Illinois – Persons who are Elderly (IL.0143.R06.05); Persons with Disabilities (IL.0142.R06.05); Persons with HIV/AIDS (IL.0202.R06.03); Persons with Brain Injury (IL.0329.R04.04); Persons who are Medically Fragile, Technology Dependent (IL.0278.R05.03); Supportive Living Program (IL.0326.R04.04); Adults with Developmental Disabilities (IL.0350.R04.05); Support Waiver for Children and Young Adults with Developmental Disabilities (CSW) (IL.0464.R02.06); Residential Waiver for Children and Young Adults with Developmental Disabilities (CRW) (IL.0473.R02.06)

Waiver Title

Persons who are Elderly (IL.0143.R06.05); Persons with Disabilities (IL.0142.R06.05); Persons with HIV/AIDS (IL.0202.R06.03); Persons with Brain Injury (IL.0329.R04.04); Persons who are Medically Fragile, Technology Dependent (IL.0278.R05.03); Supportive Living Program (IL.0326.R04.04); Adults with Developmental Disabilities (IL.0350.R04.05); Support Waiver for Children and Young Adults with Developmental Disabilities (CSW) (IL.0464.R02.06); Residential Waiver for Children and Young Adults with Developmental Disabilities (CRW) (IL.0473.R02.06)

Description of Emergency

COVID-19 pandemic. This amendment will apply waiver-wide for each waiver included in this Appendix, to all individuals impacted by the virus or the response to the virus (e.g. closure of day programs, etc.)

Waiver Description

N/A

Start Date

27-01-20

End Date

26-01-21

Description of Transition Plan

All activities will take place in response to the impact of COVID-19 as efficiently and effectively as possible based upon the complexity of the change

Area(s) Affected

Area Affected

These actions will apply across the waiver to all individuals impacted by the COVID-19 virus

Increase Cost Limits

Adults with Developmental Disabilities (0350), CSW (0464): For new applicants and participants currently enrolled in the waivers Appendix B-2: • The specific annual dollar amount may increase beyond the currently specified amount of $17,592 but we’re unable to determine a new ceiling because the duration of the emergency is unknown. Therefore, we will set t

Modify Targeting Criteria

N/A

Modify Scope or Coverage

• Persons who are Elderly (0143), Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): Effective 3/16/2020, temporarily suspend Adult Day Services (ADS). Care coordinators will increase the hours of in-home supports for those participants impacted by the closure of ADS. • Adults with Developmental Disabilities (0350): Modify Community Day Program Services: Temporarily suspend Community Day Services. Temporarily modify access to any other day program services in the event the health and safety of individuals is at risk. • Persons with Brain Injury (0329): Temporarily suspend Day

Exceed Service Limitations

Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): • The maximum number of hours of respite per calendar year is 240. The State will allow up to 480 hours per year, authorizing an amount dependent upon participant specific needs. Persons who are Medically Fragile, Technology Dependent (0278): • The current maximum number of respite hours per calendar year is 336. The State will allow up to 672 hours per year, authorizing an amount dependent upon participant specific needs. Adults with Developmental Disabilities (0350), CRW (0473): • Service definition limitations on the number of people served in each licensed home may be exceeded. • Up to an additional 25 hours per week of billable staff hours will be authorized for individuals authorized for intermittent and family/intermittent CILA. These additional billable hours will be available for individuals to use as needed to help assure the health, safety and wellbeing of people with intermittent supports who will not be attending a CDS. • Additional Staff – Residential can be provided, without requesting prior approval, during the provision of licensed residential habilitation to address the increased needs of individuals affected by the epidemic/pandemic or increased number of individuals served in a service location. Additional Staff – Residential may be used to supplement staffing in the residential home itself or support a participant while the participant stays in the home of friends or family.

