The Healthcare Transformation 1115 Demonstration waiver was federally approved July 2, allowing the Illinois Department of Healthcare and Family Services to expand Medicaid coverage.
That additional coverage is expected to help address root causes of health disparities, according to an Illinois Gov. JB Pritzker press release. That includes housing and food insecurities, struggles facing those transitioning out of incarceration and support for violence prevention.
This waiver is part of a larger strategy, according to Pritzker.
“Illinois is leading the way in this work and once again setting the nationwide standard for what equitable, effective and people-centric healthcare should look like,” he said in the release.
The Centers for Medicare & Medicaid Services approved an amendment and an extension for five years for the existing 1115 waiver. It now includes services that are newly eligible for federal Medicaid match, according to the release. These programs help address health-related social needs, including medical respite.
In Oak Park, The Write Inn operated by Housing Forward serves as one such location for medical respite, allowing individuals experiencing homelessness to rest and recover safely. Sojourner House is another such location.
Medical respite helps improve patient outcomes, too, according to Lynda Schueler, Housing Forward’s chief executive officer.
“Everyone deserves to have access to affordable, quality healthcare, regardless of their living situation or income level,” Schueler said in the release. “The revenue stream provided by the expansion of the 1115 waiver will expedite and expand our ability to address the substantial and unmet health, service and housing needs for the unhoused community.”
Chad Williams said he was a former Housing Forward client at a press conference discussing the waiver’s approval in July.
In 2017, Williams said he was discharged from West Suburban Medical Center, where he was treated for congestive heart failure. He said he had nowhere to go. But a doctor directed him to Housing Forward, where he then spent two years in the overnight shelter.
“I received warm meals, a safe place to sleep,” he said. “Eventually, it came to be like home.”
Then, Williams became one of the first residents at Sojourner House. There, he said he was “temporarily able to enjoy the human experience once more.” Without a home, it can be hard to do so, he said.
In 2020, he was able to move into an apartment in Oak Park.
“Today I’m doing well,” he said. “And have access to quality, affordable healthcare. This has made a big difference in reaffirming my trust in people and having consistent healthcare … [has] meant the difference, for me, between life and death.”
Williams said he hopes the waiver’s extension means more people like him can receive medical and housing support.
According to the release, the 1115 waiver also includes coverage for pre-release services for individuals leaving incarceration, services to address firearm violence and other home-, community- and employment-based services. Those seeking assistance for substance use disorders or who need violence prevention or intervention services can also expect coverage, officials said in the release.
For Medicaid-eligible individuals in a local jail, prison or youth correctional facility, officials state that they can access case management, prescription medication, services for substance use disorders and other treatment.
Authorized waivers, like this one, allow Illinois to test new services and remain eligible for Medicaid matching funds, according to the release.
“This Medicaid initiative requested by the Governor recognizes the role of community investments to improve health care, including by addressing hunger, housing, and opioid treatment barriers,” Illinois Senator Dick Durbin said in the release.
Illinois Representative Camille Lilly said in the release that the waiver will give vulnerable populations hope. It’s important to support resources like this, she said, to help people have healthy lives.