Program Narrative

Division of Alcoholism and Substance Abuse

Addictions remain a pressing social problem nationally and in Illinois. Left untreated, addictions can cause debilitating consequences to individuals, families and communities. This results in dramatic costs to society. The Division of Alcoholism and Substance Abuse (DASA) is the designated lead agency to address recovery from addiction issues in Illinois. DASA and the Office of Prevention work together to provide a comprehensive prevention, intervention, treatment and recovery support system for the citizens of Illinois.

DASA's responsibilities are to license, develop, maintain, monitor and evaluate a comprehensive statewide intervention, treatment and recovery support system. System components include: screening, assessment, referral, intervention, treatment and recovery for individuals with limited or no financial resources. Intervention and treatment services include: community and early intervention, detoxification, outpatient, intensive outpatient, residential rehabilitation and extended aftercare services. DASA contracts with community-based treatment and recovery support organizations to operate the system according to the needs of various communities and their populations.

FY10 Highlights

• DASA will launch a performance based contracting system for substance abuse treatment providers designed to: improve provider performance; continually attend to improvement of processes; improve client outcomes and take advantage of emerging technology. For FY10 DASA will focus on the following three areas:
  1. engagement of the client in treatment beyond the initial assessment;
  2. retention in care and
  3. continuing to the next level of care.
• The FY10 budget proposal for addiction treatment services includes $5.0 million in budget relief funds for outstanding liabilities related to Medicaid Addiction Treatment Services provided in FY09.

Division of Community Health & Prevention

The Division of Community Health and Prevention (DCHP) improves the health and well-being of families and individuals through partnerships and services that build community competence.

To accomplish this mission, the Division of Community Health and Prevention is structured into seven program bureaus and five geographic regions. This structure allows the Division to lead the state in improving community health and building the capacity of communities to identify and address the problems that are keeping families from reaching their full potential.

The breadth of the division's services include:

• Services to help men and women choose the number and spacing of their children.
• Services to improve the health of pregnant women, infants and new parents through outreach and case management (to ensure access to health and social services).
• Targeted initiatives to reduce racial and ethnic disparities in infant mortality.
• Home visiting to reduce the risk of child abuse and neglect.
• Nutrition education and supplemental foods for pregnant women, infants, young children and breast feeding mothers to ensure health growth and development.
• Targeted initiatives to coordinate the delivery of services to families with young children.
• Training and technical assistance to improve the health and safety of child care settings.
• Services to help children with developmental delays or disabilities achieve the greatest degree of functioning possible.
• Support for coordinated school health programs and continuing education for school health personnel.
• Structured activities during out-of-school time for youth 6 to 17, to prevent involvement in risk-taking behavior and to promote and encourage academic achievement and healthy lifestyles.
• School-based health services.
• Prevention efforts that focus on the development of positive lifestyles and the reduction of substance abuse through outcome-based planning and programming.
• Services to improve the health of adolescents, including services to reduce teen pregnancy and services to help teen parents become self-sufficient.
• Diversion and intervention services for youth to stabilize families in crisis; prevent juvenile delinquency; and divert at-risk youth from involvement in the child welfare or juvenile justice systems.
• Housing and case management services for homeless youth to help them transition from homelessness to self-sufficient living and/or to reunify the youth with his/her family.
• Volunteerism and community service programs and activities that strengthen Illinois' communities.
• Comprehensive services to meet the immediate and long-term needs of victims of domestic and/or sexual violence and their children, as well as outreach and prevention education and training in the area of domestic violence.
• Distribution of supplemental commodity foods and fresh produce to low income seniors.
• Activities to prevent and control Diabetes.

FY10 Highlights

• The FY10 budget request includes an additional $2.1 million to support the Early Intervention program liability. The program expects to provide services to over 17,000 children in FY10.
• The Early Intervention appropriation includes an increase in appropriation authority for the Federal Medicaid Assistance Program/IDEA Part-C to support services for the Early Intervention program.
• An increase in appropriation authority of $25.0 million for the WIC Free Distribution Food Supplemental program will utilize additional Federal funding to support increased program liability and caseload growth.
• The FY10 budget request includes additional appropriation authority for the Federal American Recovery Reinvestment Act of 2009 to support increased participation in the Women, Infants and Children (WIC) program.

Division of Developmental Disabilities

The Division of Developmental Disabilities oversees the design and delivery of person centered services for individuals who have developmental disabilities. These services include pre admission screening, service linkage and coordination, in-home support services, residential services, day and supported employment services, therapies, and other support services.

