Home-Based Support Services Illinois: 2026 Budget Rates and How the Program Works

What the HBS Program Is

Home-Based Support Services is the self-directed pathway within the Illinois Adults with Developmental Disabilities Medicaid waiver. Once an individual is selected from the PUNS waiting list and enrolled in the DDD waiver, HBS provides a monthly budget to purchase disability-related services — personal support workers, community day services, therapies, respite, assistive technology — based on a plan developed with the individual and their family.

The funds aren't cash payments. They represent a maximum spending allocation for approved services identified in the individual's Person-Centered Personal Plan. The family hires and manages the service providers directly, within the budget cap.

2026 Budget Calculations

HBS budgets are calculated using a formula tied to the federal SSI benefit rate, with a 5% legislative increase approved for 2026.

Adults who have exited special education (age 18+ and out of school):

Monthly budget = (SSI rate × 3) × 1.05 = ($994 × 3) × 1.05 = $3,131 per month

Annual maximum = $37,573

Children and young adults still in school (ages 3–21 with an IEP):

Monthly budget = (SSI rate × 2) × 1.05 = ($994 × 2) × 1.05 = $2,088 per month

Annual maximum = $25,049

The annual maximum allows flexibility — families can carry over unused funds and spend up to $4,176 in a single month for the children's program, which helps cover periods of higher service need (school breaks, medical episodes) without losing unused funds.

What the Budget Covers

HBS funds can be used for:

• Personal support workers (PSWs) — direct care staff for daily living assistance, community participation, and skill building
• Community day services — structured programming during daytime hours
• Behavioral intervention — applied behavior analysis or other behavioral support
• Therapies — occupational, speech-language, and physical therapy beyond what Medicaid fee-for-service covers
• Respite care — temporary relief for primary caregivers
• Assistive technology — devices and equipment supporting independence
• Transportation — to and from services

Every service must be listed in the Person-Centered Personal Plan before spending against the budget. Services not in the plan aren't reimbursable, even if they fall within an eligible category.

The Wage Rate Squeeze

Effective January 1, 2026, Illinois increased the statewide Direct Support Professional hourly wage reimbursement to $21.30 under Public Act 104-0002. Metro areas receive a higher rate of $24.50 per hour.

Here's the math that keeps families up at night: at $21.30/hour, the adult monthly budget of $3,131 purchases roughly 147 hours of PSW support per month — about 4.9 hours per day. At the metro rate of $24.50/hour, that drops to about 128 hours, or 4.3 hours daily.

These numbers assume 100% of the budget goes to PSW wages, which isn't realistic — families also need respite, therapy, and other services from the same pool. In practice, many families get 2–3 hours of daily support once the budget is split across multiple service types.

The state increased wage reimbursement rates to address a severe workforce shortage — DSP turnover statewide exceeds 40% annually — but the HBS budget formula hasn't kept pace. Rising wages within a fixed budget means fewer purchasable hours each year.

Managing the Budget

Overspending the HBS budget can result in losing the right to self-direct services — the individual gets moved to agency-directed services, losing family control over hiring and scheduling. Budget management is not optional.

Practical approaches:

• Track spending monthly against the annual cap, not just the monthly allocation
• Use the carry-over provision strategically — bank lighter months for periods of higher need
• Negotiate PSW rates within the allowable range (you're not required to pay the maximum reimbursement rate)
• Request a budget review through the ISC if the individual's needs have changed materially

Getting Into the Program

HBS access requires selection from the PUNS waiting list (currently 42–43 months in the "Seeking Services" category) followed by DDD waiver enrollment. There is no direct application to the HBS program — it's one option within the waiver menu, selected during the Person-Centered Planning process after PUNS selection.

The Illinois SSI at 18 & Adult Disability Benefits Guide covers the full path from PUNS registration through waiver enrollment and HBS budget setup, alongside the parallel SSI and Medicaid applications that determine which funding streams your young adult can access.

See more Illinois guides →