Consumer Handbook for Home-Based Services

Children's and Adult Medicaid Waivers

Last Updated December 2021

Table of Contents

  1. I. Introduction
  2. II. What is the Purpose of Home-Based Services?
  3. III. What Services Are Available in the Home-Based Services (HBS) Program?
  4. IV. How To Decide Which Services to Select
  5. V. What Are My Responsibilities in Home-Based Services?
  6. VI. Who is Available to Help?

I. Introduction

This handbook is designed to help you and/or your Employer of Record, if it is someone else, understand and manage the services available through the Illinois Department of Human Services/Division of Developmental Disabilities' (DDD) Home-Based Services (HBS) program.

Whether you are currently receiving DDD HBS or you recently received notice from the Division of your eligibility to begin services, this Handbook offers information to help you make informed decisions based on your individual needs and desires.

If you have any questions about this handbook, please reach out to your Independent Service Coordination (ISC) agency to make sure you and/or your Employer of Record, if it is someone else, understands your rights and responsibilities to self-direct your services. Appendices at the end of this handbook, will provide resources explaining in more detail the definitions and terms you will need to know.

II. What is the Purpose of Home-Based Services?

The purpose of the Home-Based Services' (HBS) program is to purchase needed services that will help you continue living safely and successfully in your own home or with your family. HBS is a "self-directed" program meaning individuals with the help of their guardians and families have the responsibility to arrange and manage their own services and supports.

HBS provides funds you can use to purchase needed services and supports, as identified in your Personal Plan (PP). The amount of money is based on Supplemental Security Income (SSI). SSI may change annually based on Cost of Living Adjustments approved by the federal government. You will receive 2x annual SSI amount or 3 x the annual SSI amount depending on which the DDD waiver program you are in. Your HBS monthly budget does not come to you in cash or a check but is a set amount available for you to purchase the services identified in your PP. Remember, HBS is to be used for to meet your personal needs and desires, not for the benefit of your family, guardians or service providers.

You have the right to:

  • Be safe;
  • Be treated with respect;
  • Have your choices explained to you in a way you understand;
  • Tell or show others what is important to you, what you want and need;
  • Privacy;
  • Be free from abuse;
  • Speak up and complain if you don't like something;
  • Be told about changes that affect you;
  • Ask questions about any decision that takes services away from you;
  • Ask for a review or appeal on any decision(s) that denies services or takes away your services.

III. What Services Are Available in the Home-Based Services (HBS) Program?

 The list below contains all the services available to you in the HBS program. Please refer to Appendix B for a full description of each service.

Service

Is this

available in HBS in the Adult Waiver?

Is this

available in Children's Support Waiver?

 Do I need approval before starting this service? Does this come out of my monthly budget?
Adaptive Equipment YES YES YES NO
Adult Day Care YES NO YES YES
Assistive Technology YES YES YES NO
Behavior Counseling (Individual and Group) YES NO NO YES
Behavior Intervention & Treatment YES YES NO YES
Community Day Services YES NO NO YES
Emergency Home Response YES NO NO YES
Fiscal Employer/Agent YES YES NO NO
Home Accessibility Modification YES YES YES NO
Individual Service and Support Advocacy YES YES NO NO
Non-Medical Transportation YES NO NO YES
Nursing (HBS only) YES NO NO YES
Occupational Therapy YES NO YES YES
Out of Home Respite YES YES NO NO
Personal Support Worker YES YES NO YES
Physical Therapy YES NO YES YES
Psychotherapy YES NO NO YES
Self Direction Assistance YES YES NO YES
Speech Therapy YES NO YES YES
Support Services Team YES YES YES NO
Supported Employment YES NO YES YES
Temporary Assistance YES YES YES YES
Training & Counseling Services for Unpaid Caregivers YES YES NO YES
Vehicle Modifications YES YES YES NO

* Please note, the services outline above are voluntary with the following exceptions. Neither of these services are paid for through your individual budget.

  • Fiscal Agent: you're required to use a fiscal agency when hiring personal support workers who is not employee of a provider agency
    • ISC Case Manager: your ISC will help develop and monitor your Personal Plan each year.
  • Programs offered by park districts, health clubs and community colleges do not meet the criteria for Home and Community Based Waiver services and cannot be paid for directly through the HBS program.
  • Both the Children's Support Waiver and the Adults with DD Waiver HBS programs permit hiring family members to be PSWs.
  • The Children's Support Waiver does not permit a legally responsible individual, who is any person who has a duty under state law to care for another person and typically includes: (a) the parent (biological or adoptive) of a minor child or the guardian of a minor child who must provide care to the child or (b) a spouse of a waiver participant to be a Personal Support Worker.
  • The Adult Waiver HBS program does not permit a legally responsible individual, who is any person who has a duty under state law to care for another person and typically includes: (a) the parent (biological or adoptive) of a minor child or the guardian of a minor child who must provide care to the child or (b) a spouse or minor child of a waiver participant to be a Personal Support Worker.
  • If you need assistance in securing a PSW, your ISC can refer you to provider agencies who have PSWs. You may also purchase Self-Direction Assistance (SDA) services which can assist you in finding and hiring PSWs.
  • Please note, you should explore the Medicaid state plan for possible funding of services including nursing and occupational, speech, and physical therapy.

IV. How To Decide Which Services to Select

Choosing what services to purchase with your Home-Based funds involves three main considerations:

  • Choose services based on your Personal Plan
  • Choose the services that fit within your HBS budget
  • Choose services that are available in your area

A. Choose Services Based on Your Personal Plan

Developing a thorough Personal Plan is the key to identifying what Home-Based services and supports you will need to help achieve your desired outcomes. A good Plan documents what you want and need to continue successfully living in your home and ensures you, your family or guardians, and any service providers understand and fulfill their roles and responsibilities. It also ensures funds are used in your best interest. The Independent Service Coordination (ISC) Agency is responsible for working with you through the Discovery Process to develop a Personal Plan that includes all needed services. If you identify a service need not currently included in the plan, reach out to your ISC to update the plan.

The Children's Support Waiver and the Adults with DD Waiver use a Person-Centered Planning approach where you and your family or guardian are key members of the planning team. Other members include your ISC, current provider agencies and may also include other people you invite to be members of the team, such as potential service providers, other family members, friends, or natural supports from within your community.

B. Choose the Services that Fit Within Your HBS Budget

Mix and Match Based on Your Needs, Priorities, and Outcome.