Add Services

Developmental Disabilities (0350)—adding respite • Adults with Developmental Disabilities (0350), CSW (0464), Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329) –adding Communication, intensive personal care, and/or behavioral stabilization

Expand Settings

Supportive Living Program (0326) • Temporarily allow settings to be expanded in the event it is determined by local public health authorities that SLP participants need to be transferred to another setting for their health and safety; either to prevent contraction of COVID-19 or to be treated separately from the healthy population. The same waiver services would be required for transferred participants. The State will notify CMS if such changes will occur. The State will ensure participants effected will continue to receive the necessary services as authorized in their person centered plan of care and that services provided are in the best interest of the individual. Adults with Developmental Disabilities (0350) • Temporarily allow CILA group homes to be fully reimbursed for services rendered during an emergency evacuation to an unlicensed site (as deemed appropriate by the Department) where the evacuating service provider continues to render services. The State will notify CMS when such changes will occur. The State will ensure participants effected will continue to receive the necessary services as authorized in their person centered plan of care and that services provided are in the best interest of the individual. • Unlicensed sites include approved Day Habilitation Sites and unlicensed CILAs that have not finished the CILA licensure process. All these settings meet the Settings Rule. All unlicensed sites that are utilized as a CILA site will also be approved through the Bureau of Accreditation, Licensure, and Certification (BALC). CRW (0473) • Temporarily allow Child Group Homes (CGH) to be fully reimbursed for services rendered during an emergency evacuation to an unlicensed site where the evacuating service provider continues to render services. The State will notify CMS if such changes will occur. The State will ensure participants effected will continue to receive the necessary services as authorized in their person centered plan of care and that services provided are in the best interest of the individual. • Unlicensed sites include approved Day Habilitation Sites and unlicensed CILAs that have not finished the CILA licensure process. All these settings meet the Settings Rule. All unlicensed sites that are utilized as a CILA site will also be approved through BALC.

Provide Service Out of State

Adults with Developmental Disabilities (0350), CSW (0464): • During this emergency period, DDD may permit receipt of services in another state. This would apply to clients receiving support from Personal Support Workers and would be approved through DDD protocol.

