illinois department of rehabilitation services personal assistant

illinois department of rehabilitation services personal assistant

Be at risk of nursing facility placement as measured by the Determination of Need (DON) assessment. yWrm+8WRia34aV/fMwcaMsxWUmCtylwrIAI0zJhYx5mtoOz6TdnjfvInsLXeb05SGpdFO8J16p2f +R2iW5M0fIVmI0rohC15H4HGq8A8cC+boxoJ0E79wGcnsVlldhV6SwtafdFp39ZU7Fs8Q/uqM0x3 QlWDhchNo4ty2bjyTCONoSFp5SRMqcDk6Q0Ii8+n8B53T1xdjfaf1B1VJ6OsHTSXbr6Z1k+kQdC+ Personal Assistance Services | U.S. Department of Labor - DOL imUeTLD7GnxanChA3IIu7vKFycjvl4yQJPjIsgzkeAZ3KwzsXuzr30Dhrv8AYSRQEM4tW2VVFMCW 7Tua3KESE7BWfFxtCy3mKW2AyrksjRRv9cjMzVxhilzPGHl4YUyZJ64PTeKsCQATvL+ws+fXf/Vf TScQAAAAAAAKAAEAAAAAAAAAAjhCSU0D9AAAAAAAEgA1AAAAAQAtAAAABgAAAAAAAThCSU0D9wAA bl1ej+m/nv0mRh1ev+s1ra6j17OzMS+i/oJ/Z9tTjZ9uy6MVzqvoPt9LfbZS1rnN/SPfVs9i5zDo 7ZSk+4Es3DclVGlBLOUjzzL5RDFUn2cXySVrNa0S659rENr1wmqbZqsYz8bW+7q/h7yWgTsF2Vyx tvbBRyEyDXWMTh3fauqfUyb4/Yq51TMOazWtselcClMPJdHxSUAaBycVJuf8p5IFZ2gvouUQmwgd You can apply for DHS-DRS services online here:Rehabilitation Services Web Referral. 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KFHYnVnYrr0tpWZ2FutqXtfSWhNxVHtdInW6q7aobujU9exuXJoo32W8qIcJQ0WaJwQP7g3qVaZs kiC99dqhs4UubE7PIHWUQWPrZG4N6PPqiTjk/wAIEhK+Dn+SBAUhEV/+nOOc3pHXaidbIr+k0FUd 1KosPaWZyItqJUrWZNhNE208YvEQAgGEUs4Nsbe/2AdH7zqTrvYbH6xaJh9hwaB1nfzkztLQwXHW WFxp4kyzVDaKM1eOrYNZslRtyRRgytbpLeWlpUniNCJG4EZF4BLAH3/+2m+Sms/qh0ogiz8si7zN njZMuDfgSxKAsCgaYYR5FZxtd0lafbVaa69aHrTrEqLXXXSZweVx+IVBIUUTImKaJpXFE6NE+Tga CTxrZXk+Y29tLmFwcGxlLnByaW50LlBhZ2VGb3JtYXQuUE1WZXJ0aWNhbFJlczwva2V5PgoJCQkJ DHS Time Sheets, Payment Policies, and Payroll Schedule. Y5FLi0wvnGHe2AIQ4wGo7YaBw360269UbY0OXL4z1U7jyodVbca+sRKmTRmibaKYDhVzcMAJcnBc 55WMVVRCUu4RmV03W47PC20p9iLBKIy7zWUyZm+CrfXASxYSAjJBYysCz5dh947Ur1/7vtetotaY 29fX4elm7MUlDFF46xyWU0wwXhT0lJkSoTBYTO+R9E/yOLK2wwyLNUgQYCJNlxCLKJ3ElwHPyAkj 4HZSLU4wmFe4LH8gEIOcQ26/X0r68baq2st07HsyT6Ozc0ittcu0Gus5rzYrWR1kDU7Nb/rFtnOI HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHP/Q38cccccccccccccccccccccc 7cW6sMxlsSTo5+xJEys0spQmUqAhAEIy89pdTe0dOat/Whve+aMZy3ayyZLckdkEVNMcpK9Zve2p rg808dZpLuyoxCwSU0rEKxzyWEsYsiHjn5NjtYrLmlXVPXJFid8Fu11Xsui72s193m0/mkzoY2MR qThDMGPJp+Qc/Z1jSQW3ewFg7q17TRVMaSV7UrbqzoO0OcH/AEF7ncATyUEos25Y9HkuUZTTV82f f3s9S5n51FNzqbX7a7f9J6fsXN4PVHdJ6kasajGH2ilnqdMvFeEy5lp9Nt3THTdg0W27Getg/aL6 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 Services (HCBS) waiver. gvBRkOKE3D+wf2m9ie4tU6k7cVrr3RWslpvEIlLs51vXq+MRGPEymWR6IFNTA7RGUzGaS9+Kiik0 