Choose services depending on your needs, and make sure to keep the total costs within your monthly individual budget amount. Prioritize your needs and concentrate on finding services and supports for those high priority areas first. Think carefully about how you want to manage your services, and how much control and choice will work best for you. For example, you may choose to use some of your budget to attend Community Day Services and then use the rest to hire a neighbor to provide personal support services. Each option comes with different levels of responsibility for you and/or your Employer of Record

Understand your Monthly Individual Budget

Children's Support Waiver - Children ages 3 to 21 can be in the Children's Support Waiver. If you fall into this category, you have an ANNUAL budget which is developed using 2 times Supplemental Security Income (SSI) per month. For example, effective January 1, 2022, the annual maximum is $20,184 based on a monthly amount of $1,682. People in the Children's Support Waiver have an option for flexible spending between months. Flexible spending allows you to spend up to 4 times the SSI amount in a month. For example, individuals in the Children's Support Waiver who choose to use flexible spending can spend up to $3,364 which is 4 times the SSI amount. You can also spend less than 2 times the monthly allotment of SSI in a month. The money that is not used in a month carries over until the end of the calendar year. This means that if you did not spend your full allotment in some earlier months of the year, you can spend more than your monthly allotment in some later months of the year as long as you do not go above the annual spending limit. Said another way, if your spending exceeds your monthly allotment up in some of the early months, you will need to cut back on your spending in later months to meet your annual allotment limit. Money unspent at the end of the calendar year cannot be accessed in the next year.

Adult Home-Based Waiver - Individuals who are at least 18 can be enrolled in the Adult Home-Based Services (AHBS) waiver. They have a monthly budget of 3 times SSI. For example, effective January 1, 2022, the annual maximum is $30,276 and the maximum monthly amount is $2,523. Money does not carry over to the following month so it must be used within the month it is allocated. The AHBS waiver does not allow flexible spending. Because it is a monthly budget, money not spent does not carry over to the next calendar year.

Individuals enrolled in the AHBS waiver, usually between the ages of 18 and 22 years old, who are enrolled in a Special Education program have a monthly budget of 2 times SSI. For example, effective January 1, 2022, the monthly Individual Budget is $1,682 per month. This money must be used within the month. The AHBS waiver does not allow flexible spending. The money that is not spent, does not carry over to the next month. Because it is a monthly budget, money not spent does not carry over to the next calendar year.

DDD releases an information bulletin each year with the new funding amounts.

Understand that Service Costs Vary
  • Although you can negotiate some service costs, most are fixed rates set by the State of Illinois. There is no negotiation allowed for these fees. The current fee or rate for these services can be found on the DD Current Rate Table.
  • The amount you pay Personal Support Workers, if you choose to hire your own workers, is negotiated directly between you and the worker. You decide what rate of pay is appropriate based on market conditions, level of experience or training you want/need, and hours/days of the week you need workers. You must decide how much to pay per hour and how many hours of service you can afford while remaining within your monthly individual budget.
Establish Service Agreement(s) and Service Authorization(s)
  • Ensure a written Service Agreement is completed between you and each service provider. Use the IL462-2029 (R-06-17) Home-Based Support Services (HBS) Service Agreement form (which is also found in Appendix E of this Handbook) to do this.
  • The Service Agreement defines the terms of the services to be provided including the effective date, the rate of payment, the maximum units of service to be provided each month and the maximum monthly charge. A unit is equal to a 15-minute period of time
Update Service Authorizations
  • Update and/or change the Service Authorization as necessary. Provide copies of the revised Service Authorization to the Fiscal/Employer Agent (F/EA). If you pay for Self-Directed Assistance (SDA) services, your SDA can assist you or do this for you. If you do not use SDA services, you must do this yourself. The F/EA, ACCES$, can help to support you if you have questions.

C. Choose Providers That Are Available in Your Area

  • Service providers are located throughout Illinois. However, not all providers offer programs or services you want are within easy driving distance from your home. There are several ways to check on availability of services.
  • Your ISC agency is usually the best and first source of information about services and providers. The ISC agencies are familiar with service options and provider agencies within your area and can help with information on how to contact them.
  • The DDD also maintains a list of Providers by Service Type - with Developmental Disabilities.
  • You can also ask friends, neighbors, classmates, teachers, therapists, your doctor, faith community, or any of the statewide disability advocacy groups for referrals. Most people recommend you visit each site or service provider in person before making your selections.

D. Out of State Services

  • In an effort to allow you to participate in the broader community and maintain relationships with family and friends residing outside of Illinois, you can receive Personal Support services out of state when meeting the following requirements:
    • You notify your ISC Agency prior to leaving the state and immediately upon your return to the state;
    • The service is provided by an individual who is an approved Illinois Medicaid provider prior to leaving the state;
    • The service is provided during a vacation or visit to family or friends who don't reside in Illinois; and
    • Personal support services out of state can be funded for up to 2 continuous weeks (14 calendar days). You may remain out of the state beyond 2 weeks, but personal support services can only be claimed for payment up to the 2 continuous weeks (14 calendar days).

V. What Are My Responsibilities in Home-Based Services?

A. Maintain Your Financial Medicaid Eligibility

You must maintain continuous Medicaid eligibility to continue receiving HCBS Waiver services. The Waiver requires a yearly redetermination which includes documentation of your continued Medicaid eligibility as well as looking at your level of need.

Every year, you will receive two Medicaid Redetermination notices in the mail. The first mailing is a letter notifying you that your Redetermination date is approaching and to watch for the Redetermination Form in approximately two weeks. The second mailing contains the actual Redetermination Form which you need to complete, attach any verifications and/or documentation requested, sign, and return by the deadline date indicated in your letter.

It is crucial that you watch for, complete, and return your Medicaid Redetermination Form within the specified time frames, or you may lose your Medicaid status and be ineligible for HBS. This means that any Personal Support Worker paychecks or reimbursement checks to other service providers or agencies may stop.

If you have any questions or concerns about Medicaid Redetermination, follow the instructions included in your letters or call your ISC agency.

B. Manage Your Services

You must make sure you understand your rights and work with your ISC to make sure your needs and desires are reflected in the services purchased through your HBS budget. If you have any concerns about this, please check out Section E in this handbook.

If you are an individual receiving services and are your own employer of record or if you are the employer of record for an individual served, you must:

  • Educate yourself about HBS rules, procedures, and forms. Keep this Handbook and any other documentation you need related to your PSWs or other service providers in a place where you can access them easily.
  • Educate yourself by starting with this list of Home-Based resources compiled by topic, responsible state agency, web page links, and Division contacts:
    The Division maintains consumer webpages with information about many HBS topics.
  • Manage your individual budget wisely to avoid spending more than you have. If you spend more than what is provided for you, someone will not get paid. If you overspend your budget in multiple months, you may lose your right to self-direct your own services.
  • Maintain communication with your ISC, F/EA, and your other providers. Respond promptly to phone calls and requests for information.
  • Complete and submit time sheets and other required paperwork in a timely basis. Timesheets must be submitted to the F/EA within 90 days of the day the service was provided.
  • Ensure the timesheets submitted to the F/EA are accurate and the service was provided. Submitting billing for services not provided or inaccurately could be considered Medicaid fraud and will be investigated, as appropriate.

