103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3398

 

Introduced 2/17/2023, by Rep. Lakesia Collins

 

SYNOPSIS AS INTRODUCED:
 
5 ILCS 100/5-45.35 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, 2023 shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in effect on June 30, 2023 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, 2023, shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in effect on June 30, 2023 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.


LRB103 28846 KTG 55231 b

 

 

A BILL FOR

 

HB3398LRB103 28846 KTG 55231 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 22,000 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) In Illinois, nearly half of direct care workers
16    rely on public assistance to make ends meet, creating
17    additional expenditures for State government; low wages
18    are a consequence of the historically low reimbursement
19    rates paid by the State of Illinois to community-based
20    service providers.
21        (3) The lack of adequate wages for employees who
22    perform the challenging work of supporting persons with
23    intellectual and developmental disabilities results in

 

 

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1    high employee turnover, which in turn negatively impacts
2    the quality of services provided, higher wages are proven
3    to reduce staff turnover, improving stability and quality
4    of services while reducing employer training costs.
5        (4) Rising wages in other sectors now mean, despite
6    the modest wage increase and strenuous efforts to recruit
7    new workers, agencies are experiencing DSP vacancy rates
8    of 27%; excessive vacancies force employers to rely more
9    on overtime, leading to staff burnout and driving up
10    costs; for the eighth year in a row the federal court
11    monitor documented how this growing hiring crisis impedes
12    the ability of community disability agencies to expand to
13    accommodate persons newly approved for services as part of
14    the Ligas Consent Decree.
15        (5) A December 2020 report issued by an independent
16    consulting group commissioned by the State to propose
17    changes to the State's reimbursement for community
18    disability agencies recommended that addressing DSP wages
19    was the number one priority for ensuring compliance with
20    the mandates of the Ligas Consent Decree, and further
21    recommended that wages for DSPs should be fixed at 150% of
22    the prevailing minimum wage plus additional funding for
23    benefits.
24        (6) The difference between 150% of the State minimum
25    wage on January 1, 2023 and the hourly DSP wage rate set by
26    the State amounts to $4.00 per hour.

 

 

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1        (7) The General Assembly finds that in order to reduce
2    turnover, increase retention, fill vacancies, and ensure
3    DSPs are adequately compensated for the critically
4    important work they do, an increase in rates and
5    reimbursements to community-based service providers to
6    effectuate an increase in the hourly wage paid to DSPs is
7    needed.
 
8    Section 3. Purpose and intent. It is the purpose of this
9Act to increase the wages of DSPs and other frontline staff in
10community disability agencies beyond the poverty level and to
11a level competitive with rival employers and above the State
12minimum wage, in an effort to improve the lives of DSPs and the
13lives of the vulnerable persons they support.
14    It is the intent of the General Assembly to ensure that all
15funds resulting from rate increases provided to community
16disability agencies are allocated to front-line employee wages
17in order to address the current workforce crisis which is the
18primary obstacle to the availability of community-based
19services for people with disabilities.
 
20    Section 5. The Illinois Administrative Procedure Act is
21amended by adding Section 5-45.35 as follows:
 
22    (5 ILCS 100/5-45.35 new)
23    Sec. 5-45.35. Emergency rulemaking; Departments of Human

 

 

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1Services and Healthcare and Family Services. To provide for
2the expeditious and timely implementation of changes made by
3this amendatory Act of the 103rd General Assembly to Section
474 of the 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 implementing the
7changes made by this amendatory Act of the 103rd General
8Assembly to Section 74 of the Mental Health and Developmental
9Disabilities Administrative Act and to Sections 5-5.4 and
105-5.4i of the Illinois Public Aid Code may be adopted in
11accordance with Section 5-45 by the respective Department. The
12adoption of emergency rules authorized by Section 5-45 and
13this Section is deemed to be necessary for the public
14interest, safety, and welfare.
15    This Section is repealed one year after the effective date
16of this amendatory Act of the 103rd General Assembly.
 
17    Section 10. The Mental Health and Developmental
18Disabilities Administrative Act is amended by changing Section
1974 and by adding Section 55.5 as follows:
 
20    (20 ILCS 1705/55.5 new)
21    Sec. 55.5. Increased wages for front-line personnel. As
22used in this Section, "front-line personnel" means direct
23support persons, aides, front-line supervisors, and
24non-administrative support staff working in service settings

 

 

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1outlined in this Section.
2    The Department shall establish reimbursement rates that
3build toward livable wages for front-line personnel in
4residential and day programs and service coordination agencies
5serving persons with intellectual and developmental
6disabilities under Section 54 of this Act, including, but not
7limited to, intermediate care for the developmentally disabled
8facilities, medically complex for the developmentally disabled
9facilities, community-integrated living arrangements,
10community day services, employment, and other residential and
11day programs for persons with intellectual and developmental
12disabilities supported by State funds or funding under Title
13XIX of the federal Social Security Act.
14    The Department shall increase rates and reimbursements so
15that by July 1, 2023 direct support persons wages shall be
16increased by $4.00 per hour, and so that other front-line
17personnel earn a commensurate wage.
 
18    (20 ILCS 1705/74)
19    Sec. 74. Rates and reimbursements.
20    (a) Within 30 days after July 6, 2017 (the effective date
21of Public Act 100-23), the Department shall increase rates and
22reimbursements to fund a minimum of a $0.75 per hour wage
23increase for front-line personnel, including, but not limited
24to, direct support professionals, aides, front-line
25supervisors, qualified intellectual disabilities

 

 

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1professionals, nurses, and non-administrative support staff
2working in community-based provider organizations serving
3individuals with developmental disabilities. The Department
4shall adopt rules, including emergency rules under subsection
5(y) of Section 5-45 of the Illinois Administrative Procedure
6Act, to implement the provisions of this Section.
7    (b) Rates and reimbursements. Within 30 days after June 4,
82018 (the effective date of Public Act 100-587) this
9amendatory Act of the 100th General Assembly, the Department
10shall increase rates and reimbursements to fund a minimum of a
11$0.50 per hour wage increase for front-line personnel,
12including, but not limited to, direct support professionals,
13aides, front-line supervisors, qualified intellectual
14disabilities professionals, nurses, and non-administrative
15support staff working in community-based provider
16organizations serving individuals with developmental
17disabilities. The Department shall adopt rules, including
18emergency rules under subsection (bb) of Section 5-45 of the
19Illinois Administrative Procedure Act, to implement the
20provisions of this Section.
21    (c) Rates and reimbursements. Within 30 days after June 5,
222019 (the effective date of Public Act 101-10) this amendatory
23Act of the 101st General Assembly, subject to federal
24approval, the Department shall increase rates and
25reimbursements in effect on June 30, 2019 for community-based
26providers for persons with Developmental Disabilities by 3.5%

 

 

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1The Department shall adopt rules, including emergency rules
2under subsection (jj) of Section 5-45 of the Illinois
3Administrative Procedure Act, to implement the provisions of
4this Section, including wage increases for direct care staff.
5    (d) For community-based providers serving persons with
6intellectual/developmental disabilities, subject to federal
7approval of any relevant Waiver Amendment, the rates taking
8effect for services delivered on or after January 1, 2022,
9shall include an increase in the rate methodology sufficient
10to provide a $1.50 per hour wage increase for direct support
11professionals in residential settings and sufficient to
12provide wages for all residential non-executive direct care
13staff, excluding direct support professionals, at the federal
14Department of Labor, Bureau of Labor Statistics' average wage
15as defined in rule by the Department.
16    The establishment of and any changes to the rate
17methodologies for community-based services provided to persons
18with intellectual/developmental disabilities are subject to
19federal approval of any relevant Waiver Amendment and shall be
20defined in rule by the Department. The Department shall adopt
21rules, including emergency rules as authorized by Section 5-45
22of the Illinois Administrative Procedure Act, to implement the
23provisions of this subsection (d).
24    (e) For community-based providers serving persons with
25intellectual/developmental disabilities, subject to federal
26approval of any relevant Waiver Amendment, the rates taking

