I/DD Waivers in Illinois

All states: Medicaid disability services map

Illinois I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Illinois?

Two state agencies share the work. The Illinois Department of Healthcare and Family Services (HFS) is the state Medicaid agency and oversees the developmental disability (DD) waivers. The Illinois Department of Human Services, Division of Developmental Disabilities (IDHS-DDD), operates all three waivers day to day. The front door for families is a local Independent Service Coordination (ISC) agency under contract with DDD.

• HFS: the Medicaid agency. Its DD waiver page describes the adult waiver and names IDHS-DDD as the operating agency.
• IDHS-DDD: runs the developmental disabilities system, contracts with providers and ISC agencies, keeps the waiting list database and pays providers through its ROCS billing system.
• Front door: the DD helpline, 1-888-DD-PLANS (1-888-337-5267), routes callers by ZIP code to their local ISC agency. For adults, a Preadmission Screening agency can also fill this role. The ISC enrolls the person on the waiting list database, called PUNS.
• Case management: ISC agencies employ Individual Service and Support Advocacy coordinators (ISSAs), who write and monitor each person's Person-Centered Plan. ISC agencies are conflict-free, which means they are separate from the agencies that provide services.

What Medicaid waivers and programs serve people with I/DD in Illinois?

Illinois has three 1915(c) waivers for people with intellectual or developmental disabilities. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. All three require ICF/IID level of care, meaning the person's needs would qualify them for an intermediate care facility for individuals with intellectual disabilities.

• Waiver for Adults with Developmental Disabilities (1915(c), control number IL.0350): serves Medicaid eligible adults 18 and older who do not need 24-hour nursing care. It is by far the largest program, projected to serve 25,250 people in its first year (from July 1, 2022) rising to 27,758 in its fifth year. People choose either residential services from a provider or Home-Based Services, a monthly budget they use for services at home. Services include Residential Habilitation (24-hour CILA, Intermittent CILA, Host Family CILA and Community Living Facilities), Community Day Services, Supported Employment, Adult Day Service, Personal Support, Temporary Assistance (a respite type service), Self-Direction Assistance, behavior services, skilled nursing and therapies, Remote Support in CILA, 24-hour Stabilization Services, transportation, adaptive equipment, assistive technology and home and vehicle changes.
• Support Waiver for Children and Young Adults with Developmental Disabilities (1915(c), control number IL.0464): serves children and young adults ages 3 through 21 who live at home with family. Family income is not counted. Services include Personal Support, Temporary Assistance, Self-Direction Assistance, Behavior Intervention and Treatment, training and counseling for unpaid caregivers, and equipment, technology and home and vehicle changes. We did not find its current capacity on a state source.
• Residential Waiver for Children and Young Adults with Developmental Disabilities (1915(c), control number IL.0473): serves children and young adults ages 3 through 21 who live in a Child Group Home licensed by the Department of Children and Family Services (DCFS). It covers residential habilitation in the group home, Behavior Intervention and Treatment, and adaptive equipment and assistive technology.

Illinois also has ICF/IID, including state-operated developmental centers and private facilities, as the institutional option, paid separately from the waivers. Waivers for brain injury and physical disability are run by a different IDHS division and are not part of the DD system.

Does Illinois pay for I/DD services through managed care?

No. Illinois pays for DD waiver services fee-for-service, through IDHS-DDD. Providers bill DDD's ROCS system, and ISC agencies, not health plans, coordinate services.

• No managed care authority: the federal Medicaid fact sheet for Illinois lists the three DD waivers with no managed care authority attached. By contrast, the state's waivers for older adults and people with physical disabilities do run alongside managed care.
• HealthChoice Illinois: the state's Medicaid health plans do not run DD waiver services.

Is there a waiting list for I/DD services in Illinois?

Yes. People wait on a database called PUNS (Prioritization of Urgency of Need for Services). On April 10, 2026, IDHS counted 14,823 people in the Seeking Services group, with another 2,825 in the Planning for Services group, for 17,648 in total. People are selected from PUNS as funding allows, mainly by how long they have been in Seeking Services.

