101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4872

 

Introduced 2/18/2020, by Rep. Robyn Gabel - Yehiel M. Kalish and Daniel Didech

 

SYNOPSIS AS INTRODUCED:
 
See Index

    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 the Department shall increase rates and reimbursements so that by July 1, 2020 direct support persons wages shall be increased by $2 per hour, and so that other front-line personnel earn a commensurate wage. Requires the Department to increase rates and reimbursements in effect on January 1, 2020 for community-based providers for persons with developmental disabilities in order to fund, at a minimum, a $2 per hour wage increase. Amends the Illinois Public Aid Code. Provides that for facilities ID/DD facilities and MC/DD facilities, the rates taking effect within 30 days after the effective date of the amendatory Act shall include an increase sufficient to provide a $2 per hour wage increase for non-executive front-line personnel, including, but not limited to, other specified staff and support personnel. Requires the Department of Healthcare and Family Services to increase the rates for ID/DD facilities and MC/DD facilities taking effect for services delivered on or after January 1, 2020 to provide a minimum $2 per hour wage increase over the wages in effect on December 30, 2019. Requires the Department to increase rates and reimbursements in effect on January 1, 2020 for community-based providers for persons with developmental disabilities in order to fund a minimum $2 per hour wage increase. Amends the Illinois Administrative Procedure Act. Provides that the Departments of Human Services and Healthcare and Family Services may adopt emergency rules. Effective immediately.


LRB101 19303 KTG 68770 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB4872LRB101 19303 KTG 68770 b

1    AN ACT concerning care for persons with developmental
2disabilities, which may be referred to as the Community
3Disability Living Wage Act.
 
4    WHEREAS, An estimated 27,000 children and adults with
5intellectual and developmental disabilities are supported in
6community-based settings in Illinois; direct support persons
7(DSPs), are trained paraprofessional staff that are engaged in
8activities of daily living and community support; too many of
9these employees earn wages that place them and their families
10below the poverty level; and
 
11    WHEREAS, According to the most recent Illinois industry
12surveys, the average DSP wage in Illinois is below the U.S.
13Department of Health and Human Services poverty threshold of
14$12.38 for a family of 4 and one out of every 4 DSP jobs in
15provider agencies are going unfilled; low wages often compel
16DSPs to work many overtime hours or hold down a second job to
17support their families; research by the American Network of
18Community Options and Resources (ANCOR), inclusive of
19Illinois, reveals 56% of DSPs rely on public assistance to make
20ends meet, creating additional expenditures for State
21government; low wages are a consequence of the historically low
22reimbursement rates paid by the State of Illinois to
23community-based service providers; and
 
24    WHEREAS, Starting wages at many provider agencies are below

 

 

HB4872- 2 -LRB101 19303 KTG 68770 b

1$10 per hour, the scheduled state minimum wage rate as of July
21, 2020; and
 
3    WHEREAS, The lack of adequate wages for employees who
4perform the challenging work of supporting persons with
5intellectual and developmental disabilities results in high
6employee turnover, which in turn negatively impacts the quality
7of services provided, higher wages are proven to reduce staff
8turnover, improving stability and quality of services while
9reducing employer training costs; and
 
10    WHEREAS, Rising wages in several other sectors now mean,
11despite the modest wage increase and strenuous efforts to
12recruit new workers, agencies are experiencing staff vacancy
13rates of up to 40%; excessive vacancies force employers to rely
14more on overtime, leading to staff burnout and driving up
15costs; for the third year in a row the federal court monitor
16documented how this growing hiring crisis impedes the ability
17of community disability agencies to expand to accommodate
18persons newly approved for services as part of the Ligas
19Consent Decree; and
 
20    WHEREAS, The General Assembly finds that in order to reduce
21turnover, increase retention, fill vacancies, and ensure DSPs
22are adequately compensated for the critically important work
23they do, an increase in rates and reimbursements to

 

 

HB4872- 3 -LRB101 19303 KTG 68770 b

1community-based service providers to effectuate an increase in
2the hourly wage paid to DSPs is needed; and
 
3    WHEREAS, It is the purpose of this Act to increase the
4wages of DSPs in community disability agencies beyond the
5poverty level and to a level competitive with rival employers
6and above the State minimum wage, in an effort to improve the
7lives of DSPs and the lives of the vulnerable persons they
8support; and
 
9    WHEREAS, It is the intent of the General Assembly to ensure
10that all funds resulting from rate increases provided to
11community disability agencies are allocated to frontline
12employee compensation in order to address the current workforce
13crisis which is the primary obstacle to the availability of
14community-based services for people with disabilities;
15therefore
 
16    Be it enacted by the People of the State of Illinois,
17represented in the General Assembly:
 
18    Section 5. The Illinois Administrative Procedure Act is
19amended by adding Section 5-45.1 as follows:
 
20    (5 ILCS 100/5-45.1 new)
21    Sec. 5-45.1. Emergency rulemaking; Departments of Human

 

 

HB4872- 4 -LRB101 19303 KTG 68770 b

1Services and Healthcare and Family Services. To provide for the
2expeditious and timely implementation of changes made by this
3amendatory Act of the 101st General Assembly to Section 74 of
4the Mental Health and Developmental Disabilities
5Administrative Act and to Sections 5-5.4 and 5-5.4i of the
6Illinois Public Aid Code, emergency rules may be adopted in
7accordance with Section 5-45 by the respective Department. The
8adoption of emergency rules authorized by Section 5-45 and this
9Section is deemed to be necessary for the public interest,
10safety, and welfare.
11    This Section is repealed on January 1, 2026.
 
12    Section 10. The Mental Health and Developmental
13Disabilities Administrative Act is amended by changing Section
1474 and by adding Section 55.5 as follows:
 
15    (20 ILCS 1705/55.5 new)
16    Sec. 55.5. Increased wages for front-line personnel. As
17used in this Section, "front-line personnel" means direct
18support persons, aides, front-line supervisors, qualified
19intellectual disabilities professionals, nurses, and
20non-administrative support staff working in service settings
21outlined in this Section.
22    The Department shall establish reimbursement rates that
23build toward livable wages for front-line personnel in
24residential and day programs and service coordination agencies

 

 

HB4872- 5 -LRB101 19303 KTG 68770 b

1serving persons with intellectual and developmental
2disabilities under Section 54 of this Act, including, but not
3limited to, intermediate care for the developmentally disabled
4facilities, medically complex for the developmentally disabled
5facilities, community-integrated living arrangements,
6community day services, employment, and other residential and
7day programs for persons with intellectual and developmental
8disabilities supported by State funds or funding under Title
9XIX of the federal Social Security Act.
10    The Department shall increase rates and reimbursements so
11that by July 1, 2020 direct support persons wages shall be
12increased by $2 per hour, and so that other front-line
13personnel earn a commensurate wage.
 
14    (20 ILCS 1705/74)
15    Sec. 74. Rates and reimbursements.
16    (a) Within 30 days after July 6, 2017 (the effective date
17of Public Act 100-23), the Department shall increase rates and
18reimbursements to fund a minimum of a $0.75 per hour wage
19increase for front-line personnel, including, but not limited
20to, direct support persons, aides, front-line supervisors,
21qualified intellectual disabilities professionals, nurses, and
22non-administrative support staff working in community-based
23provider organizations serving individuals with developmental
24disabilities. The Department shall adopt rules, including
25emergency rules under subsection (y) of Section 5-45 of the

 

 

HB4872- 6 -LRB101 19303 KTG 68770 b

1Illinois Administrative Procedure Act, to implement the
2provisions of this Section.
3    (b) Rates and reimbursements. Within 30 days after the
4effective date of this amendatory Act of the 100th General
5Assembly, the Department shall increase rates and
6reimbursements to fund a minimum of a $0.50 per hour wage
7increase for front-line personnel, including, but not limited
8to, direct support persons, aides, front-line supervisors,
9qualified intellectual disabilities professionals, nurses, and
10non-administrative support staff working in community-based
11provider organizations serving individuals with developmental
12disabilities. The Department shall adopt rules, including
13emergency rules under subsection (bb) of Section 5-45 of the
14Illinois Administrative Procedure Act, to implement the
15provisions of this Section.
16    (c) Rates and reimbursements. Within 30 days after the
17effective date of this amendatory Act of the 101st General
18Assembly, subject to federal approval, the Department shall
19increase rates and reimbursements in effect on June 30, 2019
20for community-based providers for persons with Developmental
21Disabilities by 3.5% The Department shall adopt rules,
22including emergency rules under subsection (jj) of Section 5-45
23of the Illinois Administrative Procedure Act, to implement the
24provisions of this Section, including wage increases for direct
25care staff.
26    (d) Rates and reimbursements. Within 30 days after the

 

 

HB4872- 7 -LRB101 19303 KTG 68770 b

1effective date of this amendatory Act of the 101st General
2Assembly, subject to federal approval, the Department shall
3increase rates and reimbursements in effect on January 1, 2020,
4for community-based providers for persons with developmental
5disabilities in order to fund a minimum $2 per hour wage
6increase. The Department shall adopt rules, including
7emergency rules under the Illinois Administrative Procedure
8Act, to implement the provisions of this Section, and ensure
9funds are allocated to compensation increases for direct care
10staff.
11(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
12101-10, eff. 6-5-19.)
 
13    Section 15. The Illinois Public Aid Code is amended by
14changing Sections 5-5.4 and 5-5.4i as follows:
 
15    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
16    Sec. 5-5.4. Standards of Payment - Department of Healthcare
17and Family Services. The Department of Healthcare and Family
18Services shall develop standards of payment of nursing facility
19and ICF/DD services in facilities providing such services under
20this Article which:
21    (1) Provide for the determination of a facility's payment
22for nursing facility or ICF/DD services on a prospective basis.
23The amount of the payment rate for all nursing facilities
24certified by the Department of Public Health under the ID/DD

 

 

HB4872- 8 -LRB101 19303 KTG 68770 b

1Community Care Act or the Nursing Home Care Act as Intermediate
2Care for the Developmentally Disabled facilities, Long Term
3Care for Under Age 22 facilities, Skilled Nursing facilities,
4or Intermediate Care facilities under the medical assistance
5program shall be prospectively established annually on the
6basis of historical, financial, and statistical data
7reflecting actual costs from prior years, which shall be
8applied to the current rate year and updated for inflation,
9except that the capital cost element for newly constructed
10facilities shall be based upon projected budgets. The annually
11established payment rate shall take effect on July 1 in 1984
12and subsequent years. No rate increase and no update for
13inflation shall be provided on or after July 1, 1994, unless
14specifically provided for in this Section. The changes made by
15Public Act 93-841 extending the duration of the prohibition
16against a rate increase or update for inflation are effective
17retroactive to July 1, 2004.
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 Long Term Care for Under
21Age 22 facilities, the rates taking effect on July 1, 1998
22shall include an increase of 3%. For facilities licensed by the
23Department of Public Health under the Nursing Home Care Act as
24Skilled Nursing facilities or Intermediate Care facilities,
25the rates taking effect on July 1, 1998 shall include an
26increase of 3% plus $1.10 per resident-day, as defined by the

 

 

HB4872- 9 -LRB101 19303 KTG 68770 b

1Department. For facilities licensed by the Department of Public
2Health under the Nursing Home Care Act as Intermediate Care
3Facilities for the Developmentally Disabled or Long Term Care
4for Under Age 22 facilities, the rates taking effect on January
51, 2006 shall include an increase of 3%. For facilities
6licensed by the Department of Public Health under the Nursing
7Home Care Act as Intermediate Care Facilities for the
8Developmentally Disabled or Long Term Care for Under Age 22
9facilities, the rates taking effect on January 1, 2009 shall
10include an increase sufficient to provide a $0.50 per hour wage
11increase for non-executive staff. For facilities licensed by
12the Department of Public Health under the ID/DD Community Care
13Act as ID/DD Facilities the rates taking effect within 30 days
14after July 6, 2017 (the effective date of Public Act 100-23)
15shall include an increase sufficient to provide a $0.75 per
16hour wage increase for non-executive staff. The Department
17shall adopt rules, including emergency rules under subsection
18(y) of Section 5-45 of the Illinois Administrative Procedure
19Act, to implement the provisions of this paragraph. For
20facilities licensed by the Department of Public Health under
21the ID/DD Community Care Act as ID/DD Facilities and under the
22MC/DD Act as MC/DD Facilities, the rates taking effect within
2330 days after the effective date of this amendatory Act of the
24100th General Assembly shall include an increase sufficient to
25provide a $0.50 per hour wage increase for non-executive
26front-line personnel, including, but not limited to, direct

 

 

HB4872- 10 -LRB101 19303 KTG 68770 b

1support persons, aides, front-line supervisors, qualified
2intellectual disabilities professionals, nurses, and
3non-administrative support staff. The Department shall adopt
4rules, including emergency rules under subsection (bb) of
5Section 5-45 of the Illinois Administrative Procedure Act, to
6implement the provisions of this paragraph.
7    For 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 101st General Assembly shall include an
12increase sufficient to provide a $2 per hour wage increase for
13non-executive front-line personnel, including, but not limited
14to, direct support persons, aides, front-line supervisors,
15qualified intellectual disabilities professionals, nurses, and
16non-administrative support staff. The Department shall adopt
17rules, including emergency rules under the Illinois
18Administrative Procedure Act, to implement the provisions of
19this paragraph and ensure funds are allocated to compensation
20increases for direct care staff.
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 Under
24Age 22 facilities, the rates taking effect on July 1, 1999
25shall include an increase of 1.6% plus $3.00 per resident-day,
26as defined by the Department. For facilities licensed by the

 

 

HB4872- 11 -LRB101 19303 KTG 68770 b

1Department of Public Health under the Nursing Home Care Act as
2Skilled Nursing facilities or Intermediate Care facilities,
3the rates taking effect on July 1, 1999 shall include an
4increase of 1.6% and, for services provided on or after October
51, 1999, shall be increased by $4.00 per resident-day, as
6defined by the Department.
7    For facilities licensed by the Department of Public Health
8under the Nursing Home Care Act as Intermediate Care for the
9Developmentally Disabled facilities or Long Term Care for Under
10Age 22 facilities, the rates taking effect on July 1, 2000
11shall include an increase of 2.5% per resident-day, as defined
12by the Department. For facilities licensed by the Department of
13Public Health under the Nursing Home Care Act as Skilled
14Nursing facilities or Intermediate Care facilities, the rates
15taking effect on July 1, 2000 shall include an increase of 2.5%
16per resident-day, as defined by the Department.
17    For facilities licensed by the Department of Public Health
18under the Nursing Home Care Act as skilled nursing facilities
19or intermediate care facilities, a new payment methodology must
20be implemented for the nursing component of the rate effective
21July 1, 2003. The Department of Public Aid (now Healthcare and
22Family Services) shall develop the new payment methodology
23using the Minimum Data Set (MDS) as the instrument to collect
24information concerning nursing home resident condition
25necessary to compute the rate. The Department shall develop the
26new payment methodology to meet the unique needs of Illinois

 

 

HB4872- 12 -LRB101 19303 KTG 68770 b

1nursing home residents while remaining subject to the
2appropriations provided by the General Assembly. A transition
3period from the payment methodology in effect on June 30, 2003
4to the payment methodology in effect on July 1, 2003 shall be
5provided for a period not exceeding 3 years and 184 days after
6implementation of the new payment methodology as follows:
7        (A) For a facility that would receive a lower nursing
8    component rate per patient day under the new system than
9    the facility received effective on the date immediately
10    preceding the date that the Department implements the new
11    payment methodology, the nursing component rate per
12    patient day for the facility shall be held at the level in
13    effect on the date immediately preceding the date that the
14    Department implements the new payment methodology until a
15    higher nursing component rate of reimbursement is achieved
16    by that facility.
17        (B) For a facility that would receive a higher nursing
18    component rate per patient day under the payment
19    methodology in effect on July 1, 2003 than the facility
20    received effective on the date immediately preceding the
21    date that the Department implements the new payment
22    methodology, the nursing component rate per patient day for
23    the facility shall be adjusted.
24        (C) Notwithstanding paragraphs (A) and (B), the
25    nursing component rate per patient day for the facility
26    shall be adjusted subject to appropriations provided by the

 

 

HB4872- 13 -LRB101 19303 KTG 68770 b

1    General Assembly.
2    For facilities licensed by the Department of Public Health
3under the Nursing Home Care Act as Intermediate Care for the
4Developmentally Disabled facilities or Long Term Care for Under
5Age 22 facilities, the rates taking effect on March 1, 2001
6shall include a statewide increase of 7.85%, as defined by the
7Department.
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, except facilities participating
12in the Department's demonstration program pursuant to the
13provisions of Title 77, Part 300, Subpart T of the Illinois
14Administrative Code, the numerator of the ratio used by the
15Department of Healthcare and Family Services to compute the
16rate payable under this Section using the Minimum Data Set
17(MDS) methodology shall incorporate the following annual
18amounts as the additional funds appropriated to the Department
19specifically to pay for rates based on the MDS nursing
20component methodology in excess of the funding in effect on
21December 31, 2006:
22        (i) For rates taking effect January 1, 2007,
23    $60,000,000.
24        (ii) For rates taking effect January 1, 2008,
25    $110,000,000.
26        (iii) For rates taking effect January 1, 2009,

 

 

HB4872- 14 -LRB101 19303 KTG 68770 b

1    $194,000,000.
2        (iv) For rates taking effect April 1, 2011, or the
3    first day of the month that begins at least 45 days after
4    the effective date of this amendatory Act of the 96th
5    General Assembly, $416,500,000 or an amount as may be
6    necessary to complete the transition to the MDS methodology
7    for the nursing component of the rate. Increased payments
8    under this item (iv) are not due and payable, however,
9    until (i) the methodologies described in this paragraph are
10    approved by the federal government in an appropriate State
11    Plan amendment and (ii) the assessment imposed by Section
12    5B-2 of this Code is determined to be a permissible tax
13    under Title XIX of the Social Security Act.
14    Notwithstanding any other provision of this Section, for
15facilities licensed by the Department of Public Health under
16the Nursing Home Care Act as skilled nursing facilities or
17intermediate care facilities, the support component of the
18rates taking effect on January 1, 2008 shall be computed using
19the most recent cost reports on file with the Department of
20Healthcare and Family Services no later than April 1, 2005,
21updated for inflation to January 1, 2006.
22    For facilities licensed by the Department of Public Health
23under the Nursing Home Care Act as Intermediate Care for the
24Developmentally Disabled facilities or Long Term Care for Under
25Age 22 facilities, the rates taking effect on April 1, 2002
26shall include a statewide increase of 2.0%, as defined by the

 

 

HB4872- 15 -LRB101 19303 KTG 68770 b

1Department. This increase terminates on July 1, 2002; beginning
2July 1, 2002 these rates are reduced to the level of the rates
3in effect on March 31, 2002, as defined by the Department.
4    For facilities licensed by the Department of Public Health
5under the Nursing Home Care Act as skilled nursing facilities
6or intermediate care facilities, the rates taking effect on
7July 1, 2001 shall be computed using the most recent cost
8reports on file with the Department of Public Aid no later than
9April 1, 2000, updated for inflation to January 1, 2001. For
10rates effective July 1, 2001 only, rates shall be the greater
11of the rate computed for July 1, 2001 or the rate effective on
12June 30, 2001.
13    Notwithstanding any other provision of this Section, for
14facilities licensed by the Department of Public Health under
15the Nursing Home Care Act as skilled nursing facilities or
16intermediate care facilities, the Illinois Department shall
17determine by rule the rates taking effect on July 1, 2002,
18which shall be 5.9% less than the rates in effect on June 30,
192002.
20    Notwithstanding any other provision of this Section, for
21facilities licensed by the Department of Public Health under
22the Nursing Home Care Act as skilled nursing facilities or
23intermediate care facilities, if the payment methodologies
24required under Section 5A-12 and the waiver granted under 42
25CFR 433.68 are approved by the United States Centers for
26Medicare and Medicaid Services, the rates taking effect on July

 

 

HB4872- 16 -LRB101 19303 KTG 68770 b

11, 2004 shall be 3.0% greater than the rates in effect on June
230, 2004. These rates shall take effect only upon approval and
3implementation of the payment methodologies required under
4Section 5A-12.
5    Notwithstanding any other provisions of this Section, for
6facilities licensed by the Department of Public Health under
7the Nursing Home Care Act as skilled nursing facilities or
8intermediate care facilities, the rates taking effect on
9January 1, 2005 shall be 3% more than the rates in effect on
10December 31, 2004.
11    Notwithstanding any other provision of this Section, for
12facilities licensed by the Department of Public Health under
13the Nursing Home Care Act as skilled nursing facilities or
14intermediate care facilities, effective January 1, 2009, the
15per diem support component of the rates effective on January 1,
162008, computed using the most recent cost reports on file with
17the Department of Healthcare and Family Services no later than
18April 1, 2005, updated for inflation to January 1, 2006, shall
19be increased to the amount that would have been derived using
20standard Department of Healthcare and Family Services methods,
21procedures, and inflators.
22    Notwithstanding any other provisions of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as intermediate care facilities that
25are federally defined as Institutions for Mental Disease, or
26facilities licensed by the Department of Public Health under

 

 

HB4872- 17 -LRB101 19303 KTG 68770 b

1the Specialized Mental Health Rehabilitation Act of 2013, a
2socio-development component rate equal to 6.6% of the
3facility's nursing component rate as of January 1, 2006 shall
4be established and paid effective July 1, 2006. The
5socio-development component of the rate shall be increased by a
6factor of 2.53 on the first day of the month that begins at
7least 45 days after January 11, 2008 (the effective date of
8Public Act 95-707). As of August 1, 2008, the socio-development
9component rate shall be equal to 6.6% of the facility's nursing
10component rate as of January 1, 2006, multiplied by a factor of
113.53. For services provided on or after April 1, 2011, or the
12first day of the month that begins at least 45 days after the
13effective date of this amendatory Act of the 96th General
14Assembly, whichever is later, the Illinois Department may by
15rule adjust these socio-development component rates, and may
16use different adjustment methodologies for those facilities
17participating, and those not participating, in the Illinois
18Department's demonstration program pursuant to the provisions
19of Title 77, Part 300, Subpart T of the Illinois Administrative
20Code, but in no case may such rates be diminished below those
21in effect on August 1, 2008.
22    For facilities licensed by the Department of Public Health
23under the Nursing Home Care Act as Intermediate Care for the
24Developmentally Disabled facilities or as long-term care
25facilities for residents under 22 years of age, the rates
26taking effect on July 1, 2003 shall include a statewide

 

 

HB4872- 18 -LRB101 19303 KTG 68770 b

1increase of 4%, as defined by the Department.
2    For facilities licensed by the Department of Public Health
3under the Nursing Home Care Act as Intermediate Care for the
4Developmentally Disabled facilities or Long Term Care for Under
5Age 22 facilities, the rates taking effect on the first day of
6the month that begins at least 45 days after the effective date
7of this amendatory Act of the 95th General Assembly shall
8include a statewide increase of 2.5%, as defined by the
9Department.
10    Notwithstanding any other provision of this Section, for
11facilities licensed by the Department of Public Health under
12the Nursing Home Care Act as skilled nursing facilities or
13intermediate care facilities, effective January 1, 2005,
14facility rates shall be increased by the difference between (i)
15a facility's per diem property, liability, and malpractice
16insurance costs as reported in the cost report filed with the
17Department of Public Aid and used to establish rates effective
18July 1, 2001 and (ii) those same costs as reported in the
19facility's 2002 cost report. These costs shall be passed
20through to the facility without caps or limitations, except for
21adjustments required under normal auditing procedures.
22    Rates established effective each July 1 shall govern
23payment for services rendered throughout that fiscal year,
24except that rates established on July 1, 1996 shall be
25increased by 6.8% for services provided on or after January 1,
261997. Such rates will be based upon the rates calculated for

