The Community Care Program (CCP) in Illinois is a state-funded initiative designed to offer vital support to older adults. Its primary goal is to empower seniors to continue living in their own homes and communities, preventing or delaying the need for nursing home placement. This program provides a range of services aimed at maintaining independence and quality of life for eligible individuals.
Who is Eligible for the Community Care Program in Illinois?
To qualify for the Illinois Community Care Program, individuals must meet specific criteria. Eligibility requirements are designed to ensure that the program serves those who genuinely need assistance to remain at home. You may be eligible for CCP services if you meet the following conditions:
- Age Requirement: You must be 60 years of age or older. This program is specifically tailored to support the elderly population in Illinois.
- Residency Status: Applicants must be a citizen of the United States, a permanent resident, or residing in the U.S. under color of law. This includes individuals such as refugees or those seeking political asylum.
- Illinois Residency: You must be a resident of the state of Illinois. The CCP is an Illinois state program and services are for residents of Illinois.
- Income and Asset Limits: There are monthly income and asset limitations to qualify for the CCP. These financial criteria are in place to ensure that the program supports those with genuine financial need. It’s important to note that these limits are subject to change, so it is best to confirm the current thresholds with the Illinois Department on Aging or a local Case Coordination Unit.
- Need for Services: A key eligibility factor is the demonstrated need for services to prevent nursing home placement. Applicants must require assistance with daily living activities to remain safely at home. The program is designed to provide support that enables individuals to live independently in their own homes rather than requiring institutional care.
- Medicaid Application: As part of the application process, individuals are required to apply for Medicaid. While not all CCP recipients will necessarily qualify for Medicaid, the application is a procedural step in determining program eligibility.
Comprehensive Services Offered by the Community Care Program
The Illinois Community Care Program offers a variety of services to support seniors in their homes and communities. These services are tailored to individual needs and are designed to promote independence and well-being. Here are the core services available through the CCP:
Case Management Services: Your Personal Guide to Long-Term Care
Navigating long-term care options can be complex. Case management services are a central component of the CCP, providing personalized guidance and support. If you are exploring long-term care solutions, meeting with a case manager is a crucial first step. During these consultations, you will discuss your abilities to perform daily activities and identify areas where you need assistance.
Case managers play a vital role in:
- Needs Assessment: They conduct thorough assessments to understand your specific needs and challenges in managing daily life at home.
- Service Identification: Based on the assessment, case managers identify appropriate services that can help you maintain your independence and continue living in your home or community.
- Care Planning: They collaborate with you to develop a personalized service plan tailored to your unique requirements.
- Resource Connection: Case managers connect you with local resources and service providers within the CCP network.
Example: Consider an individual recovering from a hip replacement. A case manager might recommend services such as home-delivered meals to ease meal preparation, transportation assistance for doctor appointments, and homemaker services to help with household tasks during recovery.
Case managers are based at local agencies known as “Case Coordination Units” (CCUs). To find a CCU in your area, you can contact your local Area Agency on Aging or the Senior Helpline. A directory of CCUs is also available on the Illinois Department of Aging’s Website.
Homemaker Services: Assistance with Daily Living at Home
Homemaker services provide direct, in-home support with everyday tasks, making it easier for seniors to manage their households and personal care. A homemaker will visit your home to assist with various activities, according to a service plan developed in consultation with your case manager.
Homemaker services can include:
- Meal Planning and Preparation: Help with planning nutritious meals, cooking, and preparing special diets as needed.
- Housekeeping and Cleaning: Routine cleaning tasks to maintain a safe and healthy home environment.
- Shopping and Errands: Assistance with grocery shopping, pharmacy pickups, and other essential errands.
- Personal Care Assistance: Support with personal hygiene tasks such as bathing, dressing, and grooming.
- Laundry Services: Help with washing, drying, and putting away laundry.
- Medication Reminders: Reminding and assisting with medication schedules to ensure proper adherence.
- Transportation to Appointments: Accompanying you to doctor’s appointments or other essential outings.
Adult Day Services: Community-Based Support and Engagement
Adult Day Service programs offer a structured and supportive environment for seniors outside of their homes, within a community setting. These programs provide a range of activities and services designed to promote social interaction, cognitive stimulation, and overall well-being. Transportation to and from the adult day service site is typically arranged by the provider.
