102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB3607

 

Introduced 1/19/2022, by Sen. Celina Villanueva

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 100/5-45.21 new
20 ILCS 1705/55.5 new
20 ILCS 1705/74
305 ILCS 5/5-5.4  from Ch. 23, par. 5-5.4
305 ILCS 5/5-5.4i

    Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Human Services to establish reimbursement rates that build toward livable wages for front-line personnel in residential and day programs and service coordination agencies serving persons with intellectual and developmental disabilities. Provides that for community-based providers serving persons with intellectual or developmental disabilities, subject to federal approval, the rates taking effect for services delivered on or after July 1, 2022 shall be increased sufficiently to: (i) provide a minimum $3.50 per hour wage increase over the wages in effect on June 30, 2022 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support personnel, at the U.S. Department of Labor's average wage as defined, by rule, by the Department. Amends the Illinois Public Aid Code. Provides that for ID/DD facilities and MC/DD facilities, the rates taking effect for services delivered on or after July 1, 2022, shall be increased sufficiently to: (i) provide a minimum $3.50 per hour wage increase over the wages in effect on June 30, 2022 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support personnel, at the U.S. Department of Labor's average wage as defined, by rule, by the Department. Requires the same increase for front-line personnel employed at community-based providers serving persons with intellectual or developmental disabilities. Amends the Illinois Administrative Procedure Act. Grants the Departments of Human Services and Healthcare and Family Services emergency rulemaking authority. Effective immediately.


LRB102 23780 KTG 32971 b

 

 

A BILL FOR

 

SB3607LRB102 23780 KTG 32971 b

1    AN ACT concerning care for persons with developmental
2disabilities.
 
3    Be it enacted by the People of the State of Illinois,
4represented in the General Assembly:
 
5    Section 1. This Act may be referred to as the Community
6Disability Living Wage Act.
 
7    Section 2. Findings.
8        (1) An estimated 27,000 children and adults with
9    intellectual and developmental disabilities are supported
10    in community-based settings in Illinois; direct support
11    persons (DSPs), are trained paraprofessional staff who are
12    engaged in activities of daily living and community
13    support; too many of these employees earn wages that place
14    them and their families below the poverty level.
15         (2) According to the most recent Illinois industry
16    surveys, the median DSP wage in Illinois is just $12.04
17    per hour, below the U.S. Department of Health and Human
18    Services poverty threshold of $12.60 for a family of 4 and
19    one out of every 4 DSP jobs in provider agencies are going
20    unfilled; low wages often compel DSPs to work many
21    overtime hours or hold down a second job to support their
22    families; research by the American Network of Community
23    Options and Resources (ANCOR), inclusive of Illinois,

 

 

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1    reveals 56% of DSPs rely on public assistance to make ends
2    meet, creating additional expenditures for State
3    government; low wages are a consequence of the
4    historically low reimbursement rates paid by the State of
5    Illinois to community-based service providers.
6        (3) Starting wages at many provider agencies are below
7    $12 per hour, the scheduled State minimum wage rate as of
8    January 1, 2022.
9        (4) The lack of adequate wages for employees who
10    perform the challenging work of supporting persons with
11    intellectual and developmental disabilities results in
12    high employee turnover, which in turn negatively impacts
13    the quality of services provided, higher wages are proven
14    to reduce staff turnover, improving stability and quality
15    of services while reducing employer training costs.
16         (5) Rising wages in other sectors now mean, despite
17    the modest wage increase and strenuous efforts to recruit
18    new workers, agencies are experiencing staff vacancy rates
19    of up to 40%; excessive vacancies force employers to rely
20    more on overtime, leading to staff burnout and driving up
21    costs; for the fourth year in a row the federal court
22    monitor documented how this growing hiring crisis impedes
23    the ability of community disability agencies to expand to
24    accommodate persons newly approved for services as part of
25    the Ligas Consent Decree.
26        (6) A December 2020 report issued by an independent

 

 

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1    consulting group commissioned by the State to propose
2    changes to the State's reimbursement for community
3    disability agencies recommended that addressing DSP wages
4    was the number one priority for ensuring compliance with
5    the mandates of the Ligas Consent Decree, and further
6    recommended that wages for DSPs should be fixed at 150% of
7    the prevailing minimum wage plus additional funding for
8    benefits.
9        (7) The difference between 150% of the State minimum
10    wage on January 1, 2022 and the hourly DSP wage rate set by
11    the State amounts to $3.50 per hour.
12        (8) The General Assembly finds that in order to reduce
13    turnover, increase retention, fill vacancies, and ensure
14    DSPs are adequately compensated for the critically
15    important work they do, an increase in rates and
16    reimbursements to community-based service providers to
17    effectuate an increase in the hourly wage paid to DSPs is
18    needed.
 
19    Section 3. Purpose and intent. It is the purpose of this
20Act to increase the wages of DSPs and other frontline staff in
21community disability agencies beyond the poverty level and to
22a level competitive with rival employers and above the State
23minimum wage, in an effort to improve the lives of DSPs and the
24lives of the vulnerable persons they support.
25    It is the intent of the General Assembly to ensure that all

 

 

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1funds resulting from rate increases provided to community
2disability agencies are allocated to front-line employee wages
3in order to address the current workforce crisis which is the
4primary obstacle to the availability of community-based
5services for people with disabilities.
 
6    Section 5. The Illinois Administrative Procedure Act is
7amended by adding Section 5-45.21 as follows:
 
8    (5 ILCS 100/5-45.21 new)
9    Sec. 5-45.21. Emergency rulemaking; Departments of Human
10Services and Healthcare and Family Services. To provide for
11the expeditious and timely implementation of changes made by
12this amendatory Act of the 102nd General Assembly to Section
1374 of the Mental Health and Developmental Disabilities
14Administrative Act and to Sections 5-5.4 and 5-5.4i of the
15Illinois Public Aid Code, emergency rules implementing the
16changes made by this amendatory Act of the 102nd General
17Assembly to Section 74 of the Mental Health and Developmental
18Disabilities Administrative Act and to Sections 5-5.4 and
195-5.4i of the Illinois Public Aid Code may be adopted in
20accordance with Section 5-45 by the respective Department. The
21adoption of emergency rules authorized by Section 5-45 and
22this Section is deemed to be necessary for the public
23interest, safety, and welfare.
24    This Section is repealed one year after the effective date

 

 

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1of this amendatory Act of the 102nd General Assembly.
 
2    Section 10. The Mental Health and Developmental
3Disabilities Administrative Act is amended by changing Section
474 and by adding Section 55.5 as follows:
 
5    (20 ILCS 1705/55.5 new)
6    Sec. 55.5. Increased wages for front-line personnel. As
7used in this Section, "front-line personnel" means direct
8support persons, aides, front-line supervisors, and
9non-administrative support staff working in service settings
10outlined in this Section.
11    The Department shall establish reimbursement rates that
12build toward livable wages for front-line personnel in
13residential and day programs and service coordination agencies
14serving persons with intellectual and developmental
15disabilities under Section 54 of this Act, including, but not
16limited to, intermediate care for the developmentally disabled
17facilities, medically complex for the developmentally disabled
18facilities, community-integrated living arrangements,
19community day services, employment, and other residential and
20day programs for persons with intellectual and developmental
21disabilities supported by State funds or funding under Title
22XIX of the federal Social Security Act.
23    The Department shall increase rates and reimbursements so
24that by July 1, 2022 direct support persons wages shall be

 

 

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1increased by $3.50 per hour, and so that other front-line
2personnel earn a commensurate wage.
 
3    (20 ILCS 1705/74)
4    Sec. 74. Rates and reimbursements.
5    (a) Within 30 days after July 6, 2017 (the effective date
6of Public Act 100-23), the Department shall increase rates and
7reimbursements to fund a minimum of a $0.75 per hour wage
8increase for front-line personnel, including, but not limited
9to, direct support persons, aides, front-line supervisors,
10qualified intellectual disabilities professionals, nurses, and
11non-administrative support staff working in community-based
12provider organizations serving individuals with developmental
13disabilities. The Department shall adopt rules, including
14emergency rules under subsection (y) of Section 5-45 of the
15Illinois Administrative Procedure Act, to implement the
16provisions of this Section.
17    (b) Rates and reimbursements. Within 30 days after the
18effective date of this amendatory Act of the 100th General
19Assembly, the Department shall increase rates and
20reimbursements to fund a minimum of a $0.50 per hour wage
21increase for front-line personnel, including, but not limited
22to, direct support persons, aides, front-line supervisors,
23qualified intellectual disabilities professionals, nurses, and
24non-administrative support staff working in community-based
25provider organizations serving individuals with developmental

 

 

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1disabilities. The Department shall adopt rules, including
2emergency rules under subsection (bb) of Section 5-45 of the
3Illinois Administrative Procedure Act, to implement the
4provisions of this Section.
5    (c) Rates and reimbursements. Within 30 days after the
6effective date of this amendatory Act of the 101st General
7Assembly, subject to federal approval, the Department shall
8increase rates and reimbursements in effect on June 30, 2019
9for community-based providers for persons with Developmental
10Disabilities by 3.5% The Department shall adopt rules,
11including emergency rules under subsection (jj) of Section
125-45 of the Illinois Administrative Procedure Act, to
13implement the provisions of this Section, including wage
14increases for direct care staff.
15    (d) For community-based providers serving persons with
16intellectual/developmental disabilities, subject to federal
17approval of any relevant Waiver Amendment, the rates taking
18effect for services delivered on or after January 1, 2022,
19shall include an increase in the rate methodology sufficient
20to provide a $1.50 per hour wage increase for direct support
21personnel in residential settings and sufficient to provide
22wages for all residential non-executive direct care staff,
23excluding direct support personnel, at the federal Department
24of Labor, Bureau of Labor Statistics' average wage as defined
25in rule by the Department.
26    The establishment of and any changes to the rate

 

 

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1methodologies for community-based services provided to persons
2with intellectual/developmental disabilities are subject to
3federal approval of any relevant Waiver Amendment and shall be
4defined in rule by the Department. The Department shall adopt
5rules, including emergency rules as authorized by Section 5-45
6of the Illinois Administrative Procedure Act, to implement the
7provisions of this subsection (d).
8    (e) For community-based providers serving persons with
9intellectual or developmental disabilities, subject to federal
10approval, the rates taking effect for services delivered on or
11after July 1, 2022 shall be increased sufficiently to provide
12a minimum $3.50 per hour wage increase over the wages in effect
13on June 30, 2022 for front-line personnel, including, but not
14limited to, direct support persons, aides, front-line
15supervisors, and non-administrative support staff working in
16community-based provider organizations serving individuals
17with developmental disabilities, and sufficiently to provide
18wages for all other residential non-executive direct care
19staff, excluding direct support personnel, at the U.S.
20Department of Labor, Bureau of Labor Statistics' average wage
21as defined, by rule, by the Department. The Department shall
22adopt rules, including emergency rules in accordance with the
23Illinois Administrative Procedure Act, to implement the
24provisions of this subsection.
25(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21.)
 

 

 

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1    Section 15. The Illinois Public Aid Code is amended by
2changing Sections 5-5.4 and 5-5.4i as follows:
 
3    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
4    Sec. 5-5.4. Standards of Payment - Department of
5Healthcare and Family Services. The Department of Healthcare
6and Family Services shall develop standards of payment of
7nursing facility and ICF/DD services in facilities providing
8such services under this Article which:
9    (1) Provide for the determination of a facility's payment
10for nursing facility or ICF/DD services on a prospective
11basis. The amount of the payment rate for all nursing
12facilities certified by the Department of Public Health under
13the ID/DD Community Care Act or the Nursing Home Care Act as
14Intermediate Care for the Developmentally Disabled facilities,
15Long Term Care for Under Age 22 facilities, Skilled Nursing
16facilities, or Intermediate Care facilities under the medical
17assistance program shall be prospectively established annually
18on the basis of historical, financial, and statistical data
19reflecting actual costs from prior years, which shall be
20applied to the current rate year and updated for inflation,
21except that the capital cost element for newly constructed
22facilities shall be based upon projected budgets. The annually
23established payment rate shall take effect on July 1 in 1984
24and subsequent years. No rate increase and no update for
25inflation shall be provided on or after July 1, 1994, unless

 

 

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1specifically provided for in this Section. The changes made by
2Public Act 93-841 extending the duration of the prohibition
3against a rate increase or update for inflation are effective
4retroactive to July 1, 2004.
5    For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as Intermediate Care for the
7Developmentally Disabled facilities or Long Term Care for
8Under Age 22 facilities, the rates taking effect on July 1,
91998 shall include an increase of 3%. For facilities licensed
10by the Department of Public Health under the Nursing Home Care
11Act as Skilled Nursing facilities or Intermediate Care
12facilities, the rates taking effect on July 1, 1998 shall
13include an increase of 3% plus $1.10 per resident-day, as
14defined by the Department. For facilities licensed by the
15Department of Public Health under the Nursing Home Care Act as
16Intermediate Care Facilities for the Developmentally Disabled
17or Long Term Care for Under Age 22 facilities, the rates taking
18effect on January 1, 2006 shall include an increase of 3%. For
19facilities licensed by the Department of Public Health under
20the Nursing Home Care Act as Intermediate Care Facilities for
21the Developmentally Disabled or Long Term Care for Under Age
2222 facilities, the rates taking effect on January 1, 2009
23shall include an increase sufficient to provide a $0.50 per
24hour wage increase for non-executive staff. For facilities
25licensed by the Department of Public Health under the ID/DD
26Community Care Act as ID/DD Facilities the rates taking effect

 

 

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1within 30 days after July 6, 2017 (the effective date of Public
2Act 100-23) shall include an increase sufficient to provide a
3$0.75 per hour wage increase for non-executive staff. The
4Department shall adopt rules, including emergency rules under
5subsection (y) of Section 5-45 of the Illinois Administrative
6Procedure Act, to implement the provisions of this paragraph.
7For facilities licensed by the Department of Public Health
8under the ID/DD Community Care Act as ID/DD Facilities and
9under the MC/DD Act as MC/DD Facilities, the rates taking
10effect within 30 days after the effective date of this
11amendatory Act of the 100th General Assembly shall include an
12increase sufficient to provide a $0.50 per hour wage increase
13for non-executive front-line personnel, including, but not
14limited to, direct support persons, aides, front-line
15supervisors, qualified intellectual disabilities
16professionals, nurses, and non-administrative support staff.
17The Department shall adopt rules, including emergency rules
18under subsection (bb) of Section 5-45 of the Illinois
19Administrative Procedure Act, to implement the provisions of
20this paragraph.
21    For facilities licensed by the Department of Public Health
22under the ID/DD Community Care Act as ID/DD facilities and
23under the MC/DD Act as MC/DD facilities, the rates taking
24effect for services delivered on or after July 1, 2022, shall
25be increased sufficiently to provide a minimum $3.50 per hour
26wage increase over the wages in effect on June 30, 2022 for

 

 

SB3607- 12 -LRB102 23780 KTG 32971 b

1front-line personnel, including, but not limited to, direct
2support persons, aides, front-line supervisors, and
3non-administrative support staff working in community-based
4provider organizations serving individuals with developmental
5disabilities, and sufficiently to provide wages for all other
6residential non-executive direct care staff, excluding direct
7support personnel, at the U.S. Department of Labor, Bureau of
8Labor Statistics' average wage as defined, by rule, by the
9Department. The Department shall adopt rules, including
10emergency rules in accordance with the Illinois Administrative
11Procedure Act, to implement the provisions of this paragraph.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as Intermediate Care for the
14Developmentally Disabled facilities or Long Term Care for
15Under Age 22 facilities, the rates taking effect on July 1,
161999 shall include an increase of 1.6% plus $3.00 per
17resident-day, as defined by the Department. For facilities
18licensed by the Department of Public Health under the Nursing
19Home Care Act as Skilled Nursing facilities or Intermediate
20Care facilities, the rates taking effect on July 1, 1999 shall
21include an increase of 1.6% and, for services provided on or
22after October 1, 1999, shall be increased by $4.00 per
23resident-day, as defined by the Department.
24    For facilities licensed by the Department of Public Health
25under the Nursing Home Care Act as Intermediate Care for the
26Developmentally Disabled facilities or Long Term Care for

 

 

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1Under Age 22 facilities, the rates taking effect on July 1,
22000 shall include an increase of 2.5% per resident-day, as
3defined by the Department. For facilities licensed by the
4Department of Public Health under the Nursing Home Care Act as
5Skilled Nursing facilities or Intermediate Care facilities,
6the rates taking effect on July 1, 2000 shall include an
7increase of 2.5% per resident-day, as defined by the
8Department.
9    For facilities licensed by the Department of Public Health
10under the Nursing Home Care Act as skilled nursing facilities
11or intermediate care facilities, a new payment methodology
12must be implemented for the nursing component of the rate
13effective July 1, 2003. The Department of Public Aid (now
14Healthcare and Family Services) shall develop the new payment
15methodology using the Minimum Data Set (MDS) as the instrument
16to collect information concerning nursing home resident
17condition necessary to compute the rate. The Department shall
18develop the new payment methodology to meet the unique needs
19of Illinois nursing home residents while remaining subject to
20the appropriations provided by the General Assembly. A
21transition period from the payment methodology in effect on
22June 30, 2003 to the payment methodology in effect on July 1,
232003 shall be provided for a period not exceeding 3 years and
24184 days after implementation of the new payment methodology
25as follows:
26        (A) For a facility that would receive a lower nursing

 

 

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1    component rate per patient day under the new system than
2    the facility received effective on the date immediately
3    preceding the date that the Department implements the new
4    payment methodology, the nursing component rate per
5    patient day for the facility shall be held at the level in
6    effect on the date immediately preceding the date that the
7    Department implements the new payment methodology until a
8    higher nursing component rate of reimbursement is achieved
9    by that facility.
10        (B) For a facility that would receive a higher nursing
11    component rate per patient day under the payment
12    methodology in effect on July 1, 2003 than the facility
13    received effective on the date immediately preceding the
14    date that the Department implements the new payment
15    methodology, the nursing component rate per patient day
16    for the facility shall be adjusted.
17        (C) Notwithstanding paragraphs (A) and (B), the
18    nursing component rate per patient day for the facility
19    shall be adjusted subject to appropriations provided by
20    the General Assembly.
21    For facilities licensed by the Department of Public Health
22under the Nursing Home Care Act as Intermediate Care for the
23Developmentally Disabled facilities or Long Term Care for
24Under Age 22 facilities, the rates taking effect on March 1,
252001 shall include a statewide increase of 7.85%, as defined
26by the Department.

 

 

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1    Notwithstanding any other provision of this Section, for
2facilities licensed by the Department of Public Health under
3the Nursing Home Care Act as skilled nursing facilities or
4intermediate care facilities, except facilities participating
5in the Department's demonstration program pursuant to the
6provisions of Title 77, Part 300, Subpart T of the Illinois
7Administrative Code, the numerator of the ratio used by the
8Department of Healthcare and Family Services to compute the
9rate payable under this Section using the Minimum Data Set
10(MDS) methodology shall incorporate the following annual
11amounts as the additional funds appropriated to the Department
12specifically to pay for rates based on the MDS nursing
13component methodology in excess of the funding in effect on
14December 31, 2006:
15        (i) For rates taking effect January 1, 2007,
16    $60,000,000.
17        (ii) For rates taking effect January 1, 2008,
18    $110,000,000.
19        (iii) For rates taking effect January 1, 2009,
20    $194,000,000.
21        (iv) For rates taking effect April 1, 2011, or the
22    first day of the month that begins at least 45 days after
23    the effective date of this amendatory Act of the 96th
24    General Assembly, $416,500,000 or an amount as may be
25    necessary to complete the transition to the MDS
26    methodology for the nursing component of the rate.

 

 

SB3607- 16 -LRB102 23780 KTG 32971 b

1    Increased payments under this item (iv) are not due and
2    payable, however, until (i) the methodologies described in
3    this paragraph are approved by the federal government in
4    an appropriate State Plan amendment and (ii) the
5    assessment imposed by Section 5B-2 of this Code is
6    determined to be a permissible tax under Title XIX of the
7    Social Security Act.
8    Notwithstanding any other provision of this Section, for
9facilities licensed by the Department of Public Health under
10the Nursing Home Care Act as skilled nursing facilities or
11intermediate care facilities, the support component of the
12rates taking effect on January 1, 2008 shall be computed using
13the most recent cost reports on file with the Department of
14Healthcare and Family Services no later than April 1, 2005,
15updated for inflation to January 1, 2006.
16    For facilities licensed by the Department of Public Health
17under the Nursing Home Care Act as Intermediate Care for the
18Developmentally Disabled facilities or Long Term Care for
19Under Age 22 facilities, the rates taking effect on April 1,
202002 shall include a statewide increase of 2.0%, as defined by
21the Department. This increase terminates on July 1, 2002;
22beginning July 1, 2002 these rates are reduced to the level of
23the rates in effect on March 31, 2002, as defined by the
24Department.
25    For facilities licensed by the Department of Public Health
26under the Nursing Home Care Act as skilled nursing facilities

 

 

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1or intermediate care facilities, the rates taking effect on
2July 1, 2001 shall be computed using the most recent cost
3reports on file with the Department of Public Aid no later than
4April 1, 2000, updated for inflation to January 1, 2001. For
5rates effective July 1, 2001 only, rates shall be the greater
6of the rate computed for July 1, 2001 or the rate effective on
7June 30, 2001.
8    Notwithstanding any other provision of this Section, for
9facilities licensed by the Department of Public Health under
10the Nursing Home Care Act as skilled nursing facilities or
11intermediate care facilities, the Illinois Department shall
12determine by rule the rates taking effect on July 1, 2002,
13which shall be 5.9% less than the rates in effect on June 30,
142002.
15    Notwithstanding any other provision of this Section, for
16facilities licensed by the Department of Public Health under
17the Nursing Home Care Act as skilled nursing facilities or
18intermediate care facilities, if the payment methodologies
19required under Section 5A-12 and the waiver granted under 42
20CFR 433.68 are approved by the United States Centers for
21Medicare and Medicaid Services, the rates taking effect on
22July 1, 2004 shall be 3.0% greater than the rates in effect on
23June 30, 2004. These rates shall take effect only upon
24approval and implementation of the payment methodologies
25required under Section 5A-12.
26    Notwithstanding any other provisions of this Section, for

 

 

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1facilities licensed by the Department of Public Health under
2the Nursing Home Care Act as skilled nursing facilities or
3intermediate care facilities, the rates taking effect on
4January 1, 2005 shall be 3% more than the rates in effect on
5December 31, 2004.
6    Notwithstanding any other provision of this Section, for
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as skilled nursing facilities or
9intermediate care facilities, effective January 1, 2009, the
10per diem support component of the rates effective on January
111, 2008, computed using the most recent cost reports on file
12with the Department of Healthcare and Family Services no later
13than April 1, 2005, updated for inflation to January 1, 2006,
14shall be increased to the amount that would have been derived
15using standard Department of Healthcare and Family Services
16methods, procedures, and inflators.
17    Notwithstanding any other provisions of this Section, for
18facilities licensed by the Department of Public Health under
19the Nursing Home Care Act as intermediate care facilities that
20are federally defined as Institutions for Mental Disease, or
21facilities licensed by the Department of Public Health under
22the Specialized Mental Health Rehabilitation Act of 2013, a
23socio-development component rate equal to 6.6% of the
24facility's nursing component rate as of January 1, 2006 shall
25be established and paid effective July 1, 2006. The
26socio-development component of the rate shall be increased by

 

 

SB3607- 19 -LRB102 23780 KTG 32971 b

1a factor of 2.53 on the first day of the month that begins at
2least 45 days after January 11, 2008 (the effective date of
3Public Act 95-707). As of August 1, 2008, the
4socio-development component rate shall be equal to 6.6% of the
5facility's nursing component rate as of January 1, 2006,
6multiplied by a factor of 3.53. For services provided on or
7after April 1, 2011, or the first day of the month that begins
8at least 45 days after the effective date of this amendatory
9Act of the 96th General Assembly, whichever is later, the
10Illinois Department may by rule adjust these socio-development
11component rates, and may use different adjustment
12methodologies for those facilities participating, and those
13not participating, in the Illinois Department's demonstration
14program pursuant to the provisions of Title 77, Part 300,
15Subpart T of the Illinois Administrative Code, but in no case
16may such rates be diminished below those in effect on August 1,
172008.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as Intermediate Care for the
20Developmentally Disabled facilities or as long-term care
21facilities for residents under 22 years of age, the rates
22taking effect on July 1, 2003 shall include a statewide
23increase of 4%, as defined by the Department.
24    For facilities licensed by the Department of Public Health
25under the Nursing Home Care Act as Intermediate Care for the
26Developmentally Disabled facilities or Long Term Care for

 

 

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1Under Age 22 facilities, the rates taking effect on the first
2day of the month that begins at least 45 days after the
3effective date of this amendatory Act of the 95th General
4Assembly shall include a statewide increase of 2.5%, as
5defined by the Department.
6    Notwithstanding any other provision of this Section, for
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as skilled nursing facilities or
9intermediate care facilities, effective January 1, 2005,
10facility rates shall be increased by the difference between
11(i) a facility's per diem property, liability, and malpractice
12insurance costs as reported in the cost report filed with the
13Department of Public Aid and used to establish rates effective
14July 1, 2001 and (ii) those same costs as reported in the
15facility's 2002 cost report. These costs shall be passed
16through to the facility without caps or limitations, except
17for adjustments required under normal auditing procedures.
18    Rates established effective each July 1 shall govern
19payment for services rendered throughout that fiscal year,
20except that rates established on July 1, 1996 shall be
21increased by 6.8% for services provided on or after January 1,
221997. Such rates will be based upon the rates calculated for
23the year beginning July 1, 1990, and for subsequent years
24thereafter until June 30, 2001 shall be based on the facility
25cost reports for the facility fiscal year ending at any point
26in time during the previous calendar year, updated to the

 

 

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1midpoint of the rate year. The cost report shall be on file
2with the Department no later than April 1 of the current rate
3year. Should the cost report not be on file by April 1, the
4Department shall base the rate on the latest cost report filed
5by each skilled care facility and intermediate care facility,
6updated to the midpoint of the current rate year. In
7determining rates for services rendered on and after July 1,
81985, fixed time shall not be computed at less than zero. The
9Department shall not make any alterations of regulations which
10would reduce any component of the Medicaid rate to a level
11below what that component would have been utilizing in the
12rate effective on July 1, 1984.
13    (2) Shall take into account the actual costs incurred by
14facilities in providing services for recipients of skilled
15nursing and intermediate care services under the medical
16assistance program.
17    (3) Shall take into account the medical and psycho-social
18characteristics and needs of the patients.
19    (4) Shall take into account the actual costs incurred by
20facilities in meeting licensing and certification standards
21imposed and prescribed by the State of Illinois, any of its
22political subdivisions or municipalities and by the U.S.
23Department of Health and Human Services pursuant to Title XIX
24of the Social Security Act.
25    The Department of Healthcare and Family Services shall
26develop precise standards for payments to reimburse nursing

 

 

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1facilities for any utilization of appropriate rehabilitative
2personnel for the provision of rehabilitative services which
3is authorized by federal regulations, including reimbursement
4for services provided by qualified therapists or qualified
5assistants, and which is in accordance with accepted
6professional practices. Reimbursement also may be made for
7utilization of other supportive personnel under appropriate
8supervision.
9    The Department shall develop enhanced payments to offset
10the additional costs incurred by a facility serving
11exceptional need residents and shall allocate at least
12$4,000,000 of the funds collected from the assessment
13established by Section 5B-2 of this Code for such payments.
14For the purpose of this Section, "exceptional needs" means,
15but need not be limited to, ventilator care and traumatic
16brain injury care. The enhanced payments for exceptional need
17residents under this paragraph are not due and payable,
18however, until (i) the methodologies described in this
19paragraph are approved by the federal government in an
20appropriate State Plan amendment and (ii) the assessment
21imposed by Section 5B-2 of this Code is determined to be a
22permissible tax under Title XIX of the Social Security Act.
23    Beginning January 1, 2014 the methodologies for
24reimbursement of nursing facility services as provided under
25this Section 5-5.4 shall no longer be applicable for services
26provided on or after January 1, 2014.

 

 

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1    No payment increase under this Section for the MDS
2methodology, exceptional care residents, or the
3socio-development component rate established by Public Act
496-1530 of the 96th General Assembly and funded by the
5assessment imposed under Section 5B-2 of this Code shall be
6due and payable until after the Department notifies the
7long-term care providers, in writing, that the payment
8methodologies to long-term care providers required under this
9Section have been approved by the Centers for Medicare and
10Medicaid Services of the U.S. Department of Health and Human
11Services and the waivers under 42 CFR 433.68 for the
12assessment imposed by this Section, if necessary, have been
13granted by the Centers for Medicare and Medicaid Services of
14the U.S. Department of Health and Human Services. Upon
15notification to the Department of approval of the payment
16methodologies required under this Section and the waivers
17granted under 42 CFR 433.68, all increased payments otherwise
18due under this Section prior to the date of notification shall
19be due and payable within 90 days of the date federal approval
20is received.
21    On and after July 1, 2012, the Department shall reduce any
22rate of reimbursement for services or other payments or alter
23any methodologies authorized by this Code to reduce any rate
24of reimbursement for services or other payments in accordance
25with Section 5-5e.
26    For facilities licensed by the Department of Public Health

 

 

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1under the ID/DD Community Care Act as ID/DD Facilities and
2under the MC/DD Act as MC/DD Facilities, subject to federal
3approval, the rates taking effect for services delivered on or
4after August 1, 2019 shall be increased by 3.5% over the rates
5in effect on June 30, 2019. The Department shall adopt rules,
6including emergency rules under subsection (ii) of Section
75-45 of the Illinois Administrative Procedure Act, to
8implement the provisions of this Section, including wage
9increases for direct care staff.
10    For facilities licensed by the Department of Public Health
11under the ID/DD Community Care Act as ID/DD Facilities and
12under the MC/DD Act as MC/DD Facilities, subject to federal
13approval, the rates taking effect on the latter of the
14approval date of the State Plan Amendment for these facilities
15or the Waiver Amendment for the home and community-based
16services settings shall include an increase sufficient to
17provide a $0.26 per hour wage increase to the base wage for
18non-executive staff. The Department shall adopt rules,
19including emergency rules as authorized by Section 5-45 of the
20Illinois Administrative Procedure Act, to implement the
21provisions of this Section, including wage increases for
22direct care staff.
23    For facilities licensed by the Department of Public Health
24under the ID/DD Community Care Act as ID/DD Facilities and
25under the MC/DD Act as MC/DD Facilities, subject to federal
26approval of the State Plan Amendment and the Waiver Amendment

 

 

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1for the home and community-based services settings, the rates
2taking effect for the services delivered on or after July 1,
32020 shall include an increase sufficient to provide a $1.00
4per hour wage increase for non-executive staff. For services
5delivered on or after January 1, 2021, subject to federal
6approval of the State Plan Amendment and the Waiver Amendment
7for the home and community-based services settings, shall
8include an increase sufficient to provide a $0.50 per hour
9increase for non-executive staff. The Department shall adopt
10rules, including emergency rules as authorized by Section 5-45
11of the Illinois Administrative Procedure Act, to implement the
12provisions of this Section, including wage increases for
13direct care staff.
14    For facilities licensed by the Department of Public Health
15under the ID/DD Community Care Act as ID/DD Facilities and
16under the MC/DD Act as MC/DD Facilities, subject to federal
17approval of the State Plan Amendment, the rates taking effect
18for the residential services delivered on or after July 1,
192021, shall include an increase sufficient to provide a $0.50
20per hour increase for aides in the rate methodology. For
21facilities licensed by the Department of Public Health under
22the ID/DD Community Care Act as ID/DD Facilities and under the
23MC/DD Act as MC/DD Facilities, subject to federal approval of
24the State Plan Amendment, the rates taking effect for the
25residential services delivered on or after January 1, 2022
26shall include an increase sufficient to provide a $1.00 per

 

 

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1hour increase for aides in the rate methodology. In addition,
2for residential services delivered on or after January 1, 2022
3such rates shall include an increase sufficient to provide
4wages for all residential non-executive direct care staff,
5excluding aides, at the federal Department of Labor, Bureau of
6Labor Statistics' average wage as defined in rule by the
7Department. The Department shall adopt rules, including
8emergency rules as authorized by Section 5-45 of the Illinois
9Administrative Procedure Act, to implement the provisions of
10this Section.
11    For facilities licensed by the Department of Public Health
12under the ID/DD Community Care Act as ID/DD facilities and
13under the MC/DD Act as MC/DD facilities, subject to federal
14approval, the rates taking effect for services delivered on or
15after July 1, 2022, shall be increased sufficiently to provide
16a minimum $3.50 per hour wage increase over the wages in effect
17on June 30, 2022 for front-line personnel, including, but not
18limited to, direct support persons, aides, front-line
19supervisors, and non-administrative support staff working in
20community-based provider organizations serving individuals
21with developmental disabilities, and sufficiently to provide
22wages for all other residential non-executive direct care
23staff, excluding direct support personnel, at the U.S.
24Department of Labor, Bureau of Labor Statistics' average wage
25as defined, by rule, by the Department. The Department shall
26adopt rules, including emergency rules in accordance with the

 

 

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1Illinois Administrative Procedure Act, to implement the
2provisions of this paragraph.
3(Source: P.A. 101-10, eff. 6-5-19; 101-636, eff. 6-10-20;
4102-16, eff. 6-17-21.)
 
5    (305 ILCS 5/5-5.4i)
6    Sec. 5-5.4i. Rates and reimbursements.
7    (a) Within 30 days after July 6, 2017 (the effective date
8of Public Act 100-23), the Department shall increase rates and
9reimbursements to fund a minimum of a $0.75 per hour wage
10increase for front-line personnel, including, but not limited
11to, direct support persons, aides, front-line supervisors,
12qualified intellectual disabilities professionals, nurses, and
13non-administrative support staff working in community-based
14provider organizations serving individuals with developmental
15disabilities. The Department shall adopt rules, including
16emergency rules under subsection (y) of Section 5-45 of the
17Illinois Administrative Procedure Act, to implement the
18provisions of this Section.
19    (b) Within 30 days after June 4, 2018 (the effective date
20of Public Act 100-587), the Department shall increase rates
21and reimbursements to fund a minimum of a $0.50 per hour wage
22increase for front-line personnel, including, but not limited
23to, direct support persons, aides, front-line supervisors,
24qualified intellectual disabilities professionals, nurses, and
25non-administrative support staff working in community-based

 

 

SB3607- 28 -LRB102 23780 KTG 32971 b

1provider organizations serving individuals with developmental
2disabilities. The Department shall adopt rules, including
3emergency rules under subsection (bb) of Section 5-45 of the
4Illinois Administrative Procedure Act, to implement the
5provisions of this Section.
6    (c) Within 30 days after the effective date of this
7amendatory Act of the 101st General Assembly, subject to
8federal approval, the Department shall increase rates and
9reimbursements in effect on June 30, 2019 for community-based
10providers for persons with Developmental Disabilities by 3.5%.
11The Department shall adopt rules, including emergency rules
12under subsection (ii) of Section 5-45 of the Illinois
13Administrative Procedure Act, to implement the provisions of
14this Section, including wage increases for direct care staff.
15    (d) For community-based providers serving persons with
16intellectual or developmental disabilities, subject to federal
17approval, the rates taking effect for services delivered on or
18after July 1, 2022, shall be increased sufficiently to provide
19a minimum $3.50 per hour wage increase over the wages in effect
20on June 30, 2022 for front-line personnel, including, but not
21limited to, direct support persons, aides, front-line
22supervisors, and non-administrative support staff working in
23community-based provider organizations serving individuals
24with developmental disabilities, and sufficient to provide
25wages for all other residential non-executive direct care
26staff, excluding direct support personnel, at the U.S.

 

 

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1Department of Labor, Bureau of Labor Statistics' average wage
2as defined, by rule, by the Department. The Department shall
3adopt rules, including emergency rules in accordance with the
4Illinois Administrative Procedure Act, to implement the
5provisions of this subsection.
6(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
7101-10, eff. 6-5-19.)
 
8    Section 99. Effective date. This Act takes effect upon
9becoming law.