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  3. Children with Complex Medical Needs

Children with Complex Medical Needs 

A stakeholder work group, including physicians and other providers who specialize in serving children with severe disabilities as well as advocates will be formed to review and make recommendations with respect to the issues identified. The department will assist the stakeholder work group in review of federal requirements, further research of how states assess, plan and implement service plans, and other options that Illinois may consider.

The intent of this group is to contribute to a full review of options and recognition of the needs of the children being served through the waiver and other similar programs.

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.