Illinois Medicaid Resources

• State Medicaid Website: Illinois
• Illinois Council on Developmental Disabilities Website
• The Arc of Illinois

Illinois Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 292,700 people with disabilities covered by Medicaid in Illinois. Illinois spent $18,386 on each Medicaid recipient with a disability in 2007.

13% of all people covered by Medicaid in Illinois have a disability, while the national percentage is 15%.

Illinois spends 43% of all money spent on Medicaid on services for people with disabilities, which is almost the same as the national percentage of 42%.

Illinois HealthConnect Primary Care Case Management

This program provides services to adults with disabilities, except those also eligible for Medicare. It does not cover children who have disabilities. This program covers a very wide range of services, including common Medicaid services. It also covers treatments usually not covered, such as assisted or augmentative communication devices, blood and blood components, psychiatric care, non-durable medical equipment and supplies, and midwife services.

• Community:  transportation
• Health: audiology, chiropractic, clinic services, dental, vision, disease management, durable medical equipment, emergency services, early and periodic screening, diagnosis and treatment, family planning, immunization, hospice, hospital services, mental health, substance abuse treatment, laboratory, occupational therapy, prosthetic or orthotic devices, pharmacy, physical therapy, physician, podiatry, skilled nursing facilities, speech therapy, vision, x-ray, communication devices, blood and blood components, psychiatric care, disposable medical equipment and supplies, midwife services
• Home: home health care
• Social Services: case management

Children and Young Adults with Developmental Disabilities Support waiver

This program covers children who have intellectual and developmental disabilities and are at risk of being placed in an intermediate care facility. It helps provide needed services in the family home or another community setting.

Ages: between 3 and 21 years old

• Health: assistive technology, behavior intervention and treatment, adaptive equipment
• Home: personal support, home accessibility modifications, vehicle modifications, training and counseling services for unpaid caregivers
• Social Services: service facilitation

Children and Young Adults with Developmental Disabilities Residential waiver

This waiver provides services to children who are at risk of placement in an intermediate care facility. Instead of these facilities, this program serves children in group homes.

Ages: between 3 and 21

• Health: assistive technology, behavioral intervention and treatment, adaptive equipment
• Home: residential habilitation (including in homes for ten or fewer children)

Medically Fragile and Technology-Dependent Children’s waiver

This is similar to the Katie Beckett waiver in other states. This waiver covers children with disabilities who meet criteria defined by the state and who would otherwise have to get care in a nursing facility or hospital. This waiver allows them to receive these services in the family home or other community setting.

Ages: 21 and under

• Community: medically supervised day care; placement counseling
• Health: early and periodic screening, diagnosis and treatment; specialized medical equipment and supplies
• Home: nurse and family caregiver training; environmental modifications; respite care, either in the home or in care centers

Persons with Disabilities waiver

This waiver covers people with disabilities who would otherwise have to live in a nursing facility.

Ages: 59 and under. People who are 60 or older who were previously enrolled in this program can also choose to continue services.

Level of Care: nursing

• Community: adult day care
• Health: skilled nursing, physical therapy, occupational therapy, speech therapy, personal emergency response systems, specialized medical equipment and supplies
• Home: homemaker services, personal care, respite, home health care, environmental accessibility adaptations, home delivered meals

Persons with Brain Injury waiver

This waiver applies to any person with brain injury of any age who is eligible for Medicaid and would otherwise have to be placed in a nursing home.

Level of Care: nursing

• Community: adult day care, day habilitation
• Health: personal emergency response systems, behavioral services, physical therapy, occupational therapy, speech therapy, specialized medical equipment and supplies, skilled nursing
• Home: homemaker services, personal care, environmental accessibility modifications, home health aides, respite care, home delivered meals
• Work: supported employment, prevocational services

Adults with Developmental Disabilities waiver

This waiver applies to adults with disabilities who would otherwise be places in a residential care facility. This waiver helps pay for services delivered in a home or community setting.

Ages: 18 and over

Level of Care: intermediate

• Community: day habilitation, adult day care, transportation
• Health: nursing, behavior services, physical therapy, occupational therapy, speech therapy, personal emergency response systems, adaptive equipment
• Home: residential habilitation (in family homes or in community living facilities with 16 or fewer persons), personal support, training and counseling for unpaid caregivers, home and vehicle modifications
• Work: supported employment

Waiver for Persons who are Elderly

This waiver can cover anyone over the age of 60 who is eligible for Medicaid, regardless of disability, who would otherwise be placed in a nursing home.

Ages: 60 and over

Level of Care: nursing

• Health: emergency response services
• Home: homemaking services, adult day care (in the patient’s home or community residence)

Illinois Supportive Living Program

This waiver provides services to people with disabilities who want to live in a supported living facility instead of in a nursing home.

Ages: 22 and older

Level of Care: nursing

• Community: social and recreational activities, transportation
• Health: nursing, help with medication, 24-hour emergency response and security, health promotion and exercise, emergency call system
• Home: personal care, laundry, housekeeping and home maintenance