The Division in coordinating the State's response to the needs of people with developmental disabilities throughout the State, is committed to implementing a strategic plan in full partnership with people with developmental disabilities. In addition, the Division actively seeks ideas regarding its policies and operations from many other partners, including families, friends, advisory councils, community providers, state-operated developmental center staff, central division staff, and other advocates throughout the system.

The strategic plan is designed in accordance with the federal government's Quality Framework for Home and Community Based Waivers and is built around three basic themes: putting people who have developmental disabilities first, supporting choice, and managing as one system. These themes are reflected in the vision and mission statements:

• Vision: People who have developmental disabilities are able to enjoy meaningful relationships with family, friends and others in their lives; to experience personal growth and development; and to fully participate in activities of their choice in communities of their choice.
• Mission: The Illinois Department of Human Services, Division of Developmental Disabilities provides leadership for an effective management of the design and delivery of quality outcome-based, person-centered services and supports for individuals who have developmental disabilities. These services and supports will be appropriate to their needs, gifts, talents and strengths; accessible; life-spanning; based on informed choice; and monitored to ensure individual progress, quality of life and safety.

In order to ensure both progress and the overall health and well-being of those we serve, the Division commits to the following guiding principles:

• People with developmental disabilities will be actively involved in policy discussions and decisions and will be respected as partners in the process, making informed choices and decisions in order to support productive and fulfilling lives.
• Families and guardians will be listened to and respected, we will strive to earn and keep their trust along with the trust of the public.
• As small, home and community-based options are increased and enhanced, we will look at new and creative ways to utilize resources across the service delivery system.
• Public resources will be used effectively and efficiently to help those we serve achieve their goals.
• The integration of habilitation, social and clinical supports will be considered paramount when enhancing and developing services throughout the delivery systems.
• We will establish goals, monitor our progress and ensure quality for those we serve.

As you can see from the highlights below, the Fiscal Year 2010 proposed budget reflects the Division's efforts to increase opportunities for community-based services and enhance community capabilities.

FY10 Highlights

• The Division of Developmental Disabilities request includes a lump sum appropriation for Howe Developmental Center to allow for transitions to community settings or other state operated developmental centers. The state will continue efforts to develop a long-term plan for the system, including state-operated developmental centers with a particular focus in the near-term on the appropriate disposition for Howe Developmental Center.
• The State reached agreement with the plaintiffs in the Division's Olmstead litigation, Ligas v. Maram. This lawsuit was brought on behalf of people that live in private ICFs/DD who want to transition to Community Integrated Living Arrangements (CILA) or other waiver settings but, prior to this agreement, were not able to do so. People waiting for services in their families' homes, who are at risk of institutionalization, were also included as part of the class. The settlement agreement will allow those that want to transition from private ICF/DDs the ability to do so, and will require the Division to increase capacity in the Medicaid waiver program to serve an additional 3,000 people living at home over the next six years.
• The Division of Developmental Disabilities budget request includes $8.9 million to support moving 180 individuals from state-operated developmental centers to community-based services during FY10, as well as annualize the cost of services to the approximately 190 individuals who are moving during FY09. This will not only provide new opportunities for individuals who wish to move but also improve staffing ratios at our state-operated developmental centers for those who continue to reside there.
• The budget request also includes $5.3 million to annualize the cost of services for the individuals that transitioned as wards of the Department of Children and Family Services in FY09 and to support an additional 85 wards in FY10.
• The budget consolidates funding into one appropriation line for major developmental disabilities programs that had previously been separated into smaller appropriation lines. This consolidation will facilitate the Division's efforts to direct funding in accordance with individuals' identified choices.
• The budget increases appropriation authority for the Dedicated Trust Fund to $25.0 million during FY10 to reflect anticipated enhanced matching funds from the federal stimulus package and growth from the children's waivers now serving approximately 1,200 children.
• The budget request reflects a $63.0 million increase for prompt payment of Intermediate Care Facilities for the developmental disabled.

Division of Human Capital Development

The Division of Human Capital Development (HCD) administers Illinois' public assistance programs through 115 Family Community Resource Centers statewide. These programs include cash assistance, Supplemental Nutrition Assistance Program (Food Stamps), Medical, Child Care, Employment and Training, Homeless Services, Refugee & Immigrant Services, the Empowerment Zone/Enterprise Community grant programs, and other social services programs. The Division also develops policy for these programs, designs new programs, and evaluates new and existing programs for improvement.

