Placements for Individuals with Developmental Disabilities
Medicaid Waiver: How Residential/Vocational Programs are funded: Individuals seeking residential or vocational settings and need assistance from the State of IL to fund those programs have to apply for Medicaid Waiver funding. The federal Medicaid Waiver program is a dollar match program. The program is funded with a mix of funding from the State of Illinois and the Federal Government. The State of Illinois pays the providers of supports and services. Then the Federal Government reimburses the State 50 cents for every dollar they have spent.
Pre-Admission Screening (PAS) for Residential/Vocational Placement: The purpose of PAS is to ensure compliance with applicable federal and state laws, arrange for and conduct assessments, make necessary determinations regarding eligibility for services, educate individuals and their families regarding services, as well as make referrals and provide linkage to appropriate services. Central IL Service Access (CISA) is a contractual agent of the State of IL to act in the role of a PAS screener as well as competing the actual pre-admission screen (PAS) for nine counties, Peoria, McLean, Logan, Tazewell, Woodford, Mason, Menard, Sangamon and Christian.
Eligibility- The individual has to meet the State’s Definition of Developmental Disability, which entails:
- Full Scale IQ below 70 (as documented prior to an individual’s 18th birthday) or a documented related condition (as documented prior to an individual’s 22nd birthday) with a deficit of three of the six daily living skill guidelines.
1. Related Conditions:
a. Autism
b. Cerebral Palsy
c. Epilepsy
d. Brain Injury prior to the age of 18
2. Areas of Daily Living Skills:
a. Self Care: Individuals ability to complete hygiene tasks (bathing, feeding, toileting, dressing, grooming)
b. Learning: Individuals with moderate mental retardation and below will qualify for learning due to their compromised ability to learn new tasks.
c. Mobility: An individuals need for mobility assistance. If they are able to manage with assistive devices then they would not qualify for mobility as a deficit.
d. Language: How well is the individual able to make his/her needs known to others. May use assistive devices to communicate.
e. Self-Direction: How well the individual makes decisions in their own life and is able to direct their own decisions in their life.
f. Capacity for Independent Living: The individuals ability to access the community and perform cleaning tasks within their environment.
- Indications of Developmental Delays must be present prior to age 18 in documentation.
- Must apply for Medicaid or already receiving payments.
Funding Sources for Residential Placement within IL:
IL Dept. of Public Health (IDPH): IDPH license ICF/DD’s while HFS funds:
Intermediate Care Facilities (ICF/DD) group homes. These range from being as small as 16 beds up to 200-300 bed facilities. The larger settings are medically based settings and have nursing on staff. The 16 bed settings are generally made up of individuals with disabilities that are higher functioning individuals. These settings offer 24hr. support by staff to the individuals that reside with in them.
Dept. of Human Services (DHS): DHS funds the following settings:
Community Integrated Living Arrangements (CILA’s): Group homes set in the community that has anywhere from four to eight individuals within it. The site allows for 24hr staff support to the individuals within it.
Family/Intermittent CILA: These are individuals that reside either in their own apartment or family home with staff providing 15hrs. of support, on average, per week.
Child/Adult Home Based Services: Allows individuals to obtain and pay for services in their family home or own apartment. The allotment of funding would be provided each month by the state to cover services such as a personal assistant, day programming, nursing, behavioral supports, PT/OT and speech supports. The family is connected to a service provider agency for service facilitation (case manager) who assists the family in selecting the services that they want to purchase and connecting them to the vendors who provide the service.
Host Family Services: Allows individuals to live in a family homes with a foster family. The prospective families are screened and have to undergo training to have an individual in their home. Individuals that generally elect these settings prefer a more home like environment or have difficulties having a larger number of roommates and rotating staff.
Community Living Facilities (CLF): Individuals have their own bed room and restroom but there is a communal kitchen to assist with cooking tasks. There is 24hr. staff support for the environment.
Funding Sources for Vocational Placement within IL:
- Department of Human Services (DHS):
1. Sheltered Workshop Settings: These consist of vocational settings that do recreational/leisure programs as well as doing step by step training for a task, called "piece rate."
Basically a task is broken down to the different steps and a person completes one step of the process and gets paid at a broken down rate for that one step that is completed.
- Department of Rehabilitation Services (DRS):
1. Supportive Employment: Allows for assistance in seeking a community job then a job coach to assist in learning tasks while on the job. This is a short term situation with the idea
that the job coach will eventually fade out and the individual will be competitively employed at the job.
DHS is no longer handing out funding just for day programming at a sheltered workshop setting. The person now has to enter into Home Based Services (HBS) to access a day program setting.
Pre-Admission Screening (PAS)
Priority of Urgency for Need
of Services (PUNS)
Frequently Asked Questions About PUNS
What is PUNS and how is it used?
PUNS (Prioritization for Urgency of Need for Services) is a statewide database that records information about individuals with developmental disabilities who are potentially in need of services
The State uses the data to select individuals for services as funding becomes available, to develop proposals and materials for budgeting, and to plan for future needs.
Why enroll in PUNS?
To assist with identifying service needs and, if necessary, to enroll on a waiting list
Who can enroll in PUNS?
Children, teens, and adults with developmental disabilities who need services or supports
What can families expect during the PUNS enrollment process?
The individual with the developmental disability (along with guardian/caregiver/family) meets with an Independent Service Coordination Agent (ISC)
The ISC Agent will work with the individual and their family to identify the need for services, explain services and identify the urgency of need
WHEN DOES PUNS INFORMATION GET UPDATED?
At least annually the ISC Agency will contact families
Anytime a need for service changes
When contact information changes, such as address or telephone number
When caregiver information changes
How does the PUNS selection work?
The selection is an open and fair process using criteria such as length of time on database, urgency of need and geographic area of the state
WHEN WILL AN INDIVIDUAL BE SELECTED?
PUNS selections are based upon funding availability and ability to fill program vacancies
How do people know if they get selected?
Individuals selected from the database will receive a letter directly from the Department of Human Services announcing their selection and inviting them to apply for services by contacting their ISC Agency
What do families do if a crisis emerges while enrolled in PUNS?
Families should contact their ISC Agency immediately for available options in their area
Individuals who meet the crisis criteria do not have to wait on PUNS
Please Note: Enrolling in PUNS does not confirm that you are eligible for services nor guarantee that services will be provided. It does ensure that the IDHS' Division of Developmental Disabilities knows about an individual's need for services.
To contact CISA, Inc. about getting yourself or someone else started enrolling onto the PUNS list please contact us at 217-732-4731 and press 141 for the Intake Coordinator or e-mail. [email protected]