WEBVTT 1 "Bansa, Melishia" (3129318656) 00:00:09.793 --> 00:00:30.019 Hello everyone and welcome to the 1115 Waiver Healthcare Transformation Annual public form. My name is Malicia Deputy Director of Community outreach, and boards and commissions. I will be your facilitator on today. At this time, I would like to turn it over to our Chief of staff. 2 "Bansa, Melishia" (3129318656) 00:00:30.019 --> 00:00:35.555 Of HFS miss Dana Kelly, to do our welcome. 3 "Kelly, Dana" (778400256) 00:00:35.555 --> 00:00:52.850 Hi everyone. Thank you for joining this forum today. I just wanted to speak on behalf of HFS leadership. I'm Dana Kelly. I am the chief of staff here at HFS and I'm honored and so pleased to work with our 1115 waiver team. 4 "Kelly, Dana" (778400256) 00:00:52.850 --> 00:01:08.160 Team who our director is Theya, who has been a dear friend and colleague of mine for some time and and Kristen, they will get back, they will be managing most of this conversation. So. 5 "Kelly, Dana" (778400256) 00:01:08.160 --> 00:01:28.160 Just to kind of lay the groundwork here, today you're gonna hear a lot about where we are with the rollout of the 1115 waiver. And what I will say is that this is an incredibly exciting effort. It is a bright spot amongst a lot of uncertainty. We are, we are pleased that we can. 6 "Kelly, Dana" (778400256) 00:01:28.160 --> 00:01:56.060 Continue to have the authority to implement this regardless of kind of what has happened elsewise to other programming related to healthcare. And so we are we are moving full steam ahead, but it isn't, you know, immune from some of the impacts of the uncertainty around us and we'll talk through some of those challenges in terms of how we have to think about this in light of, HR one and the budgeting things that have come. 7 "Kelly, Dana" (778400256) 00:01:56.060 --> 00:02:16.060 From that. However, we're, we are excited to push forward. It is an incredible amount of work to get this off the ground, so the team is gonna detail some of the very, you know, complicated things they're working through to be able to really make this live and real in our. 8 "Kelly, Dana" (778400256) 00:02:36.060 --> 00:02:56.060 To inform our work and inform our model moving forward. And you know, I really again want to thank the leadership here at HFS for working through this very detailed project to get us to a point where we can really realize the benefits of. 9 "Kelly, Dana" (778400256) 00:02:56.060 --> 00:03:16.060 These services long term. So they are an incredible team. They will walk you through where we're at and we really open this up for your comments, your thoughts, your questions, and we'll be eager to hear what you have to say. So I would just wanna thank you for coming and, thank you. 10 "Kelly, Dana" (778400256) 00:03:16.060 --> 00:03:24.235 Thank you for being a part of this endeavor and I'll turn it over to the rest of my team. 11 "Bansa, Melishia" (3129318656) 00:03:24.235 --> 00:03:41.880 Thank you so much, Dana. Next slide, please. So we've got a jam packed agenda and we are excited about it. You just heard from our wonderful chief of staff, and we'll go over and introduce some of our other colleagues leads on this. 12 "Bansa, Melishia" (3129318656) 00:03:41.880 --> 00:04:01.880 A particular form, as well as we'll touch on the purpose of today's form, some housekeeping rules. You'll also hear background of the health care transformation 1115 waiver and current approvals. You'll also get some further insight into some program updates, and then we'll get right into the public. 13 "Bansa, Melishia" (3129318656) 00:04:01.880 --> 00:04:12.960 The section of today's form followed by that we will end promptly after that. Next slide, please. 14 "Bansa, Melishia" (3129318656) 00:04:12.960 --> 00:04:32.960 And so again, you heard from our chief of staff. We've got some other phenomenal colleagues on this project, Eric Foster, who's our senior policy advisor of the SUD pilots. Christen Hartzolt special assistant to the director from medical policy. Diaquorus Floresce, special assistance to the director for health. 15 "Bansa, Melishia" (3129318656) 00:04:32.960 --> 00:04:48.449 Related social needs, myself, Mili Schedman said Deputy Director of community outreach, boards and commissions, and some of our boards and commissions support staff, Jerome Beverly and Susan lightly. Next slide, please. 16 "Bansa, Melishia" (3129318656) 00:04:48.449 --> 00:05:08.449 And so today of, the purpose of this form is to comply with the 42 CFR 431 .20 C and the state's special terms and conditions for the Illinois Healthcare Transformation 1115 demonstration waiver. And then also to afford the. 17 "Bansa, Melishia" (3129318656) 00:05:08.449 --> 00:05:19.439 Public an opportunity to provide meaningful comment on the progress of the 1115 waiver demonstration. Next slide please. 18 "Bansa, Melishia" (3129318656) 00:05:19.439 --> 00:05:39.439 And just some housekeeping rules for today's public forum. I do want to say 1st and foremost, we have noticed that there are some recording and AI bots that have appeared in the chat, but I do want to shed a light that none of those bots or AI. 19 "Bansa, Melishia" (3129318656) 00:05:39.439 --> 00:05:59.439 A recording note taker apps that you see are the official record of today's public form. So we will not be utilizing any of that. Please be sure to mute your audio except for when speaking. HFS may mute participants to minimize disruptive noise or feedback. HFS will not be answered. 20 "Bansa, Melishia" (3129318656) 00:05:59.439 --> 00:06:19.439 Answering questions during today's form, but commenters are welcome to submit questions with their remarks. HFS is committed to hosting meetings that are accessible in ADA compliant, closed captioning, and foreign language captioning are both provided for you today through the Webex platform via. 21 "Bansa, Melishia" (3129318656) 00:06:19.439 --> 00:06:51.139 The web widget closed captioning icon. You can find that by looking at the little CC and your left hand corner of your Webex screen on this platform. For public comments, to accommodate as many comments as possible today, we request that commenters keep their feedback to 3 min. Written public comments will be accepted until 1159pM. On Wednesday 15 October 2000 and. 22 "Bansa, Melishia" (3129318656) 00:06:51.139 --> 00:07:04.196 Point 25. You can also submit those comments by emailing HFS.eleven 15 waiver@Illinois.gov. Next slide, please. 23 "Hartsaw, Kristin" (352810240) 00:07:04.196 --> 00:07:06.176 Yeah. 24 "Bansa, Melishia" (3129318656) 00:07:06.176 --> 00:07:29.849 For some instructions for public commenters as you're preparing those exciting comments today in the background, we want you to know that the public comments section of today's forum form will follow the HFS presentation. Participants who registered in advance and requested to provide public comments will be called upon 1st. 25 "Bansa, Melishia" (3129318656) 00:07:29.849 --> 00:07:45.749 If you did not register in advance of today's form and would like to provide comments, please notify the host in the chat. When sharing your comments, please provide your name if applicable, the organization you represent. 26 "Bansa, Melishia" (3129318656) 00:07:45.749 --> 00:08:01.379 To accommodate as many speakers as possible, we again ask that you limit your comments to 3 min. Organizations are asked to select one representative to comment on their behalf. Next slide. 27 "Bansa, Melishia" (3129318656) 00:08:01.379 --> 00:08:16.874 Without further ado, I will turn it over to my colleagues, Kirsten and Theya, who will go on with more information about the 1115 waiver. Kristen? Thaya? 28 "Kachoris-Flores, Thea" (1136221440) 00:08:16.874 --> 00:08:29.639 Thanks Malicia. Hi everyone, I'm really grateful for everyone for being here today and showing interest in the 1115 waiver. As Dana mentioned, I'm. 29 "Kachoris-Flores, Thea" (1136221440) 00:08:29.639 --> 00:08:49.639 Working on the 1115 waiver here at HFS along with Kristen. We've been working on this for Christen longer than I, but I've been here for about a year now. But also just want to acknowledge all the other people behind the scenes that are, we couldn't do this work without them as well. I do also before I. 30 "Kachoris-Flores, Thea" (1136221440) 00:08:49.639 --> 00:09:11.009 To kind of keep going with our deck here. I want to acknowledge I think there's some questions about how to to to enter a request for public comments in the chat. I don't know if it's been fixed yet, but we're working on it if you can't do that yet. There was a comment that I think the chat was not enabled, so if it hasn't been fixed. 31 "Bansa, Melishia" (3129318656) 00:09:11.009 --> 00:09:38.697 Yeah, let me just go ahead and test on that. Please send your comment to the host. Everyone has capabilities to do that. And so you may need to exit out and come back in for that as well. If you're still having issues, please go ahead and email the HFS boards and commissions email which was listed in the public meeting posting. We will also monitor that. Thank you. Thanks. 32 "Kachoris-Flores, Thea" (1136221440) 00:09:38.697 --> 00:10:10.969 So I just want to make sure people have a, have a chance to to comment today if they want. But again, as Malicia said, today is not the only day. You can also email us at that email address that we'll give again at the end. So as Malicia said, we are going to give a a brief overview of the waiver, provide some updates where we are in our current planning for implementation, and also talk about some of the existing services that have been underway since the previous waiver, but we do want to spend the majority of our time. 33 "Kachoris-Flores, Thea" (1136221440) 00:10:10.969 --> 00:10:36.649 I'm hearing from all of you. So we will save some time for that at the end. So most of you probably already know what an of 1115 waiver is but this is the ability for states, this is federal kind of authority for the states to be able to ask federal CMS for approval for expenditure authority on services that are not traditionally allowed. 34 "Kachoris-Flores, Thea" (1136221440) 00:10:36.649 --> 00:10:51.989 By Medicaid. So the waiver grants states the flexibility to test or demonstrate innovative services that are in alignment with the Medicaid program to achieve the goals of improving health care access, improving. 35 "Kachoris-Flores, Thea" (1136221440) 00:10:51.989 --> 00:11:11.989 Healthcare outcomes and then ultimately reducing costs to the Medicaid system. There are a number of different types of services that can be approved under a waiver. Just for a little bit of national context, there are 66 waivers that are approved across 74 I'm not sorry nearly a 40. 36 "Kachoris-Flores, Thea" (1136221440) 00:11:11.989 --> 00:11:31.989 Across 47 states, 25 states currently have approval for HRSN services, and 19 states have approval for reentry services. So there are a few states that are already out there. If you want more kind of that national landscape, KFF dot. 37 "Kachoris-Flores, Thea" (1136221440) 00:11:31.989 --> 00:12:01.639 That org is a great resource for that just to see what other states are doing and to see the kind of the the breadth of them out there. You can go to the next slide. So while waivers give states flexibility to test new services, they still must operate within the within Medicaid rules, and there are a lot of requirements that we still have to fulfill to be able to launch services, which makes this all really complex. One of the things that I wanted to highlight and remind. 38 "Kachoris-Flores, Thea" (1136221440) 00:12:01.639 --> 00:12:34.439 Folks for about is how the funding comes to this state. It's different than what many of us are used to in terms of grant funding and getting funding for some of the services that we have approved in the waiver, but the 1115 waiver funding is very similar to other Medicaid service expenditures. It authorizes federal matching for what the state spends on the approved services. So it's not a grant program. We don't get money up front from CMS. Instead, the state has to spend money up front. 