Personal Support, Agency-Based

  1. What is it?

Personal Support, Agency-Based, provides services that include training and assistance to enable participants to accomplish tasks that they would normally do for themselves if they did not have a disability.  These services may include:

  • Teaching adaptive skills to assist the individual to reach personal goals.
  • Personal assistance in activities of daily living.
  • Services provided on a short-term basis because of the absence, incapacity or need for relief of those persons who are normally provide care (typically referred to as respite). 
  • Assistance in performing age-appropriate housekeeping chores (bed-making, dusting, vacuuming) that are essential to the health and welfare of the individual.

Personal Support Services, Agency-Based, must be documented in the Personal Plan, and service authorizations must specify the monthly number of hours and the hourly rate.


Actively enrolled CILA and Community Day Service providers that want to add this service can submit an IMPACT Enrollment Modification to Personal Support-Agency Based Services.

  1. Your agency may already be enrolled in IMPACT so please check the Personal Support-Agency Based Provider List first.  If your agency is listed as an enrolled provider, than you do not need to do anything further.
  2. If your agency is not listed as an enrolled Personal Support-Agency Based provider, please use the IMPACT Enrollment Modification Request PowerPoint Presentation to assist you in accessing the modification request application. 
    1. If the person that originally submitted the IMPACT enrollment application for your agency is not able to submit the modification request, another person from your agency you can submit an Electronic Signature Agreement HFS 2400 Form to have Provider Enrollment Access transferred to you.
    2. If you need to apply for a Single Sign On ID, please use the Single Sign On ID PowerPoint Prestation as a guide.  When completed, please email the form to the IMPACT helpdesk at IMPACT.HELP@illinois.gov
  3. On Step 3 of the Modification request please add the following Specialty:  Home Health; Home Services Agency; No Subspecialty.
  4. Please review the information on the other steps (location/address, email addresses, ownership details, etc.) to ensure the information is accurate. If anything has changed, please update the information.
  5. Complete the Modification Checklist and Submit the Modification Request for review.
  6. Once submitted, please email DHS.DDDMedProv@illinois.gov to notify a DHS/DDD Provider Enrollment Specialist that the modification request has been submitted. 
  7. After the modification request has been approved, the agency may begin providing the service. 

  1. You must be in compliance with:

    1. You must be an agency that meets the Department of Human Services (DHS) contractual requirements as outlined in the  Developmental Disabilities CSA Attachment A.
    2. Rule 50.
    3. 59 Ill. Adm. Code 120 (Medicaid Home and Community-Based Waiver Programs for Individuals with Developmental Disabilities). The Provider, as a Personal Support provider, agrees to provide services to persons with developmental disabilities pursuant to this rule, the Division's Information Bulletins, and the Waiver Manual.
  2. You must have staff with required qualifications and training.

  3. You must determine if your agency needs to obtain a National Provider Identification Number (NPI).

    • Personal Support agencies are currently not required to have an NPI to enroll in as a Medicaid Waiver provider.However, if your agency plans on providing services that require a NPI, it is advised that you obtain one. Currently the only DD waiver services that require an NPI are CILAs, Child Group Homes, Community Living Facilities and Developmental Training providers. Please see the National Plan and Provider Enumeration System website for information on applying for an NPI.
  4. You must submit the following documents to DDD Provider Enrollment

  5. You must submit an IMPACT provider enrollment application to enroll as a Medicaid Waiver provider.

    • All users to the IMPACT system must have a Single Sign-On ID to access the provider enrollment system.  Once the User has been granted access to the provider enrollment system, the user may begin the provider enrollment application for your agency. 
    • The first step in the provider enrollment application is selecting the agency's enrollment type.  The enrollment type is based on whether or not your agency is choosing to enroll with a National Provider Identifier. Agencies enrolling with an NPI will select the enrollment type Facility, Agency, Organization (FAO).  Agencies enrolling without an NPI will select the enrollment type Atypical Agency. Please use the PowerPoint presentations available on the DDD IMPACT Provider page  to walk you through each step of the applications. 
    • The application must include the following information:
      • Step 3, Add Specialty:  Home Health; Home Services Agency; No Subspecialty
      • Step 6, Associate Billing Agent:  Billing Agent ID number 7094638; Billing Agent Name:  DDD Billing Agent
      • Step 9, Associate MCO Plan:  MCO Plan ID number 3000006; Plan Name:  DDD MCO
    • After submitting the IMPACT application, please email Provider Enrollment the IMPACT application ID to ensure that the application is reviewed by a DDD Provider Enrollment Specialist.
  6. You Must Submit DSP Training Programs for Approval to:

    • Illinois Department of Human Services
      Division of Developmental Disabilities
      Bureau of Quality Management
      600 East Ash, Building 400, Mail Stop 2 North
      Springfield, IL  62703

      Attention: DSP Training Program

Important Resources For Program Requirements