Bill
HB 2869
HFS, with DHS, must seek CMS approval to expand HCBS waivers to cover therapeutic recreation by park districts, health clubs, and community colleges, if CMS approves.
Status: Introduced in the Illinois House (Rep. Charles Meier). Referred to Rules Committee; listed as Rule 19(a) / re‑referred to Rules Committee. (Introduced 02/06/2025; legislative activity through May 2025 noted in bill file.)
Citation added: 305 ILCS 5/12‑21.22 (new).
Purpose
- Requires the Illinois Department of Healthcare and Family Services (HFS), in consultation with the Department of Human Services (DHS), to submit to the federal Centers for Medicare & Medicaid Services (CMS) any necessary application to amend Illinois’ Home‑ and Community‑Based Services (HCBS) waiver programs for children and adults with developmental disabilities so that therapeutic recreation programs offered by park districts, health clubs, and community colleges can be covered under the State’s Home‑Based Services Program.
Key provisions
- Adds new statutory section 305 ILCS 5/12‑21.22 to the Illinois Public Aid Code.
- Directs HFS (with DHS consultation) to prepare and submit a CMS waiver amendment application to:
- Expand HCBS waiver coverage to include "therapeutic recreation" programs when those programs are offered by park districts, health clubs, or community colleges.
- The bill is procedural/authorizational: it mandates submission of a waiver amendment request but does not itself create an immediate entitlement — federal CMS approval is required before services become Medicaid‑covered.
Who would be affected
- Primary beneficiaries: children and adults with developmental disabilities who are eligible for Illinois HCBS waiver services — potentially gaining Medicaid coverage for therapeutic recreation delivered by community providers.
- Providers: park districts, health clubs, and community colleges that operate therapeutic recreation programs — they could become Medicaid‑reimbursed providers if the waiver amendment is approved and program/provider standards are established.
- State agencies: HFS (lead) and DHS (consultation) responsible for preparing the waiver amendment and negotiating program details with CMS.
- Medicaid program/budget: potential changes to service mix and expenditures pending CMS approval and negotiated service scope and payment rates.
Procedural/timeline notes and limitations
- The bill compels the State to submit an application to CMS; it does not guarantee approval. Coverage only begins if and when CMS approves the amendment and the State implements it.
- Important implementation details — definitions of “therapeutic recreation,” provider qualifications, service limits, billing rates, and any state match or budget impacts — would be worked out during the waiver application and approval process.
- The bill does not specify deadlines for HFS/DHS to file the application nor set provider or reimbursement rules; those steps follow standard CMS waiver procedures.
Potential impacts (anticipated)
- Access: May increase access to community‑based therapeutic recreation for Medicaid‑eligible people with developmental disabilities if approved.
- Cost: Could increase Medicaid spending depending on utilization and negotiated reimbursement; state fiscal effects depend on waiver design and federal matching.
- Administrative: Requires agency staff time to design, submit, and negotiate the waiver amendment and to set provider enrollment and oversight processes.
Related legislation
- Companion bill: SB 1963.
(Prepared as an objective summary of the bill text and procedural status provided.)
Compiled from official sources — confirm details with the bill’s official record.
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