Last Thursday, the Governor’s Office invited stakeholders to another meeting on the
Medicaid Transformation Waiver Section 1115.

In attendance were:  Cristal Thomas, Deputy Governor; Michael Gelder, Health Policy
Advisor to the Governor; Secretary Saddler; Health Management Associates Representatives
including Shane Spotts, former DD Director in Indiana, and Representative Feigenholtz.

The State of Illinois has launched this effort to develop a Path to Transformation Medicaid
Waiver under the Centers for Medicare and Medicaid Services waiver authority, Section 1115
of the Social Security Act. Section 1115 waivers allow states to test new approaches in Medicaid
that differ from federal program rules. So it is the intent of the Administration to combine nine
Illinois Waivers into one Section 1115 Waiver that will strengthen Home & Community Based
Services, modernize our delivery systems and increase federal funding.

I was hoping to learn more of the details of the specific content on the 1115 Waiver, but it
turns out that the meeting was for us to provide the Administration with specific
recommendations stakeholders would like to see in the final 1115 Waiver Application.
They want specific recommendations that will improve the disability system.

My comments from last Tuesday are still very valid about the 1115 Waiver.

There was good discussion about the 1115 Waiver and the medical model. Shane Spotts
from HMA indicated that the first section of the 1115 Waiver is a social model component
regarding Home & Community Based Infrastructure, Coordianation and Choice. It was also
stated that the waiver application was not about saving money or cutting services, but rather
providing services/supports based on individual need.

I will be drafting my comments this week and will include recommendations such as ending
the waiting list, increasing wages for direct care staff and maintaining free standing,
independent service coordination to name a few.

Here is the draft 1115 Waiver concept paper. If you are interested in providing ideas
that can help shape the goals and strategies of the waiver, they invite you to submit
written recommendations (no more than 5 pages of double spaced text per organization)
to HMPRG at, using the subject line “1115 Waiver”, no later than
November 25th.

You should organize your comments around the following waiver categories:

1.     Home and Community Based Infrastructure, Coordination and Choice
2.     Delivery System Transformation
3.     Build Capacity of the Health Care System for Population Health Management
4.     21st Century Health Care Workforce
5.     General Comments

HMPRG will summarize all of the written recommendations for consideration by state
leaders and the HMA staff preparing the application. There will be a second opportunity
for stakeholder response after the application draft has been developed.

Here is the PowerPoint Presentation from Thursday’s meeting.

Timeline for 1115 Waiver Application Process:

October 18, 2013 Stakeholder kick-off meeting
Oct. 18-Dec. 13, 2013 Stakeholder meetings
November 5, 2013 Concept paper finalized
December 13, 2013 First draft of waiver proposal
January 5, 2014   Draft waiver posted for comment
January 15, 2014 Final waiver w/comments posted
February 15, 2014 Waiver submitted to CMS

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)