Section 1115 Medicaid waivers allow states to test new approaches to healthcare by temporarily “waiving” some federal Medicaid rules so they can provide additional services or redesign how care is delivered. The Kaiser Family Foundation tracks these waivers nationwide through its Medicaid waiver tracker. In Illinois, the state operates the Healthcare Transformation 1115 Waiver, originally approved in 2018 and extended through 2029, which gives the state flexibility to improve care for Medicaid populations and address health disparities. The waiver supports new services such as treatment for substance use disorders, supportive employment, services for people leaving incarceration, and programs that address health-related social needs like housing instability, food insecurity, and transportation barriers. These programs aim to improve health outcomes and make the healthcare system more equitable for vulnerable communities.
For Community Health Workers in Illinois, this waiver is especially important because it expands the role of community-based care teams and recognizes that social conditions strongly affect health. The state’s transformation plan highlights the need to train and integrate frontline workers, including CHWs, into healthcare teams because they often have the most direct contact with patients and their families. The initiative includes major workforce investments to train community-based health workers and strengthen outreach, care coordination, and support services for Medicaid beneficiaries.
Overall, the Illinois 1115 waiver connects healthcare with social services, which aligns closely with the work CHWs already do. By addressing housing, food access, transportation, and reentry from incarceration, the waiver creates new opportunities for CHWs to help patients navigate services, reduce barriers to care, and improve health outcomes in low-income communities across the state.