 

 

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1effect for services delivered on or after January 1, 2023,
2shall include an increase in the rate methodology sufficient
3to provide a $1.00 per hour wage increase for all direct
4support professionals personnel and all other frontline
5personnel who are not subject to the Bureau of Labor
6Statistics' average wage increases, who work in residential
7and community day services settings, with at least $0.50 of
8those funds to be provided as a direct increase to base wages,
9with the remaining $0.50 to be used flexibly for base wage
10increases. In addition, the rates taking effect for services
11delivered on or after January 1, 2023 shall include an
12increase sufficient to provide wages for all residential
13non-executive direct care staff, excluding direct support
14professionals personnel, at the federal Department of Labor,
15Bureau of Labor Statistics' average wage as defined in rule by
16the Department.
17    The establishment of and any changes to the rate
18methodologies for community-based services provided to persons
19with intellectual/developmental disabilities are subject to
20federal approval of any relevant Waiver Amendment and shall be
21defined in rule by the Department. The Department shall adopt
22rules, including emergency rules as authorized by Section 5-45
23of the Illinois Administrative Procedure Act, to implement the
24provisions of this subsection.
25    (f) For community-based providers serving persons with
26intellectual or developmental disabilities, subject to federal

 

 

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1approval, the rates taking effect for services delivered on or
2after July 1, 2023 shall be increased sufficiently to provide
3a minimum $4.00 per hour wage increase over the wages in effect
4on June 30, 2023 for front-line personnel, including, but not
5limited to, direct support persons, aides, front-line
6supervisors, and non-administrative support staff working in
7community-based provider organizations serving individuals
8with developmental disabilities, and sufficient to provide
9wages for all other residential non-executive direct care
10staff, excluding direct support personnel, at the U.S.
11Department of Labor, Bureau of Labor Statistics' average wage
12as defined, by rule, by the Department. The Department shall
13adopt rules, including emergency rules in accordance with the
14Illinois Administrative Procedure Act, to implement the
15provisions of this subsection.
16(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
17102-699, eff. 4-19-22; 102-830, eff. 1-1-23; revised
1812-13-22.)
 
19    Section 15. The Illinois Public Aid Code is amended by
20changing Sections 5-5.4 and 5-5.4i as follows:
 
21    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
22    Sec. 5-5.4. Standards of Payment - Department of
23Healthcare and Family Services. The Department of Healthcare
24and Family Services shall develop standards of payment of

 

 

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1nursing facility and ICF/DD services in facilities providing
2such services under this Article which:
3    (1) Provide for the determination of a facility's payment
4for nursing facility or ICF/DD services on a prospective
5basis. The amount of the payment rate for all nursing
6facilities certified by the Department of Public Health under
7the ID/DD Community Care Act or the Nursing Home Care Act as
8Intermediate Care for the Developmentally Disabled facilities,
9Long Term Care for Under Age 22 facilities, Skilled Nursing
10facilities, or Intermediate Care facilities under the medical
11assistance program shall be prospectively established annually
12on the basis of historical, financial, and statistical data
13reflecting actual costs from prior years, which shall be
14applied to the current rate year and updated for inflation,
15except that the capital cost element for newly constructed
16facilities shall be based upon projected budgets. The annually
17established payment rate shall take effect on July 1 in 1984
18and subsequent years. No rate increase and no update for
19inflation shall be provided on or after July 1, 1994, unless
20specifically provided for in this Section. The changes made by
21Public Act 93-841 extending the duration of the prohibition
22against a rate increase or update for inflation are effective
23retroactive to July 1, 2004.
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,
21998 shall include an increase of 3%. For facilities licensed
3by the Department of Public Health under the Nursing Home Care
4Act as Skilled Nursing facilities or Intermediate Care
5facilities, the rates taking effect on July 1, 1998 shall
6include an increase of 3% plus $1.10 per resident-day, as
7defined by the Department. For facilities licensed by the
8Department of Public Health under the Nursing Home Care Act as
9Intermediate Care Facilities for the Developmentally Disabled
10or Long Term Care for Under Age 22 facilities, the rates taking
11effect on January 1, 2006 shall include an increase of 3%. For
12facilities licensed by the Department of Public Health under
13the Nursing Home Care Act as Intermediate Care Facilities for
14the Developmentally Disabled or Long Term Care for Under Age
1522 facilities, the rates taking effect on January 1, 2009
16shall include an increase sufficient to provide a $0.50 per
17hour wage increase for non-executive staff. For facilities
18licensed by the Department of Public Health under the ID/DD
19Community Care Act as ID/DD Facilities the rates taking effect
20within 30 days after July 6, 2017 (the effective date of Public
21Act 100-23) shall include an increase sufficient to provide a
22$0.75 per hour wage increase for non-executive staff. The
23Department shall adopt rules, including emergency rules under
24subsection (y) of Section 5-45 of the Illinois Administrative
25Procedure Act, to implement the provisions of this paragraph.
26For 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, the rates taking
3effect within 30 days after the effective date of this
4amendatory Act of the 100th General Assembly shall include an
5increase sufficient to provide a $0.50 per hour wage increase
6for non-executive front-line personnel, including, but not
7limited to, direct support persons, aides, front-line
8supervisors, qualified intellectual disabilities
9professionals, nurses, and non-administrative support staff.
10The Department shall adopt rules, including emergency rules
11under subsection (bb) of Section 5-45 of the Illinois
12Administrative Procedure Act, to implement the provisions of
13this paragraph.
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, the rates taking effect for services delivered on or
18after July 1, 2023, shall be increased sufficiently to provide
19a minimum $4.00 per hour wage increase over the wages in effect
20on June 30, 2023 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 paragraph.
6    For facilities licensed by the Department of Public Health
7under the Nursing Home Care Act as Intermediate Care for the
8Developmentally Disabled facilities or Long Term Care for
9Under Age 22 facilities, the rates taking effect on July 1,
101999 shall include an increase of 1.6% plus $3.00 per
11resident-day, as defined by the Department. For facilities
12licensed by the Department of Public Health under the Nursing
13Home Care Act as Skilled Nursing facilities or Intermediate
14Care facilities, the rates taking effect on July 1, 1999 shall
15include an increase of 1.6% and, for services provided on or
16after October 1, 1999, shall be increased by $4.00 per
17resident-day, as defined by the Department.
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
21Under Age 22 facilities, the rates taking effect on July 1,
222000 shall include an increase of 2.5% per resident-day, as
23defined by the Department. For facilities licensed by the
24Department of Public Health under the Nursing Home Care Act as
25Skilled Nursing facilities or Intermediate Care facilities,
26the rates taking effect on July 1, 2000 shall include an

 

 

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1increase of 2.5% per resident-day, as defined by the
2Department.
3    For facilities licensed by the Department of Public Health
4under the Nursing Home Care Act as skilled nursing facilities
5or intermediate care facilities, a new payment methodology
6must be implemented for the nursing component of the rate
7effective July 1, 2003. The Department of Public Aid (now
8Healthcare and Family Services) shall develop the new payment
9methodology using the Minimum Data Set (MDS) as the instrument
10to collect information concerning nursing home resident
11condition necessary to compute the rate. The Department shall
12develop the new payment methodology to meet the unique needs
13of Illinois nursing home residents while remaining subject to
14the appropriations provided by the General Assembly. A
15transition period from the payment methodology in effect on
16June 30, 2003 to the payment methodology in effect on July 1,
172003 shall be provided for a period not exceeding 3 years and
18184 days after implementation of the new payment methodology
19as follows:
20        (A) For a facility that would receive a lower nursing
21    component rate per patient day under the new system than
22    the facility received effective on the date immediately
23    preceding the date that the Department implements the new
24    payment methodology, the nursing component rate per
25    patient day for the facility shall be held at the level in
26    effect on the date immediately preceding the date that the

