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| 1 | AN ACT concerning care for persons with developmental | ||||||||||||||||||||||||
| 2 | disabilities, which may be referred to as the Community | ||||||||||||||||||||||||
| 3 | Disability Living Wage Act.
| ||||||||||||||||||||||||
| 4 | WHEREAS, An estimated 27,000 children and adults with | ||||||||||||||||||||||||
| 5 | intellectual and developmental disabilities are supported in | ||||||||||||||||||||||||
| 6 | community-based settings in Illinois; direct support persons | ||||||||||||||||||||||||
| 7 | (DSPs), are trained paraprofessional staff that are engaged in | ||||||||||||||||||||||||
| 8 | activities of daily living and community support; too many of | ||||||||||||||||||||||||
| 9 | these employees earn wages that place them and their families | ||||||||||||||||||||||||
| 10 | below the poverty level; and
| ||||||||||||||||||||||||
| 11 | WHEREAS, According to the most recent Illinois industry | ||||||||||||||||||||||||
| 12 | surveys, the average DSP wage in Illinois is below the U.S. | ||||||||||||||||||||||||
| 13 | Department of Health and Human Services poverty threshold of | ||||||||||||||||||||||||
| 14 | $12.38 for a family of 4 and one out of every 4 DSP jobs in | ||||||||||||||||||||||||
| 15 | provider agencies are going unfilled; low wages often compel | ||||||||||||||||||||||||
| 16 | DSPs to work many overtime hours or hold down a second job to | ||||||||||||||||||||||||
| 17 | support their families; research by the American Network of | ||||||||||||||||||||||||
| 18 | Community Options and Resources (ANCOR), inclusive of | ||||||||||||||||||||||||
| 19 | Illinois, reveals 56% of DSPs rely on public assistance to make | ||||||||||||||||||||||||
| 20 | ends meet, creating additional expenditures for State | ||||||||||||||||||||||||
| 21 | government; low wages are a consequence of the historically low | ||||||||||||||||||||||||
| 22 | reimbursement rates paid by the State of Illinois to | ||||||||||||||||||||||||
| 23 | community-based service providers; and
| ||||||||||||||||||||||||
| 24 | WHEREAS, Starting wages at many provider agencies are below | ||||||||||||||||||||||||
| |||||||
| |||||||
| 1 | $10 per hour, the scheduled state minimum wage rate as of July | ||||||
| 2 | 1, 2020; and | ||||||
| 3 | WHEREAS, The lack of adequate wages for employees who | ||||||
| 4 | perform the challenging work of supporting persons with | ||||||
| 5 | intellectual and developmental disabilities results in high | ||||||
| 6 | employee turnover, which in turn negatively impacts the quality | ||||||
| 7 | of services provided, higher wages are proven to reduce staff | ||||||
| 8 | turnover, improving stability and quality of services while | ||||||
| 9 | reducing employer training costs; and
| ||||||
| 10 | WHEREAS, Rising wages in several other sectors now mean, | ||||||
| 11 | despite the modest wage increase and strenuous efforts to | ||||||
| 12 | recruit new workers, agencies are experiencing staff vacancy | ||||||
| 13 | rates of up to 40%; excessive vacancies force employers to rely | ||||||
| 14 | more on overtime, leading to staff burnout and driving up | ||||||
| 15 | costs; for the third year in a row the federal court monitor | ||||||
| 16 | documented how this growing hiring crisis impedes the ability | ||||||
| 17 | of community disability agencies to expand to accommodate | ||||||
| 18 | persons newly approved for services as part of the Ligas | ||||||
| 19 | Consent Decree; and
| ||||||
| 20 | WHEREAS, The General Assembly finds that in order to reduce | ||||||
| 21 | turnover, increase retention, fill vacancies, and ensure DSPs | ||||||
| 22 | are adequately compensated for the critically important work | ||||||
| 23 | they do, an increase in rates and reimbursements to | ||||||
| |||||||
| |||||||
| 1 | community-based service providers to effectuate an increase in | ||||||
| 2 | the hourly wage paid to DSPs is needed; and
| ||||||
| 3 | WHEREAS, It is the purpose of this Act to increase the | ||||||
| 4 | wages of DSPs in community disability agencies beyond the | ||||||
| 5 | poverty level and to a level competitive with rival employers | ||||||
| 6 | and above the State minimum wage, in an effort to improve the | ||||||
| 7 | lives of DSPs and the lives of the vulnerable persons they | ||||||
| 8 | support; and
| ||||||
| 9 | WHEREAS, It is the intent of the General Assembly to ensure | ||||||
| 10 | that all funds resulting from rate increases provided to | ||||||
| 11 | community disability agencies are allocated to frontline | ||||||
| 12 | employee compensation in order to address the current workforce | ||||||
| 13 | crisis which is the primary obstacle to the availability of | ||||||
| 14 | community-based services for people with disabilities; | ||||||
| 15 | therefore | ||||||
| 16 | Be it enacted by the People of the State of Illinois,
| ||||||
| 17 | represented in the General Assembly:
| ||||||
| 18 | Section 5. The Illinois Administrative Procedure Act is | ||||||
| 19 | amended by adding Section 5-45.1 as follows: | ||||||
| 20 | (5 ILCS 100/5-45.1 new) | ||||||
| 21 | Sec. 5-45.1. Emergency rulemaking; Departments of Human | ||||||