39 "Kachoris-Flores, Thea" (1136221440) 00:12:34.439 --> 00:12:54.439 And then we get it matched at a per certain percentage, so it's not a hundred percent kind of reimbursement back to the state and it can, and it also varies by who's being served. And we cannot claim dollars that are already funded by other federal funding. So this really has to be coordinated with other. 40 "Kachoris-Flores, Thea" (1136221440) 00:12:54.439 --> 00:13:19.249 Programs and services that are grant funded and we can't duplicate services. Also just want to note that within our approval for the waiver, it gives us some expenditure amounts for each of the services, and that's what CMS has authorized, but that is an up to amount. We are not required to spend that every year, and nor is it guaranteed money that comes to the state. 41 "Kachoris-Flores, Thea" (1136221440) 00:13:19.249 --> 00:13:40.009 We go to the next slide. Currently, Illinois has two approved 1115 waivers. One is a continuity of care one that we are not discussing here today and the other is the healthcare transformation waiver, which is what we're here to talk about today. 42 "Kachoris-Flores, Thea" (1136221440) 00:13:40.009 --> 00:13:59.279 The health care transformation waiver was technically an amendment on our be our previous behavioral health waiver. That amendment was approved in July of 2024, and included a range of services that are listed here on this slide. 43 "Kachoris-Flores, Thea" (1136221440) 00:13:59.279 --> 00:14:18.659 The services that we are focusing our current implementation efforts on are in that left box. The health related social needs are HRSN services, which includes housing and and medical respite and the nutrition support services. 44 "Kachoris-Flores, Thea" (1136221440) 00:14:18.659 --> 00:14:38.659 And then with each of within each of those HRSN services as a range of different housing and nutrition services that were kind of defined and approved by CMS. We are not necessarily required to implement all of the services within each of those categories, but we included them in our. 45 "Kachoris-Flores, Thea" (1136221440) 00:14:38.659 --> 00:15:02.669 A year ago to give us the broadest range of services that CMS would allow at the time and give us flexibility for implementation. In addition, the other area that we're focusing our time on right now in our implementation efforts are re entry, and those reentry services are for a set services within the 90 days. 46 "Kachoris-Flores, Thea" (1136221440) 00:15:02.669 --> 00:15:22.669 Prior to release for incarceration. So it's to help set people up for reentry, but the services are actually within the 90 days pre release, and we'll get into a little bit more of that in a few minutes. The middle box is the continuing SUD services that were approved in the. 47 "Kachoris-Flores, Thea" (1136221440) 00:15:22.669 --> 00:15:42.029 Previous waiver and are continuing in our amendment for this waiver and we'll give a brief update on that. And then on the right side there are the services that we're currently holding off on our planning for. So today we're going to be providing some updates on HRSN re entry and SUD. 48 "Kachoris-Flores, Thea" (1136221440) 00:15:42.029 --> 00:16:02.029 You can go to the next slide. So as we mentioned or you know Dana mentioned you'll probably kind of hear this theme. Implementation of all of this is really complex, even in the best of circumstances. And now about a year later, we find ourselves. 49 "Kachoris-Flores, Thea" (1136221440) 00:16:02.029 --> 00:16:34.639 In a very different situation than we had a year ago. So while David said this is a, a really bright light and is giving people hope, we just want to kind of give some context, and mention a few things that we've learned in the last year and some of the headwinds we're facing right now. So we've spent a lot of time over the last year learning from other states. I mentioned the other states that have, a little bit further ahead of us. Some of them are the same situation of, of us, but what we're really. 50 "Kachoris-Flores, Thea" (1136221440) 00:16:34.639 --> 00:16:56.149 Learning is that these services take time, an intentional effort, and so they're taking at least one to two years to launch from approval. There's just a lot of things that, again, we'll get into, but takes time to, to work through all the details. We also know that we're facing some difficult financial headwinds. 51 "Kachoris-Flores, Thea" (1136221440) 00:16:56.149 --> 00:17:16.579 The state budget last fiscal year was tight. We're only expecting it to get tighter this year, especially with all the, the federal cuts that we're hearing that and that are coming nationally. And the state's gonna have to make some decisions on what we'll be able to cover, both within the waiver. 52 "Kachoris-Flores, Thea" (1136221440) 00:17:16.579 --> 00:17:38.479 Other places that we're not talking about today but and also we know that the implementation of HR one is having a strain on our resources. You know, the changes that are coming with HR one are OBBBA folks are used to that name, including changes to. 53 "Kachoris-Flores, Thea" (1136221440) 00:17:38.479 --> 00:17:54.449 Medicaid eligibility while it doesn't impact the waiver directly, it will put strain on our systems and resources to be able to implement those changes while also trying to stand up new services. 54 "Kachoris-Flores, Thea" (1136221440) 00:17:54.449 --> 00:18:14.449 So, you know, while, again, while these things don't have a direct impact on the waiver, it is impacting our timeline and our capacity to implement the 1115 waiver services. So while we continue to plan for implementation of these services, we are having to kind of rethink the time. 55 "Kachoris-Flores, Thea" (1136221440) 00:18:14.449 --> 00:18:35.273 Planning of when we're able to do so and we continue to monitor federal policies and guidance as we continue to plan for launch. So I think with that, I'm going to kind of setting that context. I'm gonna turn it over to Kristen who's gonna kind of start walking us through some of the specific program updates. 56 "Hartsaw, Kristin" (352810240) 00:18:35.273 --> 00:18:42.449 Sure. Thank you so much and thank you everyone for joining us this morning. Next slide, please. 57 "Hartsaw, Kristin" (352810240) 00:18:42.449 --> 00:19:03.739 And next slide. So I will give a brief update on the existing substance use disorder pilots. Our colleague Eric Foster, deserves some credit for this. He was unable to join us today, so I'll do my best to give the update. But many maybe aware that this 1150. 58 "Hartsaw, Kristin" (352810240) 00:19:03.739 --> 00:19:23.739 Waiver for health care transformation is actually a continuation of a previous waiver. And when we requested to extend the authority, we had two existing substance use disorder pilots that were active and we did request and receive approval to continue these small pilots. The 1st is a. 59 "Hartsaw, Kristin" (352810240) 00:19:23.739 --> 00:19:43.739 Case management pilot and you can think about this as almost a diversion program for people who have either opioid use or substance use disorders. It is specialized case management to really focus on connecting them to not only needed SUD treatment but other medical services, social. 60 "Hartsaw, Kristin" (352810240) 00:19:43.739 --> 00:20:15.679 Services and the like. Currently there are two providers that are licensed by our now division of Behavioral health and recovery at Illinois Department of Human Services. Some of you may have been familiar with the acronym of super, but with their recent reorg now known as DBHR. And so those two licensed programs include family Guidance Center and task, and they are currently operating this pilot over 13 different locations. 61 "Hartsaw, Kristin" (352810240) 00:20:15.679 --> 00:20:43.699 Eric has included some numbers here in terms of numbers served over the last two years for you. Next slide. And then the other program or pilot, if you will, is substance use disorder treatment in an institution of mental disease. So historically Medicaid doesn't allow for subtreatment in residential settings of an IMD. 62 "Hartsaw, Kristin" (352810240) 00:20:43.699 --> 00:21:03.699 This waiver allows us to do so, and so again it's targeted towards those Medicaid customers who are short term residents of those types of facilities. The, the intention is that they are there for less than 30 days. Currently there are 16 facilities that are. 63 "Hartsaw, Kristin" (352810240) 00:21:03.699 --> 00:21:37.339 Participating in this pilot and again some numbers served. So we just wanted to give you the brief progress or highlights of these two substance use disorder pilots. Next slide. We, as part of the 1115 waiver, it does require an independent evaluation and so for the 1st five years of the demonstration, which included those two sub pilots, we did have to submit an interim evalu. 64 "Hartsaw, Kristin" (352810240) 00:21:37.339 --> 00:21:57.339 Evaluation report that is available online. It is part of the administrative record and so we've given you here the link to the medicaid.gov website for that. We are, our evaluators are currently working on a final summative evaluation, but with the. 65 "Hartsaw, Kristin" (352810240) 00:21:57.339 --> 00:22:17.339 1st five years, we actually ended up with an extra year extension, and so that pilot now or that evaluation now includes the six year of service. And so that will be submitted to CMS I believe later this year or early next year. So stay tuned for a final summit. 66 "Hartsaw, Kristin" (352810240) 00:22:17.339 --> 00:22:44.729 Of of the 1st six years of the demonstration and then we are are working on evaluation design for the current approval as well. Next slide. So now I'm going to start off just giving you a couple of updates about the implementation planning to date for the services that were newly authorized with the July second 2024 approval. Next slide. 67 "Hartsaw, Kristin" (352810240) 00:22:44.729 --> 00:23:06.739 So what have we been doing? Really we we got approval in July of 2024 and it's pretty much been non stopped since and you'll hear me say this again, but we've been doing a lot of work behind the scenes. With approval came some specific deliverables that needed to be. 68 "Hartsaw, Kristin" (352810240) 00:23:06.739 --> 00:23:27.469 Be Composed and submitted to federal CMS for their review and negotiation, and so I think they'll talk a little bit about some of those post approval deliverables with the health related social needs HRSN services, and I'll talk a little bit about re entry in a moment. But we did work on. 69 "Hartsaw, Kristin" (352810240) 00:23:27.469 --> 00:23:50.299 That for the 1st six months of the year, have had a little bit of back and forth with CMS and also obtained some approvals with those. We also convened provider technical workgroups to help inform some of those deliverables. So one of them was our operational protocol where we discussed provider eligibility at a high level, service eligibility. 70 "Hartsaw, Kristin" (352810240) 00:23:50.299 --> 00:24:10.299 Of customers as well as service descriptions. We've also can utilized those provider technical workgroups to start considering other items as well. So we are really appreciative of those who have volunteered their times to participate in those. We've also. 71 "Hartsaw, Kristin" (352810240) 00:24:10.299 --> 00:24:28.049 As they have mentioned been discussing with other states who are a little further along in their implementation planning and and several states have been very generous with their time and expertise and lessons learned, and I'll highlight a few of those on the next slide. And then this is. 72 "Hartsaw, Kristin" (352810240) 00:24:28.049 --> 00:24:48.049 It is complex to set up new services, and there maybe an additional layer of complexity too with some of these services because they are what you may consider atypical providers in the Medicaid world, as in they're not always traditional health care settings, right? And that maybe many of you on the line today. So if you're a small. 73 "Hartsaw, Kristin" (352810240) 00:24:48.049 --> 00:25:08.049 Food pantry or a housing support organization that doesn't bill Medicaid today, you know, we recognize that that is another layer of complexity. But internally at HFS, we've been having a number of conversations with our internal subject matter experts for IT systems. 