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| [ Introduced ] | [ Engrossed ] | [ Senate Amendment 002 ] |
91_SB1844sam001
SRS91SB1844DLsaam01
1 AMENDMENT TO SENATE BILL 1844
2 AMENDMENT NO. . Amend Senate Bill 1844, on page 10,
3 line 3, by deleting "and adding Section 3-120"; and
4 on page 10, by deleting lines 4 through 9; and
5 on page 13, by replacing lines 19 through 31 with the
6 following:
7 "changing Section 5-5.5 as follows:
8 (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
9 Sec. 5-5.5. Elements of Payment Rate.
10 (a) The Department of Public Aid shall develop a
11 prospective method for determining payment rates for skilled
12 nursing and intermediate care services in nursing facilities
13 composed of the following cost elements:
14 (1) Standard Services, with the cost of this
15 component being determined by taking into account the
16 actual costs to the facilities of these services subject
17 to cost ceilings to be defined in the Department's rules.
18 (2) Resident Services, with the cost of this
19 component being determined by taking into account the
20 actual costs, needs and utilization of these services, as
21 derived from an assessment of the resident needs in the
22 nursing facilities. The Department shall adopt rules
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1 governing reimbursement for resident services as listed
2 in Section 5-1.1. Surveys or assessments of resident
3 needs under this Section shall include a review by the
4 facility of the results of such assessments and a
5 discussion of issues in dispute with authorized survey
6 staff, unless the facility elects not to participate in
7 such a review process. Surveys or assessments of
8 resident needs under this Section may be conducted
9 semi-annually and payment rates relating to resident
10 services may be changed on a semi-annual basis. The
11 Illinois Department shall initiate a project, either on a
12 pilot basis or Statewide, to reimburse the cost of
13 resident services based on a methodology which utilizes
14 an assessment of resident needs to determine the level of
15 reimbursement. This methodology shall be different from
16 the payment criteria for resident services utilized by
17 the Illinois Department on July 1, 1981. On March 1,
18 1982, and each year thereafter, until such time when the
19 Illinois Department adopts the methodology used in such
20 project for use statewide or the Illinois Department
21 reports to the Citizens Assembly/Council on Public Aid
22 that the methodology did not meet the Department's goals
23 and objectives and therefore is ceasing such project, the
24 Illinois Department shall report to the General Assembly
25 on the implementation and progress of such project. The
26 report shall include:
27 (A) A statement of the Illinois Department's
28 goals and objectives for such project;
29 (B) A description of such project, including
30 the number and type of nursing facilities involved
31 in the project;
32 (C) A description of the methodology used in
33 such project;
34 (D) A description of the Illinois Department's
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1 application of the methodology;
2 (E) A statement on the methodology's effect on
3 the quality of care given to residents in the sample
4 nursing facilities; and
5 (F) A statement on the cost of the methodology
6 used in such project and a comparison of this cost
7 with the cost of the current payment criteria.
8 (3) Ancillary Services, with the payment rate being
9 developed for each individual type of service. Payment
10 shall be made only when authorized under procedures
11 developed by the Department of Public Aid.
12 (4) Nurse's Aide Training, with the cost of this
13 component being determined by taking into account the
14 actual cost to the facilities of such training.
15 (5) Real Estate Taxes, with the cost of this
16 component being determined by taking into account the
17 figures contained in the most currently available cost
18 reports (with no imposition of maximums) updated to the
19 midpoint of the current rate year for long term care
20 services rendered between July 1, 1984 and June 30, 1985,
21 and with the cost of this component being determined by
22 taking into account the actual 1983 taxes for which the
23 nursing homes were assessed (with no imposition of
24 maximums) updated to the midpoint of the current rate
25 year for long term care services rendered between July 1,
26 1985 and June 30, 1986.
27 (b) In developing a prospective method for determining
28 payment rates for skilled nursing and intermediate care
29 services in nursing facilities, the Department of Public Aid
30 shall consider the following cost elements:
31 (1) Reasonable capital cost determined by utilizing
32 incurred interest rate and the current value of the
33 investment, including land, utilizing composite rates, or
34 by utilizing such other reasonable cost related methods
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1 determined by the Department. However, beginning with the
2 rate reimbursement period effective July 1, 1987, the
3 Department shall be prohibited from establishing,
4 including, and implementing any depreciation factor in
5 calculating the capital cost element.
6 (2) Profit, with the actual amount being produced
7 and accruing to the providers in the form of a return on
8 their total investment, on the basis of their ability to
9 economically and efficiently deliver a type of service.
10 The method of payment may assure the opportunity for a
11 profit, but shall not guarantee or establish a specific
12 amount as a cost.
13 (c) The Illinois Department may implement the amendatory
14 changes to this Section made by this amendatory Act of 1991
15 through the use of emergency rules in accordance with the
16 provisions of Section 5.02 of the Illinois Administrative
17 Procedure Act. For purposes of the Illinois Administrative
18 Procedure Act, the adoption of rules to implement the
19 amendatory changes to this Section made by this amendatory
20 Act of 1991 shall be deemed an emergency and necessary for
21 the public interest, safety and welfare.
22 (d) No later than January 1, 2001, the Department of
23 Public Aid shall file with the Joint Committee on
24 Administrative Rules, pursuant to the Illinois Administrative
25 Procedure Act, a proposed rule, or a proposed amendment to an
26 existing rule, regarding payment for appropriate services,
27 including assessment, care planning, and treatment provided
28 by nursing facilities to residents who have a serious mental
29 illness.
30 (Source: P.A. 86-651; 86-705; 86-1028; 87-14; 87-435.)"; and
31 by deleting all of pages 14 through 36; and
32 on page 37, by deleting lines 1 through 4.