• How the list works: the local ISC agency enrolls a person on PUNS in one of two groups. Seeking Services is for people who want services now. Planning for Services is for people who expect to need them later. The IDHS PUNS summary counts each person once and leaves out closed records.
• Priority groups: the adult waiver serves these groups first, in this order: people facing abuse, neglect or homelessness; youth aging out of DCFS care or children's residential services; people living in state-operated developmental centers; Bogard class members; people selected from PUNS; and people with intellectual disabilities in state mental health hospitals.
• Recent selections: DDD selected more than 300 people in March 2026 and mailed 965 selection letters on July 10, 2026. DDD now selects in smaller groups so ISC agencies can keep up with the work.

For a person's PUNS status, families should ask their ISC agency or call 1-888-DD-PLANS. The IDHS PUNS page explains the process.

How do people apply for I/DD services in Illinois, and how are budgets set?

A person starts by calling 1-888-DD-PLANS to reach their local ISC agency, which enrolls them on PUNS. When the person is selected, the ISC confirms eligibility using the ICAP and other assessments and helps write a Person-Centered Plan. Budgets and rates are then set by the type of service: a monthly budget for Home-Based Services, or an individual daily rate for CILA.

• Eligibility: an intellectual or developmental disability, Medicaid eligibility, Illinois residence and ICF/IID level of care, with no need for 24-hour nursing care. The adult waiver serves ages 18 and older and the two children's waivers serve ages 3 through 21.
• Assessment: ISC agencies complete the Inventory for Client and Agency Planning (ICAP), along with psychological and other assessments. An ICAP is required each year to stay eligible.
• Home-Based Services: the person receives a monthly service cost maximum and chooses services within it. The children's Support Waiver also uses a Home-Based Services budget.
• CILA: each person's rate is built from a staffing model. The ICAP service score and the Health Risk Screening Tool (HRST) Health Care Level set the staffing hours in the rate.
• Self-direction: in Home-Based Services, families can hire their own Personal Support Workers with employer and budget authority through ACES$, the state's fiscal/employer agent, use a provider agency, or both. Self-directing families and workers negotiate the Personal Support pay rate.

What day and residential services can I/DD providers offer in Illinois?

Under the adult waiver, providers can offer four day and employment services and four residential settings. CILA (Community Integrated Living Arrangement) homes are licensed by IDHS, and day programs are certified by IDHS. Children's residential services are provided in Child Group Homes licensed by DCFS.

Day and employment services (adult waiver)

• Community Day Services (on-site and off-site): skill building and community activities, based at a site with community outings. They cannot be provided in the person's home or during residential habilitation. Providers need certification under 59 Ill. Adm. Code 119 (Developmental Training) and a DDD contract, checked by an annual certification survey. Billed hourly. Rates assume 1 staff to 5 people on-site and 1 to 4 off-site; these are rate model assumptions, not a staffing rule. Limited to 5 hours a day, 115 hours a month and 1,200 hours a year across all day programs.
• Supported Employment: Individual Employment Support for jobs in the community, and Small Group Supports that lead toward individual jobs. Billed in 15-minute units. Small group rates are set at 1 staff to 3 people (Level 1) and 1 to 6 (Level 2). These hours count toward the 1,200-hour yearly day program cap.
• Adult Day Service: a supervised day program for older or medically fragile adults, delivered by centers that hold a Department on Aging adult day contract and meet 89 Ill. Adm. Code 240. Billed hourly at $21.82 an hour. The Department on Aging rule requires at least 2 staff, then about 1 staff for every 7 people.
• Enhanced Residential Habilitation: daytime supports from the residential provider for people who cannot or choose not to attend a day program (for example because of medical needs or age over 60). Up to 5 days a week with prior approval, billed hourly and funded at 1 staff to 3 people (ranging from 1:1 to 1:4).

Residential services

• 24-Hour CILA: homes for one to eight unrelated adults, with staff present whenever residents are home (unless remote supports or a safety plan applies). Paid per day; the average daily rate is $375.11. Licensed by the IDHS Bureau of Accreditation, Licensure and Certification under 59 Ill. Adm. Code 115.
• Intermittent CILA: supports for up to eight people in a group home, family home or their own apartment who do not need staff on site around the clock. Staff are on call 24 hours. Billed hourly at 1:1, 1:2 or 1:3 rates, with 780 hours a year authorized by default. Licensed under the same CILA rule.
• Host Family CILA: shared living in the home of an unrelated host family under contract with a provider agency, with no more than two people per host family. Standard and comprehensive levels, with a daily stipend set by ICAP need level. Licensed under the CILA rule.
• Community Living Facility (CLF): a residence focused on skills training to help people move toward independent living. Licensed by the Illinois Department of Public Health under 77 Ill. Adm. Code 370.
• Child Group Home (children's residential waiver): residential habilitation for ages 3 through 21, licensed by DCFS, with rates that follow DCFS child group home rates.

