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Mary Killough, Director Senior HelpLine: 1-800-252-8966 (711 TRS)

Community Care Program Online Application

The applications will be submitted online through DocuSign. As a cost-saving measure for you, we ask that you NOT mail the application to the department.

Starting the Application Process

IMPACT Enrollment

If you are applying to become a Community Care Program (CCP) provider, IDoA/HFS encourages you to submit an application to Illinois Healthcare and Family Services IMPACT (Illinois Medicaid Program Advance Cloud Technology) as soon as possible.  While it is not necessary for your IDoA application to be approved prior to submitting an IMPACT application, you cannot become an active CCP provider until IDoA notifies HFS. Additionally, CCP providers of In-home services must be enrolled in IMPACT to have the required HHAeXchange EVV portal prior to serving CCP participants.

Additional IMPACT Resources:

To learn more about the process before submitting an application, visit:

 

If you have questions about the Rules and Regulations for the Community Care Program, visit the Statutes and Rules page.

This online application is for NEW applicants only! Current providers can NOT use this application.

3 STEP PROCESS:

  • Step 1: Legal Entity Application
  • Step 2: In-Home Service Application and/or Adult Day Service Application
  • Step 3:  Application Complete Submission Form

Once all of the required parts of the application are completed, a representative will review the application and contact you.

Start Legal Entity Application