| |||||||
| |||||||
| 1 | Services and Healthcare and Family Services. To provide for the | ||||||
| 2 | expeditious and timely implementation of changes made by this | ||||||
| 3 | amendatory Act of the 101st General Assembly to Section 74 of | ||||||
| 4 | the Mental Health and Developmental Disabilities | ||||||
| 5 | Administrative Act and to Sections 5-5.4 and 5-5.4i of the | ||||||
| 6 | Illinois Public Aid Code, emergency rules may be adopted in | ||||||
| 7 | accordance with Section 5-45 by the respective Department. The | ||||||
| 8 | adoption of emergency rules authorized by Section 5-45 and this | ||||||
| 9 | Section is deemed to be necessary for the public interest, | ||||||
| 10 | safety, and welfare. | ||||||
| 11 | This Section is repealed on January 1, 2026. | ||||||
| 12 | Section 10. The Mental Health and Developmental | ||||||
| 13 | Disabilities Administrative Act is amended by changing Section | ||||||
| 14 | 74 and by adding Section 55.5 as follows: | ||||||
| 15 | (20 ILCS 1705/55.5 new) | ||||||
| 16 | Sec. 55.5. Increased wages for front-line personnel. As | ||||||
| 17 | used in this Section, "front-line personnel" means direct | ||||||
| 18 | support persons, aides, front-line supervisors, qualified | ||||||
| 19 | intellectual disabilities professionals, nurses, and | ||||||
| 20 | non-administrative support staff working in service settings | ||||||
| 21 | outlined in this Section. | ||||||
| 22 | The Department shall establish reimbursement rates that | ||||||
| 23 | build toward livable wages for front-line personnel in | ||||||
| 24 | residential and day programs and service coordination agencies | ||||||
| |||||||
| |||||||
| 1 | serving persons with intellectual and developmental | ||||||
| 2 | disabilities under Section 54 of this Act, including, but not | ||||||
| 3 | limited to, intermediate care for the developmentally disabled | ||||||
| 4 | facilities, medically complex for the developmentally disabled | ||||||
| 5 | facilities, community-integrated living arrangements, | ||||||
| 6 | community day services, employment, and other residential and | ||||||
| 7 | day programs for persons with intellectual and developmental | ||||||
| 8 | disabilities supported by State funds or funding under Title | ||||||
| 9 | XIX of the federal Social Security Act. | ||||||
| 10 | The Department shall increase rates and reimbursements so | ||||||
| 11 | that by July 1, 2020 direct support persons wages shall be | ||||||
| 12 | increased by $2 per hour, and so that other front-line | ||||||
| 13 | personnel earn a commensurate wage. | ||||||
| 14 | (20 ILCS 1705/74) | ||||||
| 15 | Sec. 74. Rates and reimbursements. | ||||||
| 16 | (a) Within 30 days after July 6, 2017 (the effective date | ||||||
| 17 | of Public Act 100-23), the Department shall increase rates and | ||||||
| 18 | reimbursements to fund a minimum of a $0.75 per hour wage | ||||||
| 19 | increase for front-line personnel, including, but not limited | ||||||
| 20 | to, direct support persons, aides, front-line supervisors, | ||||||
| 21 | qualified intellectual disabilities professionals, nurses, and | ||||||
| 22 | non-administrative support staff working in community-based | ||||||
| 23 | provider organizations serving individuals with developmental | ||||||
| 24 | disabilities. The Department shall adopt rules, including | ||||||
| 25 | emergency rules under subsection (y) of Section 5-45 of the | ||||||
| |||||||
| |||||||
| 1 | Illinois Administrative Procedure Act, to implement the | ||||||
| 2 | provisions of this Section. | ||||||
| 3 | (b) Rates and reimbursements. Within 30 days after the | ||||||
| 4 | effective date of this amendatory Act of the 100th General | ||||||
| 5 | Assembly, the Department shall increase rates and | ||||||
| 6 | reimbursements to fund a minimum of a $0.50 per hour wage | ||||||
| 7 | increase for front-line personnel, including, but not limited | ||||||
| 8 | to, direct support persons, aides, front-line supervisors, | ||||||
| 9 | qualified intellectual disabilities professionals, nurses, and | ||||||
| 10 | non-administrative support staff working in community-based | ||||||
| 11 | provider organizations serving individuals with developmental | ||||||
| 12 | disabilities. The Department shall adopt rules, including | ||||||
| 13 | emergency rules under subsection (bb) of Section 5-45 of the | ||||||
| 14 | Illinois Administrative Procedure Act, to implement the | ||||||
| 15 | provisions of this Section. | ||||||
| 16 | (c) Rates and reimbursements. Within 30 days after the | ||||||
| 17 | effective date of this amendatory Act of the 101st General | ||||||
| 18 | Assembly, subject to federal approval, the Department shall | ||||||
| 19 | increase rates and reimbursements in effect on June 30, 2019 | ||||||
| 20 | for community-based providers for persons with Developmental | ||||||
| 21 | Disabilities by 3.5% The Department shall adopt rules, | ||||||
| 22 | including emergency rules under subsection (jj) of Section 5-45 | ||||||
| 23 | of the Illinois Administrative Procedure Act, to implement the | ||||||
| 24 | provisions of this Section, including wage increases for direct | ||||||
| 25 | care staff.