If at any time, you or your family/guardian feel you cannot uphold these responsibilities, you may voluntarily request Self-Direction Assistance. Contact your ISC to begin this process if you decide to do so.

C. Report Occurrences of Abuse, Neglect or Exploitation

Any type of serious or dangerous incident must be reported. Anyone, this includes you, your family/guardian, your ISC, SDA, or anyone you trust, may make a report if something bad happens to you. A serious or dangerous incident means someone has hurt you, called you names, left you alone, didn't take care of you, stole your money, or did other bad things. If you are away at work or at a day program, the service provider must report an incident or ongoing issue.

DDD released this information bulletin on abuse, neglect, exploitation and mistreatment: https://www.dhs.state.il.us/page.aspx?item=136404. This bulletin also outlines the ways to make a report if you have an issue.

The following numbers are helpful for making reports of abuse, neglect, and exploitation:

  • Illinois Department of Children and Family services: 800-252-2873
  • DHS OIG- 800-368-1463 or 866-324-5553 TTY
  • Adult Protective Services- 866-800-1409 or 888-206-1327 TTY

D. Update Your ISC Agency

Keep your ISC up to date on any significant changes to your life or your needs. This can be done by phone, email or during a regularly scheduled visit. Let them know if anything has happened in your life that may affect your needs for services and supports. You should also let them know if you've changed your mind about the services you want or need. Let them know about new health issues, changes in prescription medication, health issues with a primary caregiver, if your Personal Support Worker resigns or quits, if you move, get a new job, or lose your current job.

You, your family/guardian, Employer of Record, PSW, or any service providers who work for you must immediately report to your ISC if any of these things happen to you:

  • Injuries or death
  • Hospitalization for an unplanned reason
  • If you are lost or missing and the police have been called
  • If you are arrested, have legal charges, or are jailed
  • If someone has stolen from you or hurt you physically
  • If you were restrained or put in seclusion

In the event of an immediate crisis, call 911 and then contact your ISC agency as soon as possible. Each ISC has a 24-hour emergency hotline number which you can call at any time of the day or night. Your ISC can help you understand what additional, short-term, emergency services may be available to help and establish a backup plan. If you purchase SDA services, you can also notify your SDA with issues.

E. Ensure HBS Supports Are Used Appropriately

Home-Based Waiver Services are designed to support you in making progress toward and reaching desired outcomes, as documented in your Personal Plan. Services are also designed to keep you safe and well, in your home or community. Funds are to be used to meet your personal needs and desires not to help your family or friends. Involuntary Termination of your right to Self-Direct your Home-Based Services may happen if:

  • You or your family/guardian/Employer of Record are found to have committed fraud regarding the use of funds.
  • You are found to be living with a family member or other individual(s) who has been determined by Adult Protective Services or another authorized law enforcement entity to have abused or neglected you or other individuals.
  • The ISC and Fiscal Employer Agency have determined and documented that you or your family/guardian/Employer of Record are not able to satisfactorily direct your own services, either with or without the help of an SDA. This includes your inability to purchase your services within the monthly or annual budget.
  • Family/guardian has been found to be acting in his/her own interest rather than in your best interests and no other guardian or representative is willing to take on this responsibility.

In cases of suspected fraud, abuse, neglect, or financial exploitation, your ISC agency can help you file a complaint. The form used is the Rights of Individuals Form: https://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-1201.pdf.

If you have been denied eligibility or services, been terminated, suspended, or received a reduction of waiver-funded services, you have the right to ask that this decision be reconsidered. This is called the Right to Appeal. For more information on your appeal rights, access the following link: https://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-1202.pdf. The ISC is also responsible for filling out this form: https://www.dhs.state.il.us/onenetlibrary/12/documents/Forms/IL462-0171.pdf.

VI. Who is Available to Help?

If you need more information or guidance about any part of the Home-Based Services program, your sources of support include your:

  • Independent Service Coordination (ISC) Agency
  • Fiscal/Employer Agent (F/EA)
  • Self-Direction Assistant (SDA)
  • Natural Supports

A. Independent Service Coordination (ISC) Agency

Your Independent Service Coordination (ISC) agency staff is your partner in almost every aspect of establishing and managing your services. The ISC is involved in the development of the Discovery Tool and Personal Plan; they also monitor your services as well as your general health, safety, and well-being.

There are currently eight ISC agencies serving Illinois, divided by counties. They usually are the same agency with whom you processed your eligibility screening and PUNS Waiting List application when applying for Home-Based Funding. Find your ISC agency contact information by clicking on the link and the county you live in. (If you live in Cook County, you will need to provide your zip code.)

Once you are enrolled in a DD Waiver, the ISC agency staff will provide Individual Service and Support Advocacy (ISSA) services; see section VII, B for a description of ISSA services. You may contact the ISC at any time to present a complaint or discuss unresolved issues or problems affecting your health and welfare. The ISC agency staff will work with you to resolve grievances or complaints, particularly those between you and service providers. If the grievance continues, ISC agency staff will continue the process by involving provider staff of increasing authority, up to and including the executive director of the provider agency. If the grievance cannot be resolved, ISC agency staff may help you find a new provider or contact DHS staff for technical assistance or intervention.

B. Fiscal/Employer Agent (F/EA)

If you and your family choose to hire PSWs directly, the F/EA can support the hiring process and be available for consultation if questions arise. The Division contracts with Avenues to Consumer Employer Services and $supports (ACES$) to provide F/EA services in Illinois. ACES$ will handle Personal Support Worker new hire paperwork and payroll/tax functions. If you choose to hire your own PSWs, you must use ACES$. They can be reached at:

Avenues to Consumer Employer Services and $supports (ACES$)
2960 Baker Drive
Springfield, IL 62703
Contact: Tasha Whiteside
Phone: 877-223-7781
Fax: 217-528-9849
Email: twhiteside@mycil.org
Website: www.mycil.org

C. Self-Direction Assistance (SDA)

Self-Direction Assistance (SDA) is an optional waiver service you can purchase and is available in both the Children's Support Waiver and the Adult Waiver.

In addition to support with securing PSWs, the SDA can assist in services and supports that facilitate community involvement. Each provider may offer various levels of support. Some of the activities an SDA can complete include:

  • Helping individuals secure PACE/public transportation support
  • Support securing benefits/entitlements
  • Completing home and vehicle modification, assistive technology, and adaptive equipment applications to be submitted to the DDD
  • Medical advocacy (scheduling appointments, locating community medical providers)
  • Support during school meetings (e.g. Individual Education Plan meetings)
  • General case management involved in maintaining housing in the community (banking, budgeting, assistance with utilities, securing housing, etc.) Ask your ISC for a list of providers in your area who offer Self-Direction Assistance.

D. Natural Supports

Last, but certainly not least, your friends, family, and other people you know and trust can help - these are your natural supports. They can help you plan and implement your services. They can also share their ideas, information, and personal experiences. Natural supports are an important part of everyone's life.