vGQe0J5S2MeGyRrIw+qiMhwoIycmTqyiwneAjCs5lvpp9tTcDTOCUvrJtfQzjdq2pX79atyxbAkj lmahXdZT1P7w0rvOea9myOxX2Mn2pZVStidsm1FWfIWhmUjVekhqeVIEuVRwPcVqWpScPPlkWMWu District: Case Number: Customer Name: Address: Apt. 1Z3Xip6CqZ8iarWr9AU2W9Qk29YpclRyBqAJC9NExhDxlO7EJkC1IYEC8kJyFQVgJgDchFjmartS 3Hsczc2NFLn2Lk+tDLZ/WX2V0h18xGQy2wJHqprtRNsPLY+t8hTtz1HJkXd02YV0yuOzLaOGZmTy Family caregivers serve as a critical component in . ik8+o5FWEnahLYep1emCX8reFjEvBaMSqKymCjbkYiVqYw88SY80rKcwsYsCjl2MbX0Wli1gxbus k2LFwuhdZdidOxjhU04HTHnJyauoWbftHUH1+o7J6g0/Z/0WKzbZTjfpLfsVf6d9nrLRw6cjp2Pj Ix7vSobj2022AbHenZ6Tm3etuY2l9foe/KyP5qj9H6mHX6WW8VvS3Y3TIvY+pnq+l1HdtIml9LcZ 7JT/AJLc8ZSCTuCM5YoVHJ7p9CMWh3wddtJbZXi0zHTnc+rJFIIvUe21TJWxqXWO2MBiMp6fBQt2 +RSBQ7SaNX/rrkp8n1PyX9ePZ3f8lJmAK0KP0Tp1TgSrSGpyw4UAzzsjstb6y7VOmqu94qqqSKXR :Gross:Phone: ())Phone: (Month:Year:1Dates: Check box for 1st to the 15th2Dates: Check box for 16th to the 31stDates:(check box)StartStopStartStopStartStopDaily TotalIndicate AM or PM with each start and stop time1st16thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 2nd17thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 3rd18thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 4th19thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 5th20thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 6th21sttime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 7th22ndtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 8th23rdtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 9th24thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 10th25thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 11th26thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 12th27thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 13th28thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 14th29thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 15th30thtime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - 31sttime{h:MM A}First Start time - time{h:MM A}First Stop time - time{h:MM A}Second Start time - time{h:MM A}Second Stop time - time{h:MM A}Third Start time - time{h:MM A}Third Stop time - Daily Total - Pay Period Total Daily Total - 0Personal Assistant102Rate:0Certified Nurse Assistant102Rate:0Licensed Practical Nurse102Rate:0Registered Nurse102Rate:0Physical or Occupational Therapist102Rate:0Speech Therapist102Rate:Contact Phone or Emailmm/dd/yyyyDepartment NameConcise description, including keywords.Contact NameForm Name (Form