Payers

Illinois Department on Aging – Community Care Program (CCP)

Established in 1979 by Public Act 81-202, the Illinois Department on Aging’s Community Care Program helps senior citizens, who might otherwise need nursing home care, to remain in their own homes by providing in-home and community-based services.

Are you wondering how to find the specific services that will help you or loved one remain at home? The Illinois Department of Aging would like you to know that help is offered through the Community Care Program (CCP). This program is designed to help you remain independent, in your own home, and keep you out of a nursing home, as long as nursing home placement is not necessary for you. For more information about CCP services, please contact IDOA’s Senior HelpLine by calling 1-800-252-8966 or 1-888-206-1327 (TTY) from 8:30 AM to 5 PM Monday through Friday or emailing aging.ilsenior@illinois.gov.

The Care Coordination Unit (CCU) will assign a care coordinator to visit you at home at no cost to discuss your needs and goals, and to help you choose what services may be right for you. Services include In-Home Service, Adult Day Service, Flexible Senior Services, Emergency Home Response Service and in some areas of the state, Senior Companion. If you qualify for CCP services, the Care Coordination Unit will work with you to determine your needs, set up services that are appropriate for you and keep in touch with you to make sure the services continue to meet your needs.

Services under the CCP include:

1
In-Home Service

2
Emergency Home Response Service

3
Flexible Senior Services

4
Senior Companion

You are eligible for Community Care Program services if:

You are 60 or older;
You are determined to be physically in need of service, meaning you are at least moderately impaired;
You are a resident of the State of Illinois;
You are a U.S. citizen or legal alien;
You meet the asset requirements, which will be explained to you when the care coordinator comes to your home;
You apply for medical benefits.

For more information, visit http://www.illinois.gov/aging

Department of Human Services (DHS) – Division of Rehabilitation Services (DRS)

The Illinois Department of Human Services’ Division of Rehabilitation Services (DHS-DRS) is the state’s lead agency serving persons with disabilities. The Division of Rehabilitation Services (DRS) staff works one-on-one with individuals who have disabilities and their families to empower them to reach their employment, education, and independent living goals. Through the Home Services Program, DRS provides services to individuals with significant disabilities and/or brain injuries so they can remain in their homes and live as independently as possible. DRS customers are empowered to live self-directed lives, be actively involved in their communities, and retain control over the services they receive.

The following services can, under certain circumstances, be covered by state assistance programs:

Homemaker Services
Home Health Services
Electronic Home Response
Home Delivered Meals
Assistive Equipment
Environmental Modifications
Respite Services
Brain Injury (BI) Behavioral / Cognitive Therapies
Brain Injury (BI) Habilitation
Brain Injury (BI) Pre-Vocational / Services
Brain Injury (BI) Supported Employment

The following circumstances must be met to qualify for state assistance programs:

Be under age 60 at the time of application unless in the AIDS or Brain Injury Medicaid Waiver Program.
Have a severe disability lasting 12 months or longer, or for the duration of life.
Be at imminent risk of nursing home placement.
Have applied, cooperated and obtained a decision on Medicaid eligibility unless already on Medicaid or spend-down.
Require services in the home costing the same or less than nursing home costs.
Be a State of Illinois resident with U.S. citizenship or show proof of legal entry into the United States.
Have assets under the asset limit which is different for individuals under age 18 and those 18 and older.
Have a physician’s approval of the initial plan of care.
Score a minimum of 29 points on the Determination of Need (DON).

The Home Service Program staff will:

Visit the person at home to discuss eligibility and available services.
Complete application and conduct financial and non-financial eligibility assessments.
Obtain needed releases of information for medical documentation and obtain a physician’s certification that services are needed and appropriate.
Obtain a clear and easily identifiable copy of the customer’s State of Illinois Photo ID or valid Driver’s License.
Develop a service plan and assist in locating service providers.
Provide alternative resource information and information on appeal rights if eligibility is not met.

Call toll-free: (800) 843-6154 (Voice, English or Español) (800) 447-6404 (TTY).
For general questions about DRS, email DHS.ORS@illinois.gov.

Illinois Department on Aging
Community Aging Referral Program (CARP)

CARP

Effective October 1st, 2011, Abcor Home Health is a participating provider in the Community Aging
Referral Program (CARP) through the Illinois Department on Aging (IDOA).

CARP is a referral program utilizing certified Community Care Program (CCP) providers to secure private pay In-Home Services at the State provider rate.
To be eligible for CARP you must have assets between $17,500 and $35,000.
In order to become a CARP participant you must contact IDOA for a Comprehensive Assessment and to discuss your available community resources.
You must provide the CARP form to Abcor Home Health to confirm eligibility in order to receive in-home care services at the state discounted rate of $24.96 per hour.
CARP participants must pre-pay for 2 weeks of in-home care services according to a pre-agreed contract agreement.