The Division also works cooperatively with various state and local partners in the Illinois WorkNet programs (previously called One Stop Career Centers) and in gathering information to facilitate Illinois child support enforcement and collections efforts.

In FY2010, DHS will continue to administer the myriad of public assistance and various supportive services programs, including the federal welfare reform program Temporary Assistance For Needy Families (TANF) reauthorized through September 2010 and the Child Care Assistance Program. Since implementation of TANF in July 1997, 236,953 families have worked their way off cash assistance. Cash assistance continues to be provided to persons qualifying for other state programs such as Aid to the Aged, Blind or Disabled (AABD), General Assistance and Refugee Assistance.

Supplemental Nutrition Assistance Program (SNAP)

The federally funded Food Stamp program was officially renamed by the USDA effective October 1, 2008, to the Supplemental Nutrition Assistance Program (SNAP). It is administered through the Department of Human Services, providing help to purchase food for families and individuals in Illinois. Working under the strict guidance of the U.S. Department of Agriculture, Food and Nutrition Service, Illinois makes this benefit available to low income households. When combined with the family's other income, SNAP benefits can help a family purchase a nutritionally adequate diet. Individuals do not have to receive other public assistance to receive SNAP benefits.

During the month of December 2008, 633,923 SNAP households were served in Illinois. This is an increase of 44,104 households, or 7.5% over the 589,819 households Illinois served in December 2007.

A priority for DHS has been the expanded outreach efforts to make SNAP benefits more accessible to the people who need assistance. The department is continuing to develop new methods to do these including new technology and "on-line" systems. Through a federal grant awarded to DHS from USDA to help fund development of a web application and an automated phone reapplication system, DHS is reaching more households and individuals.

Illinois residents can apply on-line for cash, medical and SNAP benefits and their application is electronically transmitted to the correct office for processing. In just over the first month of deploying this technology, over 10,000 applications were received.

The automated phone reapplication project was implemented in July 2007 and expanded in July 2008. This allows households to reapply to continue getting SNAP benefits via a scripted automated phone system. As of February 2009, over 87,000 reapplications have been completed through this system, and we are planning an additional expansion for later this year.

The Food and Nutrition Services asked DHS to partner with Northern Illinois Food Bank and America's Second Harvest to test a simple SNAP application in food pantries. This innovative project, known as Express Stamps, reaches out to the under served population that visit food pantries but are not receiving SNAP.

Express Stamps started in October 2006 and currently operates in ten food pantries in DuPage, Kane, Lake, and Will counties. Persons visiting their local food pantry can apply for food stamps, find out if they are eligible and how much they will receive, and leave the pantry with a Link card to access their benefits. As of February 2009, this project has brought SNAP to more than 1600 households.

Concentrated performance management efforts have significantly improved the accuracy levels in administering benefits. This provides Illinois' citizens the correct benefits and ensures that the state not be subjected to financial penalties.

SNAP Employment and Training Services

SNAP Employment and Training is a statewide program committed to helping able-bodied adults without dependents (ABAWDs) who receive SNAP benefits become self-sufficient. This program is funded with Federal and State monies.

SNAP E&T offers pre-employment/employment services to this population. DHS staff in the Family Community Resource Centers and contractors in the communities provide employment and training services to ABAWDs. Contractual services include the Earnfare program and the SNAP E&T Job Placement Program of which Earnfare is an activity component. Earnfare and Job Placement contracts are continued in the FY2010 budget request. Also included in the FY2010 request are funds for support service payments, including transportation, for SNAP E&T customers participating in employment and training activities and those entering employment.

Medicaid

DHS Family Community Resource Centers administer Medicaid cases consistent with eligibility rules promulgated by the Illinois Department of Healthcare and Family Services. The offices also manage ongoing case eligibility for KidCare and Parent Assist programs that provide medical coverage for Illinois citizens with income above the federal poverty level. In December 2008, medical cases totaled 1,177,708 with 2,215,055 persons served, including Medicaid, KidCare and Parent Assist cases. The medical cases are up 50,064 from December 2007 levels of 1,127,644, a 4.44% increase.

Child Care Program

The DHS Child Care Program is an income-based program primarily for working families that need help paying for childcare. Bolstering welfare-to-work efforts, the program serves families receiving TANF whose personal responsibility and services plans document a need for childcare. Additionally, non-TANF families in specified education and training activities and teen parents pursuing a high school diploma or its equivalent are able to receive child care provided they are income eligible.

