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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
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
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.
Applicants cannot receive services through two waiver program simultaneously.
• Other Illinois Waivers:DSCC- Division of Specialized Care for
ChildrenDoA- Department on AgingDDD - Division of Developmental
DisabilitiesHFS – Supported Living Facilities
Limitation
Eligibility Criteria
United States citizen or lawful permanent resident status
Illinois Resident Applicants must be under the age of 60
o AIDS/BI no age limito Services are reassessed at minimum 1x/year.
Severe disability which lasts 12 months or duration of life
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.
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.
Eligibility Criteria (cont.)
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.
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
MD, anxiety,
pneumonia, cataracts, decreased ambulation, heart attack
MD, another heart attack
2011,
oxygen 24/7, W/C
dependent
DON/Plan: 41/68 hours
DON/Plan:
42/77 hours
DON/Plan:
49/113 hours
DON/Plan:
54/140 hours
Cane Cane Cane, W/C
ramp
EHRS
W/C lift, ramp, EHRS
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
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.
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]
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.
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.
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
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
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)
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
Respite
Relief for primary caretaker.
Can be used all at once or spread out.
Up to 240 hour per calendar year.
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.