 

 

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1    Department implements the new payment methodology until a
2    higher nursing component rate of reimbursement is achieved
3    by that facility.
4        (B) For a facility that would receive a higher nursing
5    component rate per patient day under the payment
6    methodology in effect on July 1, 2003 than the facility
7    received effective on the date immediately preceding the
8    date that the Department implements the new payment
9    methodology, the nursing component rate per patient day
10    for the facility shall be adjusted.
11        (C) Notwithstanding paragraphs (A) and (B), the
12    nursing component rate per patient day for the facility
13    shall be adjusted subject to appropriations provided by
14    the General Assembly.
15    For facilities licensed by the Department of Public Health
16under the Nursing Home Care Act as Intermediate Care for the
17Developmentally Disabled facilities or Long Term Care for
18Under Age 22 facilities, the rates taking effect on March 1,
192001 shall include a statewide increase of 7.85%, as defined
20by the Department.
21    Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, except facilities participating
25in the Department's demonstration program pursuant to the
26provisions of Title 77, Part 300, Subpart T of the Illinois

 

 

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1Administrative Code, the numerator of the ratio used by the
2Department of Healthcare and Family Services to compute the
3rate payable under this Section using the Minimum Data Set
4(MDS) methodology shall incorporate the following annual
5amounts as the additional funds appropriated to the Department
6specifically to pay for rates based on the MDS nursing
7component methodology in excess of the funding in effect on
8December 31, 2006:
9        (i) For rates taking effect January 1, 2007,
10    $60,000,000.
11        (ii) For rates taking effect January 1, 2008,
12    $110,000,000.
13        (iii) For rates taking effect January 1, 2009,
14    $194,000,000.
15        (iv) For rates taking effect April 1, 2011, or the
16    first day of the month that begins at least 45 days after
17    the effective date of this amendatory Act of the 96th
18    General Assembly, $416,500,000 or an amount as may be
19    necessary to complete the transition to the MDS
20    methodology for the nursing component of the rate.
21    Increased payments under this item (iv) are not due and
22    payable, however, until (i) the methodologies described in
23    this paragraph are approved by the federal government in
24    an appropriate State Plan amendment and (ii) the
25    assessment imposed by Section 5B-2 of this Code is
26    determined to be a permissible tax under Title XIX of the

 

 

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1    Social Security Act.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, the support component of the
6rates taking effect on January 1, 2008 shall be computed using
7the most recent cost reports on file with the Department of
8Healthcare and Family Services no later than April 1, 2005,
9updated for inflation to January 1, 2006.
10    For facilities licensed by the Department of Public Health
11under the Nursing Home Care Act as Intermediate Care for the
12Developmentally Disabled facilities or Long Term Care for
13Under Age 22 facilities, the rates taking effect on April 1,
142002 shall include a statewide increase of 2.0%, as defined by
15the Department. This increase terminates on July 1, 2002;
16beginning July 1, 2002 these rates are reduced to the level of
17the rates in effect on March 31, 2002, as defined by the
18Department.
19    For facilities licensed by the Department of Public Health
20under the Nursing Home Care Act as skilled nursing facilities
21or intermediate care facilities, the rates taking effect on
22July 1, 2001 shall be computed using the most recent cost
23reports on file with the Department of Public Aid no later than
24April 1, 2000, updated for inflation to January 1, 2001. For
25rates effective July 1, 2001 only, rates shall be the greater
26of the rate computed for July 1, 2001 or the rate effective on

 

 

