HFSMedical ClientsHome and Community Based Services Waiver Programs

Persons with Brain Injury (BI)

Administrative Agency:

Illinois Healthcare and Family Services (HFS), the State Medicaid Agency

Operating Agency:

Illinois Department of Human Services-Division of Rehabilitation Services (DHS-DRS)

A component of the DHS-DRS Home Services Program (HSP)                                                

Managed Care Organization: 

For those persons receiving Medical services through a managed care organization, see contact information and links below 

Eligible Population:

Persons with brain Injury, of any age, who are at risk of nursing facility placement due to functional limitations resulting from the brain injury.

Eligibility Criteria:

U. S. citizen or legal alien

Resident of the State of Illinois

Medicaid eligible or enrolled in the Health Benefits for Workers with Disabilities (HBWD) program.

Have functional limitations directly resulting from an acquired brain injury as documented by a physician or neurologist.   

Includes traumatic brain injury, infection (encephalitis, meningitis), anoxia, stroke, aneurysm, electrical injury, malignant or benign, neoplasm of the brain, and toxic encephalopathy. This does not include degenerative, congenital or neurological disorders related to aging.

Be at risk of nursing facility placement as measured by the Determination of Need (DON) assessment.

Estimated cost to the State for home care is less than estimated cost for institutional care.

Can be safely maintained in the home or community-based setting with the services provided in the plan of care.

Services: (Descriptions)

  • Personal Assistant

  • Homemaker

  • Adult Day Care

  • Environmental Accessibility Adaptations

  • Specialized Medical Equipment

  • Home Delivered Meals

  • Personal Emergency Response Systems

  • Respite

  • Intermittent Nursing

  • Extended State Plan Therapy Services (Physical, Occupational, Speech)

  • Day Habilitation

  • Prevocational Services

  • Supported Employment

  • Cognitive Behavioral Therapies

How to Access Services:

Point of Entry - Local DHS–DRS Offices

Local offices can be found using DHS Office Locator  

Or Call: 1-800-843-6154 (#3 on menu) or 1-800-447-6404 (TTY) Select Rehabilitation Services from the drop down box

DHS Offices by county

Rehabilitation Services: Apply Online

or

Call:  1-800-843-6154 (#4 on menu) or 1-800-447-6404 (TTY) or the DHS-DRS Springfield office:  1-217-782-2722

Managed Care

Persons who have medical services through a Medicaid managed care organization may contact their care coordinator about the need for in home services and for assistance with a referral. 

* If requesting a referral directly from DHS-DRS, please tell the DHS-DRS Local Office person about your managed care, give them the name of the managed care organization and have your identification number available.

Medicaid Agency Contact Information

HFS Bureau of Long Term Care

1915 (c) Home and Community-Based Waiver Administrative Section

Phone:  1-217-557-1868  

HFS HCBS Waivers

Service Descriptions

  • Personal Assistant (PA):  Services provided by individuals who are selected, employed and supervised by the participant. These individuals may assist with household tasks, personal care and, with the permission of a physician, certain health care procedures.

  • In Home Service (Homemaker):  Services consisting of general household activities (meal preparation and routine household care) and personal care provided by a trained homecare aide, when the individual regularly responsible for these activities is unable to manage the home and care for himself or herself. Homecare aides shall meet such standards of education and training as are established by the State for the provision of these activities. This service will only be provided if personal care services are not available or are insufficient to meet the care plan or the consumer cannot manage a personal assistant.

  • Adult Day Care (ADC):  Provides direct care and supervision in community-based setting for the purpose of providing personal attention, and promoting social, physical and emotional well being in a structured setting.

  • Environmental Accessibility Adaptations:  Services to physically modify the participant’s home to accommodate the participant’s loss of function in the completion of his or her Activities of Daily Living (ADLs).

  • Specialized Medical Equipment:  Includes devices, controls, or appliances, specified in the plan of care, which enable individuals to increase their abilities to perform activities of daily living, or to perceive, control, or communicate with the environment in which they live. This service also includes items necessary for life support, ancillary supplies and equipment necessary to the proper functioning of such items and durable and non-durable medical equipment not available under the State Plan.

  • Home Delivered Meals:  One or more ready-to-eat meals per day which are delivered to the home. This service is provided to individuals who can feed themselves but are unable to prepare a meal.

  • Personal Emergency Response Systems:  A 24-hour emergency communication link to assistance outside the participant's home for participants based on health and safety needs and mobility limitations.

  • Respite:  Services provide relief for unpaid family or primary care givers, who are currently meeting all service needs of the customer. Services may include personal assistant, homemaker, nurse, or adult day care. Services are available for a maximum of 240 hours per year.

  • Nursing: Nursing is provided within the scope of the State’s Nurse Practice Act by a registered nurse, licensed practical nurse, or vocational nurse.

  • Intermittent Nursing: Used for purposes of evaluating customer needs (including assessments and wellness checks) and monitoring.

  • Home Health Aide: Provided within the State’s standards for a Certified Nursing Assistant.

  • Therapies: Provided by a licensed therapist. May be approved under the waiver if the individual is no longer eligible for therapies under the State Plan, but continues to need long-term habilitative services.

  • Day Habilitation:  Assist the individual with the acquisition, retention or improvement in self-help, socialization and adaptive skills. These services are provided in a setting separate from the individual’s home. These services focus on enabling the individual to attain or maintain a maximum functional level and may be coordinated with therapies listed in plan of care

  • Prevocational Services:  Services provided that prepare an individual for paid or unpaid employment by teaching concepts such as compliance, attendance, task completion, problem solving and safety. Activities in this service are not primarily directed at teaching specific job skills, but at underlying habilitation goals, such as span and motor skills. All prevocational services will be reflected in the individual’s plan of care as directed to habilitation, rather than explicit employment objectives.

  • Supported Employment:  Intensive ongoing supports that enable participants for whom competitive employment at or above the minimum wage is unlikely in a paid employment work setting. Supported employment includes activities needed to sustain paid work by individuals receiving waiver services, including supervision and training. When supported employment services are provided at a work site in which persons without disabilities are employed, payment will be made only for the adaptations, supervision and training required by individuals receiving waiver services as a result of their disabilities.

  • Cognitive Behavioral Therapies:  Remedial therapies to decrease maladaptive behaviors and/or to enhance cognitive functioning of the individual. These services are intended to enable the participant to better manage his or her behavior and therefore be more capable of living independently.


Home and Community Based Services Waiver Programs

 

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