Eligibility is set at 200% of the Federal Poverty Level. Eligible families participate in the program without time limits and choose the type of care they prefer, (e.g. child care center, private home, etc.), provided it meets all state and local requirements. Parents share the cost of care based on co-payments assessed according to a sliding scale.

The childcare program is administered through a network of 16 Child Care Resource & Referral Agencies (CCR&Rs) as well as contracts with site-administered providers.

TANF

Effective in FY98, the federal Aid to Families with Dependent Children (AFDC) Program was replaced by the Temporary Assistance for Needy Families (TANF) Program. TANF provides financial income assistance to eligible families, which contain a related child under age 18. A child age 18 may also qualify if attending high school full time.

TANF is designed to temporarily provide help while a family moves to self sufficiency. The Illinois TANF Program is designed to help needy families become self supporting, strengthen family life, and reduce the instances of economic need in Illinois families. Through a variety of intensive casework methods, Illinois, to date, has been extremely successful helping families move from welfare to work, and has received national recognition for its success.

Generally, families are limited to 60 months of TANF benefits. All months of TANF benefits, with some exceptions, are counted against the 60-month limit including those received in other states. Some families who have received 60 months of TANF may qualify for an exception and continue receiving benefits.

TANF Reauthorization

The Deficit Reduction Act of 2005 was signed into law in February 2006. It reauthorized the Temporary Assistance for Needy Families (TANF) program through September 2010.

In June 2006, the federal government issued an interim final regulation for implementing the reauthorized TANF. The regulation tightened the definitions of countable activities, added additional categories of individuals who must be included in the work participation rate, and required submittal of a Work Verification Plan. State accountability was tightened to:

• Count only actual hours of participation for non-paid work activities.
• Require all activities used to satisfy work requirements must be supervised.
• Require states to establish and maintain work participation verification procedures in a Work Verification Plan that must be reviewed and approved by HHS. States are subject to a new penalty of 1 to 5% of the federal TANF Block Grant for failure to establish or comply with these procedures.

TANF Employment and Training Services

The DHS focus for TANF addresses the barriers to employment, providing the needed support services and work experience. Contractual services, designed to address the specific barriers to employment faced by the remaining TANF/TANF-eligible customers, will continue in the FY2010 budget. In addition, TANF Reauthorization work participation requirements must be met through countable activities managed by and recorded by employment and training contractors. Included in the FY2010 request are funds for employment and training resources to meet TANF Reauthorization requirements as well as support services payments, including transportation, for TANF/TANF-eligible customers in employment and training activities and those entering employment.

Aid to The Aged, Blind or Disabled (AABD)

The federal Supplemental Security Income (SSI) program pays a monthly grant to persons with low income who are certified as aged, blind or disabled. In December 2008, the AABD program provided a state supplemental payment to 29,526 cases, a decrease of 679 cases, or 2.25% from December 2007 cases of 30,205.

General Assistance

General Assistance (GA) is mandated by State law and provides basic income and medical assistance to persons who are not eligible for TANF or AABD. It has two components: the State Family and Children Assistance Program and the State Transitional Assistance Program. The State Family and Children Assistance Program covers needy families who do not meet the requirements to receive TANF such as caretakers who are not related. The State Transitional Assistance Program covers adults without dependent children who have barriers to employment.

The Department administers the GA program in the city of Chicago. It also helps fund some downstate GA units, which are then required to follow Department rules including the Department's payment level. Local governmental units, such as township governments that do not receive State funds, administer their own program, establish their own rules, and set their own payment levels. The State Transitional Assistance Program served 7,801 individuals in December 2008, up 176 from the 7,625 individuals served in December 2007. The State Family and Children Assistance Program served 1,183 individuals in December 2008, up by 27 individuals from the 1,156 served in December 2007.

The Office of Family Support Services

The Office of Family Support Services (OFSS) administers programs that work together to serve the individuals and families of Illinois every day. The mission to provide services and foster success is interwoven in each of the Bureaus comprising the OFSS. The OFSS Bureaus provide refugee and immigrant services, Title XX Social Services and homeless and supportive housing services.