Appendices

A. Definitions

Term Definition
Appeal Rights If you have been denied eligibility, services, or have been terminated, suspended, or received a reduction of waiver-funded services, you have the right to ask that this decision be reconsidered.
Assessment An assessment is a test or evaluation completed by a professional qualified in an area of expertise. Assessments help accurately determine your levels of independence or supports needed to ensure your safety and well-being.
Adult Waiver A program for adults, age 18 and over, with Developmental Disabilities that provides support to prevent or delay out-of-home residential services or to provide residential services in the least restrictive community setting for individuals who would otherwise need ICF/DD level of care.
Centers for Medicare and Medicaid Services (CMS) The federal agency within the Department of Health and Human Services, which reviews, approves and monitors State Medicaid Waiver plans.
Children's Support Waiver Provides Home-Based services and supports to children and young adults with developmental disabilities ages 3 through 21 who live in their family home. Children and young adults ages 3 to 21 can be in the Children's Support Waiver. They have an ANNUAL budget that is 2 times Supplemental Security Income (SSI). Individuals are able to use up to 4 times the monthly allotment of SSI in a month. The money that is not used in a month carries over until the end of the calendar year. For example, effective January 1, 2022, the monthly Individual Budget is $1,682 per month. For individuals in the Children's Support Waiver who choose to flex their spending, the monthly maximum will be $3,364. This means that if you did not spend your full allotment in some earlier months of the year, you can spend more than your monthly allotment in some later months of the year as long as you do not go above the annual spending limit. Said another way, if your spending exceeds your monthly allotment up in some of the early months, you will need to cut back on your spending in later months to meet your annual allotment limit. Money unspent at the end of the calendar year cannot be accessed in the next year. The annual maximum is $20,184. DDD releases an information bulletin each year with the new funding amounts.
Conflict of Interest Free Case Management The Federal government regulations require states to separate case management from service delivery. Case management cannot be done by someone who: is a relative of the person served, is a direct provider of service, has a financial interest in a provider, or is employed by a provider. Case managers perform eligibility determinations, develop the Personal Plan, help families find providers, and monitor services.
DHS Family Community Resource Center The local office that you contact to apply for Medicaid. Find your local office here: DHS Office Locator
Discovery Tool A document the ISC uses in the Person-Centered Planning process to gather information on what is important to and important for a person. The Tool addresses 10 life areas. It is designed to lead conversations about a person's preferences, strengths, needs, barriers, and risks that are present. This information is used to develop the Personal Plan.
Employer of Record The individual receiving HBS and/or legal representative, family or close associate who is responsible for overseeing the services outlined in the monthly budget, signing Service Authorizations, and signing PSW time sheets. The Employer of Record is responsible for hiring, training, ensuring competency, supervising, and firing PSWs. Per the Internal Revenue Service, the same person cannot be both Employer of Record and a PSW hired by the family.
Fiscal/Employer Agent (F/EA) (updated July 2018) Company contracted by the State to help individuals using Home-Based Services hire Personal Support Workers, completing the payroll function for individually hired PSWs. F/EAs can assist with background checks, payroll taxes, completing paperwork, and paying workers out of your budgets. In Illinois, the F/EAs is ACES$ (Avenues to Consumer Employer Services and $supports).
Home and Community-Based Services (HCBS) Waivers The HCBS Waivers fund services that prevent or delay living in a long-term care facility. Illinois operates three HCBS Waivers for people with intellectual and developmental disabilities: the Adult Waiver, the Children's Residential Waiver, and the Children's Support Waiver.
Illinois Department of Healthcare and Family Services (HFS) The single Illinois state Medicaid agency that oversees waiver programs including the three Developmental Disability Waivers: the Adult Waiver, the Children's Residential Waiver, and the Children's Support Waiver.
Illinois Department of Human Services (DHS), Division of Developmental Disabilities (Division or DDD) The state agency in charge of developmental disabilities services, including the Children's Support Waiver and the Adult Waiver.
Implementation Strategy A document, created by service providers or the Employer of Record, that describes how your service providers will support the outcomes and needs documented in your Personal Plan. This is a part of the Person-Centered Planning process.
Independent Service Coordination (ISC) Agency As the case management entity, ISCs maintain the DDD's waiting list, determine clinical eligibility, assist with identifying providers of choice, develop the Personal Plan, and monitor the implementation of the Plan. ISCs serve as the front line for information and assistance to help individuals and families make informed choices and to navigate the system. The Division currently funds 8 ISC agencies in 12 regions across the state.
Individual Service and Support Advocacy (ISSA) ISSA is one of the four functions of the ISCs. When performing ISSA, ISCs help you understand and make choices, work with you to develop your Discovery and Personal Plan, refer you to area service providers, monitor services, help resolve issues and make sure your rights are respected.
Qualified Intellectual Disability Professional (QIDP) A professional staff with experience in the field of intellectual/developmental disabilities. A QIDP must meet academic and clinical standards established by the federal government and training requirements established by the State of Illinois.
Medicaid Re-Determination (clinical) Evaluates your eligibility to continue receiving Medicaid services. Requires you and your family/guardian to complete and return a Re-Determination form each year to the state Medicaid agency, documenting your continued eligibility for Medicaid, so you can continue receiving Home-Based Services.
Pre-Admission Screening (PAS) A Pre-Admission Screening is one of the four services that ISCs provide. A PAS assessment is required by the Federal Medicaid agency to determine the individual has a developmental disability or related condition and is eligible to receive services.
Person Centered Planning A process to document the balance between what is important to a person and what is important for a person. It also identifies strengths, preferences, needs (both clinical and support needs) and risks to a person. In Illinois, it has 3 main parts: Discovery Tool, Personal Plan, and Implementation Strategies.
Personal Plan The second major part of the Person-Centered Planning Process. A written vision for your life focusing on your strengths, preferences, needs and desires. The ISC agencies develop your Personal Plan along with you, family/guardian, and anyone else you wish to invite. The Personal Plan contains the outcomes you want, providers you select to help you achieve those outcomes, barriers, risk factors and plans to minimize the risk.
Personal Support Worker (PSW) A Personal Support Worker is an individual hired either by you and your family/guardian, if one has been appointed, or someone who is hired by a service provider agency. PSWs may assist with activities of daily living, supervision, or teaching skills that promote your safety and well-being, either at home or out in the community.
Self-Direction Assistance (SDA) An SDA meets the qualifications and training of a Qualified Intellectual Disabilities Professional (QIDP). They can provide skills training to enable individuals along with their families and/or Employers of Record to independently direct and manage self-directed services. They provide information and assistance in recruiting, hiring, communicating with, and managing Personal Support Workers. They provide assistance with budgeting and funding allocation management. They provide training and assistance with completion of timekeeping and other employer-related tasks required to interface with the Fiscal Management Agency. More information about SDAs is available online.
Service Agreement An agreement completed between you and each service provider which defines the terms of the services to be provided including the effective date, the rate of payment, the maximum units of service to be provided each month and the maximum monthly charge. A unit is equal to a 15-minute period. Use the Home-Based Support Services (HBS) Service Agreement form [IL462-2029] (pdf) which is also found in Appendix E of this handbook to do this.
Service Authorization A written document between you and an independently hired PSW outlining the terms of the services to be provided including the effective date, the rate of payment, the maximum units of service to be provided each month and the maximum monthly charge. Service Authorizations must be updated if there is a change in service and copies of the revised Service Authorization must be sent to the Fiscal/Employer Agent (F/EA). If you pay for Self-Direction Assistance (SDA) services, your SDA assist you or do this for you. If you do not use SDA services, you must do this yourself. F/EA, ACCES$, can help to support you if you have questions.

