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What services will you provide?

Home services means help with activities of daily living, housekeeping, personal laundry and companionship. Personal care adds hands-on tasks such as bathing, toileting and transfers, each with its own training and competency rules (245.40(c)(4)).

Will workers help clients bathe?

Tub, shower, sponge or bed baths. Needs training in each client's bath and a competency check, repeated every year (245.40(c)(4)(C)).

Will workers help with transfers?

Only for clients who can reliably stand and pivot and help with the transfer (directly or by giving feedback), after training on the client's equipment and a competency check (245.40(c)(4)(M)).

Will workers help clients change position?

Complete repositioning for a client who cannot signal is allowed only when the client's representative can help or give feedback, after training and a competency check (245.40(c)(4)(J); 245.210(d)(2)).

Will workers help clients eat?

Only for clients who swallow on their own and can sit upright. Thickeners need training and a competency check; a client at high risk of choking needs a home health or home nursing agency (245.40(c)(4)(F)).

Will workers help clients walk with walkers, canes or wheelchairs?

Once the client's own training on the equipment is finished, after worker training and a competency check (245.40(c)(4)(B)).

Will workers apply prescription compression stockings or devices?

Needs an order from the client's prescribing health care professional, worker training and a competency check. Non-prescription support stockings are ordinary dressing help (245.40(c)(4)(D)).

Will workers use a prescription shampoo?

Needs an order, training, a competency check and annual retraining (245.40(c)(4)(G)).

Will workers file nails for clients with circulation problems or loss of sensation?

For example clients with diabetes. Needs an order from the client's health care professional, training and a competency check. Workers never trim nails (245.40(c)(4)(I)).

Will workers switch clients' oxygen from stationary to portable?

Needs training and a competency check, and a staff member trained to train and evaluate workers on it. All other respiratory care is skilled care (245.40(c)(4)(O)).

Will workers remind clients to check blood pressure, heart rate, oxygen, temperature or weight?

The agency never interprets readings or acts clinically on them (245.40(c)(4)(P)).

Will workers empty catheter and ostomy bags?

Emptying or changing external collection bags is allowed. Inserting or removing catheters, enemas, suppositories and digital stimulation are not (245.40(c)(4)(L)).

Will workers remind clients to take their medication?

Only from containers filled by the client, a family member, a nurse or a pharmacist and marked with the day and time. Workers never set up medication (245.40(c)(4)(N); 245.40(c)(5)(D)).

Will you serve clients with Alzheimer's disease or another dementia?

Then Part 973 applies: an Alzheimer's services supervisor, a dementia care plan for each client with a diagnosis, disclosure materials at enrollment, and 6 hours of initial and 3 hours of annual dementia training (245.211; 973.130; 973.140). Most agencies serve clients with dementia.

Will you have a branch office or drop site?

Extra locations within your service area, supervised by the parent office and approved by IDPH (245.80(k)).

Which kind?

A drop site has no staff assigned, takes no referrals, does no payroll or billing, stores no files and is not advertised (245.80(k)(2)).

Will any services be provided through a contract with another company?

Contracted services need a written agreement with the items in 245.210(b), and unlicensed contracted workers go through the fingerprint background check (955.135(a)).

Will students from a school or college train with you?

Needs a written agreement with each educational institution (245.40(k)).

Will you serve clients under 18?

Suspected abuse or neglect of a client under 18 is reported to the DCFS Child Abuse Hotline (245.250(a)(2)).

How will you count each worker's year of annual training?

Every worker needs 10 hours of training each year; the agency picks the basis (245.71(f)).

What will the new-hire health evaluation include?

Part 245 leaves the content to your governing body (245.30(c)(1)(B)), and IDPH reviews the policy with your application. Choose what you will always do for every new worker.

Include recommended practices?

Some policies end with practical steps that go beyond the rules, such as an agency emergency plan and a client rights statement. Once adopted they are your policies and IDPH can expect you to follow them, so leave them out if you won't.