How are I/DD provider rates set and how do agencies enroll in Illinois?

DDD publishes statewide rate tables, with a 15 percent higher Regional Wage Factor for Chicago, Cook County and the collar counties. Rates follow the Guidehouse Developmental Disabilities Services Rate Study from November 2020, phased in as the General Assembly funds it. New agencies attend orientation, get licensed or certified by IDHS, then enroll with DDD and HFS.

• Rate methods: CILA rates are set for each person from staffing models based on the ICAP and HRST. Day and employment services use hourly benchmark rates. Rates are on DDD's rate tables page.
• Latest rate change: on January 1, 2026, direct support professional (DSP) wages built into rates rose $0.80 an hour, at least $0.60 of it as a direct wage increase. Child Group Home rates rose 8.8 percent and Home-Based Services budgets went up. This was funded by Public Act 104-0003 and announced in bulletin DD.26.001.
• Becoming a CILA provider: an agency attends New Provider Orientation, applies to the IDHS Bureau of Accreditation, Licensure and Certification for a CILA license, and receives a provisional license if its policies are approved. It then enrolls with DDD (with a W-9 and NPI), enrolls in IMPACT, the HFS provider enrollment system, and gets ROCS billing access. Steps are on the IDHS provider page.
• Day program providers: need certification under 59 Ill. Adm. Code 119 and a DDD contract.
• EVV: electronic visit verification has been required for agency Personal Support since September 1, 2023 and for home health services since December 31, 2023. Agencies use the free state HHAeXchange system or their own system linked to it. Self-directed workers billing through ACES$ use the CareAttend app. CILA and day services are not in EVV scope. Claims are not denied at submission for missing EVV; instead, DDD expects at least 75 percent of visits each quarter to be verified and can require a corrective action plan or recover payments, according to the DDD EVV page.

What is changing next for I/DD services in Illinois?

A proposed amendment to the adult waiver would raise the direct support wage built into rates from $21.30 to $21.90 an hour ($25.19 in the Chicago area) and raise residential, day and employment rates. It is proposed to take effect January 1, 2027, or when CMS approves it. The increase comes from Public Act 104-0466. As of October 23, 2026, we did not find a CMS approval.

• Adult waiver rates: the draft amendment, dated September 3, 2026, raises CILA, Community Day Services, Supported Employment, adult day and nursing rates. For example, the average 24-hour CILA daily rate would rise from $375.11 to $401.63, and Adult Day Service from $21.82 to $23.22 an hour.
• More day program hours for self-directing families: the same amendment would let self-directing Home-Based Services customers use Community Day Services up to 8 hours a day instead of 5.
• Child Group Homes: a proposed amendment to the children's residential waiver would raise Child Group Home rates 3 percent, following DCFS rates, on the same timing.
• ICF/IID wages: HFS and DHS have also proposed a $0.60 an hour wage increase for direct support staff in ICF/IID and MC/DD facilities for services on or after January 1, 2027, about $13.8 million a year.

For the status of these amendments, check the HFS waiver pages or ask DDD.

Illinois I/DD sources

• Illinois HFS: Waiver for Adults with Developmental Disabilities
• Illinois HFS: Support Waiver for Children and Young Adults with Developmental Disabilities
• Illinois HFS: Residential Waiver for Children and Young Adults with Developmental Disabilities
• Illinois HFS: Proposed adult DD waiver amendment effective January 1, 2027 (draft dated September 3, 2026)
• Medicaid.gov: Illinois waiver fact sheet
• IDHS: PUNS summary of statewide data
• IDHS: Prioritization of Urgency of Need for Services (PUNS)
• IDHS: Bulletin DD.26.001, January 1, 2026 rate increases
• IDHS: Becoming a DD provider
• IDHS: DDD electronic visit verification

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Efficient DSP Clock-in and Clock-out Software
• I/DD services in every state (map)
• Illinois EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.