This resource was put together by our friends at the Institute on Disability & Human Development at UIC.

See their public comment suggestions.

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The public comment period is open now through January 3, 2016 for the latest version of the State of Illinois’ Statewide Transition Plan to implement the Center for Medicare & Medicaid Services (CMS) settings rule for Home and Community Based Services. The final rule requires that all home and community-based settings meet certain qualifications. According to CMS’ website, these include:

• The setting is integrated in and supports full access to the greater community;
• Is selected by the individual from among setting options;
• Ensures individual rights of privacy, dignity and respect, and freedom from coercion and
• Optimizes autonomy and independence in making life choices; and
• Facilitates choice regarding services and who provides them.

The State of Illinois seeks stakeholder input as they continue to develop a plan to implement these guidelines in Illinois. The information below includes excerpts from CMS’ letter to the State of Illinois, the latest draft of Illinois’ Statewide Transition Plan, and the National Health Law Program’s Public Comment Suggestions. CMS gave feedback on Illinois’ previous draft of the Statewide Transition Plan (view the full letter here) and asked Illinois to do the following:

  • Elaborate on the process through which the state will determine whether or not a setting has the qualities of an institution. Settings that are presumed to have institutional qualities must go through a process called “heightened scrutiny.” Illinois has stated that heightened scrutiny will happen on a “case-by-case” basis.

Public Comment Suggestion: The state could add detail about the heightened scrutiny process. Some examples of how the state could show a setting is community-based are: descriptions of community interactions, procedures the setting uses that show support for activities in the community, pictures and/or maps of the site, which may include nearby or related institutional or disability-specific sites, descriptions of how the facility is connected, or not, with any related institutional facility, evidence showing the general community considers the setting as part of the community and does not associate the setting only with providing services to people with disabilities, and evidence that participants are involved in the community outside of the setting.

  • CMS requests that the state add a detailed ongoing monitoring strategy that lays out the methods of oversight to ensure that the settings remain in compliance. Illinois has stated that ongoing monitoring will occur primarily through periodic site visits.

Public Comment Suggestion: More detail could be added about this process, including specific examples of “performance measures that gauge choice and community integration” that the State mentions. Site visits, as a method of both compliance monitoring and heightened scrutiny, should be as transparent and consistent as possible. The detailed protocol for site visits should be provided in the State’s transition plan.

  • If a setting is found to not be community-based, the state must relocate beneficiaries if needed. CMS asks the state to describe its process to assure that critical services/supports are in place in advance of the individual’s transition. CMS states that Illinois provided high-level planning, but has not provided detailed steps for how the transition will occur or detail on how the State will ensure that critical services are in place.

Public Comment Suggestion: The relocation process should ensure that maximum community participation is made possible. Relocation, as with all HCBS, should be person-centered.

  • Each state is also required to specifically address each public comment provided during the previous comment period. You can find the public comments in Appendix H of the Revised Statewide Transition Plan.

Public Comment Suggestion: The State can provide more detailed about proposed opportunities for community education and stakeholder workgroups, which will strengthen the State’s implementation plan.

Submit comments by email to

Written comments should be mailed to:

Illinois Department of Healthcare and Family Services
Attn:  Waiver Management
201 South Grand Avenue East, FL2
Springfield, IL 62763

Persons who are unable to access the Internet may request a hard copy of the revised Statewide Transition Plan by calling HFS at (217) 524-4148.

You can find more common issues and model comments here and be sure to check out where you can find Illinois-specific documents, such as the draft of the Statewide Transition Plan, and many more resources!
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Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)