| ||||||
| 26 | (d) Rates and reimbursements. Within 30 days after the | ||||||
| |||||||
| |||||||
| 1 | effective date of this amendatory Act of the 101st General | ||||||
| 2 | Assembly, subject to federal approval, the Department shall | ||||||
| 3 | increase rates and reimbursements in effect on January 1, 2020, | ||||||
| 4 | for community-based providers for persons with developmental | ||||||
| 5 | disabilities in order to fund a minimum $2 per hour wage | ||||||
| 6 | increase. The Department shall adopt rules, including | ||||||
| 7 | emergency rules under the Illinois Administrative Procedure | ||||||
| 8 | Act, to implement the provisions of this Section, and ensure | ||||||
| 9 | funds are allocated to compensation increases for direct care | ||||||
| 10 | staff. | ||||||
| 11 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||
| 12 | 101-10, eff. 6-5-19.) | ||||||
| 13 | Section 15. The Illinois Public Aid Code is amended by | ||||||
| 14 | changing Sections 5-5.4 and 5-5.4i as follows:
| ||||||
| 15 | (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
| ||||||
| 16 | Sec. 5-5.4. Standards of Payment - Department of Healthcare | ||||||
| 17 | and Family Services.
The Department of Healthcare and Family | ||||||
| 18 | Services shall develop standards of payment of
nursing facility | ||||||
| 19 | and ICF/DD services in facilities providing such services
under | ||||||
| 20 | this Article which:
| ||||||
| 21 | (1) Provide for the determination of a facility's payment
| ||||||
| 22 | for nursing facility or ICF/DD services on a prospective basis.
| ||||||
| 23 | The amount of the payment rate for all nursing facilities | ||||||
| 24 | certified by the
Department of Public Health under the ID/DD | ||||||
| |||||||
| |||||||
| 1 | Community Care Act or the Nursing Home Care Act as Intermediate
| ||||||
| 2 | Care for the Developmentally Disabled facilities, Long Term | ||||||
| 3 | Care for Under Age
22 facilities, Skilled Nursing facilities, | ||||||
| 4 | or Intermediate Care facilities
under the
medical assistance | ||||||
| 5 | program shall be prospectively established annually on the
| ||||||
| 6 | basis of historical, financial, and statistical data | ||||||
| 7 | reflecting actual costs
from prior years, which shall be | ||||||
| 8 | applied to the current rate year and updated
for inflation, | ||||||
| 9 | except that the capital cost element for newly constructed
| ||||||
| 10 | facilities shall be based upon projected budgets. The annually | ||||||
| 11 | established
payment rate shall take effect on July 1 in 1984 | ||||||
| 12 | and subsequent years. No rate
increase and no
update for | ||||||
| 13 | inflation shall be provided on or after July 1, 1994, unless | ||||||
| 14 | specifically provided for in this
Section.
The changes made by | ||||||
| 15 | Public Act 93-841
extending the duration of the prohibition | ||||||
| 16 | against a rate increase or update for inflation are effective | ||||||
| 17 | retroactive to July 1, 2004.
| ||||||
| 18 | For facilities licensed by the Department of Public Health | ||||||
| 19 | under the Nursing
Home Care Act as Intermediate Care for the | ||||||
| 20 | Developmentally Disabled facilities
or Long Term Care for Under | ||||||
| 21 | Age 22 facilities, the rates taking effect on July
1, 1998 | ||||||
| 22 | shall include an increase of 3%. For facilities licensed by the
| ||||||
| 23 | Department of Public Health under the Nursing Home Care Act as | ||||||
| 24 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
| 25 | the rates taking effect on July 1,
1998 shall include an | ||||||
| 26 | increase of 3% plus $1.10 per resident-day, as defined by
the | ||||||
| |||||||
| |||||||
| 1 | Department. For facilities licensed by the Department of Public | ||||||
| 2 | Health under the Nursing Home Care Act as Intermediate Care | ||||||
| 3 | Facilities for the Developmentally Disabled or Long Term Care | ||||||
| 4 | for Under Age 22 facilities, the rates taking effect on January | ||||||
| 5 | 1, 2006 shall include an increase of 3%.