Allow Payment for Services by Families

N/A

Modification of Provider Qualifications

Elderly (0143) • Temporarily suspend the requirements in 89 Ill Admin Code 240, that require homecare aides (HCA) to have a high school or general education diploma, or one year employment in a comparable human services field, or demonstration of continued progress towards meeting the requirements of a general education diploma. • Temporarily allow delays with the collection of fingerprints for criminal background checks (CBC) for all unlicensed and licensed persons not already included on the Health Care Worker Registry. Many contracted vendors that collect fingerprints have closed their business due to the COVID-19 outbreak. Vendors must check the Health Care Worker Registry (which includes information from the Adult Protective Services Registry) for all new hires. Agencies will not be allowed to hire staff who show as ineligible on the Health Care Worker Registry. Agencies hiring staff pending fingerprint collection would need to document attempts to be compliant with fingerprint collection. Suspending the qualifications, 24-hour pre-service requirements, and delay in the CBCs must be thoroughly documented in the homecare aide employee file. Fingerprint collection would resume immediately when operations return to normal. Agencies must ensure arrangements for qualifications, proper training, fingerprint background checks of HCAs resume upon notice from the Operating Agency when the suspension is no longer in effect. • Temporary flexibility is provided on the following requirements of the Emergency Home Response Service (EHRS) and Automated Medication Dispenser(AMD) providers: 1. Temporarily waive the requirement that providers install and provide training to the participant during a face-to-face visit. 2. Allow for providers to deliver equipment to the participant in accordance with recommended CDC social distancing guideline. For example, leaving the equipment on participant’s doorstep. 3. Allow for providers to provide installation instructions and training to participant over the phone or allow for home care aide and/or family member to assist participant with installation of equipment telephonically with provider. 4. Temporarily waive background checks for providers when they are hiring new technicians and installers. Persons who are Medically Fragile, Technology Dependent (0278) • Home Health Nursing Agency Providers provide the majority of services to waiver participants. During this interim time, nurses whose CPR certification expire, will continue to provide services. Once the current crisis has been lifted the certification will be obtained. Illinois nurse licenses are set to expire in May 2020. The Illinois Department of Financial and Professional Regulation has extended this to September. • Home Medical Providers will suspend all in-person visits. The State will also suspend inperson supervisory visits that currently occur every 60 days. Exceptions will be considered when there are health and safety concerns. • Temporarily allow delays with the collection of fingerprints for criminal background checks for all unlicensed and licensed persons not already included on the Health Care Worker Registry. The Health Care Worker Background Check Act requires fingerprints be collected within 10 days of signing an authorization form or the employee is suspended. If fingerprints are not collected within 30 days, the employee is terminated. Many contracted vendors that collect fingerprints have closed their business due to the COVID 19 outbreak. All new hires will still need to be checked on the Registry to determine if they have a disqualifying conviction. Providers hiring staff pending fingerprint collection would need to document attempts to be compliant with the Act. Fingerprint collection would resume immediately when operations return to normal. Supportive Living Program (0326) • Temporarily allow delays with the collection of fingerprints for criminal background
checks for all unlicensed and licensed persons not already included on the Health Care
Worker Registry. The Health Care Worker Background Check Act requires fingerprints
be collected within 10 days of signing an authorization form or the employee is suspended.
If fingerprints are not collected within 30 days, the employee is terminated. Many
contracted vendors that collect fingerprints have closed their business due to the COVID19 outbreak. All new hires will still need to be checked on the Registry to determine if
they have a disqualifying conviction. SLP providers hiring staff pending fingerprint
collection would need to document attempts to be compliant with the Act. Fingerprint
collection would resume immediately when operations return to normal.
Adults with Developmental Disabilities (0350), CRW (0473), CSW (0464), CRW (0473)
• To allow redeployment of direct support and clinical staff to needed service settings during
the emergency, staff qualified under any service definition in the waivers or any other DHS
Medicaid waiver program may be used for provision of any non-professional service under
another service definition in C-1/C-3.
Adults with Developmental Disabilities (0350), CRW (0473)
• Temporarily allow delays with the collection of fingerprints for criminal background
checks for all unlicensed persons not already included on the Health Care Worker Registry.
The Health Care Worker Background Check Act requires fingerprints be collected within
10 days of signing an authorization form or the employee is suspended. If fingerprints are
not collected within 30 days, the employee is terminated. Many contracted vendors who
collect fingerprints have closed their business due to the COVID-19 outbreak. All new
hires will still need to be checked on the Registry to determine if they have a disqualifying
conviction. DDD providers hiring staff pending fingerprint collection would need to
document attempts to be compliant with the Act. Fingerprint collection would resume
immediately when operations return to normal. DSPs may undergo an abridged training
curriculum as approved by the OA.
• For the duration of this emergency period, training procedures and requirements for DSPs
to pass medications may be modified as seen appropriate by the OA. For the duration of
this emergency period, the OA may modify requirements for Qualified Intellectual
Disability Professional.
• For the duration of this emergency period, hiring credentials for Personal Support Workers
(PSW) may be modified and these PSWs may undergo an abridged training curriculum
approved by the Department for Agency-Based providers.
• The Department may temporarily waive the requirement that physicians and other
healthcare professionals including nurses be licensed in the State where they are providing
services so long as they have equivalent licensing in good standing in another state.
• PSWs may be allowed to begin work prior to the completion of the background check. In
the event the background check reveals a disqualifying offense, the staff would be
immediately terminated.
CSW (0464):
• Temporarily allow delays with the collection of fingerprints for criminal background
checks for all unlicensed and licensed persons not already included on the Health Care
Worker Registry. Many contracted vendors who collect fingerprints have closed their
business due to the COVID-19 outbreak. All new hires will still need to be checked on
the Registry to determine if they have a disqualifying conviction. DDD providers hiring
staff pending fingerprint collection would need to document attempts to be compliant with
the Act. Fingerprint collection would resume immediately when operations return to
normal. • Personal Support Workers (PSWs) may undergo an abridged training curriculum approved
by the Department for Agency-Based providers.
• Parents/legal guardians may forgo receiving a background check/fingerprints if they live
in the same house as their child. They would still have to complete the IMPACT screening
and CANTS checks. This would only be during the crisis period.

