January 27, 2021 DDD Communication

January 27, 2021

Good Morning,

On February 5, 2020, the Illinois Department of Healthcare and Family Services (HFS) released a revised Statewide Transition Plan (STP) for all nine Home & Community Based Services (HCBS) Waivers operating in the State of Illinois, including the three delivered by the Illinois Department of Human Services Division of Developmental Disabilities (DDD). The revised STP, which can be found here, was posted with a request for public comment. This communication serves as a Division-specific update to the process and our steps for moving forward. For more information about the federal HCBS Based Settings Rule and the Statewide Transition Plan process, please see the FAQ at the end of this notice.

Since February of last year, HFS has consolidated the comments received on the STP and delivered them to the Division for comment and feedback. Attached to this document, you will find the consolidated comments and the Division's response for each, including areas that will be addressed in the STP. Based on the comments received, HFS and the Division will be revising the STP to address a number of additional areas which will be posted for public comment. With that being said, HFS will be submitting this STP, including both the public comment and the DDD and other Waiver Agency responses, to the Centers for Medicare and Medicaid Services for initial approval. This does not mean that this STP is final, or that the Division does not plan to work with HFS on future revisions. It does, however, get us one step closer to a final STP.

There are a number of next steps, which include:

  • Revision of the STP based on comments received to date and reposting for public comment.
  • Discussion and feedback with stakeholders of our Developmental Disabilities Advisory Committee, as well as other stakeholder groups.
  • The release of a Provider Residential Settings Self-Assessment Survey and Non-Residential Settings Self-Assessment Survey in February. This survey will request detailed information on specific residential and non-residential settings to understand the landscape of settings located in or on the grounds of institutions across Illinois, as well as settings that isolate individuals. This information must be consolidated and submitted to federal CMS by March 31, 2021.
  • The release of an Information Bulletin that outlines and clarifies Illinois requirements for provider issuance of leases and keys to the individuals served in HCBS residential settings.

We anticipate these next steps will be completed in stages over the latter part of this fiscal year and into the next. The Division is committed to working with our stakeholders and HFS to create and implement an STP that meets Settings rule requirements and creates a better service system in Illinois.


What is the Settings Rule?

The Home & Community Based "Settings" Rule establishes requirements for home and community-based settings in Medicaid HCBS programs operated under sections 1915(c), 1915(i), and 1915(k) of the Social Security Act. The rule creates a more outcome-oriented definition of home and community-based settings, rather than one based solely on a setting's location, geography, or physical characteristics. The regulatory changes will maximize the opportunities for HCBS program participants to have access to the benefits of community living and to receive services in the most integrated setting, and will effectuate the law's intention for Medicaid home and community-based services to provide alternatives to services provided in institutions.

Illinois operates 9 HCBS waivers (DDD operates 3 of the waivers) and all must come into compliance with the Settings Rule.

What is the Statewide Transition Plan (STP)?

The STP is the mechanism that states use to demonstrate their movement towards meeting the final rule requirements for each of their waivers. Every State must file an STP as well as receive initial and final approval from federal CMS.

We look forward to working with all of you on the next steps in this important process.


Allison Stark

Director, Division of Developmental Disabilities