74 "Hartsaw, Kristin" (352810240) 00:25:08.049 --> 00:25:36.439 Everything from how we will identify the members who are eligible for these services, what will the procedure codes be? What are the provider enrollment requirements from the technical side of things? What are the billing claiming support systems, changes that are needed and much more. And then we're also engaged with our actuarial firm Millerman to work on rate development for the variety of services that were authorized on. 75 "Hartsaw, Kristin" (352810240) 00:25:36.439 --> 00:25:57.739 Under this waiver. Next slide, please. So some of the lessons learned from other states, they already mentioned it, but we are not alone in needing a significant amount of planning time before launching services. Also what we've learned from services or from other states is that they went with a. 76 "Hartsaw, Kristin" (352810240) 00:25:57.739 --> 00:26:17.739 Much smaller service package. Illinois, we went big, and granted at the time of application, you know, and I I think these are all still priorities of our Illinois administration, but it was a different world at time of application. But we wanted that flexibility, right? We wanted to be as broad. 77 "Hartsaw, Kristin" (352810240) 00:26:17.739 --> 00:26:37.739 Get and inclusive in our asks so that we have the flexibility to cover these range of services. But the reality is some services or some states are really focused on just one or two, even within the health related social needs. E.g., New Jersey, we've talked to them a couple of times and I believe they. 78 "Hartsaw, Kristin" (352810240) 00:26:37.739 --> 00:26:57.739 Started with just the home delivered meals as a food, support service. In Massachusetts, some of their housing supports are actually tailored by population and so really focusing on people who are homeless who have utilized the emergency department, e.g.. But, as you'll hear, we, we went big with our service. 79 "Hartsaw, Kristin" (352810240) 00:26:57.739 --> 00:27:20.659 Descriptions as well as criteria to be eligible for services. The other thing we've heard from states is that most recognize this need to support community based organizations. That's something they are and I and and leadership at HFS is very mindful of. And so what we've heard from most states have is there's variation. 80 "Hartsaw, Kristin" (352810240) 00:27:20.659 --> 00:27:52.129 But they all seem to have some sort of regional structure to support those community based organizations in these services, service delivery and Medicaid billing. Next slide. And I kind of outlined this a bit with, the previous slide, two slides ago, but I just can't emphasize it enough is that there are many complex moving pieces to standing up services under 1115 waiver. And so. 81 "Hartsaw, Kristin" (352810240) 00:27:52.129 --> 00:28:12.129 You know yes, there's the operational piece and planning for the launch of services, we also have budget and financing considerations that also relate to reporting and claiming to be able to access that federal financial participation. And we want to make sure we get that right. 82 "Hartsaw, Kristin" (352810240) 00:28:12.129 --> 00:28:32.129 Federal CMS is looking closely at states in terms of their ability to report and claim on these services. And I think I mentioned most of these other buckets of work, but just so you know that these are what we are currently working through. Also many of. 83 "Hartsaw, Kristin" (352810240) 00:28:32.129 --> 00:28:50.489 You maybe familiar, but we, we are requiring that especially for hrsns, but that the systems be or the services be delivered in the managed care delivery system. And so there has also been planning work that has been happening with mcos to inform some of these processes. 84 "Hartsaw, Kristin" (352810240) 00:28:50.489 --> 00:29:10.489 And there's still more to be done in each of these buckets of work. Next slide. Okay, so that's kind of the activities to date. I am going to talk a little bit about the planning for the re entry demonstration. This is something that I. 85 "Hartsaw, Kristin" (352810240) 00:29:10.489 --> 00:29:30.489 I am helping to lead with Theya, and what we are have been doing, well let me back up a little bit. What were we approved to do, right? Okay, so what the reentry demonstration does is it actually waives the federal rule in made exclusion rule, which prohibits Medicaid from being used to. 86 "Hartsaw, Kristin" (352810240) 00:29:30.489 --> 00:29:50.489 Cover the healthcare of people who are incarcerated. So that's a a federal rule that prohibits that. And therefore, this approval through this 1115 waiver demonstration gives us the permission to leverage Medicaid to cover a specific set of services in a 90 day time frame prior. 87 "Hartsaw, Kristin" (352810240) 00:29:50.489 --> 00:30:10.489 To someone's release from a carcel facility. And the overall goal or aim of this is to assist with transition to the community coordination of care and really connecting people to their needed physical or behavioral health needs as well as health related social needs, those social determination. 88 "Hartsaw, Kristin" (352810240) 00:30:10.489 --> 00:30:30.489 Once they are released. Federal CMS requires all states with approved re entry demonstrations to cover three core services and so you see those listed here. It's a 30 day supply of prescriptions at release, that means in hand when someone is being released. 89 "Hartsaw, Kristin" (352810240) 00:30:30.489 --> 00:30:47.369 If they are given the prescriptions that they need. And then also medication assisted treatment for people with substance use disorder as well as the associated counseling with it and pre release case management. And that pre release case management. 90 "Hartsaw, Kristin" (352810240) 00:30:47.369 --> 00:31:07.369 Is going to be key to the success of connecting someone with an MCO, getting someone connected to their care upon release. Illinois requested and received approval for additional services which are listed here. Diagnostic and treatment services which include. 91 "Hartsaw, Kristin" (352810240) 00:31:07.369 --> 00:31:27.369 Physical and behavioral health consultation, some durable medical equipment and other supplies, medication in that 90 day pre release period, as well as services provided by community health workers, perhaps those with lived experience who can help with that navigation. 92 "Hartsaw, Kristin" (352810240) 00:31:27.369 --> 00:31:38.609 So these are the services that we are authorized to, offer and cover under the reentry demonstration. Next slide. 93 "Hartsaw, Kristin" (352810240) 00:31:38.609 --> 00:31:58.609 And so what has our planning been? So again, behind the scenes, a lot of work being done. We have regular planning meetings with the current carsal partners included in this waiver. Those partners include Illinois Department of Corrections, Illinois Department of Judan Aisle justice, and. 94 "Hartsaw, Kristin" (352810240) 00:31:58.609 --> 00:32:18.609 Health Services at Cook County which provides the health care for both the Cook County jail and Cook County juvenile detention center residents. So there's a lot to work through, you know, figuring out what operational changes may need to be made on their end, identifying who exactly. 95 "Hartsaw, Kristin" (352810240) 00:32:18.609 --> 00:32:38.809 Is providing those services today, what needs to change to meet the definition and requirements under federal CMS rules. There are specific milestones that CMS expects states to be able to report on and complete as part of these reentry demonstrations. 96 "Hartsaw, Kristin" (352810240) 00:32:38.809 --> 00:33:10.439 So we're working through all of that, also working through, you know, again, how, how will building work for these pre release services and much, much more. We, we have always signaled, you know, that we intend to expand to other carcel facilities in the future, but right now to start the services, these are the three that we are working on. Especially when you think about those three core required services, we. 97 "Hartsaw, Kristin" (352810240) 00:33:10.439 --> 00:33:30.439 We did not want to right away roll it out to all facilities because we were not sure that every county jail in Illinois would be able to meet the requirements of those three core services. And those of you who work with the reentry population know that thanks to a lot of recent legislation, the pre trial Fairness Act. 98 "Hartsaw, Kristin" (352810240) 00:33:30.439 --> 00:33:49.379 Public safety reform overall that the patterns of detention have changed significantly. So we are working to set up these systems with these partners right now and then still thinking about the future and where that may fall to expand further. 99 "Hartsaw, Kristin" (352810240) 00:33:49.379 --> 00:34:09.379 With the reentry demonstration, we did have two post approval deliverables. That is a re entry implementation plan as well as a reinvestment plan. And those are still pending approval. I think we're getting close with the reentry implementation plan. We just received some final feedback re. 100 "Hartsaw, Kristin" (352810240) 00:34:09.379 --> 00:34:29.379 Regarding the service descriptions and how some of those services are split out. So I'm hoping to receive something confirming approval in the near future, so send positive vibes for that. And then also the reentry reinvestment plan. We submitted that in February. We've also. 101 "Hartsaw, Kristin" (352810240) 00:34:29.379 --> 00:34:58.219 Also submitted some additional questions and we're still waiting for CMS to respond and give us feedback on that. At a high level, the reinvestment plan, what we had to do is identify what services are considered existing today that we were approved to cover and what would be considered new. And then that governs when we receive federal match, how that has to be reinvested into future reentry services. 102 "Hartsaw, Kristin" (352810240) 00:34:58.219 --> 00:35:14.159 Basically, the federal government doesn't want states relieving the carcel system of its duty to provide health care to individuals who are incarcerated. So it's just another complex policy piece that. 103 "Hartsaw, Kristin" (352810240) 00:35:14.159 --> 00:35:34.159 They require us to outline how we will do that. So that's a lot, but that's the planning activities to date. We are still hopeful in the future once we get a little further along to also bring in to some of the planning conversations community based partners, and people with lived experience. But right now it's. 104 "Hartsaw, Kristin" (352810240) 00:35:34.159 --> 00:35:44.833 Kinda focus on some of those operational considerations. With that, I think I'm going to pass the baton back to Theya to talk about health related social needs. 105 "Kachoris-Flores, Thea" (1136221440) 00:35:44.833 --> 00:36:06.089 Great, thanks Kristen. And, and so I mentioned kind of earlier in that in our, in the health related social needs, what we talk about with those or what CMS defines as health related social needs are the specific nutrition and housing services. And as I mentioned, we had, we included in our. 106 "Kachoris-Flores, Thea" (1136221440) 00:36:06.089 --> 00:36:22.319 Application to CMS and what they approved was a a variety of services within each of those. Oh, so since since approval and the last public form we had, we've had two key milestones and CMS approvals that have. 107 "Kachoris-Flores, Thea" (1136221440) 00:36:22.319 --> 00:36:42.319 And have kept our work going. The 1st is the HRS on operational protocol, and that document again through negotiation with CMS details out the services, who's eligible, what's included, what are some of the requirements that need to be made in delivering those services? That. 108 "Kachoris-Flores, Thea" (1136221440) 00:36:42.319 --> 00:37:00.989 That was approved by CMS back in December. In addition, we also were fortunate to have the implementation plan approved by CMS in early January. With both of those documents, it gives us the ability to continue to implement. 