For facilities | ||||||
| 6 | licensed by the Department of Public Health under the Nursing | ||||||
| 7 | Home Care Act as Intermediate Care Facilities for the | ||||||
| 8 | Developmentally Disabled or Long Term Care for Under Age 22 | ||||||
| 9 | facilities, the rates taking effect on January 1, 2009 shall | ||||||
| 10 | include an increase sufficient to provide a $0.50 per hour wage | ||||||
| 11 | increase for non-executive staff. For facilities licensed by | ||||||
| 12 | the Department of Public Health under the ID/DD Community Care | ||||||
| 13 | Act as ID/DD Facilities the rates taking effect within 30 days | ||||||
| 14 | after July 6, 2017 (the effective date of Public Act 100-23) | ||||||
| 15 | shall include an increase sufficient to provide a $0.75 per | ||||||
| 16 | hour wage increase for non-executive staff. The Department | ||||||
| 17 | shall adopt rules, including emergency rules under subsection | ||||||
| 18 | (y) of Section 5-45 of the Illinois Administrative Procedure | ||||||
| 19 | Act, to implement the provisions of this paragraph. For | ||||||
| 20 | facilities licensed by the Department of Public Health under | ||||||
| 21 | the ID/DD Community Care Act as ID/DD Facilities and under the | ||||||
| 22 | MC/DD Act as MC/DD Facilities, the rates taking effect within | ||||||
| 23 | 30 days after the effective date of this amendatory Act of the | ||||||
| 24 | 100th General Assembly shall include an increase sufficient to | ||||||
| 25 | provide a $0.50 per hour wage increase for non-executive | ||||||
| 26 | front-line personnel, including, but not limited to, direct | ||||||
| |||||||
| |||||||
| 1 | support persons, aides, front-line supervisors, qualified | ||||||
| 2 | intellectual disabilities professionals, nurses, and | ||||||
| 3 | non-administrative support staff. The Department shall adopt | ||||||
| 4 | rules, including emergency rules under subsection (bb) of | ||||||
| 5 | Section 5-45 of the Illinois Administrative Procedure Act, to | ||||||
| 6 | implement the provisions of this paragraph. | ||||||
| 7 | For facilities licensed by the Department of Public Health | ||||||
| 8 | under the ID/DD Community Care Act as ID/DD facilities and | ||||||
| 9 | under the MC/DD Act as MC/DD facilities, the rates taking | ||||||
| 10 | effect within 30 days after the effective date of this | ||||||
| 11 | amendatory Act of the 101st General Assembly shall include an | ||||||
| 12 | increase sufficient to provide a $2 per hour wage increase for | ||||||
| 13 | non-executive front-line personnel, including, but not limited | ||||||
| 14 | to, direct support persons, aides, front-line supervisors, | ||||||
| 15 | qualified intellectual disabilities professionals, nurses, and | ||||||
| 16 | non-administrative support staff. The Department shall adopt | ||||||
| 17 | rules, including emergency rules under the Illinois | ||||||
| 18 | Administrative Procedure Act, to implement the provisions of | ||||||
| 19 | this paragraph and ensure funds are allocated to compensation | ||||||
| 20 | increases for direct care staff. | ||||||
| 21 | For facilities licensed by the Department of Public Health | ||||||
| 22 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
| 23 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
| 24 | Age 22 facilities, the rates taking
effect on July 1, 1999 | ||||||
| 25 | shall include an increase of 1.6% plus $3.00 per
resident-day, | ||||||
| 26 | as defined by the Department. For facilities licensed by the
| ||||||
| |||||||
| |||||||
| 1 | Department of Public Health under the Nursing Home Care Act as | ||||||
| 2 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
| 3 | the rates taking effect on July 1,
1999 shall include an | ||||||
| 4 | increase of 1.6% and, for services provided on or after
October | ||||||
| 5 | 1, 1999, shall be increased by $4.00 per resident-day, as | ||||||
| 6 | defined by
the Department.
| ||||||
| 7 | For facilities licensed by the Department of Public Health | ||||||
| 8 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
| 9 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
| 10 | Age 22 facilities, the rates taking
effect on July 1, 2000 | ||||||
| 11 | shall include an increase of 2.5% per resident-day,
as defined | ||||||
| 12 | by the Department. For facilities licensed by the Department of
| ||||||
| 13 | Public Health under the Nursing Home Care Act as Skilled | ||||||
| 14 | Nursing facilities or
Intermediate Care facilities, the rates | ||||||
| 15 | taking effect on July 1, 2000 shall
include an increase of 2.5% | ||||||
| 16 | per resident-day, as defined by the Department.
| ||||||
| 17 | For facilities licensed by the Department of Public Health | ||||||
| 18 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
| 19 | or intermediate care
facilities, a new payment methodology must | ||||||
| 20 | be implemented for the nursing
component of the rate effective | ||||||
| 21 | July 1, 2003. The Department of Public Aid
(now Healthcare and | ||||||
| 22 | Family Services) shall develop the new payment methodology | ||||||
| 23 | using the Minimum Data Set
(MDS) as the instrument to collect | ||||||
| 24 | information concerning nursing home
resident condition | ||||||
| 25 | necessary to compute the rate. The Department
shall develop the | ||||||
| 26 | new payment methodology to meet the unique needs of
Illinois | ||||||
| |||||||
| |||||||
| 1 | nursing home residents while remaining subject to the | ||||||
| 2 | appropriations
provided by the General Assembly.
A transition | ||||||
| 3 | period from the payment methodology in effect on June 30, 2003
| ||||||
| 4 | to the payment methodology in effect on July 1, 2003 shall be | ||||||
| 5 | provided for a
period not exceeding 3 years and 184 days after | ||||||
| 6 | implementation of the new payment
methodology as follows:
| ||||||
| 7 | (A) For a facility that would receive a lower
nursing | ||||||
| 8 | component rate per patient day under the new system than | ||||||
| 9 | the facility
received
effective on the date immediately | ||||||
| 10 | preceding the date that the Department
implements the new | ||||||
| 11 | payment methodology, the nursing component rate per | ||||||
| 12 | patient
day for the facility
shall be held at
the level in | ||||||
| 13 | effect on the date immediately preceding the date that the
| ||||||
| 14 | Department implements the new payment methodology until a | ||||||
| 15 | higher nursing
component rate of
reimbursement is achieved | ||||||
| 16 | by that
facility.
| ||||||
| 17 | (B) For a facility that would receive a higher nursing | ||||||
| 18 | component rate per
patient day under the payment | ||||||
| 19 | methodology in effect on July 1, 2003 than the
facility | ||||||
| 20 | received effective on the date immediately preceding the | ||||||
| 21 | date that the
Department implements the new payment | ||||||
| 22 | methodology, the nursing component rate
per patient day for | ||||||
| 23 | the facility shall be adjusted.