Refugee & Immigrant Services

Illinois is home to more than 1.8 million immigrants, which when including their children, are 20% of the state's population. An average of 35,000 new immigrants arrive each year. Since 1975, the state has received more than 120,000 refugees from more than 60 countries. Services to immigrants include English as a Second Language, civics, and U.S. History instruction, as well as citizenship application services to 13,000 students each year. The Outreach and Interpretation Project provides community education, translation, and interpreter services for 15,000 Department of Human Services (IDHS) customers each year. Refugee resettlement entails a comprehensive array of mainly 100% federally funded services for individuals entering as refugees or granted political asylum, including adjustment counseling, orientation, English as a Second Language, vocational training, and job placement as well as bilingual health and mental health services.

Title XX Social Services Block Grant (SSBG)

The federal Block Grant provides 23 separate categories of social services through a network of four state agencies and community-based organizations making the Block Grant program one of the main sources of funds for providing social services to families. Service categories range from services for the elderly, people with developmental disabilities or mental illness, neglected children and adults, ex-offenders, victims of domestic violence, families in need of health services, and the unemployed or under-employed. Services will be provided to over 120,000 adults and children. The State's allocation from the Block Grant is currently estimated at

$51 million for FFY09 with an additional $47 million (estimated) to be transferred to the Social Services Block Grant from the Temporary Assistance for Needy Families Block Grant

Included within the Block Grant is the State's Donated Funds Initiative. This collaborative social service delivery effort between the state and public, private, and faith-based agencies allows for the expansion of service funding without an additional commitment of state/federal funds through a local match requirement. $22.3 million is allocated from the Block Grant for the Donated Funds Initiative.

Homeless Services and Supportive Housing Services

The Bureau of Homeless Services and Supportive Housing operates Food Assistance, Homeless Prevention, Supportive Housing, Emergency Food and Shelter (i.e., Homeless Assistance) and Tax Write-In Programs. The bureau serves as the Department's liaison on legislative and community issues relating to homelessness, supportive housing, homeless prevention and emergency food assistance. Also, the bureau provides extensive technical assistance to community providers.

FY10 Highlights

• The FY10 budget request includes an increase of $3.4M for Funeral and Burial, and $1.2M for the Aid to the Aged, Blind and Disabled Program.
• A new $1.0M Food Banks appropriation is included in the FY10 request.
• Under the American Recovery and Reinvestment Act (ARRA) of 2009, Illinois will receive approximately $890.0M in additional benefits to SNAP recipients over five years. Effective April 1, the maximum SNAP benefits increase by 13.6%. For example, a family of three receiving $250 in SNAP would now receive $313, an increase of $63.
• Under ARRA, Illinois will also receive an additional $11.9M in SNAP administrative funds over two years.
• Also under ARRA (Stimulus Package):
  • Child Care will receive approximately $74.0M in additional funding over two years to expand and enhance child care services and quality to families who need it most.
  • Illinois will receive an estimated $11.5M ($3.8M each year for three years) in Emergency Food Assistance to distribute approximately 5.9 million pounds of additional food statewide through partnership with the food banks.
  • Under the TANF Program, stimulus dollars are available based on provisions tied to caseload increase and defined associated increased TANF spending.
• Illinois has been awarded $30.5M in additional Social Services Block Grant supplemental disaster funds to provide social services to affected individuals and families and address necessary expenses resulting from the federally declared major floods and natural disasters between the period of January 7 and September 30, 2008.

Division of Mental Health

The Division of Mental Health (DMH) is responsible for assuring publicly-funded mental health services to children, adolescents and adults, throughout Illinois. Service delivery in DMH is provided within five geographically organized service Regions, including Chicago Metropolitan and Greater Illinois, North, North Central, Central and South. This service delivery is provided through more than 162 community mental health centers/agencies, 28 community hospitals with psychiatric units and nine state-operated hospitals, the latter containing both civil and forensic beds. The DMH also provides statutorily required treatment services for sexually violent persons through its Treatment and Detention Facility. Children and Adolescents and Forensic Services are organized centrally and also delivered through the DMH service Regions.

Working within the framework of the six major goals and recommendations of the New Freedom Commission Report on Mental Health (Report), the DMH, the State Mental Health Authority has as its primary Vision that all persons who experience mental illnesses will recover and that effective treatment and supports, essential for full participation in one's community, will be accessible and available at all stages of a person's life. The primary Mission of the Division is to assure that recovery/resiliency-oriented, evidence-based, community-focused, culturally-sensitive, outcome-validated treatment and supports are accessible, through fiscally efficient use of public funds, to children, adolescents and adults most in need of mental health services, in order that they may be empowered to recover, succeed in accomplishing their goals and live full and productive lives.