Modify Provider Types

N/A

Modify Licensure/Requirements for Waiver Settings

The State is delaying revalidation of Medicaid providers until after the public health emergency is lifted. Supportive Living Program (0326) Residential Habilitation • Maximum number of individuals served in a service location may be exceeded to address staffing shortages or accommodating use of other sites as quarantine sites. • Minimum staffing ratios may not be met as required by licensure, service definition and personal plan due to staffing shortages. • Residents may share apartments certified for single occupancy if ill residents need to be cohorted following CDC guidelines. Adults with Developmental Disabilities (0350), CRW (0473) • Maximum number of individuals served in a service location may be exceeded to address staffing shortages or accommodating use of other sites as quarantine sites. • Staffing ratios may not be met as required by licensure, service definition and personal plan due to staffing shortages. • Temporarily extend all associated deadlines with certification licensure, life safety code, quality assessment, audits, fiscal reporting requirements, etc. for service providers during the pendency of the emergency period.

Modification LOC Eval and Re-Eval Processes

N/A

Increase Payment Rates

Supportive Living Program (0326) • The rate for Assisted Living services may be increased to account for the temporary provision of 24 hour skilled nursing care for services and monitoring of ill residents and for the required ongoing assessment of all residents and staff per CDC guidelines. • Dependent upon the need for additional staffing to meet participants’ service needs, the flat daily rate may be increased to cover costs. The methodology would be a flat rate, possibly tiered based on preventative infection control processes only vs. caring for participants who have tested positive for COVID 19.The temporary rate increase will not exceed 25% of the current rate. Persons who are Medically Fragile, Technology Dependent (0278) • Temporarily increase the rate paid for respite to the current hourly shift nursing rate for RN and LPN. • Usual respite hourly rate is $34.00. • Temporarily increased to the current hourly rates: $45.00 RN, $37.50 LPN. • The participants caregiver is an employee in a field deemed “essential” and has an increased workload in response to the COVID-19 pandemic. Nursing agencies are working to supply additional coverage to accommodate increased caregiver work schedules. • The participant was receiving nursing services through the school district prior to school closures, and now requires increased nursing in the home setting as a result of school being closed. • The RN and LPN rates may also be increased to account for excess overtime to cover staffing needs. Overtime will be allowed only by exception request with justifying circumstances. • Usual RN hourly rate $45.00, LPN $37.50. • Overtime hourly rate: RN $67.53, LPN $56.28 Parameters for increased respite and over-time may include, but not be limited to: • caregiver in the home becomes ill and is unable to assist in caring for the participant. • As a result, increased nursing in the home will be required to ensure proper care to the participant and provide relief to other caregivers. • If all caregivers are unable to provide care due to illness, the participant may require hospitalization. If respite is increased, the participant will have the option of receiving care in a respite facility such as Almost Home Kids, rather than being transferred to a hospital which could potentially put the participant at an increased risk of exposure to illness. Parameters for overtime include: • Minimize amount of staff in the home to limit exposure risk • Stretch the amount of staffing over less total nurses during a time of increased demand for nurses when we had a pre-existing nursing shortage • Prevent nurses needing additional hours from picking up additional hours with other cases/at a hospital, which adds exposure risk to the participant. Adults with Developmental Disabilities (0350) • The rate for Residential Habilitation will be changed to account for time in residential service locations by people who will not be attending a community day services program. Rates may also be increased to account for excess overtime of direct support professionals to cover staffing needs. Resulting temporary rate increases are not expected to exceed 40%. • The rate setting methodology will change by adding additional Prime and Non-Prime
staff up to 7 hours of direct care staff per weekday to the CILA Rate for people authorized
for 24-hour shift staff and Host Family/Foster Care levels of CILA supports. The current
rate methodology deducts up to 7 hours of staff coverage per weekday because the
expectation is the individual would be at a community day program. Resulting temporary
rate increases are not expected to exceed 40%.
• The Community Living Facility (16 beds or under) will receive the same increase as the
CILA providers not to exceed 40%.
CRW (0473)
• The rate for Children’s Group Home will be changed to account for time in residential
service locations by people who will not be attending school-based services. The CGH
rates are currently determined by expenses submitted through Consolidated Financial
Reports. Because of the immediate need to increase funding to meet the current
obligation, the residential habilitation rates in CGH will be increased by 20 percent to
cover the additional staff time children will be home and not participating in a school
program. These increased rates will be in effect until the OA deems sufficient resolution
of crisis to allow reinstatement of actual rates.

