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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 who 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 median DSP wage in Illinois is just $12.04 per | ||||||||||||||||||||||||
13 | hour, below the U.S. Department of Health and Human Services | ||||||||||||||||||||||||
14 | poverty threshold of $12.38 for a family of 4 and one out of | ||||||||||||||||||||||||
15 | every 4 DSP jobs in provider agencies are going unfilled; low | ||||||||||||||||||||||||
16 | wages often compel DSPs to work many overtime hours or hold | ||||||||||||||||||||||||
17 | down a second job to support their families; research by the | ||||||||||||||||||||||||
18 | American Network of Community Options and Resources (ANCOR), | ||||||||||||||||||||||||
19 | inclusive of Illinois, reveals 56% of DSPs rely on public | ||||||||||||||||||||||||
20 | assistance to make ends meet, creating additional expenditures | ||||||||||||||||||||||||
21 | for State government; low wages are a consequence of the | ||||||||||||||||||||||||
22 | historically low reimbursement rates paid by the State of | ||||||||||||||||||||||||
23 | Illinois to community-based service providers; and
| ||||||||||||||||||||||||
24 | WHEREAS, Starting wages at many provider agencies are |
| |||||||
| |||||||
1 | below $12 per hour, the scheduled state minimum wage rate as of | ||||||
2 | January
1, 2022; 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 | ||||||
7 | quality of services provided, higher wages are proven to | ||||||
8 | reduce staff turnover, improving stability and quality of | ||||||
9 | services while 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 | ||||||
14 | rely 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, A December 2020 report issued by an independent | ||||||
21 | consulting group commissioned by the State of Illinois to | ||||||
22 | propose changes to the State's reimbursement for community | ||||||
23 | disability agencies recommended that addressing DSP wages was |
| |||||||
| |||||||
1 | the number one priority for ensuring compliance with the | ||||||
2 | mandates of the Ligas Consent Decree, and further recommended | ||||||
3 | that wages for DSPs should be fixed at 150% of the prevailing | ||||||
4 | minimum wage plus additional funding for benefits; and | ||||||
5 | WHEREAS, The General Assembly finds that in order to | ||||||
6 | reduce turnover, increase retention, fill vacancies, and | ||||||
7 | ensure DSPs are adequately compensated for the critically | ||||||
8 | important work they do, an increase in rates and | ||||||
9 | reimbursements to community-based service providers to | ||||||
10 | effectuate an increase in the hourly wage paid to DSPs is | ||||||
11 | needed; and
| ||||||
12 | WHEREAS, It is the purpose of this Act to increase the | ||||||
13 | wages of DSPs in community disability agencies beyond the | ||||||
14 | poverty level and to a level competitive with rival employers | ||||||
15 | and above the State minimum wage, in an effort to improve the | ||||||
16 | lives of DSPs and the lives of the vulnerable persons they | ||||||
17 | support; and
| ||||||
18 | WHEREAS, It is the intent of the General Assembly to | ||||||
19 | ensure that all funds resulting from rate increases provided | ||||||
20 | to community disability agencies are allocated to front-line | ||||||
21 | employee compensation in order to address the current | ||||||
22 | workforce crisis which is the primary obstacle to the | ||||||
23 | availability of community-based services for people with |
| |||||||
| |||||||
1 | disabilities; therefore | ||||||
2 | Be it enacted by the People of the State of Illinois,
| ||||||
3 | represented in the General Assembly:
| ||||||
4 | Section 5. The Illinois Administrative Procedure Act is | ||||||
5 | amended by adding Section 5-45.8 as follows: | ||||||
6 | (5 ILCS 100/5-45.8 new) | ||||||
7 | Sec. 5-45.8. Emergency rulemaking; Departments of Human | ||||||
8 | Services and Healthcare and Family Services. To provide for | ||||||
9 | the expeditious and timely implementation of changes made by | ||||||
10 | this amendatory Act of the 102nd General Assembly to Section | ||||||
11 | 74 of the Mental Health and Developmental Disabilities | ||||||
12 | Administrative Act and to Sections 5-5.4 and 5-5.4i of the | ||||||
13 | Illinois Public Aid Code, emergency rules may be adopted in | ||||||
14 | accordance with Section 5-45 by the respective Department. The | ||||||
15 | adoption of emergency rules authorized by Section 5-45 and | ||||||
16 | this Section is deemed to be necessary for the public | ||||||
17 | interest, safety, and welfare. | ||||||
18 | This Section is repealed on January 1, 2026. | ||||||
19 | Section 10. The Mental Health and Developmental | ||||||
20 | Disabilities Administrative Act is amended by changing Section | ||||||
21 | 74 and by adding Section 55.5 as follows: |
| |||||||
| |||||||
1 | (20 ILCS 1705/55.5 new) | ||||||
2 | Sec. 55.5. Increased wages for front-line personnel. As | ||||||
3 | used in this Section, "front-line personnel" means direct | ||||||
4 | support persons, aides, front-line supervisors, qualified | ||||||
5 | intellectual disabilities professionals, nurses, and | ||||||
6 | non-administrative support staff working in service settings | ||||||
7 | outlined in this Section. | ||||||
8 | The Department shall establish reimbursement rates that | ||||||
9 | build toward livable wages for front-line personnel in | ||||||
10 | residential and day programs and service coordination agencies | ||||||