The DMH administers its community-based public mental health system through its five service Regions. Its specialty Children and Adolescents Mental Health and Forensic Mental Health Services are also administered through these Regions. The DMH Regions purchase outpatient mental health services from more than 162 community service providers who served almost 175,000 persons in FY08. With the ongoing development of the Community Hospital Inpatient Psychiatric Services (CHIPS) program, an increasing number of persons with mental illnesses are receiving psychiatric inpatient services in local community hospitals, with costs for some individuals supported through the Medicaid program.

Toward the actualization of its vision, the DMH is in the midst of fundamentally significant initiatives to move the community mental health system toward transformation. The DMH for example, is transitioning to a fee-for-service payment system. DMH implemented an advance and reallocation strategy, with implementation of a new fiscal system projected for FY10. In addition, the DMH continues to be a full partner, with the Departments of Healthcare and Family Services and Children and Family Services in the Screening, Assessment and Support Services (SASS) initiative. This collaborative structure has made possible the expansion of youth mental health services by creating synergies and more effective leveraging of resources. Further, the DMH continues to expand services to youth through newly funded initiatives in early intervention services, transitional services, and services for children under the age of five.

A newly funded public awareness campaign served to reduce stigma and raise awareness about the importance of mental health and its role in overall health for both children and adults. The DMH continues to collaborate with the Division of Rehabilitation Services in a Brand New Day Initiative, which will bring greater capacity for supported employment throughout the system. The DMH also is working with the Division of Alcohol and Substance Abuse to implement an action plan for improving access to integrated treatment services for individuals with co-occurring substance abuse disorders and mental illnesses. And finally, DMH is collaborating with the Department of Healthcare and Family service and other agencies to implement the Money Follows the Person Initiative while expanding housing opportunities and support services to assist persons to transition from institutional settings to the community.

Although transforming our system to be both consumer and family-driven and recovery/resiliency-oriented presents invigorating challenges, the DMH is confident that it is prepared to face those challenges toward the achievement of a transformed mental health delivery system. With the increased collaboration of its system partners, it is expected that system challenges to be faced will ultimately result in system opportunities that are realized. Consumers served deserve no less than the realization of those opportunities.

Mental Health State Hospitals

Hospital care and treatment is a vital component in the continuum of treatment services provided to individuals with serious mental illnesses. State psychiatric hospitals, administered by the DMH, serve unique functions in the system. One function is to provide an excellent, comprehensive treatment environment to meet the needs of persons who, due to a psychiatric disorder, present a danger to themselves or others and cannot be successfully treated in community hospitals. Another function is to offer inpatient psychiatric treatment that is not available in community-operated hospitals because consumers have little or no capacity to pay for the service, either directly or through an insurance plan (including Medicaid or Medicare). A third function is to provide court-ordered treatment in forensic units for persons who are found Unfit to Stand Trial (UST) or Not Guilty By Reason of Insanity (NGRI) and statutorily required treatment services for Sexually Violent Persons. The DMH strives in each of these functions to assure that evidence-based/emerging best practices are offered in our state-operated hospitals.

FY10 Highlights

• The FY10 budget request for Mental Health includes funding for continuation of the Permanent Supportive Housing program.
• The budget request includes continued funding for the Administrative Services Organization (ASO) to further implement the fee for service initiative.
• The FY10 budget request includes funding for the Supportive Employment program.
• This budget request provides funding to annualize the growth at the Treatment and Detention Facility.
• The FY10 budget proposal includes funding for the Money Follows the Person program.
• DMH anticipates receiving up to $20 million in FY10 due to the increase in FMAP as part of the Economic Stimulus Package.

Division of Rehabilitation Services

The Division of Rehabilitation Services (DRS) is the state's lead agency serving individuals with disabilities, impacting the lives of more than 240,000 individuals with disabilities in Illinois. The Division administers an array of disability-related programs and services to assist individuals with disabilities and their families in making informed choices to achieve full community participation through employment, education, and independent living opportunities. Illinois continues to be recognized as a national leader in Vocational Rehabilitation with 29,093 DRS customers entering competitive employment in the past five years. Furthermore, DRS' federally-funded Work Incentive Planning and Assistance Program provides benefits planning services to individuals with the most significant disabilities who receive Social Security benefits and want to work, enabling them to anticipate and plan for changes that may occur in their benefits when they obtain employment. The Home Services Program (HSP) is the largest single General Revenue Funded program in DRS. The program promotes independence by offering an individualized, family centered approach for individuals with the most significant disabilities who are at risk of institutionalization. In addition to preventing institutionalization, the program provides services through Community Reintegration. DRS partners with staff from Centers for Independent Living to help people with disabilities transition from nursing homes into the community. Since the inception of this innovative program, more than 1,500 individuals with disabilities have moved from nursing homes back into the community.