| ||||||
| 24 | (C) Notwithstanding paragraphs (A) and (B), the | ||||||
| 25 | nursing component rate per
patient day for the facility | ||||||
| 26 | shall be adjusted subject to appropriations
provided by the | ||||||
| |||||||
| |||||||
| 1 | General Assembly.
| ||||||
| 2 | For facilities licensed by the Department of Public Health | ||||||
| 3 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
| 4 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
| 5 | Age 22 facilities, the rates taking
effect on March 1, 2001 | ||||||
| 6 | shall include a statewide increase of 7.85%, as
defined by the | ||||||
| 7 | Department.
| ||||||
| 8 | Notwithstanding any other provision of this Section, for | ||||||
| 9 | facilities licensed by the Department of Public Health under | ||||||
| 10 | the
Nursing Home Care Act as skilled nursing facilities or | ||||||
| 11 | intermediate care
facilities, except facilities participating | ||||||
| 12 | in the Department's demonstration program pursuant to the | ||||||
| 13 | provisions of Title 77, Part 300, Subpart T of the Illinois | ||||||
| 14 | Administrative Code, the numerator of the ratio used by the | ||||||
| 15 | Department of Healthcare and Family Services to compute the | ||||||
| 16 | rate payable under this Section using the Minimum Data Set | ||||||
| 17 | (MDS) methodology shall incorporate the following annual | ||||||
| 18 | amounts as the additional funds appropriated to the Department | ||||||
| 19 | specifically to pay for rates based on the MDS nursing | ||||||
| 20 | component methodology in excess of the funding in effect on | ||||||
| 21 | December 31, 2006: | ||||||
| 22 | (i) For rates taking effect January 1, 2007, | ||||||
| 23 | $60,000,000. | ||||||
| 24 | (ii) For rates taking effect January 1, 2008, | ||||||
| 25 | $110,000,000. | ||||||
| 26 | (iii) For rates taking effect January 1, 2009, | ||||||
| |||||||
| |||||||
| 1 | $194,000,000. | ||||||
| 2 | (iv) For rates taking effect April 1, 2011, or the | ||||||
| 3 | first day of the month that begins at least 45 days after | ||||||
| 4 | the effective date of this amendatory Act of the 96th | ||||||
| 5 | General Assembly, $416,500,000 or an amount as may be | ||||||
| 6 | necessary to complete the transition to the MDS methodology | ||||||
| 7 | for the nursing component of the rate. Increased payments | ||||||
| 8 | under this item (iv) are not due and payable, however, | ||||||
| 9 | until (i) the methodologies described in this paragraph are | ||||||
| 10 | approved by the federal government in an appropriate State | ||||||
| 11 | Plan amendment and (ii) the assessment imposed by Section | ||||||
| 12 | 5B-2 of this Code is determined to be a permissible tax | ||||||
| 13 | under Title XIX of the Social Security Act. | ||||||
| 14 | Notwithstanding any other provision of this Section, for | ||||||
| 15 | facilities licensed by the Department of Public Health under | ||||||
| 16 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
| 17 | intermediate care facilities, the support component of the | ||||||
| 18 | rates taking effect on January 1, 2008 shall be computed using | ||||||
| 19 | the most recent cost reports on file with the Department of | ||||||
| 20 | Healthcare and Family Services no later than April 1, 2005, | ||||||
| 21 | updated for inflation to January 1, 2006. | ||||||
| 22 | For facilities licensed by the Department of Public Health | ||||||
| 23 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
| 24 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
| 25 | Age 22 facilities, the rates taking
effect on April 1, 2002 | ||||||
| 26 | shall include a statewide increase of 2.0%, as
defined by the | ||||||
| |||||||
| |||||||
| 1 | Department.
This increase terminates on July 1, 2002;
beginning | ||||||
| 2 | July 1, 2002 these rates are reduced to the level of the rates
| ||||||
| 3 | in effect on March 31, 2002, as defined by the Department.
| ||||||
| 4 | For facilities licensed by the Department of Public Health | ||||||
| 5 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
| 6 | or intermediate care
facilities, the rates taking effect on | ||||||
| 7 | July 1, 2001 shall be computed using the most recent cost | ||||||
| 8 | reports
on file with the Department of Public Aid no later than | ||||||
| 9 | April 1, 2000,
updated for inflation to January 1, 2001. For | ||||||
| 10 | rates effective July 1, 2001
only, rates shall be the greater | ||||||
| 11 | of the rate computed for July 1, 2001
or the rate effective on | ||||||
| 12 | June 30, 2001.
| ||||||
| 13 | Notwithstanding any other provision of this Section, for | ||||||
| 14 | facilities
licensed by the Department of Public Health under | ||||||
| 15 | the Nursing Home Care Act
as skilled nursing facilities or | ||||||
| 16 | intermediate care facilities, the Illinois
Department shall | ||||||
| 17 | determine by rule the rates taking effect on July 1, 2002,
| ||||||
| 18 | which shall be 5.9% less than the rates in effect on June 30, | ||||||
| 19 | 2002.
| ||||||
| 20 | Notwithstanding any other provision of this Section, for | ||||||
| 21 | facilities
licensed by the Department of Public Health under | ||||||
| 22 | the Nursing Home Care Act as
skilled nursing
facilities or | ||||||
| 23 | intermediate care facilities, if the payment methodologies | ||||||
| 24 | required under Section 5A-12 and the waiver granted under 42 | ||||||
| 25 | CFR 433.68 are approved by the United States Centers for | ||||||
| 26 | Medicare and Medicaid Services, the rates taking effect on July | ||||||
| |||||||
| |||||||
| 1 | 1, 2004 shall be 3.0% greater than the rates in effect on June | ||||||
| 2 | 30, 2004. These rates shall take
effect only upon approval and
| ||||||
| 3 | implementation of the payment methodologies required under | ||||||
| 4 | Section 5A-12.
