Program Service Descriptions
Program Descriptions:
Screening, Advocacy and Service Coordination Services
Pre-Admission Screening (PAS)(780)-Principal services offered through the Pre-Admission Screening (PAS) program include the provision of prior authorization for all individuals for whom there is a reasonable basis to suspect the presence of a developmental disability who request Medicaid-funded services or nursing facility services. Specific PAS include the following:
Conducting and securing assessments to determine service eligibility;
Education of individuals, guardians, and families about service opportunities, including generic and specialized services;
Notice of determinations provided to individuals and guardians;
Assistance with the choice process;
Assistance with service selection and linkage;
Assistance in preparation and approval of submissions to the Department of Human Services (DHS) for capacity and rate requests when necessary (e.g., CILA and purchase of service programs);
Monitoring for four weeks following initiation of services; and
Accessibility 24 hours per day, 365 days per year for individuals in times of crisis.
The department of Healthcare and Family Services reserves the right to review and reverse all determinations by PAS agencies, in keeping with procedures and policies laid out in those documents and pertinent memoranda and policy statements issued by the Division and other government entities, such as the Department of Healthcare and Family Services.
Individual Service and Support Advocacy (ISSA) (50D)-The individual Service and Support Advocacy (ISSA) program provides collaborative assistance to both individual receipents and their providers in order to enhance the delivery and effectiveness of service provision. Principal services offered through the ISSA program include the following:
A minimum of four visits per year (approximately one per quarter), performed with the foreknowledge of the guardian (if applicable) ad allocated according to the following guidelines:
one visit for participation in the Individual Service Plan (ISP);
one visit to either the individual's residence or day program; and
one visit each to:
the individual's residence and day program if the individual participates in a day program (if not, this visit may be to the person's home),
to complete Visiting Notes that assess whether program services are being provided in the interest of and to the satisfaction of individuals receiving the services, and
to review the individual's health, safety and well-being;
Collaborative facilitation, with service providers, of conflict resolution for matters of concern to the individual and/or guardian and provider, including satisfaction, health, safety, well-being, and development ad implementation of the ISP;
Referral to the DDD Region Facilitator or Bureau of Transition Services Representative for individuals discharged from an SODC within the 12 months, for monitoring and/or technical assistance regarding unresolved matters of concern;
Annual redetermination of waiver eligibility;
Accessibility 24 hours per day, 365 days per year for individuals in times of crisis; and
Review and verification of information submitted for the CILA program.
Review and verification of Special Funding Requests and Staff Add-on Requests.
Independent Service Coordination (500)-The Independent Service Coordination (ISC) Program provides education, referral, and linkage services for children and adults with developmental disabilities. General ISC functions include:
Intake;
Education;
Goal setting, referral and linkage to both generic and specialized services;
Transportation to facilitate referrals and linkage;
Planning (only in those instances where not otherwise provided by other programs)
Crisis intervention
In addition, this ISC program covers the following specific responsibilities:
Completion of Prioritization of Urgency of Need for Services (PUNS) database forms, as instructed by the Department, for all individuals in the assigned geographic area who seek inclusion in the database of unmet need
Completion of mandated discharge, linkage and aftercare per 59 Ill. Adm. Code 125 (Discharge/Linkage/Aftercare).