B. Description of Services

HBS offers a variety of services to help individuals live a full and productive life. This section offers a description of each of the services available in Home-Based Services. Please note, if you choose, you can hire an SDA to help facilitate these services. For further updates, you can look on the DDD website:

Adaptive Equipment

  • Adaptive equipment, as specified in the Personal Plan, includes:
    • Assessments to identify the type of equipment you need:
    • Devices, controls or appliances that enable you to increase your abilities to perform activities of daily living, or to control, access or communicate with the environment in which you live;
    • Other durable medical equipment not available under the Medicaid State Plan that is necessary to address any functional limitations;
  • Necessary initial training from the vendor about how to use the adaptive equipment. 
  • Adaptive equipment may also include necessary maintenance and repairs to adaptive equipment.
  • Items reimbursed with Waiver funds are separate and in addition to any medical equipment and supplies furnished under the Medicaid State Plan. Those items not of direct remedial benefit to you are excluded. All items shall meet applicable standards of manufacture, design, and installation. Some examples of covered adaptive equipment include reachers; grabbers; voice-activated, motion-activated, and electronic devices; and specialized computer software.
  • Lift chair mechanisms, communication devices and mobility devices may be covered if not covered by the Medicaid State Plan. Some examples of adaptive equipment that is not covered include furniture, recreational or quality of life items, such as televisions, stereos, boom boxes, fitness equipment, microwave ovens and other general appliances.
  • Medical equipment and supplies are not considered adaptive equipment.
  • There is no charge to your monthly budget for this service.
  • Please note, an SDA can support the gathering of the information.
  • For more information, please see the Adaptive Equipment, Assistive Technology, Home and Vehicle Modification Request Process DDD Information Bulletin on this topic.

Adult Day Care

  • Adult day care is available if you are aged 60 and older.
  • Individuals not yet 60 may also be served if community day services or employment services are determined not to be appropriate because of a medically fragile condition.
  • Adult day care services are generally furnished four or more hours per day on a regularly scheduled basis, for one or more days per week, or as specified in the Personal Plan, in a non-institutional, community-based setting, encompassing both health and social services needed to ensure your optimal functioning.
  • The cost for this service comes from your monthly budget and is a fixed rate established through the DDD.

Assistive Technology

  • Assistive technology devices are items, pieces of equipment, or product systems, whether acquired commercially, modified, or customized, used to increase, maintain, or improve functional capabilities.
  • Assistive technology services directly assist you in the selection, acquisition, or use of an assistive technology device. Assistive technology includes the following: evaluation of your assistive technology needs, including a functional evaluation of the impact to determine the appropriate assistive technology and services for you in your environments.
  • There is no charge to your monthly budget for this service.
  • For more information, check out the Adaptive Equipment, Assistive Technology, Home and Vehicle Modification Request Process DDD Information Bulletin on this topic.

Behavior Counseling (Individual and Group)

  • Behavior Counseling is a treatment approach in which licensed professionals meet with one or more individuals in ongoing periodic formal sessions and uses relationship skills to promote your abilities to deal with daily living issues associated with any emotional, cognitive, or behavioral problems.
  • Your Personal Plan and Implementation Strategies must include documentation of the need for behavior counseling and the services to be provided by the licensed professional.
  • Behavioral Strategies must be developed and approved in writing by your service provider within 45 days of initial contact.
  • The fee for this service will come from your monthly budget and is a fixed rate established through the DDD.

Behavior Intervention and Treatment

  • Behavior intervention and treatment includes a variety of individualized, behaviorally-based treatment models consistent with best practice and research on effectiveness that are directly related to your therapeutic goals.
  • Behavior Interventions include: an approach tailored to address your specific behavioral needs; targeted skills that are broken into small, attainable tasks; training of direct support staff, informal caregiver and family so skills can be generalized and communication promoted, especially in the areas of prevention, intervention and stabilization.
  • Services must be directly related to the outcomes contained in your Personal Plan and, if applicable, coordinated with your Individual Education Plan (IEP). To receive behavior services under the waivers, the services must be based on behavioral assessments documenting the ongoing need for the service and be included in the Personal Plan.
  • The fee for this service will come from your monthly budget and is a fixed rate established through the DDD.

Community Day Services (formerly known as Developmental Training)

  • Community Day Services provide assistance with acquisition, retention, or improvement in self-help, socialization, and adaptive skills.
  • This service takes place in a non-residential setting, separate from your private residence or other residential living arrangement and support people to access community-based activities and experiences.
  • Activities and environments are designed to foster skill development, greater independence, and personal choice.
  • Community Day Services focus on enabling you to attain or maintain your maximum functional level.
  • The fee for this service will come from your monthly budget and is a fixed rate established through the DDD.

Emergency Home Response Services

  • Emergency Home Response Services are limited to adults who:
    • live alone,
    • live with family and are alone for significant parts of the day,
    • who have no regular caregiver for extended periods of time, who would otherwise require extensive routine supervision.
  • Emergency Home Response Services (EHRS) is an electronic device that enables you to secure help in an emergency. You may also wear a portable "help" button to allow for mobility. The system is connected to your phone and programmed to signal a response center once a "help" button is activated.
  • Installation and maintenance of devices/systems can be covered.
  • The fee for this service will come from your monthly budget and a fixed rate established through the DDD.

Fiscal/Employer Agent

  • If you choose to hire your own Personal Support Workers (PSWs), you are required to work with a fiscal/employer agent (F/EA). The F/EA is a private company the Division has selected to assist Home-Based families with background checks, tax, and payroll functions.
  • Illinois contracts with Aces$ Financial Services to provide F/EA services. ACES$ can be reached at 1-877-223-7781.
  • The F/EA performs background checks on your potential employee(s), completes initial tax forms and other forms for your worker(s), and then pays your worker(s) twice per month on a predetermined schedule.
  • If you choose to hire your own PSWs, an Employer of Record must also be designated. This person is ultimately responsible for managing the employees and ensuring applicable labor laws are upheld. The F/EA will assist you with the aspects of the hiring process and be available for consultation if questions about workers arise.
  • There is no charge to your monthly budget for F/EA service.