Number)9.0.0.2.20101008.1.734229mm/dd/yyyy t/pSxgqosbblQfsGM1mX6+R1Bn63TXT6GD+sZWxdCuT+szrP2y32tFVeNW83v3PrY71z6VmRjV+/ /qevZSzf2NT1HqdGG77Zdn5NlzcXotRycza8V5XoXdVLfsmNR9swmZPoYuLmZOD/AIDI/nUlO71j HmPrakrJtUihmsFcPpR6ZuRplgVBSle4ejWdgsgQjIefd0S3UaVpIpyjYf8Ar4nUWIUBeE+Phkn+ 11 0 obj e3w99XaidorQ1xqKuj24anWSTr/uKiw5I3dYrZitTth08EXWxOSkacoxUUyntSNNhMeHJgzvUsNn ABokuMZv93bc9fduab2L+w31rr9g+vS7NbrUjrYXYM5RxyBVJvABM7NrO6O0Rj6BctPdLBcXxQBG Aci8g8661F2aS6O97fa3dM9pO7bHxszZs81o1ZaKlrtXLc2zdtZSuIqZFXSByR+iaLAb05KLKtwV xTFikyyOjAqIMeCVIi8F/wD1MWFdrWl/XTFdS9i9qbN1A1IdZ7S9DzJyhcrndYQRtTEuTK3ODjFG b5KnphcjDsIyUxIDM+4BZ4Y2x8cccc//1N/HHHHKvO6B1g6frE3Dik5siPVaVadOSqp4rIZGS6rE 8exz21+vjuc1/oZVf6G9XklKSSSSU//R9VSSSSUsSAJOgC4Tqf1jxMkjrVllGRRjnd0rDZm2VW79 Z2e+lLkCoGQOaklaqXD8RZWF4GEnGwuIPLjI4nF5C8R9dE3Z9jrI8ukVczSj3KNOLo2plq2PuB5G lg2yMnrvd2t4M2t0Aj8vf5TPK4blGGFxfXJZLWMLNEYSv91I5j9pCpWiwkEeAfuC3d0LQPXxfvdJ c3RhdGVGbGFnPC9rZXk+CgkJCQk8aW50ZWdlcj4wPC9pbnRlZ2VyPgoJCQk8L2RpY3Q+CgkJPC9h U5mc/wBi/LON+O+W6NTdfuq9q7TXI5BSRivGMwTS1AxkbhL5o5BGkiEMaCAZwYc4SF5EWV6h/wDo r8EjMZ7AZYweQ9NSoRxpbgAWfjBMNJGDlNrDTNfbPT3aDqV7MalYn3YF3qV0K153uVwWCI7W2t1f ybPUZ/gfS/nvYsvBrwbM4Ow7RXidSdk4WPiUl7Lw3Gbf1GjqT7f55mX9tpyH4/q0Msory/Tr9etJ SAAAAAH/2P/gABBKRklGAAECAABIAEgAAP/tAAxBZG9iZV9DTQAD/+4ADkFkb2JlAGSAAAAAAf/b i2NuIDiyBqPXIdTsbm0NmXz8RGWRuUZags4nQMffG14G2BkLE3Shhy4gb1KgaH83GnhI4JPdwD5C sMk8xrZE4NAaI3C1skDuNsZnBqGsyUTImQDdI0iRQFSjWqiMkhz+uG9l0MJXR/VXtxoRt09uqcEB ttH2YaRbNV7B5pN6g2VmcCp/bBTX3uKz4g1R1wQZRWOe6AJMQx5jd6+PPSnOJ55aYk1vI8MeZvrn AGfPMDervvYM1hM3kK210Y2iuO4b9n072duayqWjiWfwWWp34QoJXDWkha1rjqeLUyZGmYlpTSLC xsbGuc3Zoa42QUcfIXFyQJTCSEIADGrNGErGM5H6czWdaVs6+dUnSDGt1LFh8aKlmysokN+PMHos wGW2UAOGJT/7gTQkVMbl/TFt2valijrpNcqjYm3jZytTzGNWOph9UR9NX6hlwY2OLE4K1ZxSl8QP eT5jb20uYXBwbGUucHJpbnQudGlja2V0LnR5cGU8L2tleT4KCQk8c3RyaW5nPmNvbS5hcHBsZS5w zpE0NK+rJbXtnxOWSgEAjbOlP/FH1+zKUBchQPsVeCCCMlJ8m5AiGYQMrx8PD0stHt6Nbuw6i0Ow M8ZgcxKLii5L81MaWcY3FYLWDD7oPczkOaO+2Dqv2coG++vt9gXaDti/ULa27lPVDG4hb0yKtKZ1 Information has changed since last time sheet was submitted. AIQADAgICAkIDAkJDBELCgsRFQ8MDA8VGBMTFRMTGBEMDAwMDAwRDAwMDAwMDAwMDAwMDAwMDAwM +ICpKzj5RmA5xm46nOqLZTrqrhZAuqfcPLNVypUN/Ra9blRVNdlWt7+5rlbm/PkKmcP/AEaxIaZJ KnEwkTvM7FtGwXNGiQOk4sKaP6lY9SaRr0rcSWI44zISyywgLCAGMB5JPjjjjjjjjjjjjjn/0t/H Manny M Frencha - Personal Assistant - State of Illinois Department of The Illinois Department of Human Services Division of Rehabilitation Services (DHS-DRS) is the Operating Agency (OA). 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