| ||||||
| 5 | Notwithstanding any other provisions of this Section, for | ||||||
| 6 | facilities licensed by the Department of Public Health under | ||||||
| 7 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
| 8 | intermediate care facilities, the rates taking effect on | ||||||
| 9 | January 1, 2005 shall be 3% more than the rates in effect on | ||||||
| 10 | December 31, 2004.
| ||||||
| 11 | Notwithstanding any other provision of this Section, for | ||||||
| 12 | facilities licensed by the Department of Public Health under | ||||||
| 13 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
| 14 | intermediate care facilities, effective January 1, 2009, the | ||||||
| 15 | per diem support component of the rates effective on January 1, | ||||||
| 16 | 2008, computed using the most recent cost reports on file with | ||||||
| 17 | the Department of Healthcare and Family Services no later than | ||||||
| 18 | April 1, 2005, updated for inflation to January 1, 2006, shall | ||||||
| 19 | be increased to the amount that would have been derived using | ||||||
| 20 | standard Department of Healthcare and Family Services methods, | ||||||
| 21 | procedures, and inflators. | ||||||
| 22 | Notwithstanding any other provisions of this Section, for | ||||||
| 23 | facilities licensed by the Department of Public Health under | ||||||
| 24 | the Nursing Home Care Act as intermediate care facilities that | ||||||
| 25 | are federally defined as Institutions for Mental Disease, or | ||||||
| 26 | facilities licensed by the Department of Public Health under | ||||||
| |||||||
| |||||||
| 1 | the Specialized Mental Health Rehabilitation Act of 2013, a | ||||||
| 2 | socio-development component rate equal to 6.6% of the | ||||||
| 3 | facility's nursing component rate as of January 1, 2006 shall | ||||||
| 4 | be established and paid effective July 1, 2006. The | ||||||
| 5 | socio-development component of the rate shall be increased by a | ||||||
| 6 | factor of 2.53 on the first day of the month that begins at | ||||||
| 7 | least 45 days after January 11, 2008 (the effective date of | ||||||
| 8 | Public Act 95-707). As of August 1, 2008, the socio-development | ||||||
| 9 | component rate shall be equal to 6.6% of the facility's nursing | ||||||
| 10 | component rate as of January 1, 2006, multiplied by a factor of | ||||||
| 11 | 3.53. For services provided on or after April 1, 2011, or the | ||||||
| 12 | first day of the month that begins at least 45 days after the | ||||||
| 13 | effective date of this amendatory Act of the 96th General | ||||||
| 14 | Assembly, whichever is later, the Illinois Department may by | ||||||
| 15 | rule adjust these socio-development component rates, and may | ||||||
| 16 | use different adjustment methodologies for those facilities | ||||||
| 17 | participating, and those not participating, in the Illinois | ||||||
| 18 | Department's demonstration program pursuant to the provisions | ||||||
| 19 | of Title 77, Part 300, Subpart T of the Illinois Administrative | ||||||
| 20 | Code, but in no case may such rates be diminished below those | ||||||
| 21 | in effect on August 1, 2008.
| ||||||
| 22 | For facilities
licensed
by the
Department of Public Health | ||||||
| 23 | under the Nursing Home Care Act as Intermediate
Care for
the | ||||||
| 24 | Developmentally Disabled facilities or as long-term care | ||||||
| 25 | facilities for
residents under 22 years of age, the rates | ||||||
| 26 | taking effect on July 1,
2003 shall
include a statewide | ||||||
| |||||||
| |||||||
| 1 | increase of 4%, as defined by the Department.
| ||||||
| 2 | For facilities licensed by the Department of Public Health | ||||||
| 3 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
| 4 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
| 5 | Age 22 facilities, the rates taking
effect on the first day of | ||||||
| 6 | the month that begins at least 45 days after the effective date | ||||||
| 7 | of this amendatory Act of the 95th General Assembly shall | ||||||
| 8 | include a statewide increase of 2.5%, as
defined by the | ||||||
| 9 | Department. | ||||||
| 10 | Notwithstanding any other provision of this Section, for | ||||||
| 11 | facilities licensed by the Department of Public Health under | ||||||
| 12 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
| 13 | intermediate care facilities, effective January 1, 2005, | ||||||
| 14 | facility rates shall be increased by the difference between (i) | ||||||
| 15 | a facility's per diem property, liability, and malpractice | ||||||
| 16 | insurance costs as reported in the cost report filed with the | ||||||
| 17 | Department of Public Aid and used to establish rates effective | ||||||
| 18 | July 1, 2001 and (ii) those same costs as reported in the | ||||||
| 19 | facility's 2002 cost report. These costs shall be passed | ||||||
| 20 | through to the facility without caps or limitations, except for | ||||||
| 21 | adjustments required under normal auditing procedures.
