Eligibility

Eligibility A. In order to qualify as a beneficiary of the IL Waiver Program, an individual must meet the following criteria: 1. Must be age sixteen (16) or older; 2. Must require nursing facility level of care as determined by a comprehensive long-term service and supports (LTSS) assessment; 3. Must exhibit severe orthopedic and/or neurological impairments that render them dependent on others, assistive devices, other types of assistance, or a combination of the three (3) to accomplish the activities of daily living; 4. Must be able to express ideas and wants either verbally or nonverbally with caregivers, direct care workers, case managers or others involved in their care; 5. Must be certified as medically stable by a physician or nurse practitioner. The Division of Medicaid defines medical stability as the absence of all of the following: a) An active, life-threatening condition requiring systematic therapeutic measures; b) Intravenous drip to control or support blood pressure; and c) Intracranial pressure or arterial monitoring. 6. Must meet the criteria in one (1) of the following Categories of Eligibility (COE): a) Supplemental Security Income (SSI); b) Parents and Other Caretaker Relatives Program; c) Katie Beckett COE; d) Children under age nineteen (19) who meet the applicable income requirements; e) Disabled Adult Child; f) Protected Foster Care Adolescents; g) Child Protection Services (CPS) Foster Children and Adoption Assistance Children; h) IV-E Foster Children and Adoption Assistance Children; i) An aged, blind or disabled individual who meets all factors of institutional eligibility. If income exceeds the current institutional limit, the individual must pay the Division of Medicaid the portion of their income that is due under the terms of an Income Trust in order to qualify; or j) Working Disabled. B. IL Waiver beneficiaries cannot reside in a nursing facility or licensed or unlicensed personal care home. C. In the event of imminent danger to the beneficiary, caregiver, or service provider. An IL Waiver beneficiary may be discharged from the waiver immediately.