New Federal Requirements for Residential and Non-Residential Home and Community-Based Settings
On January 16, 2014 the Centers for Medicaid and Medicare Services (CMS) issued new regulations for the provision of Medicaid Home and Community-Based Services (HCBS). Each state that operates a 1915 (c) waiver or a Section 1915 (i) state plan benefit that was in effect on or before March 17, 2014 is required to file a Statewide Transition Plan. The intent of the new regulations is to ensure that individuals receiving long-term care services and supports through HCBS programs have full access to benefits of community living and the opportunity to receive services in the most integrated setting appropriate. This includes opportunities:
To seek employment and work in competitive and integrated settings
Engage in community life
Control personal resources
Receive services in the community, to the extent to which they are able as individuals who do not receive HCBS
The focus of the Statewide Transition Plan will be compliance with the rules as they relate to the setting where a person may live and where he/she may receive services.
The Illinois Department of Healthcare and Family Service (HFS) in collaboration with the Illinois Departments of Aging (IDOA) and Human Services (DHS) and its Divisions of Developmental Disabilities (DDD) and Mental Health (DMH) is developing a Statewide Transition Plan as a result of the new Federal Home and Community-Based Services (HCBS) setting requirements effective March 17, 2014. These regulations are CMS 2249-F and CMS 2296-F, which affect Illinois’1915 (c) Home and Community Based Services Waivers. Illinois plans to submit its Statewide Transition Plan by March 17, 2015. Our Statewide Transition Plan must include the strategies to bring Illinois in full compliance with Federal rules by March 16, 2019. All of the state departments and divisions have been working collaboratively beginning shortly after the implementation of the new rules. Stakeholder feedback on the Statewide Transition Plan is a critical component of the Plan and is required by CMS.
The following 1915(c) waivers currently operating in Illinois that need to be in compliance and addressed in the Statewide Transition Plan:
- Adults with Developmental Disabilities
- Children and Young Adults with Developmental Disabilities
- Medically Fragile/Technology Dependent Children
- Persons who are Elderly
- Persons with Brain Injury
- Persons with Disability
- Persons with HIV/AIDS
- Residential Services for Children and Young Adults with Developmental Disabilities
- Supportive Living Program
The development of the Statewide Transition Plan will involve an assessment of the State’s existing rules and regulations pertaining to HCBS settings as well as a survey of HCBS providers to determine their level of compliance with the new regulations. Secondly, the state is required to implement a remediation strategy for compliance with the new regulations.
Provider Settings Surveys: In September and October 2014, HCBS Waiver providers have been requested to complete a self-administered survey in order for the state to take an inventory of our existing settings. The results of these surveys will be analyzed by the University of Illinois at Springfield, Survey Research Office. The following are links to documents that have been developed to-date:
- Residential Settings Introduction Letter (pdf) (html)
- Non-Residential Settings Introduction Letter (pdf) (html)
- Residential Settings Cover Letter - 10-02-14 (pdf) (html)
- Non-Residential Settings Cover Letter - 10-25-14 (pdf) (html)
- Residential Agency Specific Survey (pdf)
- Residential Setting Specific Survey (pdf)
- Non-Residential Agency Specific Survey (pdf)
- Non-Residential Setting Specific Survey (pdf)
Statewide Webinar and Regional Forums
The state’s goal is to have input into our Statewide Transition Plan at various stages of its development. The state will include opportunities to provide written and verbal feedback from an array of stakeholders that will be incorporated in the Statewide Transition Plan. Watch for a published schedule of focus groups and other forums.
Please revisit this site as plans for these opportunities to receive public feedback emerge. Illinois wants and needs your input.
The Illinois Department of Healthcare and Family Services (HFS) in collaboration with the Illinois Departments on Aging (IDoA) and Human Services (DHS) and its Divisions of Developmental Disabilities (DDD) and Rehabilitative Services (DRS) have revised the Illinois Statewide Transition Plan in response to the Clarifications and/or Modifications required for Initial Approval (CMIA) correspondence dated July 30, 2015 from the Centers for Medicare and Medicaid Services (CMS). This correspondence notified Illinois that public comment, input and summary requirements are met, but CMS has identified issues that must be resolved in the Statewide Transition Plan prior to initial approval.
The State of Illinois is seeking public comment on the revised Statewide Transition Plan for a period of 30 days beginning on December 4, 2015 and ending on January 3, 2016. Comments on the revised Statewide Transition Plan may be submitted on this site or by mail. Comments by email to HFS.SWTransitionPlan@illinois.gov. Written comments should be mailed to:
Illinois Department of Healthcare and Family Services
Attn: Waiver Management
201 South Grand Avenue East, FL2
Springfield, IL 62763
Persons who are unable to access the Internet may request a hard copy of the revised Statewide Transition Plan by calling HFS at (217) 524-4148.
Revised Illinois Statewide Transition Plan submitted to federal CMS on February 29, 2016
Draft Illinois Statewide Transition Plan presented for public comment on December 4, 2015:
Original Illinois Statewide Transition Plan submitted to federal CMS on March 16, 2015.
Original Statewide Transition Plan (pdf)
For more information regarding the new Federal HCBS setting requirements, please visit: