Illinois

Main Contact: 
Kristopher Classen: Kristopher[dot]Classen[at]Illinois[dot]gov
NWD/SEP System
Name of Operating Agency: 
Illinois Department of Healthcare and Family Services (DHFS)
Participating types of NWD/SEPs: 
AAAs, CILs, Community Mental Health Centers, Pre-Admission Screening Agencies, Case Coordination Agencies, Alcohol and Substance Abuse providers, and Department of Human Services local offices.
1-800 number: 
1-888-833-4879 with plans to move to 1-844-for-C4CL
Level I screen: 
Through researching best practices in other states and surveying many commercial product options, IL developed an Initial Screen. The Initial Screen will be available through two access points: the 1-800 LTSS call center and in person at one of the NWDs.
Level II assessment: 
IL is adopting the InterRAI Community Health Assessment (CHA) as its Uniform Assessment Tool (UAT), which will be the same across all participating agencies to facilitate data sharing and referrals.
Agency responsible for completing the financial assessment: 
Financial eligibility is conducted by the Illinois Integrated Eligibility System (IES).
Coordination/automation of referrals between levels (i.e., Level I and Level II) : 
The UAT vendor will develop an automated system that captures the Level I screening questions and the UAT (Level II assessment). The system will allow users at all to NWDs to input and access data about client eligibility for community LTSS.
Core Standardized Assessment
Elderly individuals (age 65 or older): 
interRAI CHA
People with developmental disabilities: 
Inventory for Client and Agency Planning (ICAP)
People with a serious mental illness or severe emotional disturbance: 
LOCUS and the interRAI CHA
People with physical disabilities: 
interRAI CHA
Conflict-Free Case Management
Mitigation strategies in place/planned: 
Four of IL’s eight programs/service areas are conflict free. For those programs/service areas where conflict exists, IL has developed mitigation strategies, including external reviews and audits, beneficiary complaint systems, and consumer surveys.
Service data: 

All agencies maintain a claims database for billing and federal financial participation (FFP) purposes. Encounter data are maintained for managed care expenditures.

Quality measures: 

Health and Quality of Life (HEDIS) measures are calculated for all populations in addition to the following:

  • Elderly: Supportive Living Record Reviews; Community Care Program Quality Management Report
  • Developmental/Intellectual Disability (DD/ID): DD Waiver Performance Measures Report
  • Physical Disability: Division of Rehabilitation Services (DRS) WebCM Report (Home Services Program, AIDS, and BI waivers); Supportive Living Record Reviews 
Outcomes data: 

All managed care organizations are required to initiate a managed care performance improvement project on an annual basis. Outcomes measures for the DD/ID population are captured through National Core Indicators and an Incident Reporting System, which monitors critical incidents. The Participant Outcomes and Status Measures are used for the elderly population, and the Evaluation of Care Survey for the mental health population. 

 
Use of Enhanced FMAP: 

IL has spent the majority of funds on increasing DD waiver capacity. Mental Health Money Follows the Person ( MFP) coverage, Employment First Initiatives, and Services and Support Teams have been expanded. The funds have also supported improved nursing facility diversions, the Home and Community Ombudsman Program, and peer support drop-in centers. IL plans to invest additional funds in its NWD IT system.