HB0503 Engrossed LRB096 05782 DRJ 15857 b

1     AN ACT concerning public aid.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Public Aid Code is amended by
5 changing Section 5-5.5 as follows:
 
6     (305 ILCS 5/5-5.5)  (from Ch. 23, par. 5-5.5)
7     Sec. 5-5.5. Elements of Payment Rate.
8     (a) The The Department of Healthcare and Family Services
9 shall develop a prospective method for determining payment
10 rates for skilled nursing and intermediate care services in
11 nursing facilities composed of the following cost elements:
12         (1) Standard Services, with the cost of this component
13     being determined by taking into account the actual costs to
14     the facilities of these services subject to cost ceilings
15     to be defined in the Department's rules.
16         (2) Resident Services, with the cost of this component
17     being determined by taking into account the actual costs,
18     needs and utilization of these services, as derived from an
19     assessment of the resident needs in the nursing facilities.
20     The Department shall adopt rules governing reimbursement
21     for resident services as listed in Section 5-1.1. Surveys
22     or assessments of resident needs under this Section shall
23     include a review by the facility of the results of such

 

 

HB0503 Engrossed - 2 - LRB096 05782 DRJ 15857 b

1     assessments and a discussion of issues in dispute with
2     authorized survey staff, unless the facility elects not to
3     participate in such a review process. Surveys or
4     assessments of resident needs under this Section may be
5     conducted semi-annually and payment rates relating to
6     resident services may be changed on a semi-annual basis.
7     The Illinois Department shall initiate a project, either on
8     a pilot basis or Statewide, to reimburse the cost of
9     resident services based on a methodology which utilizes an
10     assessment of resident needs to determine the level of
11     reimbursement. This methodology shall be different from
12     the payment criteria for resident services utilized by the
13     Illinois Department on July 1, 1981. On March 1, 1982, and
14     each year thereafter, until such time when the Illinois
15     Department adopts the methodology used in such project for
16     use statewide, the Illinois Department shall report to the
17     General Assembly on the implementation and progress of such
18     project. The report shall include:
19             (A) A statement of the Illinois Department's goals
20         and objectives for such project;
21             (B) A description of such project, including the
22         number and type of nursing facilities involved in the
23         project;
24             (C) A description of the methodology used in such
25         project;
26             (D) A description of the Illinois Department's

 

 

HB0503 Engrossed - 3 - LRB096 05782 DRJ 15857 b

1         application of the methodology;
2             (E) A statement on the methodology's effect on the
3         quality of care given to residents in the sample
4         nursing facilities; and
5             (F) A statement on the cost of the methodology used
6         in such project and a comparison of this cost with the
7         cost of the current payment criteria.
8         (3) Ancillary Services, with the payment rate being
9     developed for each individual type of service. Payment
10     shall be made only when authorized under procedures
11     developed by the Department of Healthcare and Family
12     Services.
13         (4) Nurse's Aide Training, with the cost of this
14     component being determined by taking into account the
15     actual cost to the facilities of such training.
16         (5) Real Estate Taxes, with the cost of this component
17     being determined by taking into account the figures
18     contained in the most currently available cost reports
19     (with no imposition of maximums) updated to the midpoint of
20     the current rate year for long term care services rendered
21     between July 1, 1984 and June 30, 1985, and with the cost
22     of this component being determined by taking into account
23     the actual 1983 taxes for which the nursing homes were
24     assessed (with no imposition of maximums) updated to the
25     midpoint of the current rate year for long term care
26     services rendered between July 1, 1985 and June 30, 1986.

 

 

HB0503 Engrossed - 4 - LRB096 05782 DRJ 15857 b

1     (b) In developing a prospective method for determining
2 payment rates for skilled nursing and intermediate care
3 services in nursing facilities, the Department of Healthcare
4 and Family Services shall consider the following cost elements:
5         (1) Reasonable capital cost determined by utilizing
6     incurred interest rate and the current value of the
7     investment, including land, utilizing composite rates, or
8     by utilizing such other reasonable cost related methods
9     determined by the Department. However, beginning with the
10     rate reimbursement period effective July 1, 1987, the
11     Department shall be prohibited from establishing,
12     including, and implementing any depreciation factor in
13     calculating the capital cost element.
14         (2) Profit, with the actual amount being produced and
15     accruing to the providers in the form of a return on their
16     total investment, on the basis of their ability to
17     economically and efficiently deliver a type of service. The
18     method of payment may assure the opportunity for a profit,
19     but shall not guarantee or establish a specific amount as a
20     cost.
21     (c) The Illinois Department may implement the amendatory
22 changes to this Section made by this amendatory Act of 1991
23 through the use of emergency rules in accordance with the
24 provisions of Section 5.02 of the Illinois Administrative
25 Procedure Act. For purposes of the Illinois Administrative
26 Procedure Act, the adoption of rules to implement the

 

 

HB0503 Engrossed - 5 - LRB096 05782 DRJ 15857 b

1 amendatory changes to this Section made by this amendatory Act
2 of 1991 shall be deemed an emergency and necessary for the
3 public interest, safety and welfare.
4     (d) No later than January 1, 2001, the Department of Public
5 Aid shall file with the Joint Committee on Administrative
6 Rules, pursuant to the Illinois Administrative Procedure Act, a
7 proposed rule, or a proposed amendment to an existing rule,
8 regarding payment for appropriate services, including
9 assessment, care planning, discharge planning, and treatment
10 provided by nursing facilities to residents who have a serious
11 mental illness.
12 (Source: P.A. 95-331, eff. 8-21-07.)