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1June 30, 2001.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, the Illinois Department shall
6determine by rule the rates taking effect on July 1, 2002,
7which shall be 5.9% less than the rates in effect on June 30,
82002.
9    Notwithstanding any other provision of this Section, for
10facilities licensed by the Department of Public Health under
11the Nursing Home Care Act as skilled nursing facilities or
12intermediate care facilities, if the payment methodologies
13required under Section 5A-12 and the waiver granted under 42
14CFR 433.68 are approved by the United States Centers for
15Medicare and Medicaid Services, the rates taking effect on
16July 1, 2004 shall be 3.0% greater than the rates in effect on
17June 30, 2004. These rates shall take effect only upon
18approval and implementation of the payment methodologies
19required under Section 5A-12.
20    Notwithstanding any other provisions 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, the rates taking effect on
24January 1, 2005 shall be 3% more than the rates in effect on
25December 31, 2004.
26    Notwithstanding any other provision 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, effective January 1, 2009, the
4per diem support component of the rates effective on January
51, 2008, computed using the most recent cost reports on file
6with the Department of Healthcare and Family Services no later
7than April 1, 2005, updated for inflation to January 1, 2006,
8shall be increased to the amount that would have been derived
9using standard Department of Healthcare and Family Services
10methods, procedures, and inflators.
11    Notwithstanding any other provisions of this Section, for
12facilities licensed by the Department of Public Health under
13the Nursing Home Care Act as intermediate care facilities that
14are federally defined as Institutions for Mental Disease, or
15facilities licensed by the Department of Public Health under
16the Specialized Mental Health Rehabilitation Act of 2013, a
17socio-development component rate equal to 6.6% of the
18facility's nursing component rate as of January 1, 2006 shall
19be established and paid effective July 1, 2006. The
20socio-development component of the rate shall be increased by
21a factor of 2.53 on the first day of the month that begins at
22least 45 days after January 11, 2008 (the effective date of
23Public Act 95-707). As of August 1, 2008, the
24socio-development component rate shall be equal to 6.6% of the
25facility's nursing component rate as of January 1, 2006,
26multiplied by a factor of 3.53. For services provided on or

 

 

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1after April 1, 2011, or the first day of the month that begins
2at least 45 days after the effective date of this amendatory
3Act of the 96th General Assembly, whichever is later, the
4Illinois Department may by rule adjust these socio-development
5component rates, and may use different adjustment
6methodologies for those facilities participating, and those
7not participating, in the Illinois Department's demonstration
8program pursuant to the provisions of Title 77, Part 300,
9Subpart T of the Illinois Administrative Code, but in no case
10may such rates be diminished below those in effect on August 1,
112008.
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 as long-term care
15facilities for residents under 22 years of age, the rates
16taking effect on July 1, 2003 shall include a statewide
17increase of 4%, as defined by the Department.
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
21Under Age 22 facilities, the rates taking effect on the first
22day of the month that begins at least 45 days after the
23effective date of this amendatory Act of the 95th General
24Assembly shall include a statewide increase of 2.5%, as
25defined by the Department.
26    Notwithstanding any other provision 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, effective January 1, 2005,
4facility rates shall be increased by the difference between
5(i) a facility's per diem property, liability, and malpractice
6insurance costs as reported in the cost report filed with the
7Department of Public Aid and used to establish rates effective
8July 1, 2001 and (ii) those same costs as reported in the
9facility's 2002 cost report. These costs shall be passed
10through to the facility without caps or limitations, except
11for adjustments required under normal auditing procedures.
12    Rates established effective each July 1 shall govern
13payment for services rendered throughout that fiscal year,
14except that rates established on July 1, 1996 shall be
15increased by 6.8% for services provided on or after January 1,
161997. Such rates will be based upon the rates calculated for
17the year beginning July 1, 1990, and for subsequent years
18thereafter until June 30, 2001 shall be based on the facility
19cost reports for the facility fiscal year ending at any point
20in time during the previous calendar year, updated to the
21midpoint of the rate year. The cost report shall be on file
22with the Department no later than April 1 of the current rate
23year. Should the cost report not be on file by April 1, the
24Department shall base the rate on the latest cost report filed
25by each skilled care facility and intermediate care facility,
26updated to the midpoint of the current rate year. In

 

 

