SUPPORTING INDIVIDUALS IN MOVING FROM INSTITUTIONS TO INDEPENDENT, COMMUNITY-BASED LIVING
Community Transition Services in Illinois assist individuals in moving from institutional settings (e.g., nursing facilities, intermediate care facilities) to homes or community-based living environments. These services are authorized under Medicaid Home and Community-Based Services (HCBS) waiver programs and specialized transition initiatives to promote independence, dignity, and improved quality of life.
1. Governing Agencies
Agency: Illinois Department of Healthcare and Family Services (HFS)
Role: Administers Medicaid transition funding, authorizes provider enrollment, and reimburses transition services
Agency: Illinois Department of Human Services (DHS) — Division of Developmental Disabilities (DDD) and Division of Rehabilitation Services (DRS)
Role: Coordinates case management, transition planning, and ensures compliance with person-centered transition practices
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring that Community Transition Services meet HCBS Settings Rule standards for community integration, choice, and autonomy
2. Community Transition Service Overview
Community Transition Services help individuals safely and successfully relocate from institutional settings into community-based residences by providing necessary supports, resources, and service coordination.
Approved providers may deliver:
- Transition planning in collaboration with case managers, discharge planners, and families
- Assistance with securing housing (e.g., application support, security deposit funding)
- Purchasing essential household items (e.g., furniture, linens, kitchen supplies)
- Payment of initial housing expenses (e.g., utility setup fees, initial grocery purchases)
- Coordination of moving services and relocation logistics
- Linkage to community-based service providers for ongoing supports (e.g., personal care, home health)
- Training in independent living skills (e.g., budgeting, meal preparation, safety awareness)
All transition services must be outlined in a person-centered Transition Plan and be based on assessed needs to promote successful community integration.
3. Licensing & Provider Approval Requirements
Prerequisites:
- Register business entity with the Illinois Secretary of State
- Obtain EIN from the IRS and NPI (Type 2)
- Enroll as a Medicaid Waiver provider via the Illinois Medicaid Provider Enrollment Portal (IMPACT system)
- Maintain general liability insurance and appropriate coverage for transition assistance activities
- Develop transition service-specific policies addressing housing coordination, financial assistance management, participant protection, and documentation
- Ensure staff meet background screening, independent living training, and HCBS compliance requirements
4. Illinois Provider Enrollment Process
Initial Interest and Application:
- Submit Provider Enrollment Application through the IMPACT system for Community Transition Services under applicable waivers
Application and Documentation Submission:
- Provide Articles of Incorporation, EIN/NPI verification, liability insurance certificates, operational policies, staff credentials, and participant intake forms
Program Readiness Review:
- DHS and/or HFS review provider readiness including staff training, transition planning practices, documentation systems, billing processes, and participant protection measures
Approval & Medicaid Enrollment:
- Upon approval, providers are configured to bill Medicaid for Community Transition Services using designated codes
5. Required Documentation
- Articles of Incorporation or Business License (Illinois Secretary of State)
- IRS EIN confirmation
- NPI confirmation
- Proof of general liability insurance
Transition Services Policy & Procedure Manual including:
- Transition planning, assessment, and discharge coordination procedures
- Housing search and household setup assistance protocols
- Participant-centered planning and service tracking standards
- Financial management, purchasing guidelines, and documentation
- Incident reporting, participant rights, and grievance resolution procedures
- Medicaid billing and audit readiness documentation
6. Staffing Requirements
Role: Community Transition Specialist / Coordinator
Requirements: Bachelor’s degree in human services, social work, or related field preferred, experience in transition planning or community-based services, background screening clearance
Role: Transition Support Staff
Requirements: High school diploma or GED, training in independent living skills support, background clearance, valid driver’s license if transporting participants
All staff must complete:
- HCBS Settings Rule and person-centered planning training
- Transition planning and housing navigation training
- Financial management policies related to transition funds
- Abuse prevention, participant rights, and confidentiality training
- Ongoing professional development and competency evaluations
7. Medicaid Waiver Programs
Community Transition Services are available through the following Illinois Medicaid Waivers:
- Adults with Developmental Disabilities Waiver
- Children and Young Adults with Developmental Disabilities Waiver
- Persons with Brain Injury (BI) Waiver
- Persons with Disabilities (PD) Waiver
- Money Follows the Person (MFP) Demonstration Project
Approved providers may deliver:
- Transition coordination, discharge planning, and independent living setup
- Housing search and financial assistance management
- Moving services and household setup support
- Community service linkage and referral coordination
8. Timeline to Launch
Phase: Business Formation and Provider Readiness Preparation
Timeline: 1–2 months
Phase: Staff Hiring, Credentialing, and Policy Development
Timeline: 1–2 months
Phase: IMPACT Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Configuration and Transition Service Launch
Timeline: 30–45 days
9. Contact Information
Illinois Department of Healthcare and Family Services (HFS)
Website: https://www.hfs.illinois.gov/
Illinois Department of Human Services (DHS)
Website: https://www.dhs.state.il.us/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
10. Scope of Work
- Business registration, EIN/NPI setup, and Medicaid enrollment support
- Development of Transition Services Policy & Procedure Manual
- Staff credentialing templates and transition planning documentation tools
- Medicaid billing setup and audit-ready claims management systems
- Website, domain, and professional branding support
- Transition planning and discharge coordination training for staff
- Quality assurance programs for monitoring transition success rates
- Community resource mapping and housing partnership development strategies
Waiver Consulting Group assists transition service providers, case management organizations, and relocation specialists in launching Medicaid-compliant Community Transition Services under Illinois' HCBS Waivers and Money Follows the Person (MFP) initiatives.
To get started, click the link to request portal access