Habilitative Therapies (Physical, Occupational, Speech)

  • Physical therapy, occupational therapy and speech therapy for restorative purposes are covered under the Medicaid State Plan for Children and Adults.
  • Individuals in the Adult Waiver are eligible for additional physical, occupational and speech therapy services of a habilitative nature.
  • You must obtain approval before using these services.
  • The need for each of the therapies must be documented in the Personal Plan.
  • Provider agencies will develop Implementation Strategies or use their existing evaluation and treatment documents. In either case, the information must include documentation of your specific therapy needs and the specific services to be provided by the licensed professional.
  • Long-term habilitative physical therapy, occupational therapy and speech therapy services should assist you, family members, personal support workers/direct support workers and others to incorporate effective therapeutic activities in daily life rather than focus on intensive professional treatments focused on short-term acute restorative needs.
  • The fee for these services will come from your monthly budget and is a fixed rate established through the DDD.

Home Accessibility Modifications

  • Home Accessibility Modifications include those physical adaptations to the home you live in. It is not for your family's residence if the individual does not live there. Home accessibility modifications should enable you to function with greater independence in the home and includes necessary repair to the adaptations.
  • Home accessibility modifications may be either permanent or temporary. Permanent home modifications are either structural modifications or items that are attached to the home.
  • All services must be provided in accordance with applicable State or local building codes.
  • Examples of home accessibility modifications include:
    • Ramps;
    • Lifts/elevators necessary to enter or leave the home or to access a bedroom or a bathroom, including porch or stair lifts and hydraulic, manual, or electric lifts;
    • Bathroom modifications, including roll-in showers, sink modifications, bathtub modifications, toilet modifications, grab bars, adapted water faucet controls, floor urinal and bidet adaptations and plumbing modifications and turnaround space adaptations;
    • Widening of doorways/hallways (may include minimally necessary floor covering to cover the new floor area);
    • Specialized accessibility/safety adaptations/additions including grab bars; necessary handrails beyond those normally required by building codes; lowered or adaptive door handles;
    • Adapted fire alarms, sprinklers, and smoke detectors;
    • Doorbells; automatic door openers/doorbells;
    • Voice-activated, light-activated, motion-activated, and electronically activated devices;
    • Fire safety adaptations and electrical wiring associated with the above.
  • For more information, please see the DDD information bulletin on this topic here: https://www.dhs.state.il.us/page.aspx?item=121677.
  • There is no charge to your monthly budget for Home Accessibility Modifications.

Individual Service and Support Advocacy (ISSA)

ISSA is one of the functions of the ISC agencies. It is only provided to individuals receiving a DD Waiver service. When providing ISSA, ISC agency staff represent your interests in determining whether waiver services are being provided based on your Personal Plan. In addition to developing your Personal Plan, ISC agency staff will conduct four monitoring visit each year individuals in the Children's Support Waiver and two monitoring visits each year for individuals in the Adult Waiver to ensure you are receiving the services outlined in your Plan. They alert you and the Division when additional monitoring, intervention or technical assistance is necessary. ISSA services provide support to you, your guardians, and providers in working through a variety of service issues, including those requiring conflict resolution, increased communication, and possible changes in services or support.

  • Additionally, ISSA services provide you and your guardian, if one has been appointed, information about protections from abuse, neglect, and exploitation.
  • ISSA services are designed to assist but not replace the guardian and other appropriate advocates. You may contact your ISC agency staff at any time to present a complaint or discuss unresolved issues or problems affecting your health and welfare. If the grievance cannot be resolved, ISC agency staff may contact DHS staff for technical assistance or intervention
  • Find your ISC agency contact information by clicking on the link and the county you live in. (If you live in Cook County, you will need to provide your zip code.)
  • There is no charge to your monthly budget for ISSA services.

Nursing

  • Nursing services are available within the monthly maximum for individuals in the Adult Waiver who are authorized for Home-Based Support Services.
  • These services are in addition to any Medicaid State Plan nursing services for which the individual may qualify. Nursing services must be listed in the Personal Plan and be within the scope of the Illinois Nursing and Advanced Practice Nursing Act (225 ILSC 65).
  • Nursing services can be provided by a Professional Registered Nurse licensed to practice in the State of Illinois or a Licensed Practical Nurse under the direction of a Registered Nurse who is licensed to practice in the State of Illinois.
  • The fee for this service will come from your monthly budget and is a fixed rate established through the DDD.

Personal Support Worker

Personal Support Workers are one of the most popular service categories in the Home-Based Waiver for Children and Adults. Typical services provided by PSWs include: teaching adaptive skills to assist you to reach personal goals within your home or community; personal assistance in activities of daily living; helping you access age-appropriate community places, recreation, leisure, or volunteer activities; and providing services on a short-term basis because of the absence or need for relief of the primary caregivers.

  • PSW services can NOT be provided when the individual is not present, during the typical school day or while other waiver services are being provided, such as Community Day Services and Supported Employment.
  • Families can hire PSWs through a provider agency, hire their own PSWs or use both.
  • PSWs hired by an agency (Agency-Based PSWs): Some providers recruit, hire and train their own staff. The agency's staff then comes to your home and provides PSW services. The individual and agency negotiate the rate.
  • PSWs hired directly by the individual, family, or guardian: The Employer of Record finds, recruits, and manages the PSW. You, if you are the Employer of Record, determine the amount of pay, ensure all pre-employment and payroll matters are completed (to include signing and submitting timesheets timely), respond to billing questions and oversee your overall budget. You take responsibility for all employer-related duties for Personal Support Worker services. Timesheets for PSWs hired directly by the individual, family, or guardian must be submitted to ACES$ within 3 months of the date of service. If timesheets aren't filed timely, they will be rejected and not paid.

Employer of Record

  • The Employer of Record is the person who is ultimately responsible for ensuring wages are paid. They are also responsible for overseeing the services outlined in the monthly budget and signing Service Agreements, Service Authorizations, and time sheets. In addition, the Employer of Record may help with hiring, training, supervising, and firing PSWs.
  • The Employer of Record can be you (if you do not have a guardian), a guardian (if they are not also your PSW), or other adult members of your family or a trusted associate. The Employer of Record can be the same person who is your Representative Payee for Social Security benefits.
  • Timesheets for PSWs hired directly by the individual, family, or guardian must be submitted to ACES$ within 3 months of the date of service. If timesheets aren't filed timely, they will be rejected and not paid.
  • If you and your family choose to hire PSWs directly, the F/EA will assist with the hiring process and be available for consultation if questions arise. The Division contracts with Avenues to Consumer Employer Services and $supports (ACES$) to provide F/EA services in Illinois. ACES$ will handle personal support worker, new hire paperwork, and payroll/tax functions. If you choose to hire your own PSWs, you must use ACES$. They can be reached at:

Avenues to Consumer Employer Services and $supports (ACES$)
2960 Baker Drive
Springfield, IL 62703
Contact: Tasha Whiteside
Phone: 877-223-7781
Fax: 217-528-9849
Email: twhiteside@mycil.org 
Website: www.mycil.org

If you want help hiring, managing, and training the workers you have directly hired, you should consider purchasing services from a Self-Direction Assistance (SDA) provider. They can help you in many ways with your own PSWs. There is a description of SDA services in this section

Personal Support Worker candidates MUST:

  • Be at least 18 years of age;
  • Pass required background checks (Criminal Background, Health Care Worker Registry, IL Sex Offender Registry, HFS OIG Sanctions List, and DCFS State Central Registry);
  • Communicate well with you and your family;
  • Complete required paperwork accurately;
  • Understand waiver rules on abuse and neglect; human rights; confidentiality; handling fire and other emergencies; and
  • Show that they can safely support you, as documented in your Personal Plan.