Modifications of ISP

Persons who are Elderly (0143), Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329), Supportive Living Program (0326), Persons who are Medically Fragile, Technology Dependent (0278), Adults with Developmental Disabilities (0350), CSW (0464), CRW (0473) • All communication with waiver participants and their representatives, whether in person or remotely, will be HIPAA compliant. Supportive Living Program (0326) Participant Rights: • Suspend requirements for allowing visitors (providers may prohibit/restrict visitation inline with CMS recommendations for long term care facilities). The modification of this right is not required to be justified in the personal plan as it is reflective of the life experience of the general population at this time. • Suspend requirements for right to choose with whom to share an apartment. The modification of this right is not required to be justified in the personal plan. • Telephonic and video options will be used to join the participant and their representative with the team to develop/revise the person plan. Social and health promotion activities : • Temporarily suspend required weekly social activities both in and out of the SLP provider setting. • Temporarily suspend required three times weekly group health promotion activities. • Temporarily suspend ancillary services to include shopping trips and activities in the community. • Temporarily suspend congregate dining services. Meal delivery to residents’ apartments will be provided. Adults with Developmental Disabilities (0350) Participant Rights: • Suspend requirements for allowing visitors (providers may prohibit/restrict visitation inline with CMS recommendations for long term care facilities). The modification of this right is not required to be justified in the personal plan as it is the experience of the general population at this time. • Suspend requirements for right to choose who to share a bedroom with. The modification of this right is not required to be justified in the personal plan. • Telephonic and video options will be used to join the participant and their representative with the team to develop/revise the person plan. CSW (0464), CRW (0473) • Suspend requirements for allowing visitors (providers may prohibit/restrict visitation inline with CMS recommendations for long term care facilities). The modification of this right is not required to be justified in the personal plan as it is reflective of the life experience of the general population at this time. • Suspend requirements for right to choose who to share a bedroom with. The modification of this right is not required to be justified in the personal plan. • Telephonic and video options will be used to join the participant and their representative with the team to develop/revise the person plan.

Modify Incident Reporting/Med Management Safeguards

Persons who are Elderly (0143), Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329), Supportive Living Program (0326), Persons who are Medically Fragile, Technology Dependent (0278), Adults with Developmental Disabilities (0350), CSW (0464), CRW (0473) • The Department requests flexibility with respect to deadlines and timetables for performance of required activities conducted by the Department, providers, and contracted entities. These reports and activities include, but are not limited to, quarterly and annual quality reports, CMS 372 reports, and Evidentiary reports. The Department proposes to extend the deadline for submission of evidence based reports for 90 days past the original due date. Supportive Living Program (0326) Incident Management Changes: • Critical Incidents will be reported as described in the approved waiver. The requirement for the State Medicaid Agency (SMA) to respond and perform the appropriate follow up may be completed remotely, unless an onsite visit is deemed necessary by the SMA. • Complaint investigations will be prioritized by the SMA. The review will be completed remotely if deemed appropriate. However, if SMA determines there are immediate residential health and safety issues, and onsite review will be initiated. Adults with Developmental Disabilities (0350), CRW (0473) • Critical Incidents will be reported as outlined in the Critical Incident Reporting and Analysis System (CIRAS) Manual. The requirement of the ISC to respond and perform the appropriate follow up may be completed remotely unless an onsite visit is deemed necessary by the Division. • The 8 hour medication training class required for DSPs to be authorized to pass medications will be transferrable from other agencies. • The Division will be able to modify the current CBTA guidelines to allow additional ADSPs to be trained on new clients. • There are various nursing assessments and medication checks that are required on a weekly, monthly and quarterly basis. Each of these activities will be evaluated on an individual basis to determine if continuation puts client health and safety at risk (for example, annual medication reauthorizations, quarterly medication checks, annual nursing assessments) and Department-approved electronic or modified assessments and checks may be used during this emergency period after the completion of appropriate training. Any delay in an assessment will not negatively impact the individual. CSW (0464) Incident Management Changes: • Critical Incidents will be reported as outlined in the Critical Incident Reporting and Analysis System (CIRAS) Manual. The requirement of the ISC to respond and perform the appropriate follow up may be completed remotely unless an onsite visit is deemed necessary by the OA. Elderly (0143), Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329), Adults with Developmental Disabilities (0350): • Adult Protective Services plans to modify the investigative process for abuse/neglect/ exploitation to include telephonic contact with the alleged victim. The timeframes for outreach to the alleged victim will remain the same. For all Priority 1 calls, local law enforcement will be notified to conduct a wellbeing check with the alleged victim. Final substantiation decisions concerning abuse, neglect, or exploitation will not be made without a face to face contact with the alleged victim. APS agencies have 30 days to conduct an investigation. Two 15 day extensions can be requested, if needed. If the investigator is not able to conduct a face to face contact with the alleged victim following the two 15 day extensions, the investigator will continue to monitor the case and follow up with the alleged victim until such time it can be conducted.