 

 

HB4872- 19 -LRB101 19303 KTG 68770 b

1the year beginning July 1, 1990, and for subsequent years
2thereafter until June 30, 2001 shall be based on the facility
3cost reports for the facility fiscal year ending at any point
4in time during the previous calendar year, updated to the
5midpoint of the rate year. The cost report shall be on file
6with the Department no later than April 1 of the current rate
7year. Should the cost report not be on file by April 1, the
8Department shall base the rate on the latest cost report filed
9by each skilled care facility and intermediate care facility,
10updated to the midpoint of the current rate year. In
11determining rates for services rendered on and after July 1,
121985, fixed time shall not be computed at less than zero. The
13Department shall not make any alterations of regulations which
14would reduce any component of the Medicaid rate to a level
15below what that component would have been utilizing in the rate
16effective on July 1, 1984.
17    (2) Shall take into account the actual costs incurred by
18facilities in providing services for recipients of skilled
19nursing and intermediate care services under the medical
20assistance program.
21    (3) Shall take into account the medical and psycho-social
22characteristics and needs of the patients.
23    (4) Shall take into account the actual costs incurred by
24facilities in meeting licensing and certification standards
25imposed and prescribed by the State of Illinois, any of its
26political subdivisions or municipalities and by the U.S.

 

 

HB4872- 20 -LRB101 19303 KTG 68770 b

1Department of Health and Human Services pursuant to Title XIX
2of the Social Security Act.
3    The Department of Healthcare and Family Services shall
4develop precise standards for payments to reimburse nursing
5facilities for any utilization of appropriate rehabilitative
6personnel for the provision of rehabilitative services which is
7authorized by federal regulations, including reimbursement for
8services provided by qualified therapists or qualified
9assistants, and which is in accordance with accepted
10professional practices. Reimbursement also may be made for
11utilization of other supportive personnel under appropriate
12supervision.
13    The Department shall develop enhanced payments to offset
14the additional costs incurred by a facility serving exceptional
15need residents and shall allocate at least $4,000,000 of the
16funds collected from the assessment established by Section 5B-2
17of this Code for such payments. For the purpose of this
18Section, "exceptional needs" means, but need not be limited to,
19ventilator care and traumatic brain injury care. The enhanced
20payments for exceptional need residents under this paragraph
21are not due and payable, however, until (i) the methodologies
22described in this paragraph are approved by the federal
23government in an appropriate State Plan amendment and (ii) the
24assessment imposed by Section 5B-2 of this Code is determined
25to be a permissible tax under Title XIX of the Social Security
26Act.

 

 

HB4872- 21 -LRB101 19303 KTG 68770 b

1    Beginning January 1, 2014 the methodologies for
2reimbursement of nursing facility services as provided under
3this Section 5-5.4 shall no longer be applicable for services
4provided on or after January 1, 2014.
5    No payment increase under this Section for the MDS
6methodology, exceptional care residents, or the
7socio-development component rate established by Public Act
896-1530 of the 96th General Assembly and funded by the
9assessment imposed under Section 5B-2 of this Code shall be due
10and payable until after the Department notifies the long-term
11care providers, in writing, that the payment methodologies to
12long-term care providers required under this Section have been
13approved by the Centers for Medicare and Medicaid Services of
14the U.S. Department of Health and Human Services and the
15waivers under 42 CFR 433.68 for the assessment imposed by this
16Section, if necessary, have been granted by the Centers for
17Medicare and Medicaid Services of the U.S. Department of Health
18and Human Services. Upon notification to the Department of
19approval of the payment methodologies required under this
20Section and the waivers granted under 42 CFR 433.68, all
21increased payments otherwise due under this Section prior to
22the date of notification shall be due and payable within 90
23days of the date federal approval is received.
24    On and after July 1, 2012, the Department shall reduce any
25rate of reimbursement for services or other payments or alter
26any methodologies authorized by this Code to reduce any rate of

 

 