| ||||||
| 22 | Rates established effective each July 1 shall govern | ||||||
| 23 | payment
for services rendered throughout that fiscal year, | ||||||
| 24 | except that rates
established on July 1, 1996 shall be | ||||||
| 25 | increased by 6.8% for services
provided on or after January 1, | ||||||
| 26 | 1997. Such rates will be based
upon the rates calculated for | ||||||
| |||||||
| |||||||
| 1 | the year beginning July 1, 1990, and for
subsequent years | ||||||
| 2 | thereafter until June 30, 2001 shall be based on the
facility | ||||||
| 3 | cost reports
for the facility fiscal year ending at any point | ||||||
| 4 | in time during the previous
calendar year, updated to the | ||||||
| 5 | midpoint of the rate year. The cost report
shall be on file | ||||||
| 6 | with the Department no later than April 1 of the current
rate | ||||||
| 7 | year. Should the cost report not be on file by April 1, the | ||||||
| 8 | Department
shall base the rate on the latest cost report filed | ||||||
| 9 | by each skilled care
facility and intermediate care facility, | ||||||
| 10 | updated to the midpoint of the
current rate year. In | ||||||
| 11 | determining rates for services rendered on and after
July 1, | ||||||
| 12 | 1985, fixed time shall not be computed at less than zero. The
| ||||||
| 13 | Department shall not make any alterations of regulations which | ||||||
| 14 | would reduce
any component of the Medicaid rate to a level | ||||||
| 15 | below what that component would
have been utilizing in the rate | ||||||
| 16 | effective on July 1, 1984.
| ||||||
| 17 | (2) Shall take into account the actual costs incurred by | ||||||
| 18 | facilities
in providing services for recipients of skilled | ||||||
| 19 | nursing and intermediate
care services under the medical | ||||||
| 20 | assistance program.
| ||||||
| 21 | (3) Shall take into account the medical and psycho-social
| ||||||
| 22 | characteristics and needs of the patients.
| ||||||
| 23 | (4) Shall take into account the actual costs incurred by | ||||||
| 24 | facilities in
meeting licensing and certification standards | ||||||
| 25 | imposed and prescribed by the
State of Illinois, any of its | ||||||
| 26 | political subdivisions or municipalities and by
the U.S. | ||||||
| |||||||
| |||||||
| 1 | Department of Health and Human Services pursuant to Title XIX | ||||||
| 2 | of the
Social Security Act.
| ||||||
| 3 | The Department of Healthcare and Family Services
shall | ||||||
| 4 | develop precise standards for
payments to reimburse nursing | ||||||
| 5 | facilities for any utilization of
appropriate rehabilitative | ||||||
| 6 | personnel for the provision of rehabilitative
services which is | ||||||
| 7 | authorized by federal regulations, including
reimbursement for | ||||||
| 8 | services provided by qualified therapists or qualified
| ||||||
| 9 | assistants, and which is in accordance with accepted | ||||||
| 10 | professional
practices. Reimbursement also may be made for | ||||||
| 11 | utilization of other
supportive personnel under appropriate | ||||||
| 12 | supervision.
| ||||||
| 13 | The Department shall develop enhanced payments to offset | ||||||
| 14 | the additional costs incurred by a
facility serving exceptional | ||||||
| 15 | need residents and shall allocate at least $4,000,000 of the | ||||||
| 16 | funds
collected from the assessment established by Section 5B-2 | ||||||
| 17 | of this Code for such payments. For
the purpose of this | ||||||
| 18 | Section, "exceptional needs" means, but need not be limited to, | ||||||
| 19 | ventilator care and traumatic brain injury care. The enhanced | ||||||
| 20 | payments for exceptional need residents under this paragraph | ||||||
| 21 | are not due and payable, however, until (i) the methodologies | ||||||
| 22 | described in this paragraph are approved by the federal | ||||||
| 23 | government in an appropriate State Plan amendment and (ii) the | ||||||
| 24 | assessment imposed by Section 5B-2 of this Code is determined | ||||||
| 25 | to be a permissible tax under Title XIX of the Social Security | ||||||
| 26 | Act. | ||||||
| |||||||
| |||||||
| 1 | Beginning January 1, 2014 the methodologies for | ||||||
| 2 | reimbursement of nursing facility services as provided under | ||||||
| 3 | this Section 5-5.4 shall no longer be applicable for services | ||||||
| 4 | provided on or after January 1, 2014. | ||||||
| 5 | No payment increase under this Section for the MDS | ||||||
| 6 | methodology, exceptional care residents, or the | ||||||
| 7 | socio-development component rate established by Public Act | ||||||
| 8 | 96-1530 of the 96th General Assembly and funded by the | ||||||
| 9 | assessment imposed under Section 5B-2 of this Code shall be due | ||||||
| 10 | and payable until after the Department notifies the long-term | ||||||
| 11 | care providers, in writing, that the payment methodologies to | ||||||
| 12 | long-term care providers required under this Section have been | ||||||
| 13 | approved by the Centers for Medicare and Medicaid Services of | ||||||
| 14 | the U.S. Department of Health and Human Services and the | ||||||
| 15 | waivers under 42 CFR 433.68 for the assessment imposed by this | ||||||
| 16 | Section, if necessary, have been granted by the Centers for | ||||||
| 17 | Medicare and Medicaid Services of the U.S. Department of Health | ||||||
| 18 | and Human Services. Upon notification to the Department of | ||||||
| 19 | approval of the payment methodologies required under this | ||||||
| 20 | Section and the waivers granted under 42 CFR 433.68, all | ||||||
| 21 | increased payments otherwise due under this Section prior to | ||||||
| 22 | the date of notification shall be due and payable within 90 | ||||||
| 23 | days of the date federal approval is received. | ||||||
| 24 | On and after July 1, 2012, the Department shall reduce any | ||||||
| 25 | rate of reimbursement for services or other payments or alter | ||||||
| 26 | any methodologies authorized by this Code to reduce any rate of | ||||||
| |||||||
| |||||||
| 1 | reimbursement for services or other payments in accordance with | ||||||
