Full Answer
What is Illinois’ persons who are elderly medicaid waiver?
Illinois’ Persons who are Elderly Medicaid Waiver provides home and community-based services (HCBS) for senior residents who are at risk of being being placed in a nursing home (“institutionalized”).
What is an Illinois HCBS waiver?
A waiver is a program that provides services that allow individuals to remain in their own homes or live in a community setting, instead of in an institution. Illinois has nine HCBS waivers. Each waiver is designed for individuals with similar needs and offers a different set of services. Who is eligible for a HCBS Waiver?
What is a blanket waiver for health care providers?
When a blanket waiver is issued, providers don't have to apply for an individual 1135 waiver. When there's an emergency, we can also offer health care providers other flexibilities to make sure Americans continue to have access to the health care they need.
What are the requirements for the waiver program?
Individuals' service needs must be able to be provided in the waiver at a cost equal to or less than the cost for institutional care; and Individuals must meet any other requirements, such as age or diagnosis requirements, specific to the waiver program.
Does Illinois have Medicaid?
In Illinois, there are several Medicaid waiver programs that will assist people with developmental disabilities. Contact the Division of Developmental Disabilities for more information. Presently the largest Medicaid waiver programs in Illinois for persons with disabilities are the Intellectual Disabilities (“ID”) Waiver and the Living at Home supports waivers. Call us for more information.
Does Medicaid waiver have startup fees?
Did you know that Medicaid waiver programs typically have minimum startup fees and can be an excellent source of revenue?
What is outcome based reimbursement in Illinois?
Illinois is seeking to adopt outcome-based reimbursement strategies to ensure that waiver recipients arenot only receiving the right service at the right time, but that high quality services and support are beingprovided by qualified providers. This quality incentive program will be developed in conjunction withstakeholders, including waiver recipients, families, providers, state staff and other advocacy groups.While an incentive program will eventually be rolled out for all waiver populations, the State has optedinitially focus on outcomes for the ID/DD population. The State has identified areas for systems-levelimprovement and will target incentive payments to increase:
How does Illinois provide a continuum of services?
Illinois proposes to provide an expanded continuum of services through a state plan amendment tomeet the needs of children and adults. Evidence supports that prevention and early intervention canbend the cost curve on health care spending. A robust health care system identifies emerging illnessesand when appropriately treated can decrease the long term costs of treatment. Therefore Illinoisproposes to implement a series of prevention and early intervention programs that include Screening,Brief Intervention, and Treatment (SBIRT), as well including access to services and supports that preventor limit residential placements for children with both mental health and/or substance use disorderneeds. State agencies will develop strategies that incorporate Medicaid 1115 funding along with otherexisting federal funding streams, such as SAMHSA SAPT and MHBG funding, to create a robust proactivesystem of health care. We will reinvest savings to support enhanced skills training and assistance, peersupport services, and assistance with non-medical needs associated with long term disability and soonto be eliminated learned dependency on institutional settings. Expansion of substance use disorderservices will also include peer recovery supports and case management for those with high needs.Illinois will work with our stakeholders to prioritize access to the most vulnerable and at risk populationsincluding those leaving the criminal justice system who are living with mental health and/or substanceuse disorders and individuals and families with socioeconomic challenges associated with poverty.
What are the outcomes of Illinois' innovations?
Illinois’ innovations are expected to result in quantifiable changes in utilization and cost savings on a percapita basis. The outcome measures we will use to quantify these changes are: 1) reducing avoidableemergency room visits; 2) reducing ambulatory sensitive inpatient admissions; 3) reducing avoidableinpatient readmissions within 30 days of being discharged from a hospital for the same or relatedadmission; 4) reducing overall cost of medical care; and 5) reducing spending on institutional services.
What are the health systems in Illinois?
Illinois is home to two large public health and hospital systems – the University of Illinois Hospital andHealth System (UI Health) and Cook County Health and Hospitals System (CCHHS). These systems play avital role in the state’s health care delivery system, including the provision of trauma and burn services,transplant services, and sub-specialty care. CCHHS is a major safety net provider for the underserved ofCook County and is one of the largest and most comprehensive public health and hospital systems in thecountry. UI Health includes a 495-bed tertiary hospital with nationally recognized transplant programs,an outpatient facility, and 19 neighborhood clinics serving communities throughout the near west, southand southwest sides of Chicago. As the only State government acute care hospital and health system, UIHealth is also positioned to leverage its own strengths to improve care and lower costs for patientsstatewide. Both of these public systems were active participants in the Illinois Alliance for Health andare committed to the transformation outlined in the State Health Care Innovation Plan.
What is the Illinois Health Information Exchange?