Allow Payment for Services During Acute Care Hospital/Short Term Institutional Stay

Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): • Currently, Individual Provider (IP) services may be provided in hospital settings if the participant has a Determination of Need (DON) score of 75 or higher. During the public health emergency, IP services will be provided to all participants who are hospitalized. These services will be provided to meet needs of the individual that are not met through the provision of hospital services and/or are not a substitute for services that the hospital is obligated to provide through its conditions of participation or under Federal or State law, or under another applicable requirement. • Supports may be provided to a participant in a hospital setting by the Personal Assistant/Independent Provider (PA/IP) to foster communication, provide intensive personal care, and/or promote behavioral stabilization. Services in the plan of care that cannot be provided by facility staff will be provided by the provider types identified for this service and must be for the purpose of smooth transitions or preserve functional abilities. These services will be provided to meet needs of the individual that are not met through the provision of hospital services and/or are not a substitute for services that the hospital is obligated to provide through its conditions of participation or under Federal or State law, or under another applicable requirement. Adults with Developmental Disabilities (0350) Participants that require hospitalization due to COVID19 may receive the following services in a hospital setting: • Supports may be provided to a participant in a hospital setting by the Personal Support Worker while hospitalized to foster communication, provide intensive personal care, and/or promote behavioral stabilization. Services in the plan of care that cannot be provided by facility staff and are not a substitute for services the hospital is obligated to provide through its conditions of participation or under Federal or State law, or under another applicable requirement will be provided by the provider types identified for this service and must be for the purpose of smooth transitions or preserve functional abilities. Services in the plan of care that cannot be provided by facility staff will be provided by the provider types below. • Personal Support Worker • Additional staff – residential CSW (0464) Participants that require hospitalization due to COVID19 may receive the following services in a hospital setting: • Personal care may be provided in a hospital setting by the Personal Support Worker while hospitalized to foster communication, provide intensive personal care, and/or promote behavioral stabilization. Services in the plan of care that cannot be provided by facility staff and are not a substitute for services the hospital is obligated to provide through its conditions of participation or under Federal or State law, or under another applicable requirement will be provided by the provider types identified for this service and must be for the purpose of smooth transitions or preserve functional abilities. Services in the plan of care that cannot be provided by facility staff will be provided by the provider types below. • Personal Support Worker