Personal Support Workers CANNOT Be:

  • A person who has hurt children or other people with disabilities;
  • You as the person who is receiving DD Waiver services or another individual who is receiving DD Waiver services;
  • Your husband or wife if you are receiving DD Waiver Services;
  • Your parent, step-parent, or other legally responsible individual if you are in the Children's Support Waiver;
  • Under 18 years of age.
  • The fee for Personal Support Workers will come from your monthly budget and is a negotiated rate.

Psychotherapy (Individual and Group)

  • Psychotherapy is a treatment approach in which a licensed professional conducts formal sessions with one or more individuals. The goal is to eliminate or reduce the symptoms of emotional, cognitive, or behavioral disorders. Psychotherapy should also promote positive emotional, cognitive, and behavioral development.
  • The Personal Plan must include documentation of your need for psychotherapy and the services to be provided by the licensed professional.
  • The fee for this service will come from your monthly budget and is a fixed rate established through the DDD.

Self-Direction Assistance

  • Self-Direction Assistance (SDA) trains you (Employer of Record, as appropriate) in the process of finding, interviewing, hiring, and managing Personal Support Workers (PSWs) who will meet your specific needs. SDAs can teach you the skills to recruit, interview, manage and troubleshoot issues that arise with your PSW. The SDA can also train you to complete the documents needed when hiring and paying PSWs.
  • SDA assists the individual (or Employer of Record) in arranging for, directing, and managing services. It also offers practical skills training to enable individuals and families to independently direct and manage Waiver services. SDA includes providing information to ensure that individuals understand the responsibilities involved with directing their services. In general, the activities provided under SDA must be consistent with Federal CMS regulations, not duplicate ISC activities and be a good use of taxpayer dollars.
  • SDAs do not have a mandated set of services that they are required to provide. Each service provided must be at the request of you or your family and/or guardian. More information about SDAs is available online. All billable services must be agreed upon by the individual, family and/or guardian, as well as the SDA.
  • If you desire or need the support of a SDA, this must be documented in your Personal Plan, including the amount and frequency of services. If you purchase SDA services, the details of what will be provided should be included in the Employer of Record Implementation Strategy. As requested, the SDA can assist the HBS Employer of Record with developing the Employer of Record Implementation Strategy form.
  • The fee paid to the SDA will come from your monthly budget and is a fixed rate established through the DDD.

Supported Employment

  • The Division of Rehabilitation Services (DRS) is the initial contact for you if you are interested in gaining competitive integrated employment. DRS vocational rehabilitation services (employment services) is NOT a waiver service so it can be used alongside DDD waiver services. Use the online Rehabilitation Services Web Referral to refer yourself or someone else for services. DRS staff provide services to people with disabilities in 47 local offices located in communities throughout the state. Find your ISC agency contact information by clicking on this link: Find your ISC agency contact information by clicking on the link and the county you live in or call toll-free: (800) 843-6154 (Voice, English or Español) or (866) 324-5553 (TTY). For general questions about DRS, email DHS.DRS@illinois.gov.
  • DDD Supported Employment Program - Individual consists of ongoing supports that enable you to maintain competitive employment after placement and successful closure by DRS.
  • DDD Supported Employment Program - Group SEP does not requirement a successful closure from DRS, but rather you can go directly to DDD to join.
  • The fee for this service will come from your monthly budget and is a fixed rate established through DDD.

Temporary Assistance

  • Temporary Assistance (TA) are personal support services provided on a temporary emergency basis because the person who usually assists you and provides unpaid care (primary caregiver) - is absent or incapacitated.
  • Absence or incapacity of the primary caregivers must be due to a temporary cause, such as hospitalization, illness, injury or another emergency.
  • There is no charge to your monthly budget for Temporary Assistance. Temporary Assistance has a separate maximum of $2,000 per month for two consecutive months (60 consecutive days) for a total maximum of $4,000. 

Training and Counseling for Unpaid Caregivers

  • This service includes training and counseling for caregivers who provide unpaid support to you.
  • For purposes of this service, an unpaid caregiver is defined as any person (family member, neighbor, friend, companion, or co-worker) who provides care, training, guidance, companionship, supervision, or support and is not paid through the Home-Based funds.
  • Personal Support Workers who are paid through Home-Based funds cannot use this service.
  • Training includes instruction about supports and services in your Personal Plan (e.g. use of adaptive equipment) and updates as necessary to safely maintain you at home. Counseling must be aimed at assisting the unpaid caregiver in meeting your needs. All training for those who provide unpaid support to the individual must be included in your Personal Plan.
  • The training and/or counseling provided to your unpaid caregiver must be directly related to their role in supporting you as specified in your Personal Plan. These services should assist your unpaid caregiver to understand and address your specific needs.
  • The fee for this service will come from your monthly budget and is a fixed rate established through DDD.

Transportation (Non-Medical)

  • Non-Medical transportation includes services that enable you to gain access to waiver and other community services, activities and resources specified in the Personal Plan.
  • This service is offered in addition to Medical Transportation Services (available under the Medicaid State Plan) and must not replace them. Whenever possible, you should use family, neighbors, friends, or community agencies which can provide this service without charge.
  • Transportation to/from services covered under your Medicaid State Plan and transportation to/from a day program cannot be paid for through this service.
  • The fee for this service will come from your monthly budget and is a fixed rate established through DDD.

Vehicle Modifications

  • Vehicle Modifications are adaptations/changes to an automobile that is your primary means of transportation. Vehicle modifications are specific to your individual need; they should support you to access your community and ensure your safety.
  • The need for Vehicle Modifications must be specified in the Personal Plan.
  • Examples of vehicle modifications include adaptations/changes to:
    • Lifts or ramps;
    • Doors;
    • Seating;
    • Safety/security;
    • Inside height.
  • The following are not allowed as a vehicle modification:
    • Adaptations or improvements to the vehicle that are of general utility, and are not of direct benefit to you;
    • Purchase or lease of a vehicle;
    • Regularly scheduled upkeep and maintenance of a vehicle except upkeep and maintenance of the modification(s).
    • There is no charge to your monthly budget for Vehicle Modifications.

