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Cook County approves revised in‑home services cost‑sharing program for older adults
Summary
The board voted unanimously to adopt a revised in‑home services cost‑sharing policy that replaces a long‑running $5 sliding scale with a tiered, federal‑poverty‑guided cost‑share to stabilize the program budget and expand access.
The Cook County Public Health and Human Services Board on Feb. 17 unanimously approved changes to its in‑home services cost‑sharing program designed to shore up finances and preserve services for older adults and people with disability certifications.
Olivia Bonander, supervisor for adult and home‑and‑community‑based services, told the board the program will be renamed from a sliding fee scale to a cost‑sharing program and move to a tiered approach tied to federal poverty guidelines so higher‑income recipients pay more while most who qualify for Medical Assistance remain near the previous $5 per month level. Bonander said the program was capped while staff evaluated fiscal sustainability.
Bonander said the county currently contracts with roughly 20 independent providers who deliver home‑support services (cleaning, cooking, prescription pickup, snow‑shoveling, wood carrying and other activities of daily living) and that typical hours for recipients range from two to 10 hours a week. For the cost‑sharing option, recipients are allotted about five hours per month. Staff estimated about 30 active clients currently receive services and noted a waiting list exists for cost‑share openings.
Board members asked how pay and travel time are handled; staff said they reimburse providers for travel time and that contractors are paid roughly $7.90 per 15 minutes (about $30 per hour). PHHS staff stressed the program is meant to complement waiver and private‑pay options, not displace them, and that the change is intended to extend program sustainability so more people can be served.
Commissioner Sullivan moved to approve the 2026 in‑home services cost‑sharing plan; the board approved the motion unanimously.
What’s next: staff will implement the updated application and policy, monitor the budget impact, and report results to the board as they work to reopen the cost‑share enrollment to those on the waiting list.
