The Home-Based Services (HBS) program is designed to enable participants to remain living in their family home or in the case of adults, a home of their own if feasible, while receiving services that support them to achieve their personal goals. The HBS program provides a monthly allocation that can be used to purchase services from authorized community agencies, or to pay for Personal Support Workers (PSW) who are directed by the individual or his/her designee.

HBS resources can be used to purchase direct services such as Developmental Training (DT) and employment services from community agencies enrolled in the Medicaid Waiver program. An organization must have an authorized Medicaid contract with the state in order to have HBS resources pay for program services. Programs offered by park districts, health clubs and community colleges do not meet this criteria and cannot be paid for directly through the HBS program. Both the Children's and Adult HBS programs permit hiring family members to perform PSW duties, though the Children's HBS program does not permit parents or other legally responsible adults to provide such services, while the Adult HBS program does permit this option. The Adult HBS program prohibits spouse's or children from providing PSW services. Community agencies may also offer PSW services on an hourly fee basis.

The 2014 CMS Rule governing Medicaid Waiver programs applies to the HBS program, as well as other waiver programs such as Community Integrated Living Arrangements (CILA) and Developmental Training. This Rule outlines the expectations that all recipients of Waiver funded services participate to the fullest extent possible in planning their services and experience the community to the same degree as all others in their community, regardless of disability. The Rule also promotes competitive integrated employment as a key outcome for adults with disabilities.

HBS services are expected to promote maximum growth, independence and self-direction on the part of the individual. Services purchased through the HBS program should support the goals and priorities outlined in the Personal Plan which is developed in conjunction with the Independent Service Coordinator (ISC), the person receiving services and others invited by him/her to participate in the planning process. A pending change to the program that will take effect on July 1, 2017 is removing the requirement that all HBS participants purchase a minimum of 2 hours of Service Facilitation per month. Service Facilitation assists program participants and their families in developing the support plan that details how the HBS resources will achieve the goals outlined in the Personal Plan. Service Facilitation also interfaces on behalf of participants on issues such as maintaining Medicaid eligibility, processing PSW payroll with fiscal intermediary agencies and navigating both public and private sector disability system organizations. Individuals who choose to opt out of Service Facilitation after July 1, 2017 will be responsible for performing these duties independently.