11 | serving persons with intellectual and developmental | ||||||
12 | disabilities under Section 54 of this Act, including, but not | ||||||
13 | limited to, intermediate care for the developmentally disabled | ||||||
14 | facilities, medically complex for the developmentally disabled | ||||||
15 | facilities, community-integrated living arrangements, | ||||||
16 | community day services, employment, and other residential and | ||||||
17 | day programs for persons with intellectual and developmental | ||||||
18 | disabilities supported by State funds or funding under Title | ||||||
19 | XIX of the federal Social Security Act. | ||||||
20 | The Department shall increase rates and reimbursements so | ||||||
21 | that by July 1, 2021 direct support persons wages shall be | ||||||
22 | increased by $2 per hour, and so that other front-line | ||||||
23 | personnel earn a commensurate wage. | ||||||
24 | (20 ILCS 1705/74) | ||||||
25 | Sec. 74. Rates and reimbursements. |
| |||||||
| |||||||
1 | (a) Within 30 days after July 6, 2017 (the effective date | ||||||
2 | of Public Act 100-23), the Department shall increase rates and | ||||||
3 | reimbursements to fund a minimum of a $0.75 per hour wage | ||||||
4 | increase for front-line personnel, including, but not limited | ||||||
5 | to, direct support persons, aides, front-line supervisors, | ||||||
6 | qualified intellectual disabilities professionals, nurses, and | ||||||
7 | non-administrative support staff working in community-based | ||||||
8 | provider organizations serving individuals with developmental | ||||||
9 | disabilities. The Department shall adopt rules, including | ||||||
10 | emergency rules under subsection (y) of Section 5-45 of the | ||||||
11 | Illinois Administrative Procedure Act, to implement the | ||||||
12 | provisions of this Section. | ||||||
13 | (b) Rates and reimbursements. Within 30 days after the | ||||||
14 | effective date of this amendatory Act of the 100th General | ||||||
15 | Assembly, the Department shall increase rates and | ||||||
16 | reimbursements to fund a minimum of a $0.50 per hour wage | ||||||
17 | increase for front-line personnel, including, but not limited | ||||||
18 | to, direct support persons, aides, front-line supervisors, | ||||||
19 | qualified intellectual disabilities professionals, nurses, and | ||||||
20 | non-administrative support staff working in community-based | ||||||
21 | provider organizations serving individuals with developmental | ||||||
22 | disabilities. The Department shall adopt rules, including | ||||||
23 | emergency rules under subsection (bb) of Section 5-45 of the | ||||||
24 | Illinois Administrative Procedure Act, to implement the | ||||||
25 | provisions of this Section. | ||||||
26 | (c) 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 June 30, 2019 | ||||||
4 | for community-based providers for persons with Developmental | ||||||
5 | Disabilities by 3.5% The Department shall adopt rules, | ||||||
6 | including emergency rules under subsection (jj) of Section | ||||||
7 | 5-45 of the Illinois Administrative Procedure Act, to | ||||||
8 | implement the provisions of this Section, including wage | ||||||
9 | increases for direct care staff.
| ||||||
10 | (d) Rates and reimbursements. Within 30 days after the | ||||||
11 | effective date of this amendatory Act of the 102nd General | ||||||
12 | Assembly, subject to federal approval, the Department shall | ||||||
13 | increase rates and reimbursements in effect on January 1, | ||||||
14 | 2021, for community-based providers for persons with | ||||||
15 | developmental disabilities in order to fund a minimum $2 per | ||||||
16 | hour wage increase. The Department shall adopt rules, | ||||||
17 | including emergency rules under the Illinois Administrative | ||||||
18 | Procedure Act, to implement the provisions of this Section, | ||||||
19 | and require employers to certify that
funds are allocated to | ||||||
20 | wage increases for direct care staff. | ||||||
21 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||
22 | 101-10, eff. 6-5-19.) | ||||||
23 | Section 15. The Illinois Public Aid Code is amended by | ||||||
24 | changing Sections 5-5.4 and 5-5.4i as follows:
|
| |||||||
| |||||||
1 | (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
| ||||||
2 | Sec. 5-5.4. Standards of Payment - Department of | ||||||
3 | Healthcare and Family Services.
The Department of Healthcare | ||||||
4 | and Family Services shall develop standards of payment of
| ||||||
5 | nursing facility and ICF/DD services in facilities providing | ||||||
6 | such services
under this Article which:
| ||||||
7 | (1) Provide for the determination of a facility's payment
| ||||||
8 | for nursing facility or ICF/DD services on a prospective | ||||||
9 | basis.
The amount of the payment rate for all nursing | ||||||
10 | facilities certified by the
Department of Public Health under | ||||||
11 | the ID/DD Community Care Act or the Nursing Home Care Act as | ||||||
12 | Intermediate
Care for the Developmentally Disabled facilities, | ||||||
13 | Long Term Care for Under Age
22 facilities, Skilled Nursing | ||||||
14 | facilities, or Intermediate Care facilities
under the
medical | ||||||
15 | assistance program shall be prospectively established annually | ||||||
16 | on the
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 annually | ||||||
21 | established
payment rate shall take effect on July 1 in 1984 | ||||||
22 | and subsequent years. No rate
increase and no
update for | ||||||
23 | inflation shall be provided on or after July 1, 1994, unless | ||||||
24 | specifically provided for in this
Section.
The changes made by | ||||||
25 | Public Act 93-841
extending the duration of the prohibition | ||||||
26 | against a rate increase or update for inflation are effective |
| |||||||
| |||||||
1 | retroactive to July 1, 2004.
| ||||||
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 | ||||||
5 | Under Age 22 facilities, the rates taking effect on July
1, | ||||||
6 | 1998 shall include an increase of 3%. For facilities licensed | ||||||
7 | by the
Department of Public Health under the Nursing Home Care | ||||||
8 | Act as Skilled Nursing
facilities or Intermediate Care | ||||||
9 | facilities, the rates taking effect on July 1,
1998 shall | ||||||
10 | include an increase of 3% plus $1.10 per resident-day, as | ||||||
11 | defined by
the Department. For facilities licensed by the | ||||||
12 | Department of Public Health under the Nursing Home Care Act as | ||||||
13 | Intermediate Care Facilities for the Developmentally Disabled | ||||||
14 | or Long Term Care for Under Age 22 facilities, the rates taking | ||||||
15 | effect on January 1, 2006 shall include an increase of 3%.
For | ||||||
16 | facilities licensed by the Department of Public Health under | ||||||
17 | the Nursing Home Care Act as Intermediate Care Facilities for | ||||||
18 | the Developmentally Disabled or Long Term Care for Under Age | ||||||
19 | 22 facilities, the rates taking effect on January 1, 2009 | ||||||
20 | shall include an increase sufficient to provide a $0.50 per | ||||||
21 | hour wage increase for non-executive staff. For facilities | ||||||
22 | licensed by the Department of Public Health under the ID/DD | ||||||
23 | Community Care Act as ID/DD Facilities the rates taking effect | ||||||
24 | within 30 days after July 6, 2017 (the effective date of Public | ||||||
25 | Act 100-23) shall include an increase sufficient to provide a | ||||||
26 | $0.75 per hour wage increase for non-executive staff. The |
| |||||||
| |||||||
1 | Department shall adopt rules, including emergency rules under | ||||||
2 | subsection (y) of Section 5-45 of the Illinois Administrative | ||||||
3 | Procedure Act, to implement the provisions of this paragraph. | ||||||
4 | For facilities licensed by the Department of Public Health | ||||||
5 | under the ID/DD Community Care Act as ID/DD Facilities and | ||||||
6 | under the MC/DD Act as MC/DD Facilities, the rates taking | ||||||
7 | effect within 30 days after the effective date of this | ||||||
8 | amendatory Act of the 100th General Assembly shall include an | ||||||
9 | increase sufficient to provide a $0.50 per hour wage increase | ||||||
10 | for non-executive front-line personnel, including, but not | ||||||
11 | limited to, direct support persons, aides, front-line | ||||||
12 | supervisors, qualified intellectual disabilities | ||||||
13 | professionals, nurses, and non-administrative support staff. | ||||||
14 | The Department shall adopt rules, including emergency rules | ||||||
15 | under subsection (bb) of Section 5-45 of the Illinois | ||||||
16 | Administrative Procedure Act, to implement the provisions of | ||||||
17 | this paragraph. | ||||||
18 | For facilities licensed by the Department of Public Health | ||||||
19 | under the ID/DD Community Care Act as ID/DD facilities and | ||||||
20 | under the MC/DD Act as MC/DD facilities, the rates taking | ||||||
21 | effect within 30 days after the effective date of this | ||||||
22 | amendatory Act of the 102nd General Assembly shall include an | ||||||
23 | increase sufficient to provide a $2 per hour wage increase for | ||||||
24 | non-executive front-line personnel, including, but not limited | ||||||
25 | to, direct support persons, aides, front-line supervisors, | ||||||
26 | qualified intellectual disabilities professionals, nurses, and |
| |||||||
| |||||||
1 | non-administrative support staff. The Department shall adopt | ||||||
2 | rules, including emergency rules under the Illinois | ||||||
3 | Administrative Procedure Act, to implement the provisions of | ||||||
4 | this paragraph and ensure funds are allocated to compensation | ||||||
5 | increases for direct care staff. | ||||||
6 | For facilities licensed by the Department of Public Health | ||||||
7 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
8 | Developmentally Disabled
facilities or Long Term Care for | ||||||
9 | Under Age 22 facilities, the rates taking
effect on July 1, | ||||||
10 | 1999 shall include an increase of 1.6% plus $3.00 per
| ||||||
11 | resident-day, as defined by the Department. For facilities | ||||||
12 | licensed by the
Department of Public Health under the Nursing | ||||||
13 | Home Care Act as Skilled Nursing
facilities or Intermediate | ||||||
14 | Care facilities, the rates taking effect on July 1,
1999 shall | ||||||
15 | include an increase of 1.6% and, for services provided on or | ||||||
16 | after
October 1, 1999, shall be increased by $4.00 per | ||||||
17 | resident-day, as defined by
the Department.
