Provider Notice issued 06/04/2026

Enhanced Complaint Process for the Illinois Supportive Living Program (SLP)  

This notice is to inform Supportive Living Program (SLP) providers that on May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) finalized the Ensuring Access to Medicaid Services Rule (also known as the Access Rule). This comprehensive regulation includes various compliance milestones, with a primary focus on enhancing the complaint process for Home and Community-Based Services (HCBS) provided through fee-for-service (FFS) delivery systems. 

To improve beneficiary oversight and service quality, the rule mandates that all states establish a standardized, accessible, and user-friendly complaint system. These new requirements take effect on July 01, 2026. 

There are three (3) main components that affect Illinois SLP providers and SLP residents. 

A. Complaint Notices Sent to SLP Residents 

1. A complaint acknowledgment letter is sent out to the complainant when the complaint is related to the HCBS waiver services and was submitted by the SLP resident or their designated representative.

a. This letter informs the complainant that the Department of Healthcare and Family Services (HFS) received the complaint and explains the investigation process.

     2. A complaint resolution letter is sent after the investigation is completed. 

        a.  The letter is only sent if the complainant was the SLP resident or their designated representative and the complaint is related to the HCBS waiver services.

    3,  A SLP Complaint Investigation Request for Extension letter will be sent if the investigation goes beyond ninety (90) days.

       a.  The complainant will also receive oral notice within two (2) days of the determination, notifying them of the new timeframe.

 B. Complaint Process Overview Documents

1. SLP Resident Complaint Process Overview

a. The SLP provider is required to give this document to residents at new admissions and annual reviews.

b.  This requirement is included as part of the SLP admission and enrollment criteria.

c.  Requirements will be added to the Illinois Administrative Code (Title 89 Illinois Administrative Code at Part 146, Subparts B and E).

d. Requirements will be added to future annual review certification tools, starting with the Waiver Year 2027 (WY27) tool. 

e. The overview is posted on the SLP website.

2.  SLP Provider Complaint Process Overview 

a. This document will be provided to each SLP provider at initial enrollment and discussed and provided at every annual review 

b. The SLP provider is required to provide the document to all direct care workers.

c. The requirements outlined in this document must be incorporated into the initial training and hiring processes along with annual staff training.

d.  Requirements will be added to the Illinois Administrative Code (Title 89 Illinois Administrative Code at Part 146, Subparts B and E).

e.  Requirements will be added to future annual review certification tools, starting with the Waiver Year 2027 (WY27) tool. 

f.   The overview is posted on the SLP website.

C. Additional New SLP Complaint Processes

1. Provide the complaint investigation report to the complainant without requiring a Freedom of Information Act (FOIA) request, provided the individual is the SLP resident or a designated representative of a SLP resident.
2. A formal process for rereviewing complaint resolutions related to HCBS waiver services when an individual is dissatisfied with the original outcome.

What is considered a SLP HCBS waiver complaint? 

A complaint is any expression of dissatisfaction about SLP HCBS waiver services. 
This can include concerns about service quality, missing or late services, staff behavior, resident rights, health and safety issues, support needs, or disagreed changes in services.

Note: Only complaint investigations related to quality of care, service plans, services, and resident rights are applicable to this policy. 

Additional federal guidance: 

CMS Fact Sheet: Ensuring Access to Medicaid Services Final Rule

CMS Chart: Ensuring Access to Medicaid Services - Provisions and Relevant Timing Information and Dates

Questions regarding this notice should be directed to the Bureau of Long-Term Care Supportive Living Program via email at HFS.SLF@illinois.gov .

Laura Phelan, Administrator
Division of Medical Programs