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1determining rates for services rendered on and after July 1,
21985, fixed time shall not be computed at less than zero. The
3Department shall not make any alterations of regulations which
4would reduce any component of the Medicaid rate to a level
5below what that component would have been utilizing in the
6rate effective on July 1, 1984.
7    (2) Shall take into account the actual costs incurred by
8facilities in providing services for recipients of skilled
9nursing and intermediate care services under the medical
10assistance program.
11    (3) Shall take into account the medical and psycho-social
12characteristics and needs of the patients.
13    (4) Shall take into account the actual costs incurred by
14facilities in meeting licensing and certification standards
15imposed and prescribed by the State of Illinois, any of its
16political subdivisions or municipalities and by the U.S.
17Department of Health and Human Services pursuant to Title XIX
18of the Social Security Act.
19    The Department of Healthcare and Family Services shall
20develop precise standards for payments to reimburse nursing
21facilities for any utilization of appropriate rehabilitative
22personnel for the provision of rehabilitative services which
23is authorized by federal regulations, including reimbursement
24for services provided by qualified therapists or qualified
25assistants, and which is in accordance with accepted
26professional practices. Reimbursement also may be made for

 

 

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1utilization of other supportive personnel under appropriate
2supervision.
3    The Department shall develop enhanced payments to offset
4the additional costs incurred by a facility serving
5exceptional need residents and shall allocate at least
6$4,000,000 of the funds collected from the assessment
7established by Section 5B-2 of this Code for such payments.
8For the purpose of this Section, "exceptional needs" means,
9but need not be limited to, ventilator care and traumatic
10brain injury care. The enhanced payments for exceptional need
11residents under this paragraph are not due and payable,
12however, until (i) the methodologies described in this
13paragraph are approved by the federal government in an
14appropriate State Plan amendment and (ii) the assessment
15imposed by Section 5B-2 of this Code is determined to be a
16permissible tax under Title XIX of the Social Security Act.
17    Beginning January 1, 2014 the methodologies for
18reimbursement of nursing facility services as provided under
19this Section 5-5.4 shall no longer be applicable for services
20provided on or after January 1, 2014.
21    No payment increase under this Section for the MDS
22methodology, exceptional care residents, or the
23socio-development component rate established by Public Act
2496-1530 of the 96th General Assembly and funded by the
25assessment imposed under Section 5B-2 of this Code shall be
26due and payable until after the Department notifies the

 

 

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1long-term care providers, in writing, that the payment
2methodologies to long-term care providers required under this
3Section have been approved by the Centers for Medicare and
4Medicaid Services of the U.S. Department of Health and Human
5Services and the waivers under 42 CFR 433.68 for the
6assessment imposed by this Section, if necessary, have been
7granted by the Centers for Medicare and Medicaid Services of
8the U.S. Department of Health and Human Services. Upon
9notification to the Department of approval of the payment
10methodologies required under this Section and the waivers
11granted under 42 CFR 433.68, all increased payments otherwise
12due under this Section prior to the date of notification shall
13be due and payable within 90 days of the date federal approval
14is received.
15    On and after July 1, 2012, the Department shall reduce any
16rate of reimbursement for services or other payments or alter
17any methodologies authorized by this Code to reduce any rate
18of reimbursement for services or other payments in accordance
19with Section 5-5e.
20    For facilities licensed by the Department of Public Health
21under the ID/DD Community Care Act as ID/DD Facilities and
22under the MC/DD Act as MC/DD Facilities, subject to federal
23approval, the rates taking effect for services delivered on or
24after August 1, 2019 shall be increased by 3.5% over the rates
25in effect on June 30, 2019. The Department shall adopt rules,
26including emergency rules under subsection (ii) of Section

 

 

