HFSMedical ClientsHome and Community Based Services Waiver Programs

Persons with HIV or AIDS

Administrative Agency:

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

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

Operating Agency:

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

Managed Care Organization: 

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

Eligible Population:

Persons of any age who are diagnosed with Human Immune Deficiency Virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) and are at risk of placement in a nursing facility

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.

  • Medical determination of HIV or AIDS with severe functional limitations, which is expected to last for at least 12 months or for the duration of life

  • 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

  • Home Health Aide

  • Homemaker

  • Adult Day Care

  • Environmental Accessibility Adaptations

  • Specialized Medical Equipment

  • Home Delivered Meals

  • Personal Emergency Response System

  • Respite

  • Intermittent Nursing

  • Nursing

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

How to Access Services:

Point of Entry - DRS Statewide HIV/AIDS Unit or the DHS–DRS Local Offices

  • DRS Statewide HIV/AIDS Unit: 708-857-2378

  • DHS-DRS Local Offices can be found using the DHS Office Locator

    • Select Rehabilitation Services from the drop down box

  • DHS Offices Offices by county can be found using the DHS Office Locator

  • Online referrals: Rehabilitation Services: Apply Online or Call:  1-800-843-6154 (#4 on menu) or 800-447-6404 (TTY) or the DHS-DRS Springfield office:  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. 

Aetna Better Health: 1-866-212-2851 – member services line, press 1

IlliniCare Health Plan: 1-866-329-4701 – member services line, state “member” at the prompt

**If requesting a referral directly from DHS-DRS, please tell the HIV/AIDS Unit or 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:  217-557-1868  

HFS HCBS Waivers

Service Descriptions

  • Personal Assistant (PA): Services provided by individuals who are selected, employed and supervised by the customer. These individuals may assist with or perform 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/her Activities of Daily Living.

  • 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 System:  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 habilitation services.


Home and Community Based Services Waiver Programs

 

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