109 "Kachoris-Flores, Thea" (1136221440) 00:37:00.989 --> 00:37:20.549 HR services. Neither HR one nor any of the federal policy letters you may have seen impacts the approval of the waiver services. As I mentioned, it does kind of impact our capacity to implement all of them in budget but does not. 110 "Kachoris-Flores, Thea" (1136221440) 00:37:20.549 --> 00:37:39.449 Negate any of the approvals that we have. So we are able to continue planning. Both of those documents are on Medicaids dot gov's website and is also available on hfs's website for further details on what's included in those. I did if you wanna go to the next slide. 111 "Kachoris-Flores, Thea" (1136221440) 00:37:39.449 --> 00:37:59.449 I did want to just kind of give some examples of what's included. We're not gonna there's as I mentioned, there's a number of services that are approved under HRSN services. We're not gonna go through all of those, but want to give an example of what is included in those approvals. So when it come it sets forward who's eligible. 112 "Kachoris-Flores, Thea" (1136221440) 00:37:59.449 --> 00:38:23.149 For the services. So in the case of, HRS and services, the individuals must be Medicaid customers who are enrolled in managed care and meet both a social risk criteria as well as the clinical risk criteria. And on this slide, we're, we're noting what those are. So on the housing side. 113 "Kachoris-Flores, Thea" (1136221440) 00:38:23.149 --> 00:38:50.040 And somebody needs to either be at risk of homelessness as defined by the the CFR or or homeless, and then meet a clinical risk criteria. On the food side, again, someone has to meet the social risk criteria of being low or very low. Food insecurity is defined by the USDA and then meet some clinical risk criteria. 114 "Kachoris-Flores, Thea" (1136221440) 00:38:50.040 --> 00:39:10.040 You know, when we put out further guidance, we will be much more specific about what somebody needs to meet to receive one of these services and what needs to be documented for these services. As Kristen was talking about earlier, that is a lot of the detailed planning that we're doing both with our. 115 "Kachoris-Flores, Thea" (1136221440) 00:39:10.040 --> 00:39:30.040 Workgroups to help define what those processes will look like, and also kind of refine and and get into very specifics how we're gonna document those eligibility criteria. Next slide. And again, here's just two examples that we pulled from the protocol. 116 "Kachoris-Flores, Thea" (1136221440) 00:39:30.040 --> 00:39:47.340 And again, you can see all of the service descriptions that are in the operational protocol. One is medical respite, and so this is in the housing, set of services which is a service that is. 117 "Kachoris-Flores, Thea" (1136221440) 00:39:47.340 --> 00:40:07.340 I guess newer, and it is allows for or newer in the Medicaid space, allows for short term housing in a room and board facility for somebody that either is going into the hospital for a procedure and then needs a safe place safe and comfortable place to. 118 "Kachoris-Flores, Thea" (1136221440) 00:40:07.340 --> 00:40:27.340 Stay or somebody that's coming out of a hospital, and doesn't have a, a place to stay to recover. So that is one service that was approved by CMS. We have been doing a lot of talking to existing medical respite providers to, to determine how to set up rates and what the codes are. 119 "Kachoris-Flores, Thea" (1136221440) 00:40:27.340 --> 00:40:47.340 That would like and how people will get referred into services. And we've also been talking to some national organizations to help inform our work on that as well. On the foodside, the example that we have here are medically tailored meals. This, the protocol gives us approval for up to three meals a day for up. 120 "Kachoris-Flores, Thea" (1136221440) 00:40:47.340 --> 00:41:07.340 To six months, which is tailored to a specific medical condition. And that includes the, the kind of the delivery of that includes the preparation of those meals and delivery to a home if some if that's available or someone could pick up those meals. Both of these services have to be. 121 "Kachoris-Flores, Thea" (1136221440) 00:41:07.340 --> 00:41:25.260 Coordinated with other kind of supports that somebody has and cannot duplicate, so like in the case of medically tailored meals, if somebody is already receiving a meal benefit has to be coordinated with that meal benefit. So again, those are some of the operational things that we are working through. 122 "Kachoris-Flores, Thea" (1136221440) 00:41:25.260 --> 00:41:45.260 Next slide please. So I think we've talked about this a couple of times now. You know, one of the things that we've been doing over the past year and has been really important to inform our work is convening our stakeholder groups to get into to get input into the imp. 123 "Kachoris-Flores, Thea" (1136221440) 00:41:45.260 --> 00:42:02.880 Implementation. On the HRSN side specifically we've, we have a nutrition work group and a housing provider work group as well as a health care provider workpu work group to get input into those definitions, how to determine someone's eligibility to coordinate with other programs. 124 "Kachoris-Flores, Thea" (1136221440) 00:42:02.880 --> 00:42:22.880 We are also meeting regularly with sister agencies. Kristian talked a little bit about this too, as many of those sister agencies are already working with providers that would be delivering the housing and food, so learning from them and we're talking to mcos because this has to be delivered through our managed care partners. 125 "Kachoris-Flores, Thea" (1136221440) 00:42:22.880 --> 00:42:54.320 And we're also talking to other key stakeholders and conveners to help us think through the operationalization and coordination of these services. They have been giving us important insight into provider capacity to deliver these services and what providers will need to become Medicaid providers. As Kristen mentioned, this is something we're very aware of, and that and we've been spending some of our time planning for that too. Next. 126 "Kachoris-Flores, Thea" (1136221440) 00:42:54.320 --> 00:43:13.380 Next slide, please. So like I said, we recognize that organizations are gonna need our support in becoming Medicaid providers. Many of those that are delivering are not Medicaid providers today. And so there's lots of questions about how they would. 127 "Kachoris-Flores, Thea" (1136221440) 00:43:13.380 --> 00:43:33.380 Bill and how they become a Medicaid provider. We have made the decision that all organizations that will be delivering these services and will be a provider that wants to bill will need to become a Medicaid enrolled provider. So we know that we're going to be needing to support those organizations and there will be a way. 128 "Kachoris-Flores, Thea" (1136221440) 00:43:33.380 --> 00:43:53.380 Got more information to come about how that will happen. But a couple of things that we're doing to help that that we could share today. One is that we're leaning heavily towards creating a regional network approach that would help s providers become Medicaid billers and work with Medicaid providers and. 129 "Kachoris-Flores, Thea" (1136221440) 00:43:53.380 --> 00:44:09.750 Work with mcos. I cannot guarantee that's gonna happen today. I can't give a timeline for that, but just know that's kind of something that we've heard from other states that's been a successful approach and we are leaning towards that right now. 130 "Kachoris-Flores, Thea" (1136221440) 00:44:09.750 --> 00:44:29.750 We also have two active procurements. Again, I can't give the timeline on those, but just to make folks aware that we have two active procurements, one's for our closed loop referral system, and one is for a billing and claiming system that would help CDO. 131 "Kachoris-Flores, Thea" (1136221440) 00:44:29.750 --> 00:44:46.350 Those bill and claim for services. For the for all of those updates, I just encourage you to monitor our website and also check out bid by regularly for updates on those. 132 "Kachoris-Flores, Thea" (1136221440) 00:44:46.350 --> 00:45:06.350 Next slide. So as kind of Kristen and I have both mentioned, we're doing a lot of work behind the scenes. You know, e.g., on the HRSN side, we are identifying the billing codes and how we're going to set. 133 "Kachoris-Flores, Thea" (1136221440) 00:45:06.350 --> 00:45:26.350 Up new pro new and existing providers that want to bill for HRS and services making sure that we have all of the reporting in place so that we can document the services report back to CMS and you know work and getting those rates that I know we all know that everyone's very interested in. 134 "Kachoris-Flores, Thea" (1136221440) 00:45:26.350 --> 00:45:46.350 And knowing those details. We're not able to share those details today, but we will be putting all of that detail and instructions and the support that we will be having for CBOs. We'll have that be able to communicate all of that to you as we get closer to a launch date. We are also working. 135 "Kachoris-Flores, Thea" (1136221440) 00:45:46.350 --> 00:46:06.350 Working with MTAC. Many of you maybe familiar with the medi Medicaid technical Assistance Center of MTAC that does help with provider enrollment. We are already working with them to think about what training and support will be needed to organizations to help them enroll as Medicaid providers, and so we'll, there'll be more information about how to, to access. 136 "Kachoris-Flores, Thea" (1136221440) 00:46:06.350 --> 00:46:30.960 What type of guidance they'll, they and we will be able to give to you. Again, you know, can't give time timing today. We are still planning for hoping for launch of some of the HRS and services in later in calendar year 2026, maybe into calendar year 2027. 137 "Kachoris-Flores, Thea" (1136221440) 00:46:30.960 --> 00:46:50.960 Given kind of all of the budget and resource constraints that we're all aware of and are feeling, it is, you know, likely that we will probably need to limit some of the services, meaning that we'll do some housing, some nutrition but might not be the full gamut that you see in the operational protocol. 138 "Kachoris-Flores, Thea" (1136221440) 00:46:50.960 --> 00:47:10.960 Oh, but that is all still being determined, discussed as part of the budgeting process for FY 27. And so we are working with our part, we're working internally, we're working with the governor's office to determine what we are able to stand up. So, again. 139 "Kachoris-Flores, Thea" (1136221440) 00:47:10.960 --> 00:47:26.280 And as Dana said, as dr. white Herm has said, this, we are committed to to doing this and standing up services, just the timing and and scope is still. 140 "Kachoris-Flores, Thea" (1136221440) 00:47:26.280 --> 00:47:42.120 To be determined. So with that need to go to the next slide. So here's different ways that you can keep, current or keep up to date. We have been trying to keep our website. 141 "Kachoris-Flores, Thea" (1136221440) 00:47:42.120 --> 00:48:02.120 Current kind of reorganizing it. So check that out regularly. We have created a, a constant contact, list, so if you want to sign up for that as we have updates, we'll send them out. If you have questions in the meantime or think of ones after. 142 "Kachoris-Flores, Thea" (1136221440) 00:48:02.120 --> 00:48:19.175 The same email address to send comments. You could also send questions. And as I mentioned for those technology procurements, keep an eye on bit bye. I think that's all we had for our content, Malicia. 143 "Bansa, Melishia" (3129318656) 00:48:19.175 --> 00:48:49.160 Wonderful. Thank you so much, Kristen and Theya for giving that phenomenal overview there. We're gonna get right into our public comments. Next slide please. Got some hand hands of applauses there for you all. Yes, great work, much needed indeed. So just gonna reiterate some of those public comment house rules. We went over a few earlier. And for those of you that. 144 "Bansa, Melishia" (3129318656) 00:48:49.160 --> 00:49:09.160 Just joined just to get you up to speed on this process. Please mute your audio except for when speaking. HFS may mute participants to minimize a disruptive noise or feedback. HFS will not be answering questions during today's form, but commenters are welcome to submit questions. 145 "Bansa, Melishia" (3129318656) 00:49:09.160 --> 00:49:29.160 It's with their remarks. This is not a form for HFS to receive individual complaints about specific healthcare providers or service plants. It is also not the proper form for HFS to receive information from a vendor about its supplies, services, and operating models. Regardless of how feedback is provided, note that. 146 "Bansa, Melishia" (3129318656) 00:49:29.160 --> 00:49:45.090 But it later maybe shared outside of HFS pursuant to hfs's obligations under foya. Therefore, comments should not include personal health information or other details Commenters wish to remain private private. Next slide please. 147 "Bansa, Melishia" (3129318656) 00:49:45.090 --> 00:50:08.930 Participants who registered in advance and requested to provide public comments will be called upon 1st. If you did not register in advance and would like to provide comments, please notify the host in the chat or raise your hand. Our chat is working and it's been working, so we are happy about that. The host will call on com. 148 "Bansa, Melishia" (3129318656) 00:50:08.930 --> 00:50:33.150 Mentors and unmute their mic. When sharing your comments, please provide your name and if applicable, the organization you represent. And my favorite part here, please limit your comments to 3 min to allow HFS to accommodate as many speakers as possible. Next slide, please. 149 "Bansa, Melishia" (3129318656) 00:50:33.150 --> 00:50:55.940 Now what we've done today is, is you're preparing your comments, we've taken the liberty to provide some things and topic areas for you to consider. Of course, this list is not all inclusive, but will help give you, some additional areas of insights to kind of help you prepare. 150 "Bansa, Melishia" (3129318656) 00:50:55.940 --> 00:51:24.240 Those comments in advance before you are called upon. And of course, if you are unable to make any comments today, we of course want to continue to hear your feedback. So as we stated earlier, written public comment will be accepted until 11:59 P.M. on Wednesday, 15 October 2025 by simply emailing hFS.eleven 15 waiver. 151 "Bansa, Melishia" (3129318656) 00:51:24.240 --> 00:51:44.240 At Illinois.gov. So without further ado, we're gonna get right into our comments. I will go ahead and I will allow participants to be able to unmute themselves. And again, if, if I need to pause, I certainly will. Our 1st comment. 152 "Bansa, Melishia" (3129318656) 00:51:44.240 --> 00:52:02.856 Answer that registered to make public comment. We will go with Beth Kinnerfick, Director of public policy, and as you're preparing to unmute yourself. If I mispronounce anyone's names, apologies in advance. Beth, are you with us? 153 "Beth Kenefick, Greater Chicago Food Depository" (4110575616) 00:52:02.856 --> 00:52:25.620 I am. Thank you so much. Thank you. So I'm Beth Canadavick. I'm a director of policy with the greater Chicago food depository. Speaking on behalf of myself, our organization and my other colleagues that are here. We just wanted to say as one of the seven feeding Illinois food banks and the one serving Cook County. 154 "Beth Kenefick, Greater Chicago Food Depository" (4110575616) 00:52:25.620 --> 00:52:45.620 Given our mission is to end hunger that we've been very supportive of hfs's journey over the last many years to really bring together the social service providers and the health care world specifically using this 1115 waiver, and are appreciative of the collaborative approach that the department. 155 "Beth Kenefick, Greater Chicago Food Depository" (4110575616) 00:52:45.620 --> 00:53:03.330 Has been taking with which to sort of discuss the implementation around the nutrition services, and are happy to have this opportunity to share that here and we'll plan on providing some additional written comments by the 15th. So thank you. 156 "Bansa, Melishia" (3129318656) 00:53:03.330 --> 00:53:23.330 Thank you so much for your comments. I'm also seeing in the chat. Yes, the recording will be made available as well as this deck, so we will make sure that we get that information out to you posted on the site that my wonderful colleagues will put in the chat for everyone to be able to reference when that information. 157 "Bansa, Melishia" (3129318656) 00:53:23.330 --> 00:53:38.656 And is available. We'll get right into our next comment coming from Cole Bradham, Vice President of Business Development Organization Moms Neals. Cole, are you with us? 158 "Cole Bradham" (1120214528) 00:53:38.656 --> 00:54:06.640 I am. Thank you guys so much. Again, my name's Cole. I work as our vice president of business development with mom's meals, mission driven organization to improve life through better nutrition at home, and we provide fully prepared condition appropriate meals to those members in need. And so 1st I just want to thank the department for the opportunity to be able to share feedback on the 11th 15 waiver. We really commend Illinois in this whole team for your commitment to addressing health related social needs. 159 "Cole Bradham" (1120214528) 00:54:06.640 --> 00:54:39.830 And really working to advance health equity through this waiver. Really appreciate the collaborative approach you all are taking with this and engaging all stakeholders. You know, we do have the opportunity to see every day just how access to medically tailored and conditioned appropriate meals can help individuals manage chronic illness, right? Be able to recover after hospital stays and most importantly maintain their independence at home. And so nutrition interventions have proven to be a solution to reduce avoidable hospitalizations. 160 "Cole Bradham" (1120214528) 00:54:39.830 --> 00:55:09.950 Support better health outcomes, which I think aligns really well with the goals of the transformation waiver. And so on behalf of the team here, we just, you know, we encourage the department to continue supporting the integration of home delivery meals and other nutrition services as a part of the waiver, doing so not only improves quality of life for members, but also provides cost savings for the state and being able to reduce unnecessary utilization of higher cost care. And. 161 "Cole Bradham" (1120214528) 00:55:09.950 --> 00:55:30.140 Lastly, to meet the expectations of the state and CMS to show efficiency and outcomes, I think we need to consider speed and scalability, and we just stand ready to partner with the state providers, community based organizations, and mcos to ensure that members across Illinois have consistent. 162 "Cole Bradham" (1120214528) 00:55:30.140 --> 00:55:49.034 Can access to meals and the nutritional support they need to drive at home in the community and we just really support the goals and vision of this waiver. So I appreciate the opportunity and all the work here. Thank you all for the leadership and for including stakeholder voices in this very important process. Thanks so much. 163 "Bansa, Melishia" (3129318656) 00:55:49.034 --> 00:56:03.657 Thank you so much Cole. Our next comment will be coming from Jenna Simon, chief program and policy officer, Illinois Public Health Institutes. Are you with us? 164 "Janna Simon | she/her" (4042018048) 00:56:03.657 --> 00:56:18.690 Yes, I am. Thank you for having me. Good afternoon or good morning, everyone. I'm Jana Simon. I'm the chief program policy officer at the Illinois Public Health Institute, and we collaborate to advance health justice through equitable policy systems and institutional change. 165 "Janna Simon | she/her" (4042018048) 00:56:18.690 --> 00:56:34.350 We have supported Medicaid and health transformation, including participating in the technical workgroups on food and nutrition, housing sports and medical respite, and we wanna thank the Illinois Department of Healthcare and Family Services for supporting implementation of this 1115 waiver. 166 "Janna Simon | she/her" (4042018048) 00:56:34.350 --> 00:56:53.520 It's really important that we address health related social needs of our Medicaid clients and we thank you for your dedication to implementing this. We appreciate that hfss's efforts have thoughtfully engaged community and health care system partners, and your work to ensure multiple perspectives and experiences are accounted for as appreciated. 167 "Janna Simon | she/her" (4042018048) 00:56:53.520 --> 00:57:13.520 As we continue to support implementation, we'd like to recommend for, four things as we think about implementation. So the 1st is that we encourage HFS to use a decision support framework, as you have to roll out services knowing that maybe not all services and populations will be able to be addressed immediately given our. 168 "Janna Simon | she/her" (4042018048) 00:57:13.520 --> 00:57:31.830 Budget and resource constraints. So if you do determine that you can't roll out all of the approved benefits, we recommend that you look beyond considering the impact on health outcomes and costs and start to also consider access to services across geographies and the state making sure there's equity across the state. 169 "Janna Simon | she/her" (4042018048) 00:57:31.830 --> 00:57:48.420 Consider the time and effort needed to coordinate some of the benefits. Some of them are more time intensive than others and making sure there's a mix of efforts. Making sure that the chosen interventions set up a successful and sustainable infrastructure to scale these services in the future. 170 "Janna Simon | she/her" (4042018048) 00:57:48.420 --> 00:58:05.940 And to ensure that the community based providers, have the supports they needed to roll these out. And finally, as an example of this ensuring that at least two or more nutrition support services together are rolled out can help us create a more robust and diverse infrastructure for providers. 171 "Janna Simon | she/her" (4042018048) 00:58:05.940 --> 00:58:25.940 2nd thing we recommend is to coordinate across payers, managed care organizations, and community based organizations on how to support community based organizations. I think HFS can play a role to coordinate across philanthropy and managed care organizations to ensure investment in a common vision for how to support CBOs in these as humans. 172 "Janna Simon | she/her" (4042018048) 00:58:25.940 --> 00:58:50.870 Regional structures you're thinking about, and those groups can help co design the solution. Thirdly, we think investing in a statewide community information exchange similar to one being developed in Cook County could help create a community governed, not for profit network that helps connect social service, behavioral health, and healthcare providers, and those providing these health related social need services. 173 "Janna Simon | she/her" (4042018048) 00:58:50.870 --> 00:59:11.360 And it's, would really help connect healthcare providers and community based organizations delivering these services across the state. And lastly, we recommend transparent and ongoing communications. We're pleased to see the constant contact sign up ability and we would encourage HFS to continue to communicate broadly with providers. 174 "Janna Simon | she/her" (4042018048) 00:59:11.360 --> 00:59:31.746 About the waiver, seek continuous feedback and input from stakeholders and provide transparency on service eligibility and provide provider rates as soon as possible for folks to be able to plan accordingly. So thank you again for your commitment for addressing health based social needs and improving health and reducing costs of state. Thank you. 175 "Bansa, Melishia" (3129318656) 00:59:31.746 --> 00:59:41.155 Thank you so much. Our next comment will be coming from Latitia Price. 176 "Leticia BP-ILCHWA" (3991864832) 00:59:41.155 --> 01:00:10.480 Wow, thank you. I'm the co executive director of the Illinois Community Health Worker Association. I partner Wandy Hernandez, we're together on this. I just, 1st of all want to thank HFS for being true partners. Anything related to the Community Health worker workforce and the ecosystem, you all have included us in that and that's how this work should go. Bringing the. 177 "Leticia BP-ILCHWA" (3991864832) 01:00:10.480 --> 01:00:26.460 Write people to the table where this work is really gonna impact the most. So I am just very grateful and blessed and really call you all true partners in this work. The thing that I want to just emphasize is around the reimbursement rates. 