The Illinois Health Information Exchange (ILHIE) is a statewide, secure electronic transport network forsharing clinical and administrative data among health care providers in Illinois and bordering states. Theexchange is designed as a secure environment to improve the health of the people of Illinois throughbetter and more informed decision-making enabled by the quick exchange of, and access to patientinformation such as medical records, labs, immunizations and prescriptions at the point of care. TheIllinois Health Information Exchange Authority (ILHIE Authority) was established to provide a governancestructure for the network, which currently serves more than 3,500 health care providers throughout thestate and connects more than 120 hospitals for electronic public health reporting.
What is HCBS in Illinois?
In Illinois, home and community-based services in Home and Community Based Services (HCBS) waivers,currently approved under Section 1915(c) of the Social Security Act, are compartmentalized under nineseparate waivers managed by the Department of Healthcare and Family Services through agreementswith two other departments and numerous divisions within departments. The current waivers are foradults with developmental disabilities; children and young adults with developmental disabilities;elderly; medically fragile/technology dependent children; persons with brain injury; persons withdisabilities; persons with HIV or AIDS; supportive living facilities; and a support waiver for children andyoung adults with developmental disabilities.
Is University of Illinois a Medicaid provider?
The University of Illinois Hospital and Health Sciences System is one of the largest Medicaid providers ofinpatient and outpatient care in the state of Illinois. Given the University’s model of healthcare deliveryunder the auspices of the academic medical center model, the University’s obvious and dominantstrength lies in the provision of healthcare services that specially target very complex medicalconditions. While the University does provide primary care in its clinics and FQHC network, its ability toprovide complex medical care continues to be a significant asset to the state Medicaid program. UnderDSRIP, the University would not just continue to be a major specialty medical care provider, but it wouldexpand its specialty care capacity to address the lack of access to specialty care which is welldocumented in many parts of the Chicago area, as well as across the state. Many of the University’smedical care services have been recognized as the center for excellence for such specialty services andinclude:
What is Medicaid waiver in Illinois?
Illinois’ Persons who are Elderly Medicaid Waiver provides home and community-based services (HCBS) for senior residents who are at risk of being being placed in a nursing home (“institutionalized”). Intended to assist the elderly in maintaining independence at home, assistance with daily living activities, such as basic housecleaning, meal preparation, grocery shopping, bathing, and transportation for medical appointments and essential errands, is provided. A valuable benefit for program participants who have informal caregivers is adult day care, which allows the caregivers to continue to work outside the home. Benefits can be provided for persons residing in their own home or the home of a loved one, but cannot be provided in assisted living or adult foster care.
How to apply for Elderly Waiver in Illinois?
To apply for the Persons who are Elderly Waiver, one must apply for IL Medicaid. This can be done via one’s local Department of Human Services’ Family Community Resource Center (FCRC). One can find their local office here. Alternatively, persons can apply online via the ABE (Application for Benefits Eligibility) portal here. As part of the application process the Department on Aging will arrange an in-person needs assessment to determine if the nursing home level of care need is met.
What is HCBS waiver?
The Persons who are Elderly Waiver is formally called the HCBS Waiver for Persons who are Elderly. It is a 1915 (c) Medicaid waiver and is part of a bigger state program called the Community Care Program (CCP). CCP provides the same services as does the Persons who are Elderly Waiver, but is the non-Medicaid, state-funded part of the program, ...
How much can a spouse keep on Medicaid?
In this case, the applicant spouse can retain up to $2,000 in assets and the non-applicant spouse can keep up to $109,560. This larger allocation of assets to the non-applicant spouse is called a community spouse resource allowance. Some assets are not counted towards Medicaid’s asset limit.
How long does it take to get medicaid?
The Medicaid application process can take up to 3 months, or even longer, from the beginning of the application process through the receipt of the determination letter indicating approval or denial. Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. If the application is not properly completed, or required documentation is missing, the application process will be delayed even further. In most cases, it takes between 45 and 90 days for the Medicaid agency to review and approve or deny one’s application. Based on law, Medicaid offices have up to 45 days to complete this process (up to 90 days for disability applications). However, despite the law, applications are sometimes delayed even further. Furthermore, as wait-lists may exist, approved applicants may spend many months waiting to receive benefits.
How to contact AAA for elder waiver?
For additional information about the Elderly Waiver, click here. Persons can also contact the Senior Helpline at 1-800-252-8966 or their local Area Agency on Aging (AAA). Contact information for AAA’s by area can be found here.
Does Illinois have medicaid?
Illinois has a Medically Needy Medicaid Program for Medicaid applicants who have high medical expenses relative to their income. Also known as a spend-down program, applicants are permitted to spend “excess” income on medical expenses and health care premiums, such as Medicare Part B, in order to meet Medicaid’s income limit. The amount that must be “spent down” each month can be thought of as a deductible. Once one’s “deductible” has been met for the month, the HCBS Waiver for Persons who are Elderly will pay for care services and supports.