Participation in planning efforts for adolescents aging out of the public school system
Bogard Service Coordination (781)-The Bogard Service Coordination program provides the following services:
Provisions of assessments and reassessments of needs and goals;
Coordination of Individual Service Plan (ISP);
Specialized Service facilitation and brokering for persons in nursing facilities;
Development of natural support networks;
Performance of activities to maintain or improve availability, accessibility and quality of services;
Assistance with the procurement of adaptive equipment through the Department of Healthcare and Family Services;
Monitoring the implementation of the ISP, as well as the individual's health, safety, and well-being, through site visits to residential and day program sites;
Utilization of problem-solving procedures to achieve conflict resolution
Crisis Intervention;
Provision of transportation to facilitate the selection of employment and residential services among other options; and
Provision of the Bogard choice process, as directed in the Modified Bogard Consent Decree
Residential Services
Intermediate Care Facility for Individuals with Developmental Disabilities (ICF/DD)-An ICF/DD is a residential facility of three or more persons, or a distinct part thereof, serving residents of which more than 50% have intellectual disabilities or a related condition. Such facilities are licensed by the Department of Public Health as an Intermediate Care Facility for individuals who have a developmental disability or as a SNF/PED. The ICF/DD is a continuous program of specialized and generic training, treatment, health services and related services that is directed toward the acquisition of the behaviors necessary for the individual to function with as much self determination and independence as possible and the prevention or deceleration of regression or loss of current optimal functional status. It does not include services to maintain individuals who are able to function with little supervision or in the absence of a continuous program.
Child Care Institution Programs (19D)-Residential Services for children with developmental disabilities programs are designed to provide a structured environment to children and adolescents who cannot reside in their own home. Residential services are provided in a setting that is licensed by the Department of Children and Family Services as a Residential School/Child Care Institution (CCI)(19D). CCI settings are licensed to serve more than 10 children. Children must be enrolled in a school program approved by the Illinois State Board of Education. Tuition is paid for by the local school district. Residential funding by the Division is infrequent and is usually provided only after in-home supports have been tried and have failed.
Children's Group Home (17D) - Residential Services for children with developmental disabilities programs are designed to provide a structured environment to children and adolescents who cannot reside in their own home. Residential services are provided in a setting that is licensed by Department of Children and Family Services as a Children's Group Home. Settings can serve no more than 10 Children. Children must be enrolled in a school program approved by the Illinois State Board of Education. Tuition is paid for by the local school district. Residential funding by the Division is infrequent and is usually provided only after in-home supports have been tried and have failed. For Child Group Home services, the child must be determined eligible for the Residential Waiver for Children and Young Adults with Developmental Disabilities.
Community Living Facility (CLF) (67D)- A CLF is a residential setting licensed by the Department of Public Health that serves individuals with developmental disabilities in skill training programs that provide guidance, supervision, training and other assistance, with the goal of eventually assisting these individuals in moving to independent living. These programs include housekeeping, money management, social skills, and community living skills. Individuals are required to participate in day activities, such as vocational training, sheltered workshops or regular employment. A CLF shall not be a nursing or medical facility and shall house no more than 20 residents, excluding staff, except as provided fr in section 18 of the Community Living Facilities Licensing Act. The Department continues to support these programs and vacancies are filled.
Children's Group Home (17D) - Residential Services for children with developmental disabilities programs are designed to provide a structured environment to children and adolescents who cannot reside in their own home. Residential services are provided in a setting that is licensed by Department of Children and Family Services as a Children's Group Home. Settings can serve no more than 10 Children. Children must be enrolled in a school program approved by the Illinois State Board of Education. Tuition is paid for by the local school district. Residential funding by the Division is infrequent and is usually provided only after in-home supports have been tried and have failed. For Child Group Home services, the child must be determined eligible for the Residential Waiver for Children and Young Adults with Developmental Disabilities.
Day Services
Day Program-Developmental Training (DT) (31A, 31U, 31S)- Developmental Training (DT) is a program of day habilitation that focuses on the development of and enhancement of daily adaptive living skills and economic self-sufficiency. Typical activities should be functional and performed at the natural time and environment, properly sequenced, and be developmental and age appropriate. Such activities include: fine and gross motor skills, attention span development, safety, problem solving, grooming, dressing skills, toileting, eating, communications, reduction of maladaptive behavior and promotion of adaptive behavior, quantitative skills, and capacity for independent living.
Regular Work/Sheltered Employment (38U)- Regular Work/Sheltered Employment provides long-term employment in a sheltered environment for individuals whose functional levels require supervision but are not precluded from future movement into a Supported Employment position or a competitive employment position. Regular Work/Sheltered Employment provides general work supervision, including direction and on-the-job training in such areas as work expectations, workplace behavior, compliance to workplace safety standards, production and tasks completion. This program provides the opportunity to participate in productive work and to be compensated for that work in accordance with the Fair Labor Act of 1938 (29 U.S.C. 208).
