The following high-level timeline summarizes key tasks necessary for the development of the 1915(c) waiver application, CMS approval, and full implementation.
July - September 2010
- Determine targeted population characteristics
- Determine service needs via sampling and data review of targeted population
- Determine best Medicaid funding options(s) (i.e., waivers, state plan changes, managed care) and prioritization/sequencing of development
- Include funding options for housing/residential capacity development
- 1915(c) Medicaid Waiver
- Jointly (HFS/DHS/DMH) formulate primary policy decisions (see Integrated Policy Issue List)
- Initiate development of MIS specifications including web based functions, claims, enrollment, PAS, critical incidents, reporting, and flows, etc
October - December 2010
- 1915(c) Waiver (continued)
- Review unique Illinois waiver related issues informally with CMS
- Develop process flows for all aspects of the waiver based on above
- Draft the waiver application
- Complete public comment/input process
- Obtain final internal approvals and HFS sign off
- HFS submits waiver by end of November 2010 (CMS 120 day clock begins)
- While awaiting CMS comments, continue implementation development
- MIS specifications including web based functions, claims, enrollment, PAS, critical incidents, reporting, and flows, etc
- Finalize process flows for each operational area
- Develop procurement for Service Plan Oversight &/or monitoring
- Develop specifications for required ASO contract/deliverables changes
- Develop DHS/DMH waiver management staffing requirements including reporting, positions, qualifications, budget, internal approvals
- Develop provider certification requirements and process
- Other
- Determine State Plan changes necessary to support building housing/residential capacity (if any)
- If SPA changes necessary, make work plan (allow 9 months)
- Initiate development process for formal Rules changes/additions
- Modifications to Rule 132
- Development of new Rule for new services (residential rule, others)
- Other Rule to delineate waiver operational requirements
January - March 2011
- 1915(c) waiver (continued)
- Continue development of required processes and policies/procedures in all areas
- Development of MIS changes based on specifications
- CMS comments on application received by end of April 2011 (end of 120 day clock)
- Issue procurements (RFPs, RFQs, other)
- Initiate DHS/DMH personnel recruitment and hiring for management waiver
- Finalize all required Rule language
- Obtain required public input on all Rules changes
April - June 2011
- Respond in writing to CMS comments by end of May 2011
- 1915(c) waiver (continued)
- Continue development of required processes and policies/procedures in all areas
- Initiate certification of providers
- Continue development of MIS changes based on specifications
- Select vendor(s) and initiate contract negotiations
- Finalize hiring of all DHS/DMH waiver management staff
- Finalize Rule making (JCAR)
July - September 2011
- Receive CMS comments by end of July 2011 (end of 90 day clock)
- Submit final waiver edits for CMS approval by end of August 2011
- Obtain final CMS sign off by end of September 2011 (they can take up to 90 days)
- 1915(c) waiver (continued)
- Continue development of required processes and policies/procedures in all areas
- Finalize certification of initial providers
- Test MIS changes based on specifications
- Finalize contracts with vendor(s) and with providers
- Train new DHS/DMH waiver operations staff
- Train waiver services providers
- Providers need minimum of 60 days for billing set up and testing
- Provide information to potential waiver participants
- Test all processes and flows
- Waiver enrollment begins within 30 days of formal CMS approval of waiver (by end of October 2011)
