UPDATED - COVID-19 Home Based Support (HBS) & Fee-for-Service Billing, Agency and Consumer Guidance

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.20.009 FINAL

Purpose:

The Illinois Department of Human Services (IDHS) Division of Developmental Disabilities (DDD) is committed to protecting individuals with developmental disabilities in Illinois. This communication is intended to provide updated guidance for the Home Based Support program, as well as guidance for providers who are authorized to provide Behavior Intervention, Individual/Group Counseling, Individual/Group Therapy as well as to providers of Physical, Occupational and Speech therapy, Self-Directed Assistance, Temporary Assistance/53C and Bogard Specialized Services.

Overarching:

The DDD made a number of temporary changes to assist agencies in providing services safely during the COVID-19 crisis period. The DDD is working towards returning to pre-COVID-19 rules and regulations. Effective July 1, retainer payments will no longer be made to any fee-for-service providers.

Home Based Supports:

  1. Continue to try to obtain required signatures for Service Agreements and other documents when possible; verbal or email approvals will continue to be acceptable during this time.
  2. Personal Support Workers (PSWs) may continue to support a waiver participant in the hospital and be reimbursed.
  3. Resuming July 1, 2020, the monthly allotment for individuals who are enrolled in the Adult HBS waiver but are still in school, will return to the traditional monthly allotment of two (2) times the Supplemental Security Income (SSI) amount ($1,566).
  4. If an HBS participant's primary caregiver, who is not paid as a PSW, becomes sick a request for Temporary Assistance (53C) funds can be submitted. The 53C service requires Prior Approval from the Division. The Prior Approval Request should be developed and submitted through the ISC agency. Temporary Assistance (53C) will allow participants to hire additional persons to assist with providing essential care. It provides an additional $2,000/month for two consecutive months and is above the monthly allotment. Temporary Assistance is not available for caregiver absences for vacation, educational or employment related reasons or other non-emergency reasons.
  5. Service agreements must be updated accordingly and account for all services.

Children Home Based Support (Additional Guidance):

  • Resuming July 1, 2020, families enrolled in Children's HBS, will return to the traditional monthly allotment of two (2) times the SSI amount ($1,566). Additional funds that were accrued from March - June and not utilized will continue to carry-over as usual. Service agreements must be updated accordingly.
  • The flexible spending amount for the Children's HBS program will remain at a monthly maximum of $3,132.
  • Parents or responsible guardian will not be allowed to be enrolled as a PSW for their child after June 30, 2020.

Self-Directed Assistance Guidance:

  • The DDD expects Self-Directed Assistants (SDA), if applicable, will continue to provide remote support for individuals and families via electronic and/or phone and video communications.
  • As all services can be provided remotely, there will be no additional payment or subsidy for this service.
  • All Service Agreements must be updated to accommodate any change in total monthly expenditures. Service Agreements must be updated for the month of March if budgets changed based on CDS closures or increased PSW hours.

Individual Controlled Personal Support Worker Guidance:

  • Resuming July 1, 2020, the full-length versions of the enrollment packets for PSWs will be used.
  • Employers and employees who completed the "emergency enrollment packets" will have 30 days to complete the full-length versions. The full-length version must be submitted to ACES$ by July 30. Families must work with ACES$ if you aren't sure if you need to complete a full-length version.
  • Resuming July 1, 2020, individual controlled PSWs will have to wait for fingerprint results to be completed to start work.
  • PSWs who were hired prior to July 1, 2020, will continue to have 30 calendar days to complete their fingerprints from date of hire.
  • Individual controlled PSWs should be terminated as required by law if there is a positive hit on their background checks.
  • We suggest families continue to implement a health screening protocol prior to their PSW coming to their home.

Agency Based Personal Support Worker Guidance:

  • Effective July 1, retainer payments will no longer be made for Agency Based Personal Support Workers.
  • Resuming July 1, 2020, agency based PSWs will have to wait for fingerprint results to be completed to start working.
  • Agency based PSWs who were hired prior to July 1, 2020, will continue to have 30 calendar days to complete their fingerprints from date of hire.
  • Agency based PSWs who normally work in HBS settings should continue to do so at the discretion of the families.
  • We suggest families continue to implement a health screening protocol prior to their PSW coming to their home.

Supports that are Fee-for-Service:

A number of services under the waiver are provided on a fee-for-service basis. In general, all fee-for-service providers, who are not able to provide service in person, should continue to provide services remotely via electronic, phone and/or video communications. These will be billable through applicable DDD billing codes.

Effective July 1, retainer payments will no longer be made to any fee-for-service providers.

Behavior Intervention & Treatment (Level 1 & Level 2):

  • If this service cannot be provided safely in person, the DDD encourages this service to continue to be provided remotely via means of electronic, phone, and/or video communication to individuals, families and agency staff.
  • Behavior Intervention & Treatment services provided remotely via electronic, phone and/or video communications are billable through the applicable DDD billing code.

Occupational and Speech & Language Therapy, Counseling and/or Therapy for Group and/or Individual:

  • If this service cannot be provided safely in person, the DDD encourages this service to continue to be provided remotely via electronic, by phone, and/or video communications which are billable through the applicable DDD billing code.
  • Effective July 1, the DDD will no longer be issuing subsidy or retainer payments for these fee-for-service programs.

Supported Employment Guidance (39U/39G only):

  • Prior to and after the Shelter in Place/Stay at Home Order, the Employment staff should provide supports to individuals in their jobs, unless the individual has taken a leave.
  • Effective July 1, the DDD will no longer be issuing subsidy or retainer payments for these fee-for-service programs.

Bogard Specialized Services:

  • If this service cannot be provided safely in person, the DDD expects that Bogard service providers will continue to provide remote support electronically, by phone, and/or video communications to nursing home residents.
  • Bogard Specialized Services provided remotely via electronic, phone and/or video communications are billable through the applicable DDD billing code.
  • Effective July 1, the DDD will no longer be issuing subsidy or retainer payments for these fee-for-service programs.


Resources:

Illinois Department of Public Health at www.idph.illinois.gov

Centers for Disease Control at www.cdc.gov

Administration for Community Living at https://acl.gov/COVID-19

Self-Advocacy Resource and Technical Assistance Center at www.Selfadvocacyinfo.org

 
The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.

Effective Date:

Upon Final Posting