| ||||||
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 | ||||||
21 | Under Age 22 facilities, the rates taking
effect on July 1, | ||||||
22 | 2000 shall include an increase of 2.5% per resident-day,
as | ||||||
23 | defined by the Department. For facilities licensed by the | ||||||
24 | Department of
Public Health under the Nursing Home Care Act as | ||||||
25 | Skilled Nursing facilities or
Intermediate Care facilities, | ||||||
26 | the rates taking effect on July 1, 2000 shall
include an |
| |||||||
| |||||||
1 | increase of 2.5% per resident-day, as defined by the | ||||||
2 | Department.
| ||||||
3 | For facilities licensed by the Department of Public Health | ||||||
4 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
5 | or intermediate care
facilities, a new payment methodology | ||||||
6 | must be implemented for the nursing
component of the rate | ||||||
7 | effective July 1, 2003. The Department of Public Aid
(now | ||||||
8 | Healthcare and Family Services) shall develop the new payment | ||||||
9 | methodology using the Minimum Data Set
(MDS) as the instrument | ||||||
10 | to collect information concerning nursing home
resident | ||||||
11 | condition necessary to compute the rate. The Department
shall | ||||||
12 | develop the new payment methodology to meet the unique needs | ||||||
13 | of
Illinois nursing home residents while remaining subject to | ||||||
14 | the appropriations
provided by the General Assembly.
A | ||||||
15 | transition period from the payment methodology in effect on | ||||||
16 | June 30, 2003
to the payment methodology in effect on July 1, | ||||||
17 | 2003 shall be provided for a
period not exceeding 3 years and | ||||||
18 | 184 days after implementation of the new payment
methodology | ||||||
19 | as follows:
| ||||||
20 | (A) For a facility that would receive a lower
nursing | ||||||
21 | component rate per patient day under the new system than | ||||||
22 | the facility
received
effective on the date immediately | ||||||
23 | preceding the date that the Department
implements the new | ||||||
24 | payment methodology, the nursing component rate per | ||||||
25 | patient
day for the facility
shall be held at
the level in | ||||||
26 | effect on the date immediately preceding the date that the
|
| |||||||
| |||||||
1 | Department implements the new payment methodology until a | ||||||
2 | higher nursing
component rate of
reimbursement is achieved | ||||||
3 | by that
facility.
| ||||||
4 | (B) For a facility that would receive a higher nursing | ||||||
5 | component rate per
patient day under the payment | ||||||
6 | methodology in effect on July 1, 2003 than the
facility | ||||||
7 | received effective on the date immediately preceding the | ||||||
8 | date that the
Department implements the new payment | ||||||
9 | methodology, the nursing component rate
per patient day | ||||||
10 | for the facility shall be adjusted.
| ||||||
11 | (C) Notwithstanding paragraphs (A) and (B), the | ||||||
12 | nursing component rate per
patient day for the facility | ||||||
13 | shall be adjusted subject to appropriations
provided by | ||||||
14 | the General Assembly.
| ||||||
15 | For facilities licensed by the Department of Public Health | ||||||
16 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
17 | Developmentally Disabled
facilities or Long Term Care for | ||||||
18 | Under Age 22 facilities, the rates taking
effect on March 1, | ||||||
19 | 2001 shall include a statewide increase of 7.85%, as
defined | ||||||
20 | by the Department.
| ||||||
21 | Notwithstanding any other provision of this Section, for | ||||||
22 | facilities licensed by the Department of Public Health under | ||||||
23 | the
Nursing Home Care Act as skilled nursing facilities or | ||||||
24 | intermediate care
facilities, except facilities participating | ||||||
25 | in the Department's demonstration program pursuant to the | ||||||
26 | provisions of Title 77, Part 300, Subpart T of the Illinois |
| |||||||
| |||||||
1 | Administrative Code, the numerator of the ratio used by the | ||||||
2 | Department of Healthcare and Family Services to compute the | ||||||
3 | rate payable under this Section using the Minimum Data Set | ||||||
4 | (MDS) methodology shall incorporate the following annual | ||||||
5 | amounts as the additional funds appropriated to the Department | ||||||
6 | specifically to pay for rates based on the MDS nursing | ||||||
7 | component methodology in excess of the funding in effect on | ||||||
8 | December 31, 2006: | ||||||
9 | (i) For rates taking effect January 1, 2007, | ||||||
10 | $60,000,000. | ||||||
11 | (ii) For rates taking effect January 1, 2008, | ||||||
12 | $110,000,000. | ||||||
13 | (iii) For rates taking effect January 1, 2009, | ||||||
14 | $194,000,000. | ||||||
15 | (iv) For rates taking effect April 1, 2011, or the | ||||||
16 | first day of the month that begins at least 45 days after | ||||||
17 | the effective date of this amendatory Act of the 96th | ||||||
18 | General Assembly, $416,500,000 or an amount as may be | ||||||
19 | necessary to complete the transition to the MDS | ||||||
20 | methodology for the nursing component of the rate. | ||||||
21 | Increased payments under this item (iv) are not due and | ||||||
22 | payable, however, until (i) the methodologies described in | ||||||
23 | this paragraph are approved by the federal government in | ||||||
24 | an appropriate State Plan amendment and (ii) the | ||||||
25 | assessment imposed by Section 5B-2 of this Code is | ||||||
26 | determined to be a permissible tax under Title XIX of the |
| |||||||
| |||||||
1 | Social Security Act. | ||||||
2 | Notwithstanding any other provision of this Section, for | ||||||
3 | facilities licensed by the Department of Public Health under | ||||||
4 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
5 | intermediate care facilities, the support component of the | ||||||
6 | rates taking effect on January 1, 2008 shall be computed using | ||||||
7 | the most recent cost reports on file with the Department of | ||||||
8 | Healthcare and Family Services no later than April 1, 2005, | ||||||
9 | updated for inflation to January 1, 2006. | ||||||
10 | For facilities licensed by the Department of Public Health | ||||||
11 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
12 | Developmentally Disabled
facilities or Long Term Care for | ||||||
13 | Under Age 22 facilities, the rates taking
effect on April 1, | ||||||
14 | 2002 shall include a statewide increase of 2.0%, as
defined by | ||||||
15 | the Department.
This increase terminates on July 1, 2002;
| ||||||
16 | beginning July 1, 2002 these rates are reduced to the level of | ||||||
17 | the rates
in effect on March 31, 2002, as defined by the | ||||||
18 | Department.
| ||||||
19 | For facilities licensed by the Department of Public Health | ||||||
20 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
21 | or intermediate care
facilities, the rates taking effect on | ||||||
22 | July 1, 2001 shall be computed using the most recent cost | ||||||
23 | reports
on file with the Department of Public Aid no later than | ||||||
24 | April 1, 2000,
updated for inflation to January 1, 2001. For | ||||||
25 | rates effective July 1, 2001
only, rates shall be the greater | ||||||
26 | of the rate computed for July 1, 2001
or the rate effective on |
| |||||||
| |||||||
1 | June 30, 2001.
| ||||||
2 | Notwithstanding any other provision of this Section, for | ||||||
3 | facilities
licensed by the Department of Public Health under | ||||||
4 | the Nursing Home Care Act
as skilled nursing facilities or | ||||||
5 | intermediate care facilities, the Illinois
Department shall | ||||||
6 | determine by rule the rates taking effect on July 1, 2002,
| ||||||
7 | which shall be 5.9% less than the rates in effect on June 30, | ||||||
8 | 2002.
| ||||||
9 | Notwithstanding any other provision of this Section, for | ||||||
10 | facilities
licensed by the Department of Public Health under | ||||||
11 | the Nursing Home Care Act as
skilled nursing
facilities or | ||||||
12 | intermediate care facilities, if the payment methodologies | ||||||
13 | required under Section 5A-12 and the waiver granted under 42 | ||||||
14 | CFR 433.68 are approved by the United States Centers for | ||||||
15 | Medicare and Medicaid Services, the rates taking effect on | ||||||
16 | July 1, 2004 shall be 3.0% greater than the rates in effect on | ||||||
17 | June 30, 2004. These rates shall take
effect only upon | ||||||
18 | approval and
implementation of the payment methodologies | ||||||
19 | required under Section 5A-12.
| ||||||
20 | Notwithstanding any other provisions 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, the rates taking effect on | ||||||
24 | January 1, 2005 shall be 3% more than the rates in effect on | ||||||
25 | December 31, 2004.
| ||||||
26 | Notwithstanding any other provision of this Section, for |
| |||||||
| |||||||
1 | facilities licensed by the Department of Public Health under | ||||||
2 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
3 | intermediate care facilities, effective January 1, 2009, the | ||||||
4 | per diem support component of the rates effective on January | ||||||
5 | 1, 2008, computed using the most recent cost reports on file | ||||||
6 | with the Department of Healthcare and Family Services no later | ||||||
7 | than April 1, 2005, updated for inflation to January 1, 2006, | ||||||
8 | shall be increased to the amount that would have been derived | ||||||
9 | using standard Department of Healthcare and Family Services | ||||||
10 | methods, procedures, and inflators. | ||||||
11 | Notwithstanding any other provisions of this Section, for | ||||||
12 | facilities licensed by the Department of Public Health under | ||||||
13 | the Nursing Home Care Act as intermediate care facilities that | ||||||
14 | are federally defined as Institutions for Mental Disease, or | ||||||
15 | facilities licensed by the Department of Public Health under | ||||||
16 | the Specialized Mental Health Rehabilitation Act of 2013, a | ||||||
17 | socio-development component rate equal to 6.6% of the | ||||||
18 | facility's nursing component rate as of January 1, 2006 shall | ||||||
19 | be established and paid effective July 1, 2006. The | ||||||
20 | socio-development component of the rate shall be increased by | ||||||
21 | a factor of 2.53 on the first day of the month that begins at | ||||||
22 | least 45 days after January 11, 2008 (the effective date of | ||||||
23 | Public Act 95-707). As of August 1, 2008, the | ||||||
24 | socio-development component rate shall be equal to 6.6% of the | ||||||
25 | facility's nursing component rate as of January 1, 2006, | ||||||
26 | multiplied by a factor of 3.53. For services provided on or |
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1 | after April 1, 2011, or the first day of the month that begins | ||||||
2 | at least 45 days after the effective date of this amendatory | ||||||
3 | Act of the 96th General Assembly, whichever is later, the | ||||||
4 | Illinois Department may by rule adjust these socio-development | ||||||
5 | component rates, and may use different adjustment | ||||||
6 | methodologies for those facilities participating, and those | ||||||
7 | not participating, in the Illinois Department's demonstration | ||||||
8 | program pursuant to the provisions of Title 77, Part 300, | ||||||
9 | Subpart T of the Illinois Administrative Code, but in no case | ||||||
10 | may such rates be diminished below those in effect on August 1, | ||||||
11 | 2008.
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12 | For facilities
licensed
by the
Department of Public Health | ||||||
13 | under the Nursing Home Care Act as Intermediate
Care for
the | ||||||
14 | Developmentally Disabled facilities or as long-term care | ||||||
15 | facilities for
residents under 22 years of age, the rates | ||||||
16 | taking effect on July 1,
2003 shall
include a statewide | ||||||
17 | increase of 4%, as defined by the Department.
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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 | ||||||
21 | Under Age 22 facilities, the rates taking
effect on the first | ||||||
22 | day of the month that begins at least 45 days after the | ||||||
23 | effective date of this amendatory Act of the 95th General | ||||||
24 | Assembly shall include a statewide increase of 2.5%, as
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25 | defined by the Department. | ||||||
26 | Notwithstanding any other provision of this Section, for |
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1 | facilities licensed by the Department of Public Health under | ||||||
2 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
3 | intermediate care facilities, effective January 1, 2005, | ||||||
4 | facility rates shall be increased by the difference between | ||||||
5 | (i) a facility's per diem property, liability, and malpractice | ||||||
6 | insurance costs as reported in the cost report filed with the | ||||||
7 | Department of Public Aid and used to establish rates effective | ||||||
8 | July 1, 2001 and (ii) those same costs as reported in the | ||||||
9 | facility's 2002 cost report. These costs shall be passed | ||||||
10 | through to the facility without caps or limitations, except | ||||||
11 | for adjustments required under normal auditing procedures.
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12 | Rates established effective each July 1 shall govern | ||||||
13 | payment
for services rendered throughout that fiscal year, | ||||||
14 | except that rates
established on July 1, 1996 shall be | ||||||
15 | increased by 6.8% for services
provided on or after January 1, | ||||||
16 | 1997. Such rates will be based
upon the rates calculated for | ||||||
17 | the year beginning July 1, 1990, and for
subsequent years | ||||||
18 | thereafter until June 30, 2001 shall be based on the
facility | ||||||
19 | cost reports
for the facility fiscal year ending at any point | ||||||
20 | in time during the previous
calendar year, updated to the | ||||||
21 | midpoint of the rate year. The cost report
shall be on file | ||||||
22 | with the Department no later than April 1 of the current
rate | ||||||
23 | year. Should the cost report not be on file by April 1, the | ||||||
24 | Department
shall base the rate on the latest cost report filed | ||||||
25 | by each skilled care
facility and intermediate care facility, | ||||||
26 | updated to the midpoint of the
current rate year. In |
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1 | determining rates for services rendered on and after
July 1, | ||||||
2 | 1985, fixed time shall not be computed at less than zero. The
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3 | Department shall not make any alterations of regulations which | ||||||
4 | would reduce
any component of the Medicaid rate to a level | ||||||
5 | below what that component would
have been utilizing in the | ||||||
6 | rate effective on July 1, 1984.
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7 | (2) Shall take into account the actual costs incurred by | ||||||
8 | facilities
in providing services for recipients of skilled | ||||||
9 | nursing and intermediate
care services under the medical | ||||||
10 | assistance program.
| ||||||
11 | (3) Shall take into account the medical and psycho-social
| ||||||
12 | characteristics and needs of the patients.
| ||||||
13 | (4) Shall take into account the actual costs incurred by | ||||||
14 | facilities in
meeting licensing and certification standards | ||||||
15 | imposed and prescribed by the
State of Illinois, any of its | ||||||
16 | political subdivisions or municipalities and by
the U.S. | ||||||
17 | Department of Health and Human Services pursuant to Title XIX | ||||||
18 | of the
Social Security Act.
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19 | The Department of Healthcare and Family Services
shall | ||||||
20 | develop precise standards for
payments to reimburse nursing | ||||||
21 | facilities for any utilization of
appropriate rehabilitative | ||||||
22 | personnel for the provision of rehabilitative
services which | ||||||
23 | is authorized by federal regulations, including
reimbursement | ||||||
24 | for services provided by qualified therapists or qualified
| ||||||
25 | assistants, and which is in accordance with accepted | ||||||
26 | professional
practices. Reimbursement also may be made for |
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| |||||||
1 | utilization of other
supportive personnel under appropriate | ||||||
2 | supervision.
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3 | The Department shall develop enhanced payments to offset | ||||||
4 | the additional costs incurred by a
facility serving | ||||||
5 | exceptional need residents and shall allocate at least | ||||||
6 | $4,000,000 of the funds
collected from the assessment | ||||||
7 | established by Section 5B-2 of this Code for such payments. | ||||||
8 | For
the purpose of this Section, "exceptional needs" means, | ||||||
9 | but need not be limited to, ventilator care and traumatic | ||||||
10 | brain injury care. The enhanced payments for exceptional need | ||||||
11 | residents under this paragraph are not due and payable, | ||||||
12 | however, until (i) the methodologies described in this | ||||||
13 | paragraph are approved by the federal government in an | ||||||
14 | appropriate State Plan amendment and (ii) the assessment | ||||||
15 | imposed by Section 5B-2 of this Code is determined to be a | ||||||
16 | permissible tax under Title XIX of the Social Security Act. | ||||||
17 | Beginning January 1, 2014 the methodologies for | ||||||
18 | reimbursement of nursing facility services as provided under | ||||||
19 | this Section 5-5.4 shall no longer be applicable for services | ||||||
20 | provided on or after January 1, 2014. | ||||||
21 | No payment increase under this Section for the MDS | ||||||
22 | methodology, exceptional care residents, or the | ||||||
23 | socio-development component rate established by Public Act | ||||||
24 | 96-1530 of the 96th General Assembly and funded by the | ||||||
25 | assessment imposed under Section 5B-2 of this Code shall be | ||||||
26 | due and payable until after the Department notifies the |
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| |||||||
1 | long-term care providers, in writing, that the payment | ||||||
2 | methodologies to long-term care providers required under this | ||||||
3 | Section have been approved by the Centers for Medicare and | ||||||
4 | Medicaid Services of the U.S. Department of Health and Human | ||||||
5 | Services and the waivers under 42 CFR 433.68 for the | ||||||
6 | assessment imposed by this Section, if necessary, have been | ||||||
7 | granted by the Centers for Medicare and Medicaid Services of | ||||||
8 | the U.S. Department of Health and Human Services. Upon | ||||||
9 | notification to the Department of approval of the payment | ||||||
10 | methodologies required under this Section and the waivers | ||||||
11 | granted under 42 CFR 433.68, all increased payments otherwise | ||||||
12 | due under this Section prior to the date of notification shall | ||||||
13 | be due and payable within 90 days of the date federal approval | ||||||
14 | is received. | ||||||
15 | On and after July 1, 2012, the Department shall reduce any | ||||||
16 | rate of reimbursement for services or other payments or alter | ||||||
17 | any methodologies authorized by this Code to reduce any rate | ||||||
18 | of reimbursement for services or other payments in accordance | ||||||
19 | with Section 5-5e. | ||||||
20 | For facilities licensed by the Department of Public Health | ||||||
21 | under the ID/DD Community Care Act as ID/DD Facilities and | ||||||
22 | under the MC/DD Act as MC/DD Facilities, subject to federal | ||||||
23 | approval, the rates taking effect for services delivered on or | ||||||
24 | after August 1, 2019 shall be increased by 3.5% over the rates | ||||||
25 | in effect on June 30, 2019. The Department shall adopt rules, | ||||||
26 | including emergency rules under subsection (ii) of Section |
| |||||||
| |||||||
1 | 5-45 of the Illinois Administrative Procedure Act, to | ||||||
2 | implement the provisions of this Section, including wage | ||||||
3 | increases for direct care staff. | ||||||
4 | For facilities licensed by the Department of Public Health | ||||||
5 | under the ID/DD Community Care Act as ID/DD Facilities and | ||||||
6 | under the MC/DD Act as MC/DD Facilities, subject to federal | ||||||
7 | approval, the rates taking effect on the latter of the | ||||||
8 | approval date of the State Plan Amendment for these facilities | ||||||
9 | or the Waiver Amendment for the home and community-based | ||||||
10 | services settings shall include an increase sufficient to | ||||||
11 | provide a $0.26 per hour wage increase to the base wage for | ||||||
12 | non-executive staff. The Department shall adopt rules, | ||||||
13 | including emergency rules as authorized by Section 5-45 of the | ||||||
14 | Illinois Administrative Procedure Act, to implement the | ||||||
15 | provisions of
this Section, including wage increases for | ||||||
16 | direct care staff. | ||||||
17 | For facilities licensed by the Department of Public Health | ||||||
18 | under the ID/DD Community Care Act as ID/DD Facilities and | ||||||
19 | under the MC/DD Act as MC/DD Facilities, subject to federal | ||||||
20 | approval of the State Plan Amendment and the Waiver Amendment | ||||||
21 | for the home and community-based services settings, the rates | ||||||
22 | taking effect for the services delivered on or after July 1, | ||||||
23 | 2020 shall include an increase sufficient to provide a $1.00 | ||||||
24 | per hour wage increase for non-executive staff. For services | ||||||
25 | delivered on or after January 1, 2021, subject to federal | ||||||
26 | approval of the State Plan Amendment and the Waiver Amendment |
| |||||||
| |||||||
1 | for the home and community-based services settings, shall | ||||||
2 | include an increase sufficient to provide a $0.50 per hour | ||||||
3 | increase for non-executive staff. The Department shall adopt | ||||||
4 | rules, including emergency rules as authorized by Section 5-45 | ||||||
5 | of the Illinois Administrative Procedure Act, to implement the | ||||||
6 | provisions of this Section, including wage increases for | ||||||
7 | direct care staff. | ||||||
8 | For facilities licensed by the Department of Public Health | ||||||
9 | under the ID/DD Community Care Act as ID/DD facilities and | ||||||
10 | under the MC/DD Act as MC/DD facilities, subject to federal | ||||||
11 | approval, the rates taking effect for services delivered on or | ||||||
12 | after January 1, 2021, shall be increased sufficiently to | ||||||
13 | provide at a minimum $2 per hour wage increase over the wages | ||||||
14 | in effect on January 1, 2021. The Department shall adopt | ||||||
15 | rules, including emergency rules under the Illinois | ||||||
16 | Administrative Procedure Act, to implement the provisions of | ||||||
17 | this Section, and ensure funds are allocated to compensation | ||||||
18 | increases for direct care staff. | ||||||
19 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||
20 | 101-10, eff. 6-5-19; 101-636, eff. 6-10-20.) | ||||||
21 | (305 ILCS 5/5-5.4i) | ||||||
22 | Sec. 5-5.4i. Rates and reimbursements. | ||||||
23 | (a) Within 30 days after July 6, 2017 (the effective date | ||||||
24 | of Public Act 100-23), the Department shall increase rates and | ||||||
25 | reimbursements to fund a minimum of a $0.75 per hour wage |
| |||||||
| |||||||
1 | increase for front-line personnel, including, but not limited | ||||||
2 | to, direct support persons, aides, front-line supervisors, | ||||||
3 | qualified intellectual disabilities professionals, nurses, and | ||||||
4 | non-administrative support staff working in community-based | ||||||
5 | provider organizations serving individuals with developmental | ||||||
6 | disabilities. The Department shall adopt rules, including | ||||||
7 | emergency rules under subsection (y) of Section 5-45 of the | ||||||
8 | Illinois Administrative Procedure Act, to implement the | ||||||
9 | provisions of this Section. | ||||||
10 | (b) Within 30 days after June 4, 2018 (the effective date | ||||||
11 | of Public Act 100-587), the Department shall increase rates | ||||||
12 | and reimbursements to fund a minimum of a $0.50 per hour wage | ||||||
13 | increase for 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 working in community-based | ||||||
17 | provider organizations serving individuals with developmental | ||||||
18 | disabilities. The Department shall adopt rules, including | ||||||
19 | emergency rules under subsection (bb) of Section 5-45 of the | ||||||
20 | Illinois Administrative Procedure Act, to implement the | ||||||
21 | provisions of this Section. | ||||||
22 | (c) Within 30 days after the effective date of this | ||||||
23 | amendatory Act of the 101st General Assembly, subject to | ||||||
24 | federal approval, the Department shall increase rates and | ||||||
25 | reimbursements in effect on June 30, 2019 for community-based | ||||||
26 | providers for persons with Developmental Disabilities by 3.5%. |
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1 | The Department shall adopt rules, including emergency rules | ||||||||||||||||||||||||||||||||||||||||||||||||||
2 | under subsection (ii) of Section 5-45 of the Illinois | ||||||||||||||||||||||||||||||||||||||||||||||||||
3 | Administrative Procedure Act, to implement the provisions of | ||||||||||||||||||||||||||||||||||||||||||||||||||
4 | this Section, including wage increases for direct care staff.
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5 | (d) Within 30 days after the effective date of this | ||||||||||||||||||||||||||||||||||||||||||||||||||
6 | amendatory Act of the 102nd General Assembly, subject to | ||||||||||||||||||||||||||||||||||||||||||||||||||
7 | federal approval, the Department shall increase rates and | ||||||||||||||||||||||||||||||||||||||||||||||||||
8 | reimbursements in effect on January 1, 2021 for | ||||||||||||||||||||||||||||||||||||||||||||||||||
9 | community-based providers for persons with developmental | ||||||||||||||||||||||||||||||||||||||||||||||||||
10 | disabilities in order to fund a minimum $2 per hour wage | ||||||||||||||||||||||||||||||||||||||||||||||||||
11 | increase. The Department shall adopt rules, including | ||||||||||||||||||||||||||||||||||||||||||||||||||
12 | emergency rules under the Illinois Administrative Procedure | ||||||||||||||||||||||||||||||||||||||||||||||||||
13 | Act, to implement the provisions of this Section, and ensure | ||||||||||||||||||||||||||||||||||||||||||||||||||
14 | funds are allocated to compensation increases for direct care | ||||||||||||||||||||||||||||||||||||||||||||||||||
15 | staff. | ||||||||||||||||||||||||||||||||||||||||||||||||||
16 | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; | ||||||||||||||||||||||||||||||||||||||||||||||||||
17 | 101-10, eff. 6-5-19.)
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18 | Section 99. Effective date. This Act takes effect upon | ||||||||||||||||||||||||||||||||||||||||||||||||||
19 | becoming law.
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