C. Person Centered Planning (updated June 2018)

Person Centered Planning is the balance between what is important to you and what is important for you. It identifies your strengths, preferences, needs as well as risks. Person Centered Planning also helps you prioritize your outcomes. You can include anyone you want to be a part of your Person-Centered Planning process. Please see Appendix A for specific information regarding the person-centered discovery process, personal plan, and implementation strategies. You can also read more about Person-Centered Planning.

Person Centered Planning must:

  • Be driven by you;
  • Ensure services are provided to you in a manner that reflects your preferences and needs;
  • Include evidence that you chose the places and types of services you are receiving;
  • Assist you to achieve the outcomes you choose and in the most integrated setting;
  • If you want to work, include opportunities for you to seek employment and work in competitive jobs that people without disabilities work in;
  • Include opportunities for you to be a part of your community, have control over your money and property. You should also have opportunities to get services in the community just as people who do not have a disability.;
  • Be written in plain language that you and your family/guardian can understand;
  • Include things that are important to you about your culture (for example: how you celebrate holidays);
  • Include strategies for solving disagreements.

The Person Centered Planning process developed for the Illinois' Developmental Disability system, including Home-Based Services, consists of the three main parts explained below:

1.  The Discovery Tool & Process

The Discovery Tool is a form the ISC will use to collect information about what you want, need, like, dislike, and include your strengths and risks that are present in your life. The ISC will complete this document with you, your guardian (if you have one) and anyone else you want. They will also get information from any provider agency that is currently serving you.

The Discovery process is not necessarily a one-time event or meeting, rather is an information gathering process. The ISC can gather information through face-to-face, phone, or electronic discussions. They can also gather information by observation and reviewing records, evaluations, assessments and/or case notes. Information gathered during this process is used to develop your Personal Plan. This information will also be shared with provider agencies that you choose.

The Discovery Tool is available online (pdf).

2.  The Personal Plan

Once the Discovery Tool is complete, your ISC will use this information to develop your Personal Plan. The Personal Plan is a document that outlines what you want your life to look like. This document is also sent to provider agencies that serve you or those you want to serve you.

The Personal Plan focuses on your strengths, preferences, needs and outcomes. It reflects your preferences in how services are delivered to you, where, when and by whom. It will include your choice of providers if you have made them. It also documents any risk to your personal health, safety, and well-being along with plans necessary to lessen these risks.

You and your family/guardian will have an opportunity to review and approve the Personal Plan to ensure it has accurately captured and highlighted the information you feel is essential about you. This document is also sent to provider agencies that serve you or those you want to serve you.

The Personal Plan format is available online (pdf)

3.  Implementation Strategies

  • When the Personal Plan is complete, Implementation Strategies are written. The information identified in the Personal Plan must be addressed and accounted for in the Implementation Strategy. An Implementation Strategy must detail the services and supports that will be provided on a day-to-day basis.
  • Provider Agencies Implementation Strategy (this section was updated June 2018)
  • If you want to use services from a DD agency, the ISC will assist you to find agencies that are willing and able to provide you services. Once you have located an agency(s) and they agree to meet your needs, some provider agencies (see chart below) will develop an Implementation Strategy. Once complete, they will send you and/or your guardian for review and approval. The ISC should also receive a copy. If you have questions you should contact the agency or your ISC. Information on the Provider Implementation Strategy is available online.

  • The following services require an Implementation Strategy:

    • Adult Day Care
    • Agency-based Personal Support Worker (HBS only)
    • Child Group Home
    • Community Integrated Living Arrangement
    • Community Day Services (formerly known as Developmental Training)
    • Community Living Facility 
    • Supported Employment Program

    The following services require an Implementation Strategy OR  current Assessment/Treatment Documents:

    • Behavior Counseling
    • Nursing (HBS only)
    • Occupational Therapy
    • Physical Therapy
    • Psychotherapist
    • Speech Therapy

    The following service do not required

    an Implementation Strategy

    • Adaptive Equipment
    • Assistive Technology
    • Home Modifications
    • Non-Medical Transportation (HBS only)
    • Self-Direction Assistance (HBS only)
    • Vehicle Modifications
  • Employer of Record Implementation Strategy
  • Program participants, family, and others who act as the Employer of Record in HBS, must develop an Implementation Strategy. This Implementation Strategy will look different from the one provider agencies develop. The Employer of Record will use the Employer of Record Implementation Strategy form [IL462-1240] to develop their Implementation Strategy.  If you are hiring PSWs directly and need help completing your Implementation Strategy, you can purchase Self-Direction Assistance (SDA). Your ISC can help you locate an agency that provides SDA.
  • The Employer of Record's Implementation Strategy must:
    • Be completed using the Employer of Record Implementation Strategy for HBS form and instructions that will be provided.
    • Be completed by the HBS Employer of Record for the person receiving DDD Waiver services. If you choose, you can hire a SDA to assist you in completing the Employer of Record Implementation Strategy.
    • Be completed by the HBS Employer of Record anytime the individual or family has chosen to arrange or oversee services and/or outcomes from the Personal Plan. This might include when services are being delivered by a family member, Personal Support Workers privately hired, Special Recreation Association program, private day program, or professionals/therapists who do not accept Medicaid. If you need assistance in completing the form, you can hire a Self-Direction Assistant to help you. When an individual or family has chosen agency-based services only (i.e. Community Day Services, agency based Personal Support Workers), it is not necessary to complete this form.
    • Contain all the outcomes from the Personal Plan that you have agreed to work on or arrange.
    • Contain any of the following services that you will arrange: PSWs that you hire directly, Behavior Intervention and Treatment, Counseling, Psychotherapy, Speech Therapy, Physical Therapy, Occupational Therapy, Nursing and Non-Medical Transportation. If you are going to request Adaptive Equipment, Home or Vehicle Modifications or Assistive Technology, these must also be included.
  • Implementation Strategies must be updated at least every year by the Employer of Record. They can be updated more often if your needs or desires change with those needs and desires reflected also in your personal plan. The Implementation Strategy does not replace the Home Based Service Agreement or Service Authorization. The Employer of Record must keep the completed Strategy on hand and make it available to the Independent Service Coordination (ISC) agency and Division of Developmental Disability staff as requested. If you have hired a SDA, they may also need a copy. The Employer of Record must also ensure that all services and supports are provided and/or billed according to your HBS Service Agreements, Service Authorizations, and Implementation Strategy.

D. Employer of Record Implementation Strategy

The Employer of Record Implementation Strategy form [IL462-1240] and Instructions [IL462-1241] are available on the DHS website.

E. Home-Based Support Services Service Agreement

You can access an electronic copy of the Home-Based Support Services (HBS) Service Agreement form [IL462-2029] (pdf)