Required services at Adult Day Service sites include:
- Therapeutic Activities: Engaging activities designed to maintain or improve physical, cognitive, and social functioning.
- Rest and Relaxation: Designated time for rest and quiet relaxation throughout the day.
- Personal Care Assistance: Help with mobility, eating, toileting, and personal hygiene needs.
- Medication Assistance: Support with medication management and administration.
- Health-Related Services: Assistance with basic health needs appropriate to individual requirements.
- Daily Meal: Provision of a nutritious daily meal.
- Emergency Care: Procedures and trained staff to handle medical emergencies.
Optional services that may be available at some Adult Day Service locations:
- Therapies: Physical therapy, occupational therapy, speech therapy, or art therapy.
- Skilled Nursing Care: Services provided by licensed nurses, such as wound care, catheter care, and oxygen therapy.
- Shopping Assistance: Help with personal shopping needs.
- Escort to Appointments: Accompanying to medical or other appointments.
To locate Adult Day Services in your area, consult the Illinois Department of Aging’s Website.
Senior Companion Program: Social Support and Connection
The Senior Companion Program provides an invaluable layer of social support for CCP clients who may benefit from increased social interaction and companionship. This service is offered at no cost to CCP recipients and focuses on fostering connections and addressing social needs.
Senior Companion services may include:
- Companionship and Social Interaction: Providing friendly visits and engaging in social activities to reduce isolation.
- Peer Counseling: Offering emotional support and understanding through peer relationships.
- Family and Friend Connection: Encouraging and facilitating connections with family and friends.
- Public Service Application Assistance: Helping navigate and apply for other public assistance programs as needed.
- Addressing Unmet Needs: Identifying and addressing any unmet social or emotional needs.
For more information about the Senior Companion Program or to find a program near you, visit the Senior Corps Website. You can also get information from your local Area Agency on Aging or the Illinois Department on Aging Senior Helpline.
Demonstration and Research Projects: Innovation in Community Care
In some areas, local agencies may administer special demonstration or research projects aimed at enhancing the Community Care Program. If such projects are available in your locality, you may have the opportunity to participate and benefit from innovative approaches to community-based care.
How to Apply for the Community Care Program in Illinois
The Illinois Department on Aging partners with local agencies throughout the state to assist individuals in applying for the CCP. These local agencies act as the point of contact for application and eligibility determination.
To find the agency administering the CCP in your area, contact the Illinois Department on Aging’s Senior Helpline:
- Senior Helpline: (800) 252-8966 (Voice)
- TTY: (888) 206-1327
Calling the Senior Helpline is the most direct way to get connected with the appropriate local agency for CCP application assistance.
What to Expect from the Local Agency
Once you contact a local agency, they will guide you through the application process and determine your eligibility for CCP services. The agency’s responsibilities include:
- Eligibility Assessment: Evaluating whether you meet the age, residency, income, asset, and need for services criteria.
- Service Plan Development: If you are eligible, the agency will work with you and your family to create a personalized service plan that addresses your specific needs.
The agency will assess several factors to determine eligibility:
- Age and Residency: Verification of age (60+) and U.S. residency status.
- Income and Asset Level: Review of your financial situation to determine if you meet the program’s financial guidelines.
- Need for Services: Evaluation of your need for assistance with activities of daily living to prevent nursing home placement.
Income and Asset Considerations for CCP Eligibility
Financial eligibility for the CCP is based on your income and assets. Depending on your financial situation, you may:
- Receive Free Services: If your monthly income is below the federal poverty level (and that of your spouse, if applicable), CCP services will be provided at no cost.
- Share the Cost: If your income is above the poverty level, you may be required to contribute towards the cost of services based on a sliding fee scale. The contribution amount will depend on your income, the level of services you receive, and established CCP fee schedules.
- Not Be Eligible: In some cases, individuals with higher incomes and assets may not be eligible for CCP services.
