State of Illinois
Department of Human Services
INTRODUCTION
The Illinois Department of Human Services' Home Services Program (HSP) is a Medicaid Waiver program that helps individuals to live independently in their home. HSP supports individuals with severe disabilities who are at risk of living in a nursing home, group home, or other state or private institution. People who receive services from HSP are called Customers. As a Customer, you will work with an HSP Counselor to establish eligibility, and a service plan that supports your needs. Depending on the type of provider listed in your service plan, you will have the ability to hire and manage a provider of your choosing. This handbook provides basic information to help you understand the Home Services Program's eligibility criteria, policies and procedures, available services, and much more.
TABLE OF CONTENTS
Eligibility 4
Referrals 5
Service Plan Overview 6
Redeterminations 6
Appeals 7
Bill of Rights 7
Available Services 8
Managing Your Providers 11
Provider Employment Packets 14
Centers for Independent Living (CIL) 15
Managed Care Organizations (MCO) 16
Electronic Visit Verification (EVV) 17
Home Services Program Fraud Unit 17
IMPACT Enrollment 18
HSP Labor Relations 18
DRS Local Office Contact 19
ELIGIBILITY for the Home Services Program
Be a citizen of the United States or legal permanent resident.
Be a resident of the State of Illinois.
Must have applied for Medicaid.
Be between the ages of 18-59. (Exceptions may apply to individuals with a traumatic brain injury or HIV/AIDS.)
Have a severe disability that is expected to last for at least 12 months or the rest of the person's life.
Receive the minimum score in the Determination of Need (DON) assessment tool. The DON will be completed with an HSP Counselor.
Have less than $17,500 in non-exempt assets, $35,000 threshold for families.
Not require in-home services that cost more than living in a nursing home or other long-term care facility.
REFERRAL
To apply for the Home Services Program (HSP), you will submit a referral online at the DHS Website or in person at the DRS local office.
To submit a referral online, please visit our website at: www.dhs.state.il.us and search "Apply Online". To find the DRS local office, please search "office locator" and select Office type: "Rehabilitation Services".
After you have submitted a referral online or at your DRS local office, a member from the local office will reach out to you to schedule an initial interview and assessment.
This meeting will be conducted by the HSP Counselor assigned to your referral. You and an HSP Counselor will discuss many topics including your limitations, needs, preferences, medical diagnosis, financial status, and other areas of your life. This information will be used to determine if you meet the eligibility criteria listed on the previous page.
SERVICE PLAN OVERVIEW
Once eligible for the Home Services Program (HSP), you and your HSP Counselor (or MCO Care Coordinator) will work together to develop your service plan. The service plan is an outline of the services that will be used to determine your current unmet needs. A service plan can be thought of as a contract between yourself, HSP, and your service providers. The service plan will always be developed with your participation and agreement.
REDETERMINATIONS
Every year, you and your Counselor will meet to complete a new Determination of Need (DON) assessment and verification of all eligibility requirements. This is called an annual redetermination. This meeting will also discuss any changes needed on your service plan, your service providers, and other general areas of need. If you have a change in condition or need, a new assessment may be requested at any time before your next annual redetermination.
APPEALS
As an HSP Customer, you have the right to appeal any action, or lack of action, made by Home Services Program staff through the Illinois Department of Human Service's Bureau of Hearings. You can file an appeal with your HSP Counselor at any time. You will receive an HSP Appeals Fact Sheet (HSP 1), Request for Hearing form that will provide you will information you need for the appeal, and a copy of the HSP Customer Bill of Rights. If you need assistance with your appeal, the Illinois Home Care Ombudsman Program (HCOP) may be able to help. They can be reached by emailing the following address: Aging.HCOProgram@Illinois.gov or calling (800) 252-8966, pressing 4, and asking for the Home Care Ombudsman.
BILL OF RIGHTS
As a Customer of the Home Services Program, you have the right to:
- basic safety
- information
- choice, participation, and self-determination
- dignity and individuality
- resolve grievances
- assistance in securing your rights
A complete explanation of your rights can be found online by searching "HSP Bill of Rights" or by contacting your HSP Counselor or local DRS local office.
AVAILABLE SERVICES
Individual Providers
Non-agency providers hired and managed by the HSP Customer.
- ?Personal Assistants (PA) help with household tasks such as meal preparation, laundry, and housekeeping; personal care tasks such as bathing, transferring, and eating; and certain health care procedures upon permission of a doctor.
- CNA- Certified Nursing Assistants
- LPN/RN- Licensed Practical Nurses and Registered Nurses
Homemaker Agencies
Homemakers help with personal care and household tasks. Homemakers are employed, trained, and supervised by homemaker agencies and work for Customers unable or unwilling to supervise an Individual Provider.
Maintenance Home Health Agencies
In-home skilled healthcare services provided through a treatment plan prescribed by a doctor or other health care professional. Other services offered include nursing care and physical, occupational, and speech therapy.
Electronic Home Response Device
HSP Customers are provided with a device that provides a 24-hour connection to first responders and health care professionals.
Home Delivered Meals
Meals are delivered to the home for individuals able to feed themselves but unable to prepare food.
