No. Program Name Program Code Required Provider Qualifications and Credentials
1 Individual Service and Support Advocates (ISSA) 50D

Individual Service and Support Advocacy must be provided by:

  • Qualified staff of an independent agency that does not provide direct services.
  • Staff must be a qualified mental retardation professional (or QSP in Illinois) as defined in federal ICFMR regulations.
  • Staff who have had required background checks.

Agencies must comply with:

  • Requirements of the DHS contract and contract attachments.
  • Requirements of Rule 50, Medicaid Home and Community-Based Services Waiver Program for Individuals with Developmental Disabilities (59 Ill. Adm. Code 120) in serving individuals enrolled in the waiver programs.
  • Comply with the requirements of Rule 50, Office of Inspector General Investigations of Alleged Abuse or Neglect and Deaths in State-Operated and Community Agency Facilities.  Comply with the requirements of Rule 51, Office of Inspector General: Adults with Disabilities Abuse Project.
  • Comply with the requirements of Rule 331, Unusual Incidents, if serving children.The Individual Service and Support Advocacy (ISSA) Guidelines contain specific guidance on the qualifications and responsibilities of the ISSA.
Residential Habilitation Services
2 Residential Habilitation Services Providers of waiver residential habilitation must comply with the following, in addition to the items specific to each service type (i.e., CILA, CLF, Child Group Home or temporary intensive staffing):
  • Requirements of the DHS contract and contract attachments.
  • Requirements of Rule 120, Medicaid Home and Community-Based Services Waiver Program for Individuals with Developmental Disabilities (59 Ill. Adm. Code 120) in serving individuals enrolled in the waiver programs.
  • The requirements of the Rule 116, Administration of Medication in Community Settings.Comply with the requirements of Rule 50, Office of Inspector General Investigations of Alleged Abuse or Neglect and Deaths in State-Operated and Community Agency Facilities.
2a Community-Integrated Living Arrangement (CILA) 60D, 61D, 65H Providers of Community-Integrated Living Arrangement (CILA) supports and services must be licensed under Rule 115, the CILA licensure rule (59 Ill. Adm. Code 115).
2b Community Living Facility (CLF) 67D All Waiver Community Living Facilities (CLF) Providers must:
  • Be licensed by the Department of Public Health according to Rule 370 (77 Ill. Adm. Code 370), including requirements for reporting of deaths and allegations of abuse and neglect to the Department of Public Health.
  • Serve no more than 16 residents, be located in state and not be located on a campus setting.
2c Temporary Intensive Staffing provider 53D, 53R Temporary intensive staffing providers must meet the qualifications to be a CILA or Developmental Training (DT) provider.
2d Child Group Home 17D Providers of Child Group Home services must:
Day Programs
3 Day Programs Providers of waiver day programs must comply with the following, in addition to the items specific to each service type (i.e., DT, SEP, Adult Day Care, At Home Day, Other Day):
  • Requirements of the DHS contract and contract attachments.
  • Requirements of Rule 120, Medicaid Home and Community-Based Services Waiver Program for Individuals with Developmental Disabilities (59 Ill. Adm. Code 120) in serving individuals enrolled in the waiver programs.
  • Comply with the requirements of Rule 50, Office of Inspector General Investigations of Alleged Abuse or Neglect and Deaths in State-Operated and Community Agency Facilities.
  • Comply with the requirements of Rule 51, Office of Inspector General: Adults with Disabilities Abuse Project.
3a Developmental Training 31U, 31A Providers of Developmental Training (DT) services must:
  • Be a certified Developmental Training (DT) provider under Rule 119, which governs Developmental Training (59 Ill. Adm. Code 119).
  • Be open and serving all enrolled individuals in DT at least five hours per weekday, and be open and providing services at least 240 days per year.
3b Supported Employment - Individual 39U, 36U
3c Supported Employment - Group 39G, 36G
3d Adult Day Care 35U Adult day care providers must:
  • Have a current contract with the Department on Aging.
  • Must be in compliance with Rule 240, Community Care Program (89 Ill. Adm. Code 240).
3e Regular Work/ Sheltered Employment 38U
3f At Home Day Program 37U At Home Day Program providers must:
  • Have CILA licensure.
  • Be provided by the same agency as the individual's residential services.
3g Other Day Program 30U Other Day program providers must receive written approval to provide this service from the Division of Developmental Disabilities staff as part of the individual prior approval process.
Professional Services
4a Behavior Intervention and Treatment 56U
  • Behavior intervention and treatment providers must be one of the following provider types.A Level I provider must be a:
    • Licensed clinical psychologist, or
    • Nationally certified Behavior Analyst (certified by the Behavior Analyst Certification Board).
  • A Level II provider must be a:
    • Nationally certified Associate Behavior Analyst (certified by the Behavior Analyst Certification Board),
    • Professional certified to provide Relationship Development Assessments,· Early Intervention Specialist with a Developmental Therapy credential or equivalent experience and training, or
    • Professional with a Bachelor's Degree and who has completed at least 1,500 hours or training or supervised experience in the application of behaviorally-based therapy models.
4b Counseling - Individual and Group 57U, 57G Behavior counseling providers must be one of the following:
  • Licensed clinical psychologist,
  • Clinical social worker,
  • Social worker,
  • Marriage or family therapist,
  • Clinical professional counselor, or
  • Professional counselor.
4c Psychotherapy - Individual and Group 58U, 58G Psychotherapy providers must be one of the following:
  • Licensed clinical psychologist,
  • Clinical social worker,
  • Marriage or family therapist, or
  • Clinical professional counselor.
4d Physical Therapy 52P Physical therapy providers must be one of the following:
  • A licensed physical therapist.
  • A licensed physical therapy assistant under the direct supervision of a licensed therapist enrolled as a Medicaid State Plan Provider and waiver provider. The assistant is not required to enroll in the Medicaid State Plan nor the waiver program. Services are billed by the licensed supervisor.
4e Occupational Therapy 52O Occupational therapy providers must be one of the following:
  • A licensed occupational therapist.
  • A certified occupational therapy assistant under the direct supervision of a licensed therapist enrolled as a Medicaid State Plan Provider and waiver provider. The assistant is not required to enroll in the Medicaid State Plan nor the waiver program. Services are billed by the licensed supervisor.
4f Speech/Communication Therapy 52S Speech therapy providers must be licensed speech/language pathologists.
Self-Directed Services (Children's and Adult Home-Based Support Services)
5a Service Facilitation 55A Service Facilitation providers must:
  • Be an agency that is in compliance with contractual requirements and that does not also provide Individual Service and Support Advocacy services.
  • Comply with the requirements of Rule 50, Office of Inspector General Investigations of Alleged Abuse or Neglect and Deaths in State-Operated and Community Agency Facilities.
  • Comply with the requirements of Rule 51, Office of Inspector General: Adults with Disabilities Abuse Project.
  • Comply with the requirements of DCFS Rule 331, Unusual Incidents, if serving children.
  • Employ or contract with staff who are professionals as defined in federal regulations as a Qualified Mental Retardation Professional (QMRP). All staff in this role must be QMRPs.
  • Employ or contract with staff who are approved by the Division of Developmental Disabilities as a QMRP and must meet the training requirements set by the Department for QMRPs. All staff in this role must meet these requirements.
  • Employ or contract with staff who pass Criminal Background, Health Care Workers Registry and CANTS (if working with children) checks completed by the employing agency prior to delivering Service Facilitation.
5b Personal Support 55D Personal Support Service providers must comply with the following:
  • Agencies must be an entity that is in compliance with contractual requirements.
  • Agencies must have required all employees to pass Criminal Background and Health Care Workers Registry checks completed by the employing agency prior to delivering Personal Support.
  • Agencies providing services under the Children's Support Waiver shall require all employees having access to children (through age 17) to pass State Central Register (CANTS) and Illinois Sex Offender Registry checks prior to delivering Personal Support.
  • Agencies must require personal support workers to meet requirements for Direct Support Personnel training prior to providing Personal Support.
  • Domestic employees of the individual/guardian/employer representative must be aged 18 or older, have a high school degree or passed the Test for General Education Development (GED), and must be deemed by the individual's guardian or family to be qualified and competent to meet the participant's needs and carry out responsibilities assigned via the service plan. By signing the Service Authorization, the individual, guardian, or employer representative deems the domestic employee qualified and agrees to provide necessary training and supervision.
  • Domestic employees hired on or after July 1, 2007 must pass Criminal Background and Health Care Workers Registry checks prior to delivering Personal Support. If they are serving children (through age 17), they must also pass State Central Register and Illinois Sex Offender Registry checks prior to delivering Personal Support.
  • For the Children's Home-Based Support Services program, payment will not be made for Personal Support services by the participant's parents, guardian, siblings, aunts, uncles, first cousins, or grandparents, whether related by blood or marriage (in-laws) or through a step relationship.
  • For Adult Home-Based Support Services program, payment will not be made for Personal Support services by the spouse or child of the participant. Other relatives who provide Personal Support must meet the same standards as Personal Support workers who are unrelated to the participant.
  • For the Adult Waiver, there are special IRS requirements that apply if a guardian is also the domestic employee. Per the IRS, the same person cannot be both the employer and the domestic employee. An employer representative must be identified to take on the responsibilities of the employer of record. The representative can be anyone chosen by the participant or guardian who can sign the service authorization and time sheets.
5c Temporary Assistance (formerly Crisis Services) 53C Providers of Crisis Services must meet the same qualifications as Personal Support.
5d Nursing - RN 55N Registered professional nurse licensed to practice in the State of Illinois
5e Nursing - LPN 55P Licensed practical nurse under the direction of a registered nurse who is licensed to practice in the State of Illinois
5f Transportation (Non-Medical) 55T
  • Non-Medical Transportation providers must:
    • Have a valid driver's license and be licensed to drive in Illinois.
    • Have proof of automobile liability insurance in accordance with State law.
  • Providers of non-medical transportation services may include enrolled providers who are:
    • An agency that is approved to provide Service Facilitation or Personal Support services or domestic employees who are deemed by the individual, guardian or family to be qualified to provide Personal Support, or
    • Bus companies, taxi companies and other public transportation companies. Employees of transportation companies are exempt from the Criminal Background check and Health Care Workers Registry check requirements and from training requirements.
5g Emergency Home Response Services 55W Company approved by the Department on Aging or the DHS Division of Rehabilitation Services to provide this service.
5h Counseling Services for Unpaid Caregivers 55C Providers of counseling services for unpaid caregivers must be:
  • A licensed clinical psychologist,
  • A licensed clinical social worker,
  • A licensed social worker,
  • A licensed clinical professional counselor,
  • A licensed professional counselor, or
  • A licensed marriage and family counselor.
5i Training Services for Unpaid Caregivers 55B Providers of Training for Unpaid Caregivers must be training programs, workshops or events deemed qualified by the participant/guardian and approved by the Service Facilitator. Examples include CPR instruction, first aid, and programs on disability-specific topics such as epilepsy, autism, etc.
Other
6 Adaptive Equipment 53E Approved vendor.
7 Assistive Technology 53T Approved vendor.
8 Home Accessibility Modifications 53C Approved company or worker.
9 Vehicle Accessibility Modifications 53V Approved vendor.