Income Calculation: It’s important to note that certain types of income are not counted when determining CCP eligibility. Due to the complexity of income exclusions, it’s best to discuss your specific income situation with the local agency. For married couples living together, CCP rules allow for income transfer to the spouse who is not receiving CCP services, similar to Medicaid rules for spouses when one spouse is in a nursing home. More information on spousal income rules is available here.
Asset Limits: There is an asset limit for CCP eligibility. If the value of your non-exempt assets exceeds $17,500, you will not be eligible for the program.
Exempt Assets: Certain assets are not counted towards the asset limit. These exempt assets include:
- Your primary home and its furnishings.
- Personal clothing and effects.
- Vehicles (excluding recreational vehicles).
- Prepaid burial plans, burial plots, and markers.
Similar to income rules, CCP allows for asset transfer to the non-applicant spouse to protect assets, mirroring Medicaid spousal asset rules in nursing home scenarios.
Determination of Need (DON) Assessment
To evaluate your need for CCP services, the local agency will conduct a Determination of Need (DON) assessment. This assessment is a standardized tool used to measure your functional abilities and support requirements.
The DON assessment evaluates:
- Cognitive Functioning: Assesses any decline in mental abilities.
- Activities of Daily Living (ADLs): Evaluates your need for assistance with essential daily tasks like bathing, dressing, eating, and mobility.
- Unmet Needs: Determines the extent to which your needs are not being met by other sources of support outside of the CCP.
Your scores from each section of the DON are totaled to produce a final score. A minimum score of 29 is required to qualify for the CCP. Higher scores above the minimum indicate a greater level of unmet need and may qualify you for a broader range of services.
The agency will schedule a home visit to conduct the DON assessment. Along with the DON, you will need to provide proof of your income and assets as part of the application process. The agency is required to provide a decision on your application within 30 days. Once enrolled in CCP, it is your responsibility to report any changes in your situation to the local agency, including changes in income or assets.
Appealing Denials, Terminations, or Service Changes
Your Right to Appeal
You have the right to appeal decisions related to your CCP services if you disagree with:
- Application Denial: If your application for CCP services is denied.
- Service Changes: If you disagree with a decision to reduce, terminate, or change your services (excluding temporary suspensions).
The local agency is required to provide you with a pamphlet explaining the appeal process during your initial home visit. To initiate an appeal, you must do so within 60 days of the date of the decision you are appealing.
Appeals are submitted directly to the Illinois Department on Aging in Springfield. You can begin the appeal process by contacting the Senior Helpline. They will provide you with the necessary appeal form and instructions for mailing it to:
Illinois Department on Aging
Division of Home & Community Services
Office of Community Care Services
Client Appeals Section
421 East Capitol Ave., #100
Springfield, IL 62701-1789
The Appeal Procedure
Upon receiving your appeal, the Department on Aging will initially conduct an informal review of the case and notify you of their findings. If the Department does not overturn the local agency’s decision after this informal review, your appeal will proceed to a formal hearing.
At the hearing:
- You have the right to be represented by a lawyer or another advocate.
- You can present evidence and testimony to support your appeal.
- An impartial hearing officer, selected by the Department of Aging, will oversee the hearing and make recommendations to the Director of the Department on Aging.
Within 90 days following the hearing, the Department on Aging will issue its final decision on your appeal. If you disagree with the Department’s final decision, you have the right to file a lawsuit in the Illinois Circuit Court to seek judicial review of the agency’s decision. There is a strict 35-day deadline to file such a lawsuit from the date of the Department’s final decision, so it is crucial to consult with an attorney promptly if you intend to pursue this legal option.
Where to Find More Information
Senior Helpline and Website
The Senior Helpline is a valuable resource for information and assistance related to programs and services for seniors in Illinois.
- Senior Helpline: (800) 252-8966 (Voice)
- TTY: (888) 206-1327
The Helpline provides:
- Information on a wide range of senior services and programs.
- Connections to local services for seniors aged 60 and older and their caregivers.
- Needs assessments and referrals to services such as case management, the Long-Term Care Ombudsman Program, legal aid, transportation, employment assistance, and nutrition programs.
- Intake for elder abuse reports.
- Acceptance of appeals and service inquiries from Community Care Program clients.
For online information about the Community Care Program and other aging services in Illinois, visit the Illinois Department on Aging’s website.