Private Pay Services

Abcor Home Health also offers private pay services to individuals who neither qualify for state funded programs nor have acquired long term care insurance. In order to access our private pay non-medical home care, a personalized needs assessments and home safety inspection will need to be arranged to determine the appropriate plan of care for your or your loved ones. Abcor’sprivate pay non-medical home care terms and care options are as follows:

Come & Go
hour minimum:

3 hours

per day
Less than
20 hours per week:

$32

per hour
More than
20 hours per week:

$30

per hour
Bathing Visit
(1 hour max.):

$31

per visit

Or contact as at 847-670-8268 or visit www.abcor.com

Veteran Administration – Aid and Attendance Pension Benefit (A&A)

Veterans or their surviving spouse may qualify the Aid and Attendance (A&A) Veteran Administration Pension Benefit. A&A is the highest level awarded to veterans or surviving spouses who require assistance in activities of daily living (ADLs) such as dressing, bathing, cooking, eating, transferring, incontinence care and grooming. By working closely with community resources, Abcor can assist veterans or surviving spouses to submit an application for Aid and Attendance pension benefits.

Amount of Home Care Services Available:

74 hours
of home care per month for Veteran

48 hours
of home care per month for a Surviving Spouse

88 hours
of home care per month for a Couple

117 hours
of home care per month for 2 Married Veterans

War Periods for Eligibility:

World War II
Starting December 7, 1941
through December 31, 1946
Must have served 90 days
active duty

Korean Conflict
Starting June 27, 1950
through January 31, 1955
Must have served 90 days
active duty

Vietnam Era
Starting August 5, 1964
through May 7, 1975
Feb 28, 1961 is the starting date for veterans who served “in country” (Vietnam)
before Aug 5, 1964

Persian Gulf War
Starting August 2, 1990 through an end date to be set by law or Presidential Proclamation
Must have served 2 years active duty

Requirements

Served 90 days active duty, 1 day during wartime with honorable discharge.
Must be house bound 60% as certified by a licensed physician.
Qualifying medical expenses must exceed income by 5%.

Long Term Care Insurance

Long term care services may include the medical, social, housekeeping, or rehabilitation services a person needs over months or years in order to improve or maintain function or health. Such services are provided not only in nursing homes, but also in patients’ homes or in community-based settings such as assisted-living facilities and independent living.
Abcor Home health has many medical and non-medical services as alternatives to nursing home care. Both medical and non-medical care may be received at home or in residential settings, and can range from simple light housekeeping) to complex skilled nursing or medical therapies to maintain or improve the level of functioning of our clients.

Long -Term Care Insurance Policies may cover the following services which are available at Abcor Home Health:

Come & Go Caregiver
Live-In Caregiver
Certified Nursing Assistant
Medical Social Worker
Skilled Nursing
Physical Therapy
Occupational Therapy

Eligibility

Long term care insurance considers these triggers for the start of benefits: (1) the client suffers from a chronic disease or cognitive impairment, and they are unable to do at least two activities of daily living (ADLs) without assistance from another person for at least 90 days and (2) the client may be considered to be chronically ill and requires substantial supervision to protect his/her health and safety due to cognitive impairment. All long term care insurance policies issued before January 1st, 1997, do not have to define chronically ill as mentioned above.

Activities of Daily Living

A client’s ability or lack thereof to perform various activities of daily living (ADLs) is the most common criterion used by insurance companies to decide whether a client is eligible for benefits. ADLs most commonly used are bathing, dressing, eating, using the bathroom, and transferring. Typically, a long term care policy pays benefits based on the client’s ability to do a certain number of the ADLs, such as two out of six or three out of six. The six activities of daily living (ADLs) have been determined through years of careful scientific research. Interestingly, this and other research has shown that bathing is usually the first ADL that a person becomes unable to perform without assistance. While most long term care home care policies use all six ADLs as benefit triggers, qualifying for benefits from a policy that uses five ADLs may be more difficult if bathing is the omitted ADL. Therefore, always make sure to ask your insurance company what the ADLs are under your policy.

Chronic Illness

Chronic illness is defined as an illness with one or more of the following characteristics: permanency, residual disability, the requirement of rehabilitation training or a long period of home care supervision, home care observation, and in-home care. Chronically ill is a term which describes a person who needs long term home care either because of an inability to perform activities of daily living (ADLs) without help or because of a severe cognitive impairment.
Some long term care insurance policies will pay benefits if the client’s doctor orders or certifies that home care is medically necessary. Long term care insurance policies sold in the past required a hospital stay of at least three days before paying home care benefits. Most insurance companies no longer sell long term care insurance policies that require a hospital stay.

Elimination Period/Waiting Period

An elimination, or waiting, period is a type of deductible. It is defined as the length of time the long term home care plan holder must pay for covered home care services before the insurance company will begin to make payment. The longer the elimination period, the lower the premium will be, so check with your long term care insurance company regarding your plan’s elimination period.

Cognitive impairment

Cognitive impairment is a term used to describe deficiency in a person’s short or long term memory, orientation as to person, place, and time, deductive or abstract reasoning, or judgment as it relates to safety awareness. Most long term care insurance plans also pay benefits for “cognitive impairment.” The policy usually pays benefits if a client cannot pass certain tests of cognitive function. Coverage of cognitive impairment is especially important if you develop Alzheimer’s disease or dementia.