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.

Families have through Sept. 28, 2024, to share input on waiver amendments allowing CNAs to become paid family caregivers and nursing rate increases.

Families have an opportunity to share feedback on several significant updates to the Medicaid Home and Community-Based Services Waiver for Those Who Are Medically Fragile, Technology Dependent (MFTD waiver).

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 this waiver.

HFS is currently seeking approval from the federal Centers for Medicare and Medicaid Services (CMS) for waiver amendments that will:

• Allow parents who are certified nursing assistants (CNAs) to be paid family caregivers
• Increase rates for in-home nurses and CNA services

Read below for more details about these amendments and how to share your input.

CNAs as Paid Family Caregivers

Plans are underway to allow parents/legally responsible adults (LRAs) to become paid caregivers if they are a CNA and employed through a nursing agency.

Currently, parents/LRAs are paid for providing skilled nursing services to their children if they hold an active registered nurse (RN) or licensed practical nurse (LPN) license. This rule applies to parents/LRAs of all children approved for Home Care services, regardless of the child’s age. (Read more about our efforts to make paid licensed family caregivers a permanent benefit.)

Allowing parents and caregivers who are CNAs to become paid caregivers is an important step in strengthening our support for families of individuals who need in-home shift nursing.

This update would give more parents/LRAs the opportunity to earn payment for the caregiving they provide their children at home.

This change requires an amendment to the MFTD waiver as well as the creation of a new state plan amendment.

Nursing Rate Increase

HFS is also proposing a 7 percent rate increase for in-home nurses and CNA services to take effect on Jan. 1, 2025.

This rate increase would affect:

• RN, LPN and CNA care
• In-home and facility-based respite care
• Nurse training rates

The proposed rates are as follows:

• RN, $57.78 per hour
• LPN, $48.15 per hour
• CNA, $32.10 per hour

We hope this rate increase can help make more high-quality nursing options available for our participant families.

Transitional Care Services provided outside the home (not an MFTD waiver service) is expected to have a rate increase from $950 to $1,300 a day. This increase would also take effect on Jan. 1, 2025.

Other Key Updates in the Amendment Include:

• Adds adaptive equipment and assistive technology as new services.
• Makes pest control a post-approval process. This change means families will not need to receive prior approval for pest control services.
• Makes the Division of Specialized Care for Children (DSCC) the entity responsible for the prior approval for home accessibility modifications, vehicle modifications, medical equipment operating expenses, adaptive equipment, placement maintenance counseling and assistive technology.
• Removes the requirement of two bids if the cost exceeds $2,000 for waiver services. This change is necessary to help increase access to services.

Share Your Feedback

The public comment period for these proposed waiver amendments is now open.

To review the full list of proposed waiver updates, you can:

• Read the public comment notice on HFS’s website.

• Review a hard copy at HFS’ offices at:
  • 201 South Grand Ave. E.,
    Springfield, IL 62763
  • 401 S. Clinton
    Chicago, IL 60607

The deadline to provide feedback is Sept 28, 2024.

You can share your feedback in two ways:

• Via email to 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

This public comment process is one of the best ways you can have your voice heard.

HFS will send your comments to the federal CMS as part of the waiver approval process.

If you have questions, please contact HFS’s Waiver Operations Management Unit at (217) 524-4148 or (844) 528-8444.