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Elizabeth M. Whitehorn, Director

Persons with Brain Injury (BI)

Illinois' Persons with Brain Injuries waiver

The Persons with Brain Injury (BI) waiver provides services and individualized support to persons with a brain injury who live in the home.  These services are provided to those who would otherwise require care in a nursing facility.  The Persons with Brain Injury waiver is a part of a program called Home Services Program (HSP).

  • The Illinois Department of Healthcare and Family Services (HFS) is the state Medicaid Agency (MA) and is responsible for administration and oversight of this Home and Community Based Service (HCBS) waiver.
  • The Illinois Department of Human Services – Division of Rehabilitation Services (DHS-DRS) is the Operating Agency (OA). 

The Eligible Population for the BI waiver includes:

Individuals with brain injury, of any age, who are at risk of nursing facility placement due to functional limitations resulting from the brain injury.

To be Eligible for the BI waiver, you must be:  

  • A U S. citizen or legal alien
  • A Resident of the State of Illinois
  • Of any age
  • Medicaid eligible or enrolled in the Health Benefits for Workers with Disabilities (HBWD) program. Interested individuals may download an application from the HBWD Web site. 
  • Have functional limitations directly resulting from an acquired brain injury as documented by a physician or neurologist.   
    • This includes traumatic brain injury, infection (encephalitis, meningitis), anoxia, stroke, aneurysm, electrical injury, malignant or benign, neoplasm of the brain, and toxic encephalopathy. This does not include degenerative, congenital, or neurological disorders related to aging.
    • Be at risk of nursing facility placement as measured by the Determination of Need (DON) assessment.
    • The cost of waiver services must be less than the cost of nursing facility services.
    • Can be safely maintained in the home or community-based setting with the services provided in the plan of care.

Services and their Descriptions:

  • Individual Provider
  • Home Health Aide
  • Homemaker
  • Adult Day Care
  • Environmental Accessibility Adaptations
  • Specialized Medical Equipment
  • Home Delivered Meals
  • Personal Emergency Response System
  • Respite
  • Intermittent Nursing
  • Nursing
  • Extended State Plan Therapy Services (Physical, Occupational, Speech)
  • Day Habilitation
  • Prevocational Services
  • Supported Employment
  • Cognitive Behavioral Therapies

To see if you are eligible for services:

Contact the DHS-DRS local offices.  Local offices can be found using the DHS Office Locator. You may also call: 1-877-581-3690 1-800-447-6404 (TTY) to talk to a DHS-DRS representative in your region of the state.

You may also select 'Rehabilitation Services' from the drop down box DHS Offices by county to find the DHS-DRS office address, directions to the office, and/or phone number available in your region of the state.

You can apply for DHS-DRS services online here: Rehabilitation Services Web Referral

Managed Care

Customers who get their HCBS waiver services through an Illinois Medicaid managed care organization have a care coordinator.  Customers may contact their care coordinator about the need for in home services and for assistance with a referral.  Contact information for all Illinois Medicaid managed care organizations can be found here:

https://www2.illinois.gov/hfs/SiteCollectionDocuments/CONTACTInformationForHealthPlansForMembers012021.pdf

If you are requesting a referral directly from DHS-DRS, please inform the DHS-DRS Local Office representative that you are enrolled in a managed care organization.  Have the name of the managed care organization and your 9-digit member identification number available. 

HFS HCBS Waivers

Service Descriptions

  • Individual Providers (IPs)):  Services provided by individuals who are selected, employed, and supervised by the customer. These individuals may assist with or perform household tasks, personal care and, with the permission of a physician, certain health care procedures.
  • In Home Service (Homemaker):  Services consisting of general household activities (meal preparation and routine household care) and personal care provided by a trained homecare aide when the customer regularly responsible for these activities is unable to manage the home and care for himself or herself. Homecare aides shall meet such standards of education and training as are established by the State for the provision of these activities. This service will only be provided if personal care services are not available or are insufficient to meet the care plan or the customer cannot manage a personal assistant.
  • Adult Day Care (ADC):  Provides direct care and supervision in community-based setting for the purpose of providing personal attention, and promoting social, physical, and emotional well-being in a structured setting.
  • Environmental Accessibility Adaptations:  Services to physically modify the customer's home to accommodate the customer's loss of function in the completion of his/her Activities of Daily Living.
  • Specialized Medical Equipment:  Includes devices, controls, or appliances, specified in the plan of care, which enable customers to increase their abilities to perform activities of daily living, or to perceive, control, or communicate with the environment in which they live. This service also includes items necessary for life support, ancillary supplies, and equipment necessary to the proper functioning of such items and durable and non-durable medical equipment not available under the State Plan.
  • Home Delivered Meals:  One or more ready-to-eat meals per day which are delivered to the home.  This service is provided to customers who can feed themselves but are unable to prepare a meal.
  • Personal Emergency Response System:  A 24-hour emergency communication link for assistance outside the customer's home based on health, safety needs, and mobility limitations.
  • Respite:  Services provide relief for unpaid family or primary care givers, who are currently meeting all service needs of the customer. Services may include personal assistant, homemaker, nurse, or adult day care. Services are available for a maximum of 240 hours per year.
  • Nursing: Nursing is provided within the scope of the State's Nurse Practice Act by a registered nurse, licensed practical nurse, or vocational nurse.
  • Intermittent Nursing: Used for purposes of evaluating customer needs (including assessments and wellness checks) and monitoring.
  • Home Health Aide: Provided within the State's standards for a Certified Nursing Assistant.
  • Therapies: Provided by a licensed therapist. May be approved under the waiver if the customer is no longer eligible for therapies under the State Plan but continues to need long-term habilitative services.
  • Day Habilitation:  Assist the customer with the acquisition, retention or improvement in self-help, socialization, and adaptive skills. These services are provided in a setting separate from the customer's home. These services focus on enabling the customer to attain or maintain a maximum functional level and may be coordinated with therapies listed in plan of care.
  • Prevocational Services:  Services provided that prepare customer for paid or unpaid employment by teaching concepts such as compliance, attendance, task completion, problem solving and safety. Activities in this service are not primarily directed at teaching specific job skills, but at underlying habilitation goals, such as span and motor skills. All prevocational services will be reflected in the customer's plan of care as directed to habilitation, rather than explicit employment objectives.
  • Supported Employment:  Intensive ongoing employment support that enable customers for whom competitive employment at or above the minimum wage is unlikely in a paid employment work setting. Supported employment includes activities needed to sustain paid work by customers receiving waiver services, including supervision and training. When supported employment services are provided at a work site in which persons without disabilities are employed, payment will be made only for the adaptations, supervision and training required by customers receiving waiver services as a result of their disabilities.
  • Cognitive Behavioral Therapies:  Remedial therapies to decrease maladaptive behaviors and/or to enhance cognitive functioning of the customer. These services are intended to enable the customer to better manage his or her behavior and therefore be more capable of living independently.

Operating Agency Contact Information

Department of Human Services – Division of Rehabilitation Services
Phone: (877) 581-3690
Email: DHS.HSPWaiver@illinois.gov