Home Services Program

The DHS Division of Rehabilitation Services administers the Home Services Program (HSP), a Medicaid waiver program, which offers individuals with disabilities who are at risk of premature or unnecessary institutionalization, the alternative of in-home care when the cost of home care does not exceed the cost of a health care facility. The HSP provides the following major services:

1. Personal Assistants (PA), who are selected, employed and supervised by the individual and who help with household tasks and personal care;
2. Homemaker Services that offer personal care by trained and professionally supervised personnel for customers unable to direct a PA; and
3. Home Health Services such as nursing care and physical therapy prescribed by a physician and typically provided by a private home health agency. Other services provided include: home delivered meals, adult day care, assistive equipment, home remodeling, electronic home response, respite, diagnostic services, and case management.

Children's Residential And Educational Services

The Department provides residential and educational services to children with disabilities between the ages of 3 and 21 at three state-operated schools, one in Chicago and two in Jacksonville.

The Illinois Center for Rehabilitation and Education (ICRE-R) in Chicago provides educational and related programs in a residential setting for approximately 40 students age 5 to 21 who:

1. have severe physical disabilities and associated chronic health conditions; and
2. through the application and evaluation process are determined to be able to benefit from very specialized programming.

Most of the students are also enrolled in special education programs in Chicago schools near the facility. Other services include: occupational, physical and activity therapies; vocational evaluation and training; job and life coaching; 24-hour nursing; medical services; social work services; psychological evaluations; and recreational therapies.

The Illinois School for the Visually Impaired (ISVI) in Jacksonville provides a comprehensive educational program with emphasis on the development of independence and pre-vocational skills for approximately 130 students ages 3 to 21 for whom

1. a severe visual impairment is identified;
2. the local district recommends ISVI because the district believes the student would be better served or parents directly request admission; and
3. ISVI can provide an appropriate program to serve the student.

ISVI also provides early intervention services for children from birth to three years and has a transitional living center through which older students are receiving hands-on independent living skill training as well as orientation and mobility training.

The Illinois School for the Deaf (ISD), also in Jacksonville, provides elementary and secondary educational programs to approximately 280 students ages 3 to 21 for whom:

1. a severe hearing impairment is identified;
2. the local school district recommends ISD as the most appropriate and least restrictive option or parents directly request admission; and
3. ISD can provide an appropriate program to serve the student.

Programs emphasize total communication and include academic and vocational training programs, social and health services, and recreational activities. ISD also provides early intervention services for children from birth to three years and assessments and evaluations for adults through its evaluation center.

Centers for Independent Living

Centers for Independent Living (CIL's) are non-residential, consumer-controlled, community-based, not-for-profit organizations that provide systems advocacy to create options and choices for independent living. CIL's provide services to individuals to help them in increasing skills and abilities for independent living and provide public awareness. Core services provided by all CIL's include advocacy, peer counseling, skills training, information and referral.

Vocational Rehabilitation Services - General/Blind

The Vocational Rehabilitation Program (VR) employs Rehabilitation Counselors, Coordinators and other rehabilitation professionals in 46 local offices throughout the state to provide direct services to VR customers. Counselors determine eligibility, work closely with customers to establish suitable vocational goals and develop Individualized Plans for Employment to carry out the appropriate array of services. An individual is eligible for the VR program if he or she has a physical or mental disability that results in a substantial impediment to employment, and needs vocational rehabilitation services to prepare for, enter, engage in or retain gainful employment. Services include: training; medical services; physical and/or mental restoration; assistive technology devices and services; counseling and guidance; evaluation and diagnostics; basic adaptive skills; placement; follow-up and post employment services.

DHS DRS has a special focus on services to customers who have visual impairments. Besides the services described above, the VR Blind program offers adaptive skills for blind and visually impaired persons, mobility instruction, and Braille with an emphasis on Older Blind individuals. Approximately 2,600 individuals receive services each year. In addition, the Small Business Enterprise Program, also known as the Vending Facility Program, provides training to prepare individuals with the skills needed to manage a small business. Blind individuals who have passed a seven-month training program provided by VR Blind staff are served by this program. The Small Business Enterprise program carries out the federal Randolph/Shepard Act and is a component of the federal VR program allotment. It is anticipated that the number of primary vending facilities will be 102 with over 300 satellites.

