COMMUNITY TRANSITION SERVICES PROVIDER IN ILLINOIS

Fatumata Kaba
Jul 18
4 min read

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/

COMMUNITY TRANSITION SERVICES PROVIDER IN ILLINOIS

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — ILLINOIS COMMUNITY TRANSITION SERVICES PROVIDER

WCG 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.

Scope of Work: