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92_SB0161enr SB161 Enrolled LRB9203647DJtm 1 AN ACT in relation to 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 5-5.4 as follows: 6 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4) 7 Sec. 5-5.4. Standards of Payment - Department of Public 8 Aid. The Department of Public Aid shall develop standards of 9 payment of skilled nursing and intermediate care services in 10 facilities providing such services under this Article which: 11 (1) Provides for the determination of a facility's 12 payment for skilled nursing and intermediate care services on 13 a prospective basis. The amount of the payment rate for all 14 nursing facilities certified under the medical assistance 15 program shall be prospectively established annually on the 16 basis of historical, financial, and statistical data 17 reflecting actual costs from prior years, which shall be 18 applied to the current rate year and updated for inflation, 19 except that the capital cost element for newly constructed 20 facilities shall be based upon projected budgets. The 21 annually established payment rate shall take effect on July 1 22 in 1984 and subsequent years. Rate increases shall be 23 provided annually thereafter on July 1 in 1984 and on each 24 subsequent July 1 in the following years, except that no rate 25 increase and no update for inflation shall be provided on or 26 after July 1, 1994 and before July 1, 2001, unless 27 specifically provided for in this Section. 28 For facilities licensed by the Department of Public 29 Health under the Nursing Home Care Act as Intermediate Care 30 for the Developmentally Disabled facilities or Long Term Care 31 for Under Age 22 facilities, the rates taking effect on July SB161 Enrolled -2- LRB9203647DJtm 1 1, 1998 shall include an increase of 3%. For facilities 2 licensed by the Department of Public Health under the Nursing 3 Home Care Act as Skilled Nursing facilities or Intermediate 4 Care facilities, the rates taking effect on July 1, 1998 5 shall include an increase of 3% plus $1.10 per resident-day, 6 as defined by the Department. 7 For facilities licensed by the Department of Public 8 Health under the Nursing Home Care Act as Intermediate Care 9 for the Developmentally Disabled facilities or Long Term Care 10 for Under Age 22 facilities, the rates taking effect on July 11 1, 1999 shall include an increase of 1.6% plus $3.00 per 12 resident-day, as defined by the Department. For facilities 13 licensed by the Department of Public Health under the Nursing 14 Home Care Act as Skilled Nursing facilities or Intermediate 15 Care facilities, the rates taking effect on July 1, 1999 16 shall include an increase of 1.6% and, for services provided 17 on or after October 1, 1999, shall be increased by $4.00 per 18 resident-day, as defined by the Department. 19 For facilities licensed by the Department of Public 20 Health under the Nursing Home Care Act as Intermediate Care 21 for the Developmentally Disabled facilities or Long Term Care 22 for Under Age 22 facilities, the rates taking effect on July 23 1, 2000 shall include an increase of 2.5% per resident-day, 24 as defined by the Department. For facilities licensed by the 25 Department of Public Health under the Nursing Home Care Act 26 as Skilled Nursing facilities or Intermediate Care 27 facilities, the rates taking effect on July 1, 2000 shall 28 include an increase of 2.5% per resident-day, as defined by 29 the Department. 30 A Task Force on Long Term Care Funding is created for the 31 main purpose of examining new Medicaid reimbursement formulas 32 that more directly recognize the cost of care and patient 33 acuity levels for geriatric facilities, intermediate care 34 facilities for the developmentally disabled, skilled SB161 Enrolled -3- LRB9203647DJtm 1 pediatric facilities, and sheltered care facilities; the Task 2 Force is not limited to that purpose, however. The Task Force 3 shall make a report and recommendations to the Director of 4 Public Aid, the Secretary of Human Services, and the General 5 Assembly no later than April 1, 2002. The Task Force shall 6 consist of (i) one member appointed by the President of the 7 Senate, one member appointed by the Speaker of the House of 8 Representatives, one member appointed by the Minority Leader 9 of the Senate, and one member appointed by the Minority 10 Leader of the House of Representatives and (ii) the following 11 members appointed by the Director of Public Aid: a 12 representative designated by the Department of Public Aid, a 13 representative designated by the Department of Human 14 Services, a representative designated by the Department on 15 Aging, a representative designated by the AARP, a 16 representative designated by the Illinois Health Care 17 Association, a representative designated by the Illinois 18 Council on Long Term Care, a representative designated by 19 Life Services Network, a representative designated by the 20 County Nursing Home Association of Illinois, a representative 21 designated by the Illinois Nursing Home Administrators 22 Association, a representative designated by the Long Term 23 Care Nurses Association, and a representative from organized 24 labor that represents individuals employed in long term care 25 settings. The Director of Public Aid shall appoint the 26 representative from the Department of Public Aid as a 27 Co-Chairperson of the Task Force and shall appoint one of the 28 other members of the Task Force to serve as the other 29 Co-Chairperson. The second Co-Chairperson shall be a 30 representative from the private-sector membership on the Task 31 Force. The Department of Public Aid shall provide staff to 32 the Task Force. All Task Force members shall serve without 33 compensation but may be reimbursed for their necessary 34 expenses incurred in performing their duties. This paragraph SB161 Enrolled -4- LRB9203647DJtm 1 is inoperative after June 30, 2002. 2 Rates established effective each July 1 shall govern 3 payment for services rendered throughout that fiscal year, 4 except that rates established on July 1, 1996 shall be 5 increased by 6.8% for services provided on or after January 6 1, 1997. Such rates will be based upon the rates calculated 7 for the year beginning July 1, 1990, and for subsequent years 8 thereafter shall be based on the facility cost reports for 9 the facility fiscal year ending at any point in time during 10 the previous calendar year, updated to the midpoint of the 11 rate year The cost report shall be on file with the 12 Department no later than April 1 of the current rate year. 13 Should the cost report not be on file by April 1, the 14 Department shall base the rate on the latest cost report 15 filed by each skilled care facility and intermediate care 16 facility, updated to the midpoint of the current rate year. 17 In determining rates for services rendered on and after July 18 1, 1985, fixed time shall not be computed at less than zero. 19 The Department shall not make any alterations of regulations 20 which would reduce any component of the Medicaid rate to a 21 level below what that component would have been utilizing in 22 the rate effective on July 1, 1984. 23 (2) Shall take into account the actual costs incurred by 24 facilities in providing services for recipients of skilled 25 nursing and intermediate care services under the medical 26 assistance program. 27 (3) Shall take into account the medical and 28 psycho-social characteristics and needs of the patients. 29 (4) Shall take into account the actual costs incurred by 30 facilities in meeting licensing and certification standards 31 imposed and prescribed by the State of Illinois, any of its 32 political subdivisions or municipalities and by the U.S. 33 Department of Health and Human Services pursuant to Title XIX 34 of the Social Security Act. SB161 Enrolled -5- LRB9203647DJtm 1 The Department of Public Aid shall develop precise 2 standards for payments to reimburse nursing facilities for 3 any utilization of appropriate rehabilitative personnel for 4 the provision of rehabilitative services which is authorized 5 by federal regulations, including reimbursement for services 6 provided by qualified therapists or qualified assistants, and 7 which is in accordance with accepted professional practices. 8 Reimbursement also may be made for utilization of other 9 supportive personnel under appropriate supervision. 10 (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98; 91-24, 11 eff. 7-1-99; 91-712, eff. 7-1-00.) 12 Section 99. Effective date. This Act takes effect on 13 July 1, 2001.