Supported Employment (SEP) (36G, 36U, 39G, 39U)- The supported employment program provides the necessary supports and services to assist individuals with developmental disabilities to work for compensation in a variety of community-integrated work environments in which persons without disabilities are also employed. The program is designed to promote regular interaction with persons without disabilities who are not paid care givers or service providers. Supported employment may be provided in individual placements or in group settings of no more than eight individuals with disabilities. Remuneration for work commensurate with the task is expected.
Other Day Program, Adult Day Care, At Home Day Program (30U, 35U, 37U)- Other Day Program (30U) provides a structured individual program of community habilitation activities for individuals for whom the more traditional day program is not appropriate and who choose to participate in a variety of alternative day activities. Adult Day Care (35U) program provides direct support and supervision of adults 60 years of age and older. Intervention and activities of adult day care promote physical well being and fitness, socialization and tasks that stress the maintenance of coordination skills, as well as reducing the rate of loss of current skills that normally accompany the physical aspect of the aging process. All providers of Adult Day Care must be contracted with Illinois Department of Aging. At Home Day Program (37U) provides a structured individualized program of in-home and community habilitation activities for individuals who are unable to participate in out-of-home day programs due to medical or behavioral issues, or who are over age 60 and choose not to participate in an out-of-home day program.
Other Support Services
In-Home Respite, Residential Respite, Group Respite (87D, 89D, 88O)-The In-Home Respite (87D) program provides intensive or non-intensive support services to help maintain individuals in their homes. The Residential Respite (89D) program provides short-term stays for individuals in a residential setting that is licensed, certified or approved and is appropriate for their needs. Supervision and care for children and adults in a group setting for a portion of the day, typically before and/or after school or day program, is offered through the Group Respite (880 GIA) program. This program also provides social interaction and increased inclusion and exposure to the community.
Family Assistance Program (69)- This program provides a monthly cash stipend for the eligible child and his/her family. the Stipend is to be used to assist with the cost of caring for a child with a developmental or intellectual disability. The monthly stipend may be used for such things as respite care, medical expenses, therapies, counseling, and home remodeling to make it more accessible for the child. These are a few of the ways families may utilize the Family Assistance Program.
Home-Based Support Services (HBS) (Various Codes)- Home-Based Support Services (HBS) is an option within the adult Medicaid Waiver and the Children's Supports Waiver. HBS includes any of the individually-designed, separately covered services or assessment of the need for these services to assist individuals to live in a private family home or a private house or apartment that they own or lease. Home Based Support Services are tailored to meet individuals' evolving needs and preferences for supports, without having to leave their homes. Individuals and their guardians may choose from particular array of services of spate HBS Services, up to a monthly dollar cost maximum set by DHS, that best meets the evolving needs of the individual. All Services provided must be for the direct benefit of the individual and must be directly related to their disability.
Therapies- Behavior Intervention and Treatment; Behavior Counseling-Individual and Group; Behavior Therapy-Individual and Group; Waiver Physical Therapy, Waiver Occupational Therapy, Waiver Speech Therapy (Various Codes).
Bogard Specialized Services:- Bogard Specialized Services are aggressive, accountable, competent, and knowledgeable interactions that are habilitative in nature and directed toward meeting the individual's want and needs. The services must have functional outcomes and be based upon an Individual Service Plan (ISP) that is developed through cooperative efforts of an Interdisciplinary Team (IDT), that includes the Bogard class member and the guardian, if applicable. These services should take advantage of all opportunities that exist in the natural environments which make up the individual's day. Bogard Specialized Services are governed by the Modified Consent Decree and all pertinent guidelines.
Adaptive Equipment, Home Accessibility Modifications, Temporary Intensive Staff and Vehicle Modifications (Various Codes)- The individuals served by these programs will increase their ability to function in the environment in which they live and will improve or maintain their current functioning or ability level.