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Elizabeth M. Whitehorn, Director

Innovations Project, Children with Complex Health Needs

The department released its Solicitation for Care Coordination Entities for Children with Complex Medical Needs, a component of the Care Coordination Innovations Project. The Care Coordination Innovations Project works to form alternative models of delivering care to Medicaid clients through provider-organized networks, initially organized around the needs of our most complex clients. These provider-based networks will be organized as Care Coordination Entities (CCEs). Illinois’ goal is a redesigned healthcare delivery system that is more patient-centered, with focus on improved health outcomes, enhanced patient access, and patient safety. To learn more about the requirements for organizing CCEs through the Care Coordination Innovations Project, read the Solicitation below.

Excerpt from the Medicaid Reform Law Public Act 96-1501 Signed January 25, 2011.

(305 ILCS 5/5-29 new)

Sec. 5-29. Income Limits and Parental Responsibility. In light of the unprecedented fiscal crisis confronting the state, it is the intent of the General Assembly to explore whether the income limits, and income counting methods, established for children under the Covering ALL KIDS Health Insurance Act, pursuant to this amendatory Act of the 96th General Assembly, should apply to medical assistance programs available to children, made eligible under the Illinois Public Aid Code, including through home and community-based services waiver programs, authorized under Section 1915(c) of the Social Security Act, where parental income is currently not considered in determining a child's eligibility for medical assistance.

The Department of Healthcare and Family Services is hereby directed, with the participation of the Department of Human Services and stakeholders, to conduct an analysis of these programs to determine parental cost-sharing opportunities, how these opportunities may impact the children currently in the programs, waivers and on the waiting list, and any other factors which may increase efficiencies and decrease state costs.

The department is further directed to review how services, under these programs and waivers, may be provided by the use of a combination of skilled, unskilled, and uncompensated care, and to advise as to what revisions to the Nurse Practice Act, and Acts regulating other relevant professions, are necessary to accomplish this combination of care.

The department shall submit a written analysis on the children's programs and waivers, as part of the department's annual Medicaid reports, due to the General Assembly in 2011 and 2012.