178 "Leticia BP-ILCHWA" (3991864832) 01:00:26.460 --> 01:00:46.460 You all have definitely, considered community health workers and the employers that hire them and trying to figure out ways to support, sustain, and grow the CHW workforce. So we're just really asking. 179 "Leticia BP-ILCHWA" (3991864832) 01:00:46.460 --> 01:01:06.460 Looking for strong consideration on equitable rates that will sustain CHWs and the work that they do and encourage employers to, to retain the CHWs and get to employers that are. 180 "Leticia BP-ILCHWA" (3991864832) 01:01:06.460 --> 01:01:26.460 Interested in hiring CHWs. So we just want to strongly emphasize equitable rates that will provide a nice salary with benefits for CHWs to support their families, but also to support the communities that they serve. So. 181 "Leticia BP-ILCHWA" (3991864832) 01:01:26.460 --> 01:01:43.135 So please continue to lean on us to help you all figure this out, to help get the message out to CHWs and the ecosystem that supports them and we are happy to serve. So thank you very much. 182 "Bansa, Melishia" (3129318656) 01:01:43.135 --> 01:01:55.871 Thank you so much for your comments. We are going to go to our next public commenter. Brandy Covert Vice President Housing Aides Foundation. 183 "3126****50" (2784785152) 01:01:55.871 --> 01:02:24.870 Thank you very much. Good morning. My name is Brandy Calvert and I'm the vice president of Housing at Aides Foundation Chicago. I'm here today also representing the Center for Housing and health. Aides Foundation Chicago and the Center for Housing and Health continue to be extremely supportive of Illinois Healthcare Transformation at 1115 waiver. We look forward to ongoing partnership with the state and all stakeholders to ensure its full successful implementation. 184 "3126****50" (2784785152) 01:02:24.870 --> 01:02:44.870 Aides Foundation in Chicago in its subsidiary, the Center for Housing and Health fully support the state's innovation and commitment to addressing the social drivers of health, including providing housing related services as included in the 1115 waiver. AIDS Foundation Chicago is an organization committed to mobilizing community. 185 "3126****50" (2784785152) 01:02:44.870 --> 01:03:12.530 In the pursuit of equity and justice for people living with and vulnerable to HIV or other chronic conditions. ASC believes that housing is health care and that every person has the right to safe and decent housing. Our subsidiary organization, the Center for Housing and Health, works to increase the availability of affordable housing for low income people with HIV or chronic conditions while supporting improved health outcomes for residents. 186 "3126****50" (2784785152) 01:03:12.530 --> 01:03:32.310 Of the 3000 of the 35956 people diagnosed with HIV in Illinois in 20 2028 and a half percent or 10247 are estimated to have need for shelter or housing assistance. In other words, slightly more than one in four people. 187 "3126****50" (2784785152) 01:03:32.310 --> 01:03:52.310 Of the 10247 people living with HIV in Illinois who need shelter or housing assistance, 47 % or 4847 have an unmeet unmet need. In other words, just under half of the people living with HIV in Illinois who have a need for shelter or housing assistance. 188 "3126****50" (2784785152) 01:03:52.310 --> 01:04:11.970 Do not have their need met. People experiencing homelessness are likely to have significantly reduced life expectancy and are more likely to be the victim of a violent of solar homicide. According to a July 2024 report prepared by the Illinois Department of Public Health by the University of Illinois. 189 "3126****50" (2784785152) 01:04:11.970 --> 01:04:31.970 Chicago School of Public health. People experiencing homelessness with chronic health conditions have a very high like, high level of hospital utilization and among those that died, the majority were suffering from chronic conditions at the time of their death. I shared the above data to briefly illustrate the need. 190 "3126****50" (2784785152) 01:04:31.970 --> 01:04:49.669 For the 1115 waiver in Ya's Foundation Chicago and the Center for Housing and Health have some have been supportive since its inception. Thank you for the opportunity to provide these public comments in support of Illinois Healthcare Transformation 1115 waiver this morning. Have a good day, everyone. 191 "Bansa, Melishia" (3129318656) 01:04:49.669 --> 01:05:06.840 Thank you so much for your comments. We're gonna move to our next public commentary. Ricky Hamilton from God Jobs America, Cosio. Ricky, are you with us? Ricky? 192 "Bansa, Melishia" (3129318656) 01:05:06.840 --> 01:05:28.670 We'll circle back around to him. Give him another opportunity to come back. We're gonna move right into our chat as we're preparing to go into our chat. Also if you are unable to use the chat for any reason, you can also be free to raise your hand as well as, email. 193 "Bansa, Melishia" (3129318656) 01:05:28.670 --> 01:05:48.712 The HFS boards and commissions, email address as well. We've got several modalities to assist you today to bring us that wonderful feedback. Without further ado, I'll move to the chat. A representative Lappointete, are you with us? Yes I am. Thank you so much. 194 "Lindsey LaPointe" (1353685760) 01:05:48.712 --> 01:06:06.420 Okay. Hi everybody. I don't have a timer so HFS jump in and cut me off if I hit my I'm state representative Lindsay LaPoint I cover much of the far northwest side of the city of Chicago. Very grateful to partner with HFS and many people in this virtual meeting right now. 195 "Lindsey LaPointe" (1353685760) 01:06:06.420 --> 01:06:23.370 Just want to express a few comments and put some questions on the table. Overall I'm really supportive of of the concept of the 1115 waiver very I'm very aware that health related social needs and re entry are intertwined with health. 196 "Lindsey LaPointe" (1353685760) 01:06:23.370 --> 01:06:43.370 And human outcomes. In an ideal world, we wouldn't need this special and complex financing model because it takes so much time and energy. I get why we do need it in this world today, but in an ideal world, providers would just kind of have the ability to much better address health related social needs. 197 "Lindsey LaPointe" (1353685760) 01:06:43.370 --> 01:07:04.170 Without a waiver. A concern that I have that remains is that we don't know the timing of the waiver or it keeps changing, but more importantly, nobody seems to know the scope and scale of the waiver. 198 "Lindsey LaPointe" (1353685760) 01:07:04.170 --> 01:07:22.170 And so I'm gonna continue to have this ongoing question of how many people on Medicaid will this waiver touch? And to me, if, if we don't know the answer to that, it's really difficult to have a strong sense of what the impact. 199 "Lindsey LaPointe" (1353685760) 01:07:22.170 --> 01:07:40.920 Could be. And I I remain concerned that we, we put so much time and effort into this waiver, which again I am supportive of the concept, but in until it's actually helping a critical mass of people on the ground, like in my community. 200 "Lindsey LaPointe" (1353685760) 01:07:40.920 --> 01:08:00.920 It's hard for me to assess like, is this all worth it to be blunt about it? I wanna uplift what the person from the organization working with community health workers said. We have to make sure that this results in frontline direct service workers actually making a living wage because today often they don't. 201 "Lindsey LaPointe" (1353685760) 01:08:00.920 --> 01:08:18.330 Even when funded with public sector dollars, we have too many people making under 40 grand a year. And I want to echo what the Aids foundation said. I see lots of folks in my community struggling with health and homelessness that cycle in and out of emergency rooms. Putting some questions on the table just for the record. 202 "Lindsey LaPointe" (1353685760) 01:08:18.330 --> 01:08:36.690 Obviously the scope of the number of people this is gonna touch I think is absolutely front and center. Another question, does doc's inability to track recitivism as of 2022, which just popped in the news? Will that affect the reentry component of the waiver? 203 "Lindsey LaPointe" (1353685760) 01:08:36.690 --> 01:08:56.690 I'm really interested, another question in how much Millamin is getting paid for this? I love Millamin, but I also want to make sure that money is going to make people's lives better on the ground rather than just going to healthcare actuaries. There's two active procurements out there that were mentioned, the closed loop referral system. 204 "Lindsey LaPointe" (1353685760) 01:08:56.690 --> 01:09:17.390 And a billing and claiming system. So as a policy maker, I'm really interested in how much money those procurements include. Let's see. I think I'll leave it at that and send the rest of my questions, but I'm great. 205 "Lindsey LaPointe" (1353685760) 01:09:17.390 --> 01:09:38.747 For this space. I'm grateful for the concept of the waiver, but I I just have concerns that it's not gonna affect people's lives fast enough and add a scope and scale that actually makes this whole Shebang worth it. So I'll leave it there. Thank you so much everybody. 206 "Bansa, Melishia" (3129318656) 01:09:38.747 --> 01:09:50.975 Thank you so much representative. We'll go back to the chat. We'll take a comment from Lori Baker Association for individual development. Lori, are you with us? 207 "Lore Baker - AID" (603993856) 01:09:50.975 --> 01:10:18.400 I am. Thank you. I am Lori Baker, president and CEO of the Association for Individual Development or AID and I've spent 30 plus years developing supportive housing around the state and advocating for a pretendency tendency support service in Medicaid, so excited to see the work moving forward here and that we'll maybe finally implement this service. 208 "Lore Baker - AID" (603993856) 01:10:18.400 --> 01:10:40.130 The one thing that I would like to encourage is, working with the supportive housing Providers Association or Shippa, which is a trade association of people who provide permanent support of housing across the state as a partner in ensuring that providers are. 209 "Lore Baker - AID" (603993856) 01:10:40.130 --> 01:11:12.470 That are currently providing supportive housing services and housing services, are at the table, and I would encourage that we look at those, group of mental health providers that receive service funding right now because we already built Medicaid and perhaps can get the service rolling more quickly with a group of people as we, as you all develop the regional approach and support people and medica. 210 "Lore Baker - AID" (603993856) 01:11:12.470 --> 01:11:44.180 Decade billing ability of more on the homeless services side. I will send further comments by the 15th, but just wanna continue to encourage outreach and connection to the world that exists that is permanent sport of housing providers that, you know, HFS has probably not really had interaction with, and, want you to encourage you to make the make that connection. And finally. 211 "Lore Baker - AID" (603993856) 01:11:44.180 --> 01:12:05.900 The the final thing is as we look at the these services that are health related services, we need to look at putting them in other Medicaid waivers, particularly for people with, particularly for people with like intellectual and development. 212 "Lore Baker - AID" (603993856) 01:12:05.900 --> 01:12:16.033 All disabilities, which could benefit from this service and could be added to their waiver that they currently have. Thank you. 213 "Bansa, Melishia" (3129318656) 01:12:16.033 --> 01:12:42.595 Thank you so much. Gonna go back to our chat. Also want to let everyone know we haven't received any emails, so we're gonna continue on with the chat for now. Also, for those who just joined, if you want to raise your hand, you can also do that as well. Our other comment will be coming from Sherry Martinez M I M S consulting. Sherry, are you with us? 214 "Sherie Arriazola Martinez" (3008015360) 01:12:42.595 --> 01:13:12.160 Yeah, thank you Malicia, this is Sherie Atriazolla Martinez with men's consulting. I was hoping I'd have more time, but here we go because I've been typing my comments as I've been listening. Thank you. Thank you to all the advocates attending and not attending who've been working on the coverage of some of these services for the past decade or longer. Thank you for, that includes representative Lindsay LaPoint before she was a representative and, so grateful for your. 215 "Sherie Arriazola Martinez" (3008015360) 01:13:12.160 --> 01:13:29.430 Advocacy and for the brilliant and smart hard working people at HFS who, I'm sure do the jobs of, you know, a whole team of people and it it's NO small feet to do what you guys have been doing and for the opportunity to provide comment. 