A re-appropriation of the Federal Vocational Rehabilitation funds is required to liquidate prior year obligations beyond the lapse period deadline for payment. Case Services to Individuals obligates a large dollar amount of hospital, surgical and other medical services in which partial payment can be realized through claims processed by insurance companies. Federal regulations mandate the use of all available similar benefits of the customer prior to paying for services from Federal Vocational Rehabilitation funds. Other factors requiring the re-appropriation of Federal Vocational Rehabilitation funds are:

1. the federal and state fiscal years overlap; and
2. VR funds have multi-year obligation and liquidation authority that allows multiple federal fiscal years to be simultaneously operational. DRS obligates the federal funds throughout the year when they become available which means that ongoing services obligated at the end of the state fiscal year will not be completed in time to meet the lapse period deadline for payment.

A growing program within the Vocational Rehabilitation Program is the Supported Employment Program which provides competitive work in an integrated work setting for individuals with severe disabilities who:

1. have not worked, or have worked intermittently in competitive employment;
2. have been determined by a Vocational Rehabilitation Counselor to have a reasonable expectation of achieving employment with services;
3. need ongoing support services; and
4. can work in a supported employment setting.

Federal funds provide intensive training for the first 18 months to achieve stability and then General Revenue funds provide extended support services if and as needed. Approximately 2,500 individuals receive the short-term federally funded services each year while over 150 individuals are served by the State-funded long-term program.

Another major VR-related program is the Client Assistance Program (CAP) which is federally mandated to serve any individuals with disabilities who want, or who are receiving, services from the Division of Rehabilitation Services. CAP works autonomously so that it can work most effectively to resolve differences between customers seeking services and the staff administering the programs. More than 2,000 customers are assisted by CAP each year.

Community & Residential Services for the Blind & Visually Impaired (CRSBVI)

This program provides services to newly blinded adults to enhance their ability to live independently and reduce their risk of need for long term care. Rehabilitation Teachers and Orientation and Mobility Instructors teach independent living skills to customers in their own homes. Blind individuals who are not eligible to receive vocational rehabilitation services are served by this program. In addition to offering counseling and support groups, the program provides training in: activities of daily living (cooking, caring for household and clothing, managing financial affairs, shopping, etc.); orientation and mobility; technology access including computer access; Braille; and communication skills.

A short-term residential training program for individuals with visual impairments is also available at the Illinois Center for Rehabilitation and Education-Wood. The services provided at ICRE-Wood are similar to those provided to individuals in the community. However, most customers served by this facility are newly blinded and the intensive training and concentrated residential experience enables them to return to the community with the necessary skills to live independently. The training costs associated with ICRE-Wood are included in the CRSBVI budget. Approximately 270 individuals are served by this program annually.

Disability Determination Services

The Bureau of Disability Determination Services (BDDS) determines the eligibility of applicants for benefits under the Social Security Administration's (SSA) two disability programs: Social Security Disability Insurance (SSDI) under Title II of the Social Security Act, and Supplemental Security Income (SSI) under Title XVI of the Social Security Act. Title II (SSDI) provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security Trust Fund. Title XVI (SSI) provides for payments to individuals who are disabled and have limited income and resources.

BDDS is responsible for developing medical evidence and rendering eligibility determinations about whether an applicant is considered disabled or blind under the law. It also screens claimants for eligibility for vocational rehabilitation and refers them to VR, if appropriate. Approximately 154,000 eligibility determinations for SSDI and SSI benefits are projected to be completed in FY10.

The SSI Advocacy Program provides management of the Client Assessment Unit which annually provides nearly 50,000 medical determinations of employability for Transitional Assistance and Medicaid based on a disability. SSI Advocacy also provides services to individuals applying for Supplemental Security Income to assist them in obtaining federal benefits. DRS has contracted with Legal Assistance Foundation of Chicago (LAF-C) to provide this service in Chicago.

FY10 Highlights

• The Home Services Program funding increased nearly $26.3 million to support estimated program liability. These funds will support the annualized cost of new clients to the program in FY09 and the cost for new customers entering the program in FY10. In addition, this funding invests in the workers providing the valuable care that enables individuals with disabilities to remain in their home.
• Funding for various federal programs, including Vocational Rehabilitation, Independent Living Centers and the Older Blind Program will collectively increase nearly $22.1 million over two years through the American Recovery and Reinvestment Act of 2009.