Announcing Rate Increases for In-Home Nurses
Increased rates for in-home nurses will take effect on Jan. 1, 2024.
We have an exciting update for our participants enrolled in the Home Care Program.
The Centers for Medicare and Medicaid have approved a rate increase for in-home nurses in the new year.
We hope this rate increase can help expand available and high-quality nursing options for our participant families.
This rate increase affects:
- Registered nurse (RN), licensed practical nurse (LPN) and certified nursing assistant (CNA) care
- In-home and facility-based respite care
- Nurse training rates
This increase will take effect Jan. 1, 2024. The rates are as follows:
- RN, $54 per hour
- LPN, $45 per hour
- CNA, $30 per hour
You can see the updated Home Health Fee Schedule on the Illinois Department of Healthcare and Family Services (HFS) website.
The following rate increases are for participants who are in the Home and Community-Based Services Waiver for Those Who Are Medically Fragile, Technology Dependent (MFTD):
- Nurse training for an RN, $54 per hour
- Nurse training for an LPN, $45 per hour
- In-home respite for an RN, $54 per hour
- In-home respite for an LPN, $45 per hour
- In-home respite for a CNA, $30 per hour
HFS will also increase the maximum amount for nurse training service hours from four to 32 hours per nurse per waiver year.
As a reminder, parents and legally responsible adults who have an RN or LPN license can be paid caregivers. (Parents and legally responsible adults who are CNAs cannot be paid caregivers at this time.)
HFS will increase your nursing resource allocation amounts to reflect the increase.
Your Division of Specialized Care for Children (DSCC) care coordination team can help you with any questions about the rate increase or nursing services.
You can also find more helpful information about Home Care Program services on our website’s Home Care Information Hub.
DSCC Works to Continue Paid Licensed Caregiver Option for Families
DSCC partners with state and federal agencies to ensure licensed caregivers can be paid nurses for their children beyond the public health emergency
The COVID-19 public health emergency has given families more flexibility to help care for their children with complex medical needs.
One helpful way is allowing parents and legally responsible adults (LRAs) who are licensed nurses to be paid caregivers.
The Division of Specialized Care for Children (DSCC) is working with our state and federal partners to make this a permanent option through the Medicaid Home and Community-Based Services Waiver for Medically Fragile, Technology Dependent (MFTD) Children.
The Illinois Department of Healthcare and Family Services (HFS) is the Medicaid agency responsible for the MFTD waiver. Many families in the Home Care Program have children who receive services through the MFTD waiver.
HFS must renew Illinois’ MFTD waiver every five years. The current waiver will expire on Aug. 31.
DSCC and HFS partnered to collect family input and propose several changes as part of this year’s renewal process. Our proposal included a request for nursing by licensed LRAs to be a permanent MFTD waiver service.
We understand this option is a much-needed benefit for our participant families.
The federal Centers for Medicare and Medicaid Services (CMS) reviewed our proposed changes as part of the waiver approval process.
CMS is now asking for more time to review our request for paid nursing by licensed LRAs. Therefore, nursing by licensed LRAs is currently not part of the approved waiver that will take effect on Sept. 1.
“CMS is aware of the strong advocacy and support of this service from waiver customers, families, UIC (the University of Illinois Chicago), DSCC, and HFS. It is their intention to support the State in this endeavor; however, their review will not be completed by the waiver expiration date,” according to an HFS notice to MFTD waiver families.
In the meantime, nursing by licensed LRAs remains part of Appendix K. (Appendix K is an emergency coverage document for individuals receiving services through a Medicaid waiver.)
Licensed LRA nursing will therefore continue throughout the public health emergency and six months after it ends. (The public health emergency is currently set to end in October, but this date will likely be pushed back once more.) This option is available for all Home Care participants, including those who do not receive MFTD waiver benefits.
This timeframe will give CMS more time to review and work with DSCC and HFS to approve licensed LRA nursing as a permanent waiver service.
Families can see the approved waiver and review the changes taking effect on Sept. 1.
We will continue partnering with HFS and CMS to help meet our participants’ needs and resolve their concerns. We look forward to more progress in the coming months.
Please note this update about licensed parent caregivers is separate from DSCC and HFS’s other work to expand paid caregiving options for the Home Care Program as part of Illinois’ plans for an increased federal match (FMAP) from the American Rescue Plan Act (ARPA).
We remain committed to improving support for caregivers of children with medical complexity. We will share updates as available on this additional work.
Public Comment for Proposed MFTD Waiver Amendments
Families have until Oct. 2 to provide feedback on several updates to the Home and Community-Based Services Waiver for children who are medically fragile and technology-dependent
The state invites families to provide feedback on several proposed amendments to the Home and Community-Based Services waiver for children who are medically fragile and technology-dependent (MFTD).
The Illinois Department of Healthcare and Family Services (HFS) operates the MFTD waiver. Many families in the Home Care Program have children who receive services through the MFTD waiver.
HFS has announced the following proposed amendments:
- Increase the Placement Maintenance Counseling rate from $50 to $86.28 to be more consistent with the Illinois Department of Human Services’ rates for counseling services.
- Update the cost projections for In-Home Shift Nursing and Certified Nursing Assistant for the waiver’s fifth year to account for recent rate increases and individuals over age 21 continuing to receive waiver services.
- Add Electrical Assessments to the current service definition under “Environmental Accessibility Adaptation” as an available option.
- Add Generators to the current service definition under “Environmental Accessibility Adaptation” as an available option.
- Lower the required number of bids for vehicle modifications from three to two.
HFS now invites the public to comment on these proposed amendments. (You can read the public comment notice on the HFS website.)
To review the full waiver amendments, you can:
- Download and read and/or print a hard copy of the amendments from the HFS website.
- Call (217) 524-4148 to receive a hard copy.
- Review copies at Healthcare and Family Services offices at :
- 201 South Grand Ave. E.,
Springfield, IL 62763
- 401 S. Clinton
Chicago, IL 60607
- 201 South Grand Ave. E.,
The deadline to provide feedback is Oct. 2.
You can submit feedback in two ways:
- Via email at HFS.HCBSWaiver@illinois.gov
- Via mail to the Illinois Department of Healthcare and Family Services, Attention: Waiver Operations Management, 201 South Grand Ave. E., 2FL, Springfield, IL 62763
HFS and the University of Illinois Chicago’s Division of Specialized Care for Children will review the comments and respond to them.
We will then submit comments to the federal Centers for Medicare and Medicaid Services as part of the amendment approval process.