HB4872- 22 -LRB101 19303 KTG 68770 b

1reimbursement for services or other payments in accordance with
2Section 5-5e.
3    For facilities licensed by the Department of Public Health
4under the ID/DD Community Care Act as ID/DD Facilities and
5under the MC/DD Act as MC/DD Facilities, subject to federal
6approval, the rates taking effect for services delivered on or
7after August 1, 2019 shall be increased by 3.5% over the rates
8in effect on June 30, 2019. The Department shall adopt rules,
9including emergency rules under subsection (ii) of Section 5-45
10of the Illinois Administrative Procedure Act, to implement the
11provisions of this Section, including wage increases for direct
12care staff.
13    For facilities licensed by the Department of Public Health
14under the ID/DD Community Care Act as ID/DD facilities and
15under the MC/DD Act as MC/DD facilities, subject to federal
16approval, the rates taking effect for services delivered on or
17after January 1, 2020, shall be increased sufficiently to
18provide at a minimum $2 per hour wage increase over the wages
19in effect on December 30, 2019. The Department shall adopt
20rules, including emergency rules under the Illinois
21Administrative Procedure Act, to implement the provisions of
22this Section, and ensure funds are allocated to compensation
23increases for direct care staff.
24(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
25101-10, eff. 6-5-19.)
 

 

 

HB4872- 23 -LRB101 19303 KTG 68770 b

1    (305 ILCS 5/5-5.4i)
2    Sec. 5-5.4i. Rates and reimbursements.
3    (a) Within 30 days after July 6, 2017 (the effective date
4of Public Act 100-23), the Department shall increase rates and
5reimbursements to fund a minimum of a $0.75 per hour wage
6increase for front-line personnel, including, but not limited
7to, direct support persons, aides, front-line supervisors,
8qualified intellectual disabilities professionals, nurses, and
9non-administrative support staff working in community-based
10provider organizations serving individuals with developmental
11disabilities. The Department shall adopt rules, including
12emergency rules under subsection (y) of Section 5-45 of the
13Illinois Administrative Procedure Act, to implement the
14provisions of this Section.
15    (b) Within 30 days after June 4, 2018 (the effective date
16of Public Act 100-587), the Department shall increase rates and
17reimbursements to fund a minimum of a $0.50 per hour wage
18increase for front-line personnel, including, but not limited
19to, direct support persons, aides, front-line supervisors,
20qualified intellectual disabilities professionals, nurses, and
21non-administrative support staff working in community-based
22provider organizations serving individuals with developmental
23disabilities. The Department shall adopt rules, including
24emergency rules under subsection (bb) of Section 5-45 of the
25Illinois Administrative Procedure Act, to implement the
26provisions of this Section.

 

 

HB4872- 24 -LRB101 19303 KTG 68770 b

1    (c) Within 30 days after the effective date of this
2amendatory Act of the 101st General Assembly, subject to
3federal approval, the Department shall increase rates and
4reimbursements in effect on June 30, 2019 for community-based
5providers for persons with Developmental Disabilities by 3.5%.
6The Department shall adopt rules, including emergency rules
7under subsection (ii) of Section 5-45 of the Illinois
8Administrative Procedure Act, to implement the provisions of
9this Section, including wage increases for direct care staff.
10    (d) Within 30 days after the effective date of this
11amendatory Act of the 101st General Assembly, subject to
12federal approval, the Department shall increase rates and
13reimbursements in effect on January 1, 2020 for community-based
14providers for persons with developmental disabilities in order
15to fund a minimum $2 per hour wage increase. The Department
16shall adopt rules, including emergency rules under the Illinois
17Administrative Procedure Act, to implement the provisions of
18this Section, and ensure funds are allocated to compensation
19increases for direct care staff.
20(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
21101-10, eff. 6-5-19.)
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.

 

 

HB4872- 25 -LRB101 19303 KTG 68770 b

1 INDEX
2 Statutes amended in order of appearance
3    5 ILCS 100/5-45.1 new
4    20 ILCS 1705/55.5 new
5    20 ILCS 1705/74
6    305 ILCS 5/5-5.4from Ch. 23, par. 5-5.4
7    305 ILCS 5/5-5.4i