Service Facilitation, Home-Based

What is it?

HBS Service Facilitation is available through the Home-Based Support Services (HBS) in the Adult DD Waiver and in the Children's Support Waiver.  Service Facilitation includes case management services to assist individuals and families in gaining access to needed Waiver and other Medicaid State Plan services, medical, social, educational and other services.  Service Facilitators are responsible for the day-to-day oversight and administration of the service plan and for ensuring the health, safety and welfare of the individual.

Note:  Regarding the Enrollment Forms

How Do I Become A Provider?

1. You Must Be in Compliance With:

   1. Department of Human Services (DHS) contractual requirements. You cannot also provide Individual Service and Support Advocacy (ISSA) services.
   2. Rule 50 and Rule 51.
   3. Before serving individuals as a Qualified Intellectual Disabilities Professional (QIDP), staff must first submit QIDP Job & Educational Requirements Checklist A for approval by the Division of Developmental Disabilities and to add the person to the state QIDP database.  Submit to:

      Department of Human Services
      Division of Developmental Disabilities
      Bureau of Quality Management
      319 E. Madison Street, Suite 4J
      Springfield, IL 62701

      Attention:  QIDP Credential Review

   4. You must have staff that meet QIDP Qualification Review and Training Requirements
   5. You must submit the following documents to your Region Facilitator:
      • Letter of Interest
      • Waiver Program Provider Agreement  (HFS 1413A)
        • Instructions for HFS 1413A

          NOTE:  You must submit a Waiver Program Provider Agreement for each Provider Type for which you provide services.  List of Provider Types and Categories.

      • Provider Enrollment Application (HFS 2243)
        • Instructions for HFS 2243 

          NOTE: You must submit a Provider Enrollment Application for each Provider Type for which you provide services.  List of Provider Types and Categories.

      • Provider Information Form (IL462-1246)
      • IRS W-9 form and Guidelines
      • FTP Registration Request Form 
      • Community Provider User ID and System Access Request  (IL444-2022)

2. Once you are enrolled, you will be required to work with your Pre-Admission Screening Agency/Independent Service Coordination Agency (ISC). 

   These agencies educate, refer, and link persons with developmental disabilities to services.

3. Contract Information

   Upon meeting the specified requirements above, a Community Service Agreement and Attachment A will be sent to you, containing your specific agency information.

   NOTE:  A contract is not final until it is signed by the DHS Secretary.

Important Resources for Requirements