| 2 | Section 5-5e. | ||||||
| 3 | For facilities licensed by the Department of Public Health | ||||||
| 4 | under the ID/DD Community Care Act as ID/DD Facilities and | ||||||
| 5 | under the MC/DD Act as MC/DD Facilities, subject to federal | ||||||
| 6 | approval, the rates taking effect for services delivered on or | ||||||
| 7 | after August 1, 2019 shall be increased by 3.5% over the rates | ||||||
| 8 | in effect on June 30, 2019. The Department shall adopt rules, | ||||||
| 9 | including emergency rules under subsection (ii) of Section 5-45 | ||||||
| 10 | of the Illinois Administrative Procedure Act, to implement the | ||||||
| 11 | provisions of this Section, including wage increases for direct | ||||||
| 12 | care staff. | ||||||
| 13 | For facilities licensed by the Department of Public Health | ||||||
| 14 | under the ID/DD Community Care Act as ID/DD facilities and | ||||||
| 15 | under the MC/DD Act as MC/DD facilities, subject to federal | ||||||
| 16 | approval, the rates taking effect for services delivered on or | ||||||
| 17 | after January 1, 2020, shall be increased sufficiently to | ||||||
| 18 | provide at a minimum $2 per hour wage increase over the wages | ||||||
| 19 | in effect on December 30, 2019. The Department shall adopt | ||||||
| 20 | rules, including emergency rules under the Illinois | ||||||
| 21 | Administrative Procedure Act, to implement the provisions of | ||||||
| 22 | this Section, and ensure funds are allocated to compensation | ||||||
| 23 | increases for direct care staff. | ||||||
| 24 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||
| 25 | 101-10, eff. 6-5-19.) | ||||||
| |||||||
| |||||||
| 1 | (305 ILCS 5/5-5.4i) | ||||||
| 2 | Sec. 5-5.4i. Rates and reimbursements. | ||||||
| 3 | (a) Within 30 days after July 6, 2017 (the effective date | ||||||
| 4 | of Public Act 100-23), the Department shall increase rates and | ||||||
| 5 | reimbursements to fund a minimum of a $0.75 per hour wage | ||||||
| 6 | increase for front-line personnel, including, but not limited | ||||||
| 7 | to, direct support persons, aides, front-line supervisors, | ||||||
| 8 | qualified intellectual disabilities professionals, nurses, and | ||||||
| 9 | non-administrative support staff working in community-based | ||||||
| 10 | provider organizations serving individuals with developmental | ||||||
| 11 | disabilities. The Department shall adopt rules, including | ||||||
| 12 | emergency rules under subsection (y) of Section 5-45 of the | ||||||
| 13 | Illinois Administrative Procedure Act, to implement the | ||||||
| 14 | provisions of this Section. | ||||||
| 15 | (b) Within 30 days after June 4, 2018 (the effective date | ||||||
| 16 | of Public Act 100-587), the Department shall increase rates and | ||||||
| 17 | reimbursements to fund a minimum of a $0.50 per hour wage | ||||||
| 18 | increase for front-line personnel, including, but not limited | ||||||
| 19 | to, direct support persons, aides, front-line supervisors, | ||||||
| 20 | qualified intellectual disabilities professionals, nurses, and | ||||||
| 21 | non-administrative support staff working in community-based | ||||||
| 22 | provider organizations serving individuals with developmental | ||||||
| 23 | disabilities. The Department shall adopt rules, including | ||||||
| 24 | emergency rules under subsection (bb) of Section 5-45 of the | ||||||
| 25 | Illinois Administrative Procedure Act, to implement the | ||||||
| 26 | provisions of this Section. | ||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | (c) Within 30 days after the effective date of this | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | amendatory Act of the 101st General Assembly, subject to | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 3 | federal approval, the Department shall increase rates and | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 4 | reimbursements in effect on June 30, 2019 for community-based | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 5 | providers for persons with Developmental Disabilities by 3.5%. | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 6 | The Department shall adopt rules, including emergency rules | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 7 | under subsection (ii) of Section 5-45 of the Illinois | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 8 | Administrative Procedure Act, to implement the provisions of | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 9 | this Section, including wage increases for direct care staff.
| ||||||||||||||||||||||||||||||||||||||||||||||||||
| 10 | (d) Within 30 days after the effective date of this | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 11 | amendatory Act of the 101st General Assembly, subject to | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 12 | federal approval, the Department shall increase rates and | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 13 | reimbursements in effect on January 1, 2020 for community-based | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 14 | providers for persons with developmental disabilities in order | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 15 | to fund a minimum $2 per hour wage increase. The Department | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 16 | shall adopt rules, including emergency rules under the Illinois | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 17 | Administrative Procedure Act, to implement the provisions of | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 18 | this Section, and ensure funds are allocated to compensation | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 19 | increases for direct care staff. | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 20 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 21 | 101-10, eff. 6-5-19.)
| ||||||||||||||||||||||||||||||||||||||||||||||||||
| 22 | Section 99. Effective date. This Act takes effect upon | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 23 | becoming law.
| ||||||||||||||||||||||||||||||||||||||||||||||||||
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