Aging Out Of Children’s Residential Services

Purpose

This information bulletin is intended to clarify the process individuals and their families, state agencies, providers and the Independent Service Coordination (ISC) Agency when young adults age out of children's residential services.

• Youth funded through the Department of Human Services, Division of Developmental Disabilities (DHS/DDD) will follow the process outlined below.
• The Division has a transition agreement with the Department of Children and Family Services (DCFS), therefore, youth funded through the DCFS, who are wards of the State, will enter adult waiver services as those who are funded by DHS/DDD as outlined below. DCFS will initiate the process with the ISC Agency if the individual is seeking adult services through the Adults with Developmental Disabilities waiver.
• Children with Intellectual/Developmental Disabilities who are funded by the Illinois State Board of Education (ISBE) or Healthcare and Family Services (HFS) will be referred from these entities to their ISC if they are seeking adult services through the Adults with Developmental Disabilities waiver. Youth funded through ISBE or HFS enter adult waiver services through the normal PUNS process or by meeting crisis criteria.

Background

The Division of Developmental Disabilities has two residential services for eligible children with developmental disabilities, a Child Group Home (17D) or a Child Care Institution (19D). Services provided in these settings may include adaptive skill development, assistance with activities of daily living, personal care, protective oversight, supervision, community inclusion, transportation, and social and leisure skill development. A complete description of each of these services can be found on the DHS website at https://www.dhs.state.il.us/page.aspx?item=122709. For both these settings, the age of children allowed is 3 to 21 years of age. Once an individual reaches the age of 22, they no longer qualify to remain in the setting.

Child Group Home (17D)

A Child Group Home (CGH) is a waiver funded residential option for children under the age of 22. For Child Group Home (CGH - 17D) services, the child must be determined eligible for the Residential Waiver for Children and Young Adults with Developmental Disabilities. The Department of Children and Family Services (DCFS) is the regulating body for CGHs. CGH settings can serve no more than ten children. Children must be enrolled in a school program approved by the Illinois State Board of Education. School tuition is paid for by the local school district.

Child Care Institution (19D)

A Child Care Institution (CCI) is not a waiver service through the Children's Residential Waiver and is 100% state funded. CCI is a residential service for children and young adults under 22 years of age. Residential funding for CCI is infrequent and is usually provided only after in-home supports have been tried and have failed. The Department of Children and Family Services (DCFS) is the regulating body for CCI. CCI settings are licensed to serve more than ten children. Children must be enrolled in a school program approved by the Illinois State Board of Education. School tuition is paid for by the local school district.

Transition to Adult Services for children residing in a Child Residential Setting

Children aging out of the Children's Residential Waiver (CGH) services and Child Care Institutions are given priority status for Adult Developmental Disabilities Waiver Services. If an applicant is ineligible for the Adult Waiver, assistance is provided to access an ICF/DD, non-waiver services, State Plan services, or to other waiver services as appropriate. Waiver eligibility is outlined in Section II. Participant Eligibility and Waiver Program Enrollment in the DDD Waiver Manual.

Children may transfer to the Adult Developmental Disabilities Waiver at age 18, however, they can stay in the Children's Residential Waiver or CCI through the age of 21. This four-year transition period (from age 18 up to the 22nd birthday) is designed to enable children a smooth transition to other services, including further waiver funded residential supports, Home Based Support Services, ICF/DD services or other services, as appropriate. We expect that most participants will choose to transition as they exit the special education system.

The ISC's Role:

The Independent Service Coordination (ISC) agency determines eligibility for both CCI and CGH programs and are responsible for the successful transition from children's services to adult services as appropriate.

The ISC must begin working on a transition plan with the individual starting at age 18 in order to ensure transition by the age of 22.

For those already being funded by DDD, the ISC will initiate the process by contacting the young adult, family and guardian, if applicable, to set a date and time to discuss the steps in the transition process. The ISC should also contact the current residential provider to inform them of the transition process.

For those funded by DCFS, ISBE or HFS there will need to be outreach to the ISC to initiate the process.

The ISC will assist the participant and family by informing the participant and family about adult service and provider options, ensuring necessary eligibility screenings are completed (if they haven't already been completed), developing or updating the Personal Plan, if appropriate, and submitting a funding request to the Division when applicable.

Steps the ISC needs to follow, at a minimum, at age 18 for CGH and CCI:

• If not already completed, the ISC must determine eligibility for DD services through a Level II PAS assessment. This should be done according to the PAS Manual.
• If clinically eligible, the ISC should discuss and present all appropriate service and provider options to the person, family and guardian, if applicable.
• Once the person and guardian, if applicable, has selected a service, the ISC should proceed with a referral to the provider(s). The ISC should also facilitate visits to providers.
• Young adults transitioning from DD residential services who want or need DD Adult services do not have to be enrolled on PUNS or meet the crisis criteria for DD Waiver services.
• If the person will enter a DD Waiver program, the ISC should develop or update the Discovery Tool and Personal Plan to be included in the referral packet.
• A referral packet should include the Discovery Tool and Personal Plan, if the person chooses a DD Waiver service, clinical information such as psychological and psychiatric evaluations, medical history including current and past medication, and a social history.
• Once a provider has been selected, the ISC should submit a complete funding request packet to the DDD if DD Waiver services have been chosen.
• Once the award letter is received, the ISC should assist the person and guardian in arranging the transition from the current residential provider to the alternative service/provider.

For children transitioning from a CGH or CCI to the Adult Waiver, the process outlined above should begin at age 17 in case the child intends to transition to adult services shortly after age 18.

• Sometime around the 17th birthday (could be the annual PUNS update or the Personal Plan update) the ISC should facilitate a discussion to discuss transitioning from children's services. ISC should give general information on eligibility, service options and process as described in this IB.
• When necessary, per the PAS process, a Level II PAS must be completed within 90 days of the initial request/referral. The level II goes deeper into service options. If no level II is required, the ISC needs to have the deeper discussion about service options and providers.
• Within 90 days of the intent to transition to adult services, the family explores options, visits providers, and possibly makes a decision.
• When a decision has been made, the ISC works with the chosen provider to develop packet and do discovery/personal plan, as necessary.

If transitioning to adult services at age 18, the Division needs the complete service request no later than the 18th birthday (the packet can be sent as early as 4 weeks prior to turning 18). It's ok if the person receives their award letter and moves after their 18th birthday.

If the individual isn't going to transition immediately upon their 18th birthday, the ISC must communicate with the individual, guardian (if applicable), and residential provider to maintain and update the Personal Plan so it's ready when the individual is ready to transition to Adult Services.

The Provider's Role:

The children's residential provider, both CCI and CGH, should assist in the transition by participating in conversations with the ISC and any potential providers, ensuring that a release of information has been completed. The current provider is also responsible for providing current clinical, behavioral, and other relevant service information to the ISC and receiving provider.

If a child ages out of the Children's Residential Waiver but remains in a CGH, the provider may no longer continue to receive payment for services. The CGH provider will have to request to continue to receive payment by providing proof to the Division of attempts they have made to secure proper placement for the person who is still residing in their home. Approval for continued payment will be considered on a case by case basis.

When an Individual Terminates from CGH Services

When an individual leaves CGH services, the provider must submit a Service Termination Approval Request (STAR) form (IL462-2028) through their ISC as described in the DD Waiver Manual or Section 13 of the ISC Manual.

Effective Date

February 3rd, 2021