Adult Day Care
The direct care and supervision of Customers in a community-based setting to promote their social, physical, and emotional well-being.
Assistive Equipment
Devices or equipment installed in the home to increase the Customer's independence and ability to perform household and personal care tasks.
Environmental Modification
Modifications that increase the safety in the home and decrease the Customer's dependence on assistance from others. Examples could be modifications such as a ramp to access the home or grab bars in the bathroom.
Respite Services
Temporary care for adults and children with disabilities aimed at relieving stress to families. Respite services may be provided for vacation, rest, errands, family crisis or emergency and may include personal assistant, homemaker, or home health.
Day Habilitation
For Brain Injury Waiver recipients. Assists with selfhelp, socializing, and adaptive skills.
Pre-Vocational Services
For Brain Injury Waiver recipients. Provides services aimed at preparing an HSP Customer for employment but are not job task oriented.
Behavioral Services
For Brain Injury Waiver recipients. Intended to enable HSP Customers to better manage his or her behavior and to make the Customer more capable of living independently.
MANAGING YOUR PROVIDERS
As an HSP Customer, you will be the employer of any Individual Providers (IPs) that work in your home. It is your responsibility to find, hire and manage your IPs. You will also be responsible for making sure your IPs can complete the tasks on your service plan. The following are tips for finding and managing IPs:
Who can help me with my needs?
Most of the time, you can choose who provides the services listed in your plan. There are some situations where the person you choose may not be able to provide services. One example would be a legally responsible person: such as your spouse or a parent and guardian if you are under the age of 18.
If you are not able to manage your providers, a Homemaker Agency may be able to help.
How can I find providers?
You can find a provider through your local Center for Independent Living (CIL), word of mouth, friends, and family, or other HSP Customers. You may also try local ads or social media to find a provider.
How do I know if a provider is right for me?
It is a good idea for you to interview the provider you are thinking about hiring. Ask questions about their background, what they like to do, past work experience,and their ability to do the tasks on your service plan. Be ready to answer any questions the provider may have.
Can I run a background check on my provider?
The state will automatically run a background check on all providers after they turn in the provider employment packet. You can also request a separate background check be completed and have the results sent directly to you. HSP pays for all background checks, you will never be charged a fee. Your Counselor can provide the documents you will need to request the second background check.
Can my provider help with non-Service Plan tasks?
The provider is employed by you but paid through the Home Services Program. Therefore, your providers cannot assist others living in the home, or perform duties not in the service plan.
Additional tips and information:
You and your provider both have responsibilities to one another. Customers and providers must build a strong professional business relationship. You should expect professionalism and courtesy from your providers. Providers should be timely, understanding, flexible, and display professional behavior. Providers are always expected to maintain confidentiality.
Is training available for my provider?
You will be required to train your new provider on how to complete the tasks listed on your service plan. You know your needs better than anyone and it is important that your provider is able to safely provide these services.
An organized daily routine, a 'how-to' list, good communication, and people familiar with your care are all helpful for training new providers. Additional mandatory training is available through your provider's union. Details on this training are available on the next page.
Annual training provided by Service Employees International Union:
Service Employees International Union's (SEIU) Helen Miller SEIU Member Education and Training Center (METC) provides training for HSP Individual Providers.
SEIU METC Topics include:
- HSP Services Offered
- HSP Service Plan Assistance
- Payment (Paycheck Distribution) Options
- Timesheet and Electronic Visit Verification (EVV) Overview
- Timesheet and EVV Instructions
- Overtime
- Medicaid Fraud
- HSP Forms
- Overview, Handling, and Reporting, of Abuse
- Physical, Verbal, Emotional, Mental & Sexual Abuse
- Confinement
- Neglect
- Passive Neglect & Willful Deprivation
- Financial Exploitation
- Additional Training available
- Frequently Asked Questions for your Individual Provider
- Health Insurance (through SEIU) eligibility
PROVIDER EMPLOYMENT PACKETS
HSP is a Medicaid Waiver program and your Individual Providers must be enrolled as a Medicaid provider. In order for HSP to pay your providers, they must complete and submit the 'Individual Provider Employment Packet'.
You can request an Individual Provider Employment Packet from your DRS local office or your Managed Care Case Coordinator. You can visit the IDHS website at www.dhs.state.il.us and search "Provider Packet".
It is very important that you and your providers complete all the necessary forms and submit them to the DRS local office. Furthermore, your DRS local office cannot assist with the W4 tax forms nor the Federal I-9 employment verification form.
Once your provider's packet has been approved, the provider will receive a unique number called a Santrax ID. The Santrax ID number will be used to clock in and out of the timekeeping system called the Electronic Visit Verification (EVV) system. Once the Santrax ID has been given to your provider, you can give them a start date and schedule the days and times for them to work.
CENTER FOR INDEPENDENT LIVING
CILs are community-based non-profit organizations that provide services and support to people with disabilities. There are 21 CILs throughout Illinois, covering all regions of the State. Your local CIL supports the community by helping people with disabilities gain independence in all aspects of their lives. CILs provide peer support, information, referral, advocacy, independent living skills training, and transition support services.