216 "Sherie Arriazola Martinez" (3008015360) 01:13:29.430 --> 01:13:49.430 I've before consulting, I was the executive director of social policy at the Cook County sheriff's office, former ABP and Behavioral Health at Safer Foundation. Co founder of the supportive Reentry Network Healthcare transformation collaborative previous director managed care at task, and formerly a legislative. 217 "Sherie Arriazola Martinez" (3008015360) 01:13:49.430 --> 01:14:15.360 Staffer for public safety and human services, the member of the federal Medicare Reentry Act other than the Support Act, and so with all of that I want to give a few recommendations about the rollout of the waiver. My number one recommendation is the inclusion of organizations that are led by people who have lived experience. 218 "Sherie Arriazola Martinez" (3008015360) 01:14:15.360 --> 01:14:35.360 I think it is easy to work with providers who are already billing, but I'm concerned about the easiness of that leaving little to NO opportunity by the end of the, you know, 1st five years of the waiver for these types of. 219 "Sherie Arriazola Martinez" (3008015360) 01:14:35.360 --> 01:14:54.780 Organizations to be able to participate. Some of these organizations like I I believe will require some outreach because their current jobs likely don't evolve, like knowing about or attending Medicaid meetings to that point, it's currently prohibited for. 220 "Sherie Arriazola Martinez" (3008015360) 01:14:54.780 --> 01:15:10.230 CMHC or BHC to subcontract services to other organizations in the state regs. I would encourage 1st subcontracting to be permitted under the waiver so that smaller organizations who don't have. 221 "Sherie Arriazola Martinez" (3008015360) 01:15:10.230 --> 01:15:30.230 Infrastructure might wanna use another provider's EHR or might even want to bill under their MPI that that's allowed to do, that's allowed to happen with, you know, other considerations for implementation. Also if there could be clarity on the timeline of when the state will roll out the community. 222 "Sherie Arriazola Martinez" (3008015360) 01:15:30.230 --> 01:15:53.850 The care hubs and the regional networks and how that's gonna align with organizations ability to participate. So like if the regional network don't come online until later, like will a lot of the organizations that are said to benefit from that, like, will they have to wait, you know, additional number of years to participate? 223 "Sherie Arriazola Martinez" (3008015360) 01:15:53.850 --> 01:16:09.600 I would say also, allowing for organizations to have flexibility with how they would like to use infrastructure funds. So whether that's building out their in house ability to bill Medicaid, outsourcing. 224 "Sherie Arriazola Martinez" (3008015360) 01:16:09.600 --> 01:16:29.600 The ability to outsourcing the billing component or using some type of combination of the two but not really forcing like one model on folks also ensuring that implementation policies surrounding the waiver are being informed and led by people who have direct experience either receiving the service. 225 "Sherie Arriazola Martinez" (3008015360) 01:16:29.600 --> 01:16:55.850 That we're talking about providing the services as clinicians or case managers or billing for the affirmation services, concerned that, you know, implementation, you know, there's policy and there's implementation and I just think it's important that some of these recommendations are being informed by the on the ground struggles or the underground realities of what it takes. 226 "Sherie Arriazola Martinez" (3008015360) 01:16:55.850 --> 01:17:00.455 To deliver quality services. Am I at time? 227 "Bansa, Melishia" (3129318656) 01:17:00.455 --> 01:17:02.433 Yes, Dang it. 228 "Sherie Arriazola Martinez" (3008015360) 01:17:02.433 --> 01:17:08.452 Okay, I have other comments that I will put in writing, but thank you for your time. 229 "Bansa, Melishia" (3129318656) 01:17:08.452 --> 01:17:26.400 I tell you what, and for those of you, you know, you can come back and make another comment within 3 min as long as we are still going. So feel free to come back, but I want to get to some other folks also in our chat. 230 "Bansa, Melishia" (3129318656) 01:17:26.400 --> 01:17:45.094 Asana Sale from greater Chicago food depository. You put a comment in the chat. Did you want me to read it or did you want to say your own comment? I'll give you a moment to respond. If not, I will go ahead and read it. 231 "Sana Syal she/her - Greater Chicago Food Depository" (816620800) 01:17:45.094 --> 01:17:51.401 Thanks. It was not a comment for the public comment, it was a question on timing, but I can submit it separately through email. 232 "Bansa, Melishia" (3129318656) 01:17:51.401 --> 01:18:10.273 Sure, go right ahead. Thank you so much. Go back and we'll go back to the chat here. We have another comment coming from Kareem Watson executive director of Mouse Square Health Center. Dr. Kareem, are you with us? 233 "Karriem Watson Mile Square" (2352731904) 01:18:10.273 --> 01:18:36.060 I am. Thank you so much, Lisa. 1st of all I want to commend you all on this well, well organized and and thoughtful presentation to answer so many questions. My brief comment also somewhat aligns with the community health worker advocacy that's taking place. I just wanna encourage us to think about, I know that the current way the waiver is structured only allows for those services, the pre pre 90 day pre release. 234 "Karriem Watson Mile Square" (2352731904) 01:18:36.060 --> 01:18:56.060 I'm just wondering if there's opportunities for organizations to partner, particularly with fqhcs. I've heard some of the comments on what providers are able to build for. But for those of you all who work with federally qualified health centers who are intentionally located in some of the same communities where reentry citizens are returning, it creates a really. 235 "Karriem Watson Mile Square" (2352731904) 01:18:56.060 --> 01:19:16.060 Important opportunity for us to partner with community based organizations and community health workers. E.g., we have a great partnership that we're doing with Safer Foundation right now that's really allowing us to do that care coordination for reentry citizens once they return back. So just wondering if there's consideration to think about how we can. 236 "Karriem Watson Mile Square" (2352731904) 01:19:16.060 --> 01:19:36.060 Even if the waiver doesn't expand to that post 90 days after people are returning to the communities, if we can think about expanding the evaluation of those who have been helped in that pre 90 day to see how they can be connected to community health workers patient navigation, but specifically at medical home model in collaboration with. 237 "Karriem Watson Mile Square" (2352731904) 01:19:36.060 --> 01:19:46.914 With the fairly qualified health centers that maybe in their community areas. Again, kudos to you, Malicia and your team on this thoughtful approach and I'm proud to be in a state that is thinking like this. 238 "Bansa, Melishia" (3129318656) 01:19:46.914 --> 01:20:05.310 Thank you so much, Mariem. We appreciate your comments today. We're now gonna go ahead and switch to any anyone that has raised their hand. We're not seeing anything coming in the chat right now, but we'll circle back around and check again. So I see we've got. 239 "Bansa, Melishia" (3129318656) 01:20:05.310 --> 01:20:21.733 Some hands raising again. We want to ask everyone, please keep your comments to to 3 min. Thank you so much. Britney Ward I see you with your hands up if you want to go on with your comment. 240 "Brittany Ward" (1553506048) 01:20:21.733 --> 01:20:41.880 Hi, thank you. I'm I was on meeting. I'm Brittany Ward. I'm Director of operations for the All Hands health network at Lori children. Also a Mac public education subcommittee meeting member. I wanted to comment, I want to say thanks to HFS about the work they're doing to support CBOs with the 1115 waiver. 241 "Brittany Ward" (1553506048) 01:20:41.880 --> 01:20:59.220 I'm really excited about the opportunity for CBOs to sustain using Medicaid dollars. In my current role, I've worked a lot with CBOs to implement closer referrals and understand the challenge that that brings. Also in a formal role role helped CBO, A CBO. 242 "Brittany Ward" (1553506048) 01:20:59.220 --> 01:21:17.460 Become a community mental health provider and employee with a child's childhood there as well. So my comment and recommendation for CBOs as they become Medicaid providers is maybe to do time studies to help them understand. 243 "Brittany Ward" (1553506048) 01:21:17.460 --> 01:21:36.450 The impacts that being a Medicaid biller may have on the organization financially. I think this was helpful in my experience to kind of get buy in when they saw like what they could actually be bringing in every year for their to support the organization. I thought this was also really interesting. 244 "Brittany Ward" (1553506048) 01:21:36.450 --> 01:21:54.240 To help, the team members kind of help with them getting use the documentation. I think that, you know, there's gonna be a lot of, you know, change. There's gonna be a lot for park people to like do the documentation. I know that's gonna be a heavy lift cause they're not used to doing that. 245 "Brittany Ward" (1553506048) 01:21:54.240 --> 01:22:14.240 But I would recommend that, my second thought is to explore AI as an opportunity to support those community health workers to document considering their backgrounds and roles that might be a useful tool as they're, you know, doing service planning or whatever maybe required for them to build accordingly. 246 "Brittany Ward" (1553506048) 01:22:14.240 --> 01:22:18.017 So that's my comment. Thank you for the time. 247 "Bansa, Melishia" (3129318656) 01:22:18.017 --> 01:22:32.673 Thank you so much, Brittany. We appreciate it. Stacey, minor, I see you with your comment in the chat as well as your hand raised if you wanna go with your comment at this time. 248 "Stacey Minor" (2081859584) 01:22:32.673 --> 01:22:52.100 Sure. Good afternoon, and I am so excited about this 1115 waybrid. It's been in the making so long. I know we were working with Centine in Southern Illinois and in Chicago around medically tailored meals with in the maternal health. 249 "Stacey Minor" (2081859584) 01:22:52.100 --> 01:23:20.836 Programs. My question was regarding the medically tailored meals. I was a little bit late to the call. Would medi medically tailored meal providers need to work still through managed care agencies to provide that service through the 1115 waiver or are those type of providers able to now contract directly with the state? 250 "Bansa, Melishia" (3129318656) 01:23:20.836 --> 01:23:31.390 Thank you so much for your questions Stacey. Does that conclude your question and comment? 251 "Stacey Minor" (2081859584) 01:23:31.390 --> 01:23:33.992 Oh yes, I'm sorry that concludes my question. 252 "Bansa, Melishia" (3129318656) 01:23:33.992 --> 01:23:46.391 Okay, thank you so much. We're gonna go right into our next hand that we've got here. Richard, are you with us? 253 "Richard Ducatenzeiler" (1365089024) 01:23:46.391 --> 01:23:50.794 Yes I'm assuming you're referring to Richard Ducaton Zaylor? Yeah. 254 "Bansa, Melishia" (3129318656) 01:23:50.794 --> 01:23:56.681 Yes I'm yes, I was trying to get the last name. Thank you so much. 255 "Richard Ducatenzeiler" (1365089024) 01:23:56.681 --> 01:24:25.760 Yeah, thank you. I'll make it brief I just want to thank everyone again for this opportunity to provide some important comment and for allowing essentially everyone to be able to be a part of this process. I am the CEO at the Bullerbart of Chicago. We operate a 64 bed medical respite care program. We've been in operation for the last 30 years. Just wanted to just again express just the importance of the 1115 waiver. 