The public comment period is open until April 22

Families have an opportunity to share feedback on proposed improvements to the Medicaid Home and Community-Based Services Waiver for Those Who Are Medically Fragile and Technology Dependent (MFTD waiver). The public comment period is open until April 22.

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 several amendments to improve how the state delivers, explains and organizes services for individuals receiving MFTD waiver support. The proposed changes aim to make MFTD waiver services clearer, more efficient and easier to access.

The proposed changes include:

NEw Service Added

• Allows occupational or physical therapists to assess a person’s home. This change helps HFS determine what equipment or home changes an individual needs for safety and independence.

Equipment and Technology Updates

• Separates evaluations from equipment services (so HFS bills and and handles them separately)
• Expands the list of covered items, including:
  • Mobility aids (such as lifts and standers)
  • Adaptive items (such as utensils, bikes and seating)
  • Sensory and safety items (such as mats and trampolines)

Home and Environment Changes

• Confirms that Environmental Accessibility Adaptations is no longer a single service
• Breaks it into separate services:
  • Pest control
  • Home modifications
  • Vehicle modifications
• Clarifies that home modifications can apply to more than one home (such as shared custody situations)

Service Improvements and Clarifications

• Adds more detail and clearer rules for:
  • Home modifications (such as lifts, ramps and generators)
  • Pest control (including traps)
• Allows the state to recover certain costs if a person passes away or cannot move home after services are planned

RemoveD Services

• Removes services that the waiver already covers elsewhere to prevent duplication:
  • Placement maintenance counseling
  • Specialized medical equipment

Provider and Service Rules

• Requires providers to be in good standing
• Clarifies when family members can be paid for respite care (only if they don’t live with the individual)

Quality and Oversight Updates

• Improves how HFS monitors and reviews the program
  • Updates performance measures and tracking methods
  • Clarifies who collects and reviews data
  • Adds grievance procedures for participants

Rates and Administrative Updates

• Sets a standard rate for the new therapist assessment service
• Updates cost estimates and system changes to support the amendment

review the full waiver amendments

To review the full waiver amendments, you can:

• Read the public comment notice on HFS’ website
• Review hard copies of the notice at the Department of Human Services (DHS) local offices (except in Cook County).
  • In Cook County, you may review the notice at the Office of the Director, Illinois Department of Healthcare and Family Services, 401 S. Clinton St., First Floor, in Chicago.

How to Get a Copy of the Proposed Waiver AMENDMENTs

• You can download and print a hard copy of the proposed waiver amendments from the HFS website at https://hfs.illinois.gov/medicalclients/hcbs.html.
• You can call (217) 524-4148 to request a copy.
• Copies are also available at the following locations:
  • Healthcare and Family Services
    201 South Grand Avenue East
    Springfield, IL 62763
  • Healthcare and Family Services
    401 South Clinton
    Chicago, IL 60607

How to submit public comments

HFS now invites families and the public to comment on these proposed amendments through April 22.

You can submit feedback in two ways:

• Email HFS.HCBSWaiver@illinois.gov
• Mail written input to the Illinois Department of Healthcare and Family Services, Attention: Waiver Operations Management, 201 South Grand Avenue E., 2FL, Springfield, IL 62763

HFS and the 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.

New approval process for respite care for individuals enrolled in the MFTD waiver begins on Sept. 1

Families enrolled in the Medicaid Home and Community-Based Services Waiver for Those Who Are Medically Fragile Technology Dependent (MFTD waiver) will see a new approval process for respite nursing services.

This change will help make respite nursing services more respectful of your wishes.

Starting Sept. 1, 2025, nursing agencies must get your permission and official approval from the Division of Specialized Care for Children (DSCC) before providing respite care to your child. This means a nursing agency or respite facility cannot use your respite hours unless you ask for them and agree to the plan.

Why This Change Is Important

We are making this change because families shared concerns that agencies and/or facilities used their respite care hours without their knowledge or permission. We want to make sure:

• You are always in control of when and how your family uses respite care.
• Respite services follow Medicaid and MFTD waiver rules.
• You know exactly how many respite hours are used and when.

What You Need to Know

• Each year, families in the MFTD waiver get 336 hours of respite care.
• Respite care is only available if the legally responsible adult (LRA) asks for it.
• Nursing agencies cannot use respite hours without your clear permission.
• If you request respite, the agency must fill out a form and get approval from DSCC before care begins.
• Respite hours don’t roll over to the next year and can’t be used as overtime.

If you think your child needs respite care, talk to your nursing agency about how many hours you want and when you need them. Please give them as much notice as possible (at least two business days before you need the care).

Your nursing agency will then contact DSCC to submit your request.

If something comes up at the end of the month and you need extra help, please talk with your nursing agency. They can work with you to request respite.

If you have any questions, please reach out to your DSCC Care Coordinator. They are here to support you through this process.

Thank you for your cooperation and partnership!