Illinois Home and Community Based Services Update

Below is an update from Amber Smock, Access Living’s Director of Advocacy about the state of Home Services and Community Supports in Illinois as we move into the month of November in 2016.

The information below is taken from an advocacy alert sent by Smock on October 31.

At the beginning of November, 2016, it’s important to remember that the Illinois Home Services Program (HSP) and Community Care Program (CCP) remain vulnerable to those who would prefer to slash supports to people with disabilities and seniors. This is all in the name of “saving money” from programs that already save the State millions by keeping people in community settings. Here are some ways that we see these programs under attack:

• The Department of Human Services (DHS) has been pressing for almost a year to formally impose caps on overtime for the Home Services Program, which carries huge risk for people with disabilities and Individual Providers.

• The Department of Health and Family Services (HFS) continues to issue Medicaid redeterminations by regular mail to thousands who use state-funded home services. When people do not understand the letters or do not receive them, they become at risk of losing their Medicaid status; if they are eliminated from the rolls, they do not often know how to appeal.

• HFS is also requiring that all Medicaid providers, like the HSP Individual Providers, be enrolling in a tracking system that requires a background check; up to 6,000 Individual Providers could be eliminated due to having a felony on their record, despite having been selected by the HSP customer, who may not have access to greater supports.

• All persons who have both Medicaid and Medicare are now being automatically enrolled in a managed care organization (MCO). Many do not understand this process, and we are getting reports of people who have been automatically assigned to an MCO, which then cuts their service hours for home services. We have been working to help some of these people appeal the decisions of the MCOs.

• People with disabilities in HSP are being told that if they cannot find enough Individual Providers to assist them with personal care, they will be assigned a homemaker from an agency. However, homemakers generally do not perform personal care services. The State used to run an Emergency Back-Up Personal Attendant Program through Access Living and Progress Center, which provided emergency personal care services, but this program fell victim to the state budget crisis and no longer exists. HSP customers do not have real personal care emergency options, in the event that neither the regular nor the back-up Individual Provider can help them.

• Finally, as far as we know, the State is still looking at dividing the Community Care Program in half, removing all non-Medicaid eligible seniors and placing them in a new program called the Community Reinvestment Program, which would require a co-pay and reduce the amount/type of homemaker services a senior could receive. The State expects to save $200 million through this mechanism. Senior and disability advocates worked hard to pass HB 4351, which would preserve the DON score at 29 and prevent the creation of the CRP, through the General Assembly last spring; the Governor vetoed the bill over the summer.

The people who have support from HSP and CCP are people who really need it. They need it on an individualized basis, and they need it within the context of a system that is fair, clear, and easily engaged with. They need to know that the program is there to help, not harm. As we look forward past the election on November 8, we need to remember that our legislators will be coming together in November and December for veto session. We are looking at a state budget that expires December 31. We don’t know what’s next, but we do know that people with disabilities and seniors need programs that are fair and provide real support in homes and communities.