256 "Richard Ducatenzeiler" (1365089024) 01:24:25.760 --> 01:24:45.760 As far as the future sustainability for medical respite care in Illinois. We have been privileged to work closely with the Illinois Public Health Institute as well as the Illinois Department of Human Services to invest a lot of time and effort into capacity building and preparation for Medicaid billing over the. 257 "Richard Ducatenzeiler" (1365089024) 01:24:45.760 --> 01:25:05.760 Last couple of years. I just want to say that, you know, we have made a lot of progress hoping that this progress continues. It seems like things are continuing, and just want to continue to stress, you know, the importance of con, you know, of maintaining an open forum, including individuals and persons with lived experience and. 258 "Richard Ducatenzeiler" (1365089024) 01:25:05.760 --> 01:25:25.760 As mentioned already, but also service providers, you know, at the table. So we're, we're just very thankful, you know, for the opportunity and also with the serving as currently the only certified medical respite care program through the National Institute of Medical respite care, seeing how organizations like ours can. 259 "Richard Ducatenzeiler" (1365089024) 01:25:25.760 --> 01:25:43.712 Serve in any form of technical assistance, you know, in conjunction with the community hub or whomever, however that process, you know, kind of turns out. So just wanted to make those comments and again thank you for this opportunity. 260 "Bansa, Melishia" (3129318656) 01:25:43.712 --> 01:26:00.134 Thank you so much. Chris, Ohira. Are you with us? Amy Zimmerman, are you with us? 261 "Amy Zimmerman" (1104112640) 01:26:00.134 --> 01:26:28.520 I am. Thank you. Thank you Elicia, and thank you to the entire HFS team who I know has been working so hard on this and we've been watching with anticipation and excitement about this needed opportunity. I am the associate vice President for state Government Affairs at Jewish United Fund. I was really here listening but then decided based on all the information that's been provided to give. 262 "Amy Zimmerman" (1104112640) 01:26:28.520 --> 01:26:57.890 Do a little bit of impromptu feedback. So Jewish United Funds support the network of health and human services, community based providers, serving individuals of all faiths, ages, and abilities. And what I've seen in my time with JUF, which is in the past five years and prior to that, I ran pediatric medical legal partnership programs that were focused on eliminating social determinants of health and. 263 "Amy Zimmerman" (1104112640) 01:26:57.890 --> 01:27:28.650 And understand how important and vital this work is. I do really want to emphasize and hope that you all could think about a possible pilot around working with providers who are not currently Medicaid providers. We have a number of both Medicaid providers and providers who are not Medicaid, enrolled and are likely. 264 "Amy Zimmerman" (1104112640) 01:27:28.650 --> 01:27:45.870 Probably not ever going to leap into it. Even for our providers who do serve Medicaid and are enrolled in the system, there's so many barriers around Medicaid. 265 "Amy Zimmerman" (1104112640) 01:27:45.870 --> 01:28:05.010 Enrollment for providers. Right now impact is a huge issue that that we are are seeing and trying to address. But, e.g., two of our providers Ezra and the ARC, they are both full service pantries that work with highly vulnerable population. 266 "Amy Zimmerman" (1104112640) 01:28:05.010 --> 01:28:25.010 Arc additionally has a, has a free and charitable medical clinic. Neither of them are Medicaid enrolled. They both serve clients that will meet both the social and medi medical risk requirements. And what I would hope each of us could think about is, is there a way to do a. 267 "Amy Zimmerman" (1104112640) 01:28:25.010 --> 01:28:46.790 A small pilot to try to allow some of these smaller providers who, for whom it is gonna be very difficult to become Medicaid enrolled, to work within the confines of this really promising important system to figure out if there's, is truly a way that we can. 268 "Amy Zimmerman" (1104112640) 01:28:46.790 --> 01:28:54.595 Then allow for them to, to participate. So thank you. Really appreciate the time. 269 "Bansa, Melishia" (3129318656) 01:28:54.595 --> 01:29:09.834 Thank you so much. We're going to go right back to our chat. Julie Nelson from C S H Are you with us? 270 "julie nelson" (305000448) 01:29:09.834 --> 01:29:26.550 I am. Thank you so much. This is Julie Elson. I'm the Illinois Director for CSH. I just want to make a couple of brief comments. Absolutely. Thank you to everyone at HFS for all the work that you're doing on implementation planning, especially in current times, I really just want to recognize. 271 "julie nelson" (305000448) 01:29:26.550 --> 01:29:41.820 There's so much work happening that, most of us on the on the external side can't see, so appreciate that. Something that I was kind of reflecting on during the presentation that I wanted to particularly comment on is. 272 "julie nelson" (305000448) 01:29:41.820 --> 01:30:00.120 As you're thinking about the member experience, especially if they are accessing several of the new HRS and benefits or perhaps transitioning from one to another, I think that's a a special place to pay attention to the member experience. Certainly throughout all services member experiences is key. 273 "julie nelson" (305000448) 01:30:00.120 --> 01:30:20.120 But I think there's an opportunity to look really carefully at, you know, how are the reentry services connecting to the housing services or how are recruitive care services and respites connecting, you know, to the housing support benefits. Again, thinking about individuals are are not the the silos of the specific services that they're accessing. 274 "julie nelson" (305000448) 01:30:20.120 --> 01:30:38.880 I also want to just formally applied like the things that I have I have seen in some of the documents really so far, just really applied to state's interest in making sure that folks who have lived experience are are getting pathways into the workforce for these new services. 275 "julie nelson" (305000448) 01:30:38.880 --> 01:30:55.500 And that's great to see and also really some intention around ensuring that there aren't degree barriers or things like that that have been some historic barriers in becoming a part of the workforce for the Medicaid billing provider community. I wanted to note again. 276 "julie nelson" (305000448) 01:30:55.500 --> 01:31:15.500 A race will be key for providers, and also another concern related to ongoing kind of long term tendency sustaining services, really thinking about what are the access paths to that beyond that initial authorization period, the social criteria. 277 "julie nelson" (305000448) 01:31:15.500 --> 01:31:41.272 For getting renewed support and and how that's determined for folks will really be key for not only getting folks into housing but making sure that individuals have support when needed to stay in housing, which is really critical for for individuals in support of housing and the supportive housing providers across our states. And I think that is it for my comments, so thank you everyone. 278 "Bansa, Melishia" (3129318656) 01:31:41.272 --> 01:32:10.160 Thank you so much. I do wanna do a, another call for Ricky Hamilton just in case he joined by phone and we weren't unable to identify him. Ricky, are you with us? Okay, thank you so much. I want the public forum record to show ok Sheree, you have one more comment, come on with your comment. 279 "Bansa, Melishia" (3129318656) 01:32:10.160 --> 01:32:11.174 Okay. 280 "Sherie Arriazola Martinez" (3008015360) 01:32:11.174 --> 01:32:20.237 I was hoping you'd read it, but, because I'm not I'm trying not to take up so much easier. Okay, sure. I can read it. 281 "Bansa, Melishia" (3129318656) 01:32:20.237 --> 01:32:31.369 Individuals should be able to qualify either through identification by community organizations on the ground or through mcos. If access depends only on MCO offers. 282 "Bansa, Melishia" (3129318656) 01:32:31.369 --> 01:32:48.719 It risks delays and undermines trust. A two pronged pathway ensures people can get timely equitable access to the care, that's promise. Thank you so much Miss Martinez, we appreciate that comment. Just want the record to show from our public forum. 283 "Bansa, Melishia" (3129318656) 01:32:48.719 --> 01:33:06.209 That we have NO more requests for you're more than welcome. We have NO more requests for comments in our chat. We have gone to our HFS boards and commissions email as well. 284 "Bansa, Melishia" (3129318656) 01:33:06.209 --> 01:33:21.719 And we have NO, requests through that modality to make any further public comments, and now we're going back to our participant list and we also have. 285 "Bansa, Melishia" (3129318656) 01:33:21.719 --> 01:33:37.589 No, further indication that anyone has their hands raised virtually to make any further comments. So Jerome, you take us to the next slide, please. We want to thank everyone for. 286 "Bansa, Melishia" (3129318656) 01:33:37.589 --> 01:33:54.119 You know your comments on today and we are excited for all the information that was shared, and definitely our colleagues are taking all this feedback into review for. 287 "Bansa, Melishia" (3129318656) 01:33:54.119 --> 01:34:14.119 Consideration where appropriate. So for our future updates and communications, next slide please. Please feel free to go out and stay informed and in case you're wondering how you can keep informed, you can check out our website for updates. 288 "Bansa, Melishia" (3129318656) 01:34:14.119 --> 01:34:34.119 FAQs and official documents. We have this link here for you, the HFS.Illinois.gov forward/medical providers forward/CC forward/eleven 15 transformation.HTML. Well, so make sure that's in the chat for you. 289 "Bansa, Melishia" (3129318656) 01:34:34.119 --> 01:34:54.119 So again in case you missed it, and then for regular updates, you can feel free to join our list serve to gain access to quarterly updates related to design and, you know, and implementation of the, the waiver. You can find that, that information at HTTPS. 290 "Bansa, Melishia" (3129318656) 01:34:55.109 --> 01:35:15.109 Going over into that semi column forward/forward/LP.constant contact pages.com forward/SL forward/DC by H5V forward/eleven 15. I'm also reading the hyperlinks because. 291 "Bansa, Melishia" (3129318656) 01:35:15.109 --> 01:35:35.109 Because we want to make sure this is also ADA accessible. And then for questions, please contact us with questions through our dedicated inbox hFS.eleven 15 waiver@Illinois.gov. If you have any questions regarding the operations of. 292 "Bansa, Melishia" (3129318656) 01:35:35.109 --> 01:35:42.359 For any of our town halls or other programs, feel free to email our HFS boards and commissions. 293 "Bansa, Melishia" (3129318656) 01:35:42.359 --> 01:36:02.359 As well. Well, we are excited, as we stated earlier, for those of you that joined in at the end, you can continue to give that feedback, if you got some other great comments or questions you wanna submit, you can send that feedback regarding today's public form. Up until. 294 "Bansa, Melishia" (3129318656) 01:36:02.359 --> 01:36:22.359 So October the 15th 20251159pM. You don't want to miss out on that. So feel free to email the HFS.eleven 15 waiver@Illinois.gov. My colleagues will be monitoring that and prepared to receive your fe. 295 "Bansa, Melishia" (3129318656) 01:36:22.359 --> 01:36:32.579 Feedback. Without further ado, we thank you so much for joining today's public forum on the 1115. 296 "Bansa, Melishia" (3129318656) 01:36:32.579 --> 01:36:50.819 Waiver healthcare transformation. We hope you enjoyed our program and on behalf of Illinois Department of Healthcare and Family Services, our director Elizabeth White Horn and our entire leadership staff. We say thank you again for attending. Have a wonderful. 297 "Bansa, Melishia" (3129318656) 01:36:50.819 --> 01:37:06.492 Outstanding afternoon. Thank you. And goodbye.