Inclusion of Retainer Payments

For all the waivers listed below, retainer payments will only be applied for providers of services that have a personal care component. Retainer payments will only be applied when the participant is unavailable for services. Adults with Developmental Disabilities (0350) • Agencies who provide day habilitation services (facility based day habilitation, community based day habilitation, adult day care, regular work/sheltered employment, job development, pre-vocational training and supported employment) will be eligible to receive retainer payments. Retainer payment can only be billed for members who are not receiving planned services and only for the amount authorized. • Retainer payments will not exceed 30 consecutive days, which is the State’s behold maximum. • Retainer payments will only be paid when the participant is unavailable for services. If services are provided, no retainer payment will be made. MFTD (0278) • There are approximately 65 nursing agencies that provide nursing and personal care services to waiver participants. There are many participants who may be receiving reduced services due to COVID-19. • Retainer payments will not exceed 30 consecutive days, which is the State’s behold maximum. • Retainer payments will only be paid when the participant is unavailable for services. If services are provided, no retainer payment will be made. Persons with Brain Injury (0329): • Agencies who provide Brain Injury Habilitation and Brain Injury Prevocational training will be eligible to receive retainer payments. Retainer payment can only be billed for members who are not receiving planned services and only for the amount authorized. • Retainer payments will not exceed 30 consecutive days, which is the State’s behold maximum. • Retainer payments will only be paid when the participant is unavailable for services. If services are provided, no retainer payment will be made.

Institute/Expand Opportunities for Self-Direction

N/A

Increase Factor C

N/A

Other Changes Necessary

Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): The OA, the Division of Rehabilitation Services (DRS) utilizes Electronic Visit Verification in conjunction with a paper timesheet to determine reimbursement for Individual Provider (personal assistance, skilled nursing care) services provided to participants. DRS will move to automatic approval of Individual Provider payments utilizing the EVV system until which time the paper time sheets are available for reconciliation

Addendum

HCBS Regulations

Not comply with the HCBS settings requirement at 42 CFR 441.301(c)(4)(vi)(D) that individuals are able to have visitors of their choosing at any time, for settings added after March 17, 2014, to minimize the spread of infection during the COVID-19 pandemic.

Services

Add Electronic Method of Service Delivery

Case management, personal care services that only require verbal cueing, monthly monitoring, and other: [left blank]

Add Home Delivered Meals

N/A

Add Medical Supplies, Equipment and Appliances

N/A

Add Assistive Technology

N/A

Conflict of Interest

Other Changes Necessary

Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): The OA, the Division of Rehabilitation Services (DRS) utilizes Electronic Visit Verification in conjunction with a paper timesheet to determine reimbursement for Individual Provider (personal assistance, skilled nursing care) services provided to participants. DRS will move to automatic approval of Individual Provider payments utilizing the EVV system until which time the paper time sheets are available for reconciliation

Other Changes Necessary

Persons with Disabilities (0142), Persons with HIV/AIDS (0202), Persons with Brain Injury (0329): The OA, the Division of Rehabilitation Services (DRS) utilizes Electronic Visit Verification in conjunction with a paper timesheet to determine reimbursement for Individual Provider (personal assistance, skilled nursing care) services provided to participants. DRS will move to automatic approval of Individual Provider payments utilizing the EVV system until which time the paper time sheets are available for reconciliation

Provider Qualifications

Allow Spouses and Parents of Minor Children to Provide Personal Care Servcies

X

Allow a Family Member to be Paid to Render Services to an Individual

X

Allow Other Practitioners in Lieu of Approved Providers Within the Waiver

N/A

Modify Service Providers for Home-Delivered Meals to Allow for Additional Providers, Including Non-Traditional Providers

X

Processes

Allow an Extension for Reassessments and Reevaluations for up to One Year Past the Due Date

X

Allow the Option to Conduct Evaluations, Assessments, and Person-Centered Service Planning Meetings Virtually/Remotely in lieu of Face-to-Face Meetings

X

Adjust Prior Approval/Authorization Elements Approved in Waiver

X

Adjust Assessment Requirements

X

Add an Electronic Method of Signing Off on Required Documents Duch As The Person-Centered Service Plan

X

Link To Application

https://www.medicaid.gov/state-resource-center/downloads/il-combined-appendix-k-appvl.pdf

Link to Approval Letter

https://www.medicaid.gov/state-resource-center/downloads/il-appendix-k-appvl-ltr.pdf