- CILs provide potential HSP Customers with program information, answer questions, and submit referrals to the program.
- CILs help HSP Customers find Personal Assistants and Individual Providers who can provide the services listed on your service plan. They also provide training and guidance to help you manage your providers.
- CILs can help new HSP Customers transition from living in a nursing home to living at home again.
- CILs can train Customers in independent living skills to decrease their dependence on HSP services.
Please contact your HSP Counselor or go online at www.incil.org/locate for more information.
MANAGED CARE ORGANIZATIONS
If you are enrolled with a Managed Care Organization (MCO) for payment of medical services, that MCO will also be responsible for management of your Home Services. The Home Services Program and the MCO work together to ensure your services are delivered similarly to HSP Customers not enrolled in an MCO.
HSP is responsible for:
- ?Meeting with you to discuss the Home Services Program and to determine if you are eligible for HSP services
- ?Discussing case closure with you if you are not eligible for HSP services
- ?Process completed Individual Provider employment packets and pay IP timesheets
MCO Care Coordinator is responsible for:
- ?Developing your service plan and addressing all other of your unmet needs
- ?Answering questions about your services and providers
- ?Providing you with Individual Provider employment packets and timesheets
- ?Discussing case closure if the MCO determines your case needs to be closed
ELECTRONIC VISIT VERIFICATION
Providers use the Electronic Visit Verification (EEV) system to clock in and out of work. Providers are also required to fill out and turn in a paper timesheet. EVV is a call-in, phone-based system. Your provider must clock in and out using EVV immediately upon arriving at your home for work and before leaving your home at the end of the provider's shift.
Providers receive a step-by-step EVV instruction guide in their hiring packet, and providers should refer to this guide to answer any questions about EVV.
If your provider has questions about the EVV system, they can visit our website by going to www.dhs.state.il.us and searching "EVV", refer to the documents in their employment packet, or contact the DRS local office.
FRAUD
The HSP Fraud Unit investigates allegations of fraud by Individual Providers, Customers and Agencies. They coordinate investigations with Local, State and Federal Agencies. Common types of fraud are secondary employment fraud, hospitalization fraud, ghost employee fraud, and postmortem fraud. If you suspect Fraud by your Individual Provider or any other Individual Provider, please report this to your local DRS office.
IMPACT
IMPACT, or Illinois Medicaid Program Advanced Cloud Technology, is a provider enrollment system that allows the Home Services Program to claim federal Medicaid dollars for all eligible providers. All providers, including individual providers and agencies, are required to be enrolled in IMPACT.
Providers will be enrolled in IMPACT when they are hired by Customers, and the necessary paperwork is provided in the Individual Provider Employment Packet. If your provider has questions about IMPACT, you can direct them to your HSP Counselor or the DRS local office.
LABOR RELATIONS
The HSP Labor Relations unit provides support to your Individual Providers. IPs are unionized and represented by SEIU. This unit is responsible for SEIU related inquiries, SEIU Training, IP Grievances, Unemployment Claims, IP Employment Verification, IP Workman's Compensation, etc.
To request records for Employment Verifications (EV), Gross earnings or replacement W2's, your IP will send their Full Name, Social Security #, Current address/Phone #, Signature and date to:
HSP Labor Relations:
Fax (217) 557-9434 or PO Box 19429, Springfield, IL 62794-9429
EV or Gross earnings: DHS.HSP.LaborEV@illinois.gov
Replacement or Duplicate W2s: DHS.HSP.LaborW2@illinois.gov
DRS LOCAL OFFICES FOR HSP
To contact your DRS local office, please visit our website at www.dhs.state.il.us search "office locator" and select Office type: "Rehabilitation Services" or call the DRS Hotline at (877) 581-3690
The DRS local offices are staffed with:
Rehabilitation Services Counselor for the Home Services Program
Your HSP Counselor will be the one to visit with you and discuss program eligibility, your needs, and how HSP can help you live a more independent life.
Rehabilitation Services Coordinator for the Home Services Program
Your HSP Coordinator will assist with employee packets, timesheet questions, provider document requests, and general HSP questions.
Important and Helpful Numbers:
Report Abuse/Neglect: (800) 368-1463
General DHS Helpline: (800) 843-6154
DRS Hotline: (877) 581-3690
Provider Assistance Line: (800) 804-3833
Debit Card/Direct Deposit: (217) 785-7790
Illinois Provider Debit MasterCard: (866) 338-2944
SEIU Provider Union: (866) 933-7348
General Questions can be submitted to:
Illinois Department of Human Services
Office of Customer Support
100 S Grand Ave E
Springfield, IL 62762
To apply for services, please visit our website at: www.dhs.state.il.us and search "Apply Online" for DRS services.
Programs, activities and employment opportunities in the Illinois Department of Human Services are open and accessible to any individual or group without regard to age, sex, race, sexual orientation, disability, ethnic origin or religion. The department is an equal opportunity employer and practices affirmative action and reasonable accommodation programs.
IDHS 5470 (N-09-21) HSB Customer Handbook Printed by the Authority of the State of Illinois. 30,000 copies PO#22-0183
DHS [insert brochure number]
