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HFS set for further negotiations on 1115 waiver for behavioral health

9 Aug 2023 9:30 AM | Deborah Hodges (Administrator)

Medicaid Administrator Kelly Cunningham said last week they expect to have conversations in the coming months with federal partners regardingIllinois’ recently-submitted1115 waiver for behavioral health services.

The five-year extension application to the Centers for Medicare and Medicaid Services proposes 10 programs, including efforts to address food and nutrition services, employment assistance, non-medical transportation and community reintegration for previously incarcerated individuals.

While they await those negotiations with the federal agency, Cunningham told the Medicaid Advisory Board Friday that the next big step for the agency will be creating an implementation design for the initiatives. She said the agency will be working with stakeholders to help plan how to roll out the programs.

“It's really how do we design an implementation strategy so that these services and that this planning actually has the desired outcome in terms of improving health and addressing the needs of the Medicaid population," Cunningham said.

CMS said earlier this summer that they have extended the state’s demonstration through next June as the two sides negotiate over the current extension application.

The agency also said it is preparing to schedule a public hearing on changes to the Medicaid-like program for undocumented individuals ages 42 and older. The changes include a pause on new enrollees between the age of 42 and 64 and copays for hospital services not eligible for a federal match, such as $250 for inpatient hospitalizations and $100 for emergency room visits.

The changes also will pause enrollment in the program for those 65 and older once the total number of members reaches 16,500. Officials said last week it has yet to meet that threshold.

Laura Phelan, policy director at the department, said the details of the meeting “will be forthcoming.”

Additionally, she said work is underway to create a dashboard to track enrollment data on the program.

“Our goal is to make it consumer friendly and also easily consumable,” Phelan said.

 The committee also approved a motion for the department to respond by year’s end to a report created by the MAC’s community integration subcommittee. The report lays out short- and long-term recommendations to increase the number of seniors and persons with all types of disabilities receiving services in community settings.

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