Ill. Admin. Code tit. 89 § 676.40

Current through Register Vol. 48, No. 45, November 8, 2024

Section 676.40 - Service Description

The following is a listing of the services available through HSP. The service level, combination of services, and amount of services for which a customer is eligible is dependent upon the needs of the customer as identified during the determination of eligibility (see 89 Ill. Adm. Code 682).

a) Personal Assistant (PA) Services - services provided by an individual employed by the customer.

b) Adult Day Care (ADC) Services - direct care and monitoring of customers in a community-based setting for any portion of a 24-hour day for the purpose of promoting social, physical, and emotional health and well-being and offering an alternative to an institutional setting. ADC services are provided only when the social, emotional, and physical needs of the customer cannot be met in the home through other available services.

c) Homemaker Services - general support provided by trained and professionally supervised individuals to maintain, strengthen, and safeguard the functioning of an individual in his/her home when no responsible person is available or capable of monitoring those services. Homemaker services include the actual completion of, and the training in, completion of ADLs.

d) Maintenance Home Health Services - services provided for a customer, in his/her home, that are prescribed or recommended by a physician or other health care professional. These services include three basic categories of care, which are:

1) direct health care provided by a registered nurse (RN) and/or a licensed practical nurse (LPN);

2) direct health care provided by a Certified Nurse Aid (CNA) who is supervised by an RN or LPN; and

3) in-home therapy, including the areas of physical, occupational and speech therapy.

e) Home Delivered Meals - prepared food brought to the customer's home. Usually, home delivered meals consist of a hot lunch and a smaller dinner meal that may be refrigerated and eaten later. These services are provided when available and when they are more cost effective than PA services for an eligible individual who has a need for care in the area of meal preparation but who can adequately feed him/herself.

f) Electronic Home Response Services (EHRS) - a 24-hour per day emergency communication link to assistance outside the customer's home for customers who have no other persons available for assistance should an emergency arise.

g) Assistive Equipment - items necessary to accommodate the customer's loss of function in the completion of his/her Activities of Daily Living (ADLs). This does not include medical supplies, disposable personal hygiene items, or items necessary for medical treatment. (See 89 Ill. Adm. Code 686, Subpart H.)

h) Environmental Modification - services to physically modify the customer's home to accommodate the customer's loss of function in the completion of his/her ADLs. (See 89 Ill. Adm. Code 686, Subpart G.)

i) Respite Services - limited PA, Homemaker, and Maintenance Home Health services provided to a customer to provide for the customer's ADLs during periods of time it is necessary for the family/primary care giver to be absent. Respite services are provided to a customer to allow the family/primary care giver relief for vacations, rest, errands, family crises and emergency situations. Respite services are provided in the maximum amount of 240 hours per calendar year and are provided regardless of financial need. During the COVID-19 Gubernatorial Disaster Proclamations, and subject to federal approval, customers who exhaust 240 hours as a direct result of the COVID-19 pandemic may have additional respite hours added to the Service Plan, dependent upon the customer's needs and availability of customer's unpaid caregiver, up to a maximum of 240 additional hours per calendar year. Any additional Service Plan hours under this subsection are subject to the advance approval of the Counselor or Managed Care Organization Care Coordinator.

j) Day Habilitation Services - assistance provided to a person with a brain injury to assist with the acquisition, retention and improvement in self-help, socialization and adaptive skills. These services are provided in a setting separate from the residence in which the customer is residing.

k) Pre-Vocational Services - services provided to a person with a brain injury that are aimed at preparing the individual for paid or unpaid employment but are not job task oriented. Specific services include teaching concepts such as compliance, attendance, task completion, problem solving and safety.

l) Supported Employment Services - services provided to a customer with a brain injury that consist of paid employment for persons for whom competitive employment is unlikely, when the customer, because of his/her disabilities, needs intensive, ongoing support to perform in a work setting. Supported employment includes, but is not limited to, activities needed to sustain the customer in supported employment (i.e., supervision and training).

m) Behavioral Services - remedial therapies provided to a person with a brain injury to decrease the individual's severe maladaptive behaviors. These services are intended to enable the customer to better manage his or her behavior and to make the customer more capable of living independently.

Ill. Admin. Code tit. 89, § 676.40

Amended at 31 Ill. Reg. 12602, effective August 16, 2007

Amended at 38 Ill. Reg. 16958, effective 7/25/2014

Amended at 45 Ill. Reg. 10034, effective 7/22/2021