Application for 1915(c) HCBS Waiver: IL 0473 R01 01 - Jul 01, 2010 (as of Jul 01, 2010)-2025

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  1. Click ‘Get Form’ to open the Application for 1915(c) HCBS Waiver in our platform.
  2. Begin by filling out the 'Request Information' section. Provide details such as the State of Illinois, Program Title, Waiver Number, and Amendment Number.
  3. In the 'Purpose(s) of Amendment' section, clearly describe the purpose of your amendment. This is crucial for clarity and approval.
  4. Proceed to complete each appendix as required. Ensure that you provide accurate information regarding participant access, eligibility, and services offered under the waiver.
  5. Review all sections thoroughly before submitting. Use our editor's features to highlight any areas that need attention or clarification.

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What is an HCBS Waiver? A waiver is a program that provides services that allow individuals to remain in their own homes or live in a community setting, instead of in an institution. Illinois has nine HCBS waivers. Each waiver is designed for individuals with similar needs and offers a different set of services.
The section 1915(c) MI HealthLink Waiver will continue to provide the following: adult day program, respite, adaptive medical equipment and supplies, fiscal intermediary, assistive technology, chore services, environmental modifications, expanded community living supports, Page 2 Page 2 Ms. Massey 2 home delivered
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