093_HB1272

 
                                     LRB093 07173 DRJ 07328 b

 1        AN ACT in relation to public aid.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.  The  Illinois  Public Aid Code is amended by
 5    changing Section 5-5.5 as follows:

 6        (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
 7        Sec. 5-5.5.  Elements of Payment Rate.
 8        (a)  The  Department  of  Public  Aid  shall  develop   a
 9    prospective  method for determining payment rates for skilled
10    nursing and intermediate care services in nursing  facilities
11    composed of the following cost elements:
12             (1)  Standard   Services,  with  the  cost  of  this
13        component being determined by  taking  into  account  the
14        actual  costs to the facilities of these services subject
15        to cost ceilings to be defined in the Department's rules.
16             (2)  Resident  Services,  with  the  cost  of   this
17        component  being  determined  by  taking into account the
18        actual costs, needs and utilization of these services, as
19        derived from an assessment of the resident needs  in  the
20        nursing  facilities.   The  Department  shall adopt rules
21        governing reimbursement for resident services  as  listed
22        in  Section  5-1.1.  Surveys  or  assessments of resident
23        needs under this Section shall include a  review  by  the
24        facility  of  the  results  of  such  assessments  and  a
25        discussion  of  issues  in dispute with authorized survey
26        staff, unless the facility elects not to  participate  in
27        such   a  review  process.   Surveys  or  assessments  of
28        resident  needs  under  this  Section  may  be  conducted
29        semi-annually and  payment  rates  relating  to  resident
30        services  may  be  changed  on  a semi-annual basis.  The
31        Illinois Department shall initiate a project, either on a
 
                            -2-      LRB093 07173 DRJ 07328 b
 1        pilot basis  or  Statewide,  to  reimburse  the  cost  of
 2        resident  services  based on a methodology which utilizes
 3        an assessment of resident needs to determine the level of
 4        reimbursement. This methodology shall be  different  from
 5        the  payment  criteria  for resident services utilized by
 6        the Illinois Department on July 1,  1981.   On  March  1,
 7        1982,  and each year thereafter, until such time when the
 8        Illinois Department adopts the methodology used  in  such
 9        project  for  use  statewide  or  the Illinois Department
10        reports to the Citizens Assembly/Council  on  Public  Aid
11        that  the methodology did not meet the Department's goals
12        and objectives and therefore is ceasing such project, the
13        Illinois Department shall report to the General  Assembly
14        on  the  implementation and progress of such project. The
15        report shall include:
16                  (A)  A statement of the  Illinois  Department's
17             goals and objectives for such project;
18                  (B)  A  description  of such project, including
19             the number and type of nursing  facilities  involved
20             in the project;
21                  (C)  A  description  of the methodology used in
22             such project;
23                  (D)  A description of the Illinois Department's
24             application of the methodology;
25                  (E)  A statement on the methodology's effect on
26             the quality of care given to residents in the sample
27             nursing facilities; and
28                  (F)  A statement on the cost of the methodology
29             used in such project and a comparison of  this  cost
30             with the cost of the current payment criteria.
31             (3)  Ancillary Services, with the payment rate being
32        developed  for  each individual type of service.  Payment
33        shall be  made  only  when  authorized  under  procedures
34        developed by the Department of Public Aid.
 
                            -3-      LRB093 07173 DRJ 07328 b
 1             (4)  Nurse's  Aide  Training,  with the cost of this
 2        component being determined by  taking  into  account  the
 3        actual cost to the facilities of such training.
 4             (5)  Real  Estate  Taxes,  with  the  cost  of  this
 5        component  being  determined  by  taking into account the
 6        figures contained in the most  currently  available  cost
 7        reports  (with  no imposition of maximums) updated to the
 8        midpoint of the current rate  year  for  long  term  care
 9        services rendered between July 1, 1984 and June 30, 1985,
10        and  with  the cost of this component being determined by
11        taking into account the actual 1983 taxes for  which  the
12        nursing  homes  were  assessed  (with  no  imposition  of
13        maximums)  updated  to  the  midpoint of the current rate
14        year for long term care services rendered between July 1,
15        1985 and June 30, 1986.
16        (b)  In developing a prospective method  for  determining
17    payment  rates  for  skilled  nursing  and  intermediate care
18    services in nursing facilities, the Department of Public  Aid
19    shall consider the following cost elements:
20             (1)  Reasonable capital cost determined by utilizing
21        incurred  interest  rate  and  the  current  value of the
22        investment, including land, utilizing composite rates, or
23        by utilizing such other reasonable cost  related  methods
24        determined by the Department. However, beginning with the
25        rate  reimbursement  period  effective  July 1, 1987, the
26        Department  shall  be   prohibited   from   establishing,
27        including,  and  implementing  any depreciation factor in
28        calculating the capital cost element.
29             (2)  Profit, with the actual amount  being  produced
30        and  accruing to the providers in the form of a return on
31        their total investment, on the basis of their ability  to
32        economically  and  efficiently deliver a type of service.
33        The method of payment may assure the  opportunity  for  a
34        profit,  but  shall not guarantee or establish a specific
 
                            -4-      LRB093 07173 DRJ 07328 b
 1        amount as a cost.
 2        (b-5)  In its cost reports required to  be  submitted  to
 3    the  Department  of Public Aid under this Article, a facility
 4    must document  its  increased  costs  of  providing  services
 5    resulting from capital improvements made by the facility. The
 6    Department   must  verify  this  information  promptly  after
 7    receiving the facility's cost  report.  The  Department  must
 8    adjust  the facility's payment rates promptly after verifying
 9    the  facility's  increased  costs   of   providing   services
10    resulting  from  capital  improvements  made by the facility.
11          (c)  The  Illinois   Department   may   implement   the
12    amendatory  changes  to  this Section made by this amendatory
13    Act of 1991 through the use of emergency rules in  accordance
14    with   the   provisions  of  Section  5.02  of  the  Illinois
15    Administrative Procedure Act. For purposes  of  the  Illinois
16    Administrative  Procedure  Act,  the  adoption  of  rules  to
17    implement the amendatory changes to this Section made by this
18    amendatory  Act  of  1991  shall  be  deemed an emergency and
19    necessary for the public interest, safety and welfare.
20        (d)  No later than January 1,  2001,  the  Department  of
21    Public   Aid   shall   file   with  the  Joint  Committee  on
22    Administrative Rules, pursuant to the Illinois Administrative
23    Procedure Act, a proposed rule, or a proposed amendment to an
24    existing rule, regarding payment  for  appropriate  services,
25    including  assessment, care planning, discharge planning, and
26    treatment provided by nursing  facilities  to  residents  who
27    have a serious mental illness.
28    (Source: P.A. 91-799, eff. 6-13-00.)

29        Section  99.  Effective date.  This Act takes effect upon
30    becoming law.