modifications

23. Special Populations • AIDS and Brain Injury waiver customers have higher SCMs and utilize case managers. • Special Brain Injury waiver services include: • Habilitation • Pre-Vocational • Supported Employment • Counseling/Psychotherapy

24. Respite • Relief for primary caretaker. • Can be used all at once or spread out. • Up to 240 hour per calendar year.

25. Community Reintegration Program and Money Follows the Person • 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.

26. Referral Process • Contact your local DHS/DRS office and make a phone referral. • Visit your local DHS/DRS office in person. • Have your medical doctor/therapist make a referral. • Make a referral on-line at www.dhs.state.il.us