Waiver Services Transition

Waiver Service Transition Information Bulletin

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin



The purpose of this Information Bulletin is to clarify the process for individuals who are requesting an Adults with Developmental Disabilities Waiver Service Transition, which is the transfer from one waiver service or category of services to another (i.e., moving from Adult HBS to CILA).

Waiver Service Category Transition:

Individuals receiving waiver-funded services have an array of options available to them. If their needs or choices change, they can choose to transition to alternative waiver services. If for example, an individual who is receiving Personal Support Worker services through Home Based Support Services (HBS) and develops a new need for Behavior Services, they would add these additional services to their service array. On the other hand, there are individuals who desire/need an entirely new category of services.

Waiver Service Category Transitions are for individuals who are receiving one set of Waiver services and are seeking another set of Waiver services. For example, an individual receiving Adult HBS has a desire to move to CILA based on a change in their needs or preferences or based on the outcomes identified in their Personal Plan.

Note: In the past, some individuals who previously requested a Waiver Service Category Transition were placed on the PUNS list in the "seeking services" category. Additionally, some individuals were placed on the PUNS list after they started receiving waiver services so they would later be able to change services. It is no longer necessary for individuals currently in a DD Waiver service to be enrolled in, or selected from, the PUNS list to participate in a Waiver Service Category Transition. Ongoing, individuals currently receiving waiver services will not be placed on the PUNS list but will, instead, follow the process outlined in this Information Bulletin.

Waiver Service Category Transition Process:

The Waiver Service Category Transition process requires an individual to demonstrate the Waiver Service Category Transition is necessary to meet their needs, preferences, or outcomes identified in their Personal Plan, and that all options within the individual's current waiver services have been exhausted and continue to be unable to meet the identified needs, preferences, or outcomes. Exhausting all options ensures a person has accessed or attempted to access supports already available, which could include natural supports, State Plan services or supports available through their current authorized waiver service category. Waiver Service Category Transitions, including updates to the Plan, can occur any time the individual's desires or needs change; this is not limited to the annual update of the Plan. Individuals, families, guardians, as applicable, or providers who are aware of the need or desire to request an alternative waiver service should notify the individual's Independent Service Coordination (ISC) agency.

Waiver Service Category Transition requests are:

  • Community Day Services to Adult Home-Based Services
  • Community Day Services to Community Integrated Living Arrangement (any model)
  • Adult Home-Based Services to Community Integrated Living Arrangement (any model)
  • Intermittent CILA to 24-Hour or Host Family CILA

Note: Waiver Service Category Transitions pertain to the Adult DD Waiver only. Individuals currently in the Children's Support Waiver who want or need Children's Residential Waiver services must meet the crisis criteria.

In order to request the waiver service category change, the ISC agency submits a service request packet for a Waiver Service Category Transition to the assigned Community Services Region Representative within the Division of Developmental Disabilities (DDD). The request must:

  • Clearly state the current and proposed DD Waiver Service Category.
  • Include a narrative explaining why the individual is requesting the change in service category, the needs/desires that are not currently being met and how the person is being affected.
  • Describe how the current services have been changed and/or exhausted to meet the individual's needs or preferences as well as how the new services will help the individual meet the outcomes in their Personal Plan.
  • Contain a copy of the current Personal Plan with the appropriate signatures. The proposed service category type must be indicated on the first page of the Plan and supported by the contents of the Plan.
  • Identify a proposed provider agency, except in the case of Home-Based Services.
  • Include the required applications and supporting documents for each type of service and clearly state the current and proposed DD waiver service category.

DDD will review each request and determine that:

  • According to what is included in the Personal Plan, the request for a Waiver Service Category Transition is appropriate, at which point the packet is processed for an award letter based on appropriation authority.
    • In the event the DDD does not have appropriation authority to process the award letter, the DDD will communicate a timeline for approval.
  • A decision on a Waiver Service Category Transition cannot be made due to insufficient information. The request will be returned to the ISC agency with questions and/or a request for additional information; or
  • The need or preference for a new waiver service category has not been established or the new service category is not supported in the Personal Plan. The Waiver Service Category Transition is denied, and the packet is returned along with a denial letter to the ISC agency. In this letter, the ISC is informed of DDD's determination and that appeal rights must be given to the individual and guardian, as applicable. The individual/guardian has the right to appeal a denial of waiver services as outlined in the Notice of Individual's Right to Appeal Medicaid Waiver Determinations [IL462-1202 (R-01-17)] PDF.

Effective Date

This Information Bulletin is effective 06/01/2023