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15-45 of the Illinois Administrative Procedure Act, to
2implement the provisions of this Section, including wage
3increases for direct care staff.
4    For facilities licensed by the Department of Public Health
5under the ID/DD Community Care Act as ID/DD Facilities and
6under the MC/DD Act as MC/DD Facilities, subject to federal
7approval, the rates taking effect on the latter of the
8approval date of the State Plan Amendment for these facilities
9or the Waiver Amendment for the home and community-based
10services settings shall include an increase sufficient to
11provide a $0.26 per hour wage increase to the base wage for
12non-executive staff. The Department shall adopt rules,
13including emergency rules as authorized by Section 5-45 of the
14Illinois Administrative Procedure Act, to implement the
15provisions of this Section, including wage increases for
16direct care staff.
17    For facilities licensed by the Department of Public Health
18under the ID/DD Community Care Act as ID/DD Facilities and
19under the MC/DD Act as MC/DD Facilities, subject to federal
20approval of the State Plan Amendment and the Waiver Amendment
21for the home and community-based services settings, the rates
22taking effect for the services delivered on or after July 1,
232020 shall include an increase sufficient to provide a $1.00
24per hour wage increase for non-executive staff. For services
25delivered on or after January 1, 2021, 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, shall
2include an increase sufficient to provide a $0.50 per hour
3increase for non-executive staff. The Department shall adopt
4rules, including emergency rules as authorized by Section 5-45
5of the Illinois Administrative Procedure Act, to implement the
6provisions of this Section, including wage increases for
7direct care staff.
8    For facilities licensed by the Department of Public Health
9under the ID/DD Community Care Act as ID/DD Facilities and
10under the MC/DD Act as MC/DD Facilities, subject to federal
11approval of the State Plan Amendment, the rates taking effect
12for the residential services delivered on or after July 1,
132021, shall include an increase sufficient to provide a $0.50
14per hour increase for aides in the rate methodology. For
15facilities licensed by the Department of Public Health under
16the ID/DD Community Care Act as ID/DD Facilities and under the
17MC/DD Act as MC/DD Facilities, subject to federal approval of
18the State Plan Amendment, the rates taking effect for the
19residential services delivered on or after January 1, 2022
20shall include an increase sufficient to provide a $1.00 per
21hour increase for aides in the rate methodology. In addition,
22for residential services delivered on or after January 1, 2022
23such rates shall include an increase sufficient to provide
24wages for all residential non-executive direct care staff,
25excluding aides, at the federal Department of Labor, Bureau of
26Labor Statistics' average wage as defined in rule by the

 

 

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1Department. The Department shall adopt rules, including
2emergency rules as authorized by Section 5-45 of the Illinois
3Administrative Procedure Act, to implement the provisions of
4this Section.
5    For facilities licensed by the Department of Public Health
6under the ID/DD Community Care Act as ID/DD facilities and
7under the MC/DD Act as MC/DD facilities, subject to federal
8approval of the State Plan Amendment, the rates taking effect
9for services delivered on or after January 1, 2023, shall
10include a $1.00 per hour wage increase for all direct support
11personnel and all other frontline personnel who are not
12subject to the Bureau of Labor Statistics' average wage
13increases, who work in residential and community day services
14settings, with at least $0.50 of those funds to be provided as
15a direct increase to all aide base wages, with the remaining
16$0.50 to be used flexibly for base wage increases to the rate
17methodology for aides. In addition, for residential services
18delivered on or after January 1, 2023 the rates shall include
19an increase sufficient to provide wages for all residential
20non-executive direct care staff, excluding aides, at the
21federal Department of Labor, Bureau of Labor Statistics'
22average wage as determined by the Department. Also, for
23services delivered on or after January 1, 2023, the rates will
24include adjustments to employment-related expenses as defined
25in rule by the Department. The Department shall adopt rules,
26including emergency rules as authorized by Section 5-45 of the

 

 

HB3398- 28 -LRB103 28846 KTG 55231 b

1Illinois Administrative Procedure Act, to implement the
2provisions of this Section.
3(Source: P.A. 101-10, eff. 6-5-19; 101-636, eff. 6-10-20;
4102-16, eff. 6-17-21; 102-699, eff. 4-19-22.)
 
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

 

 

HB3398- 29 -LRB103 28846 KTG 55231 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, 2023, shall be increased sufficiently to provide
19a minimum $4.00 per hour wage increase over the wages in effect
20on June 30, 2023 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.

 

 

HB3398- 30 -LRB103 28846 KTG 55231 b

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.