State of Illinois
92nd General Assembly
Legislation

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92_SB0608eng

 
SB608 Engrossed                                LRB9203291DJgc

 1        AN ACT in relation to public aid.

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

 4        Section 5. The Illinois Public Aid  Code  is  amended  by
 5    changing Section 5-5.4 as follows:

 6        (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
 7        Sec.  5-5.4.  Standards of Payment - Department of Public
 8    Aid.  The Department of Public Aid shall develop standards of
 9    payment of skilled nursing and intermediate care services  in
10    facilities providing such services under this Article which:
11        (1)  Provides  for  the  determination  of  a  facility's
12    payment for skilled nursing and intermediate care services on
13    a  prospective basis.  The amount of the payment rate for all
14    nursing facilities certified  under  the  medical  assistance
15    program  shall  be  prospectively established annually on the
16    basis  of  historical,  financial,   and   statistical   data
17    reflecting  actual  costs  from  prior  years, which shall be
18    applied to the current rate year and updated  for  inflation,
19    except  that  the  capital cost element for newly constructed
20    facilities  shall  be  based  upon  projected  budgets.   The
21    annually established payment rate shall take effect on July 1
22    in 1984  and  subsequent  years.   Rate  increases  shall  be
23    provided  annually  thereafter  on July 1 in 1984 and on each
24    subsequent July 1 in the following years, except that no rate
25    increase and no update for inflation shall be provided on  or
26    after  July  1,  1994  and  before July 1, 2002 July 1, 2001,
27    unless specifically provided for in this Section.
28        For facilities  licensed  by  the  Department  of  Public
29    Health  under  the Nursing Home Care Act as Intermediate Care
30    for the Developmentally Disabled facilities or Long Term Care
31    for Under Age 22 facilities, the rates taking effect on  July
 
SB608 Engrossed            -2-                 LRB9203291DJgc
 1    1,  1998  shall  include  an  increase of 3%.  For facilities
 2    licensed by the Department of Public Health under the Nursing
 3    Home Care Act as Skilled Nursing facilities  or  Intermediate
 4    Care  facilities,  the  rates  taking  effect on July 1, 1998
 5    shall include an increase of 3% plus $1.10 per  resident-day,
 6    as defined by the Department.
 7        For  facilities  licensed  by  the  Department  of Public
 8    Health under the Nursing Home Care Act as  Intermediate  Care
 9    for the Developmentally Disabled facilities or Long Term Care
10    for  Under Age 22 facilities, the rates taking effect on July
11    1, 1999 shall include an increase  of  1.6%  plus  $3.00  per
12    resident-day,  as  defined by the Department.  For facilities
13    licensed by the Department of Public Health under the Nursing
14    Home Care Act as Skilled Nursing facilities  or  Intermediate
15    Care  facilities,  the  rates  taking  effect on July 1, 1999
16    shall include an increase of 1.6% and, for services  provided
17    on  or after October 1, 1999, shall be increased by $4.00 per
18    resident-day, as defined by the Department.
19        For facilities  licensed  by  the  Department  of  Public
20    Health  under  the Nursing Home Care Act as Intermediate Care
21    for the Developmentally Disabled facilities or Long Term Care
22    for Under Age 22 facilities, the rates taking effect on  July
23    1,  2000  shall include an increase of 2.5% per resident-day,
24    as defined by the Department.  For facilities licensed by the
25    Department of Public Health under the Nursing Home  Care  Act
26    as   Skilled   Nursing   facilities   or   Intermediate  Care
27    facilities, the rates taking effect on  July  1,  2000  shall
28    include  an  increase of 2.5% per resident-day, as defined by
29    the Department.
30        For facilities  licensed  by  the  Department  of  Public
31    Health  under  the  Nursing  Home Care Act as skilled nursing
32    facilities or intermediate care facilities, the rates  taking
33    effect  on July 1, 2001, and each subsequent year thereafter,
34    shall be computed using the most recent cost reports on  file
 
SB608 Engrossed            -3-                 LRB9203291DJgc
 1    with the Department of Public Aid no later than April 1, 2000
 2    updated   for  inflation  to  January  1,  2001.   For  rates
 3    effective July 1, 2001 only, rates shall be  the  greater  of
 4    the  rate  computed for July 1, 2001 or the rate effective on
 5    June 30, 2001.
 6        Rates established effective  each  July  1  shall  govern
 7    payment  for  services  rendered throughout that fiscal year,
 8    except that rates  established  on  July  1,  1996  shall  be
 9    increased  by  6.8% for services provided on or after January
10    1, 1997.  Such rates will be based upon the rates  calculated
11    for the year beginning July 1, 1990, and for subsequent years
12    thereafter until June 30, 2001 shall be based on the facility
13    cost reports for the facility fiscal year ending at any point
14    in  time  during  the  previous calendar year, updated to the
15    midpoint of the rate year.  The cost report shall be on  file
16    with the Department no later than April 1 of the current rate
17    year.   Should the cost report not be on file by April 1, the
18    Department shall base the rate  on  the  latest  cost  report
19    filed  by  each  skilled  care facility and intermediate care
20    facility, updated to the midpoint of the current  rate  year.
21    In  determining rates for services rendered on and after July
22    1, 1985, fixed time shall not be computed at less than  zero.
23    The  Department shall not make any alterations of regulations
24    which would reduce any component of the Medicaid  rate  to  a
25    level  below what that component would have been utilizing in
26    the rate effective on July 1, 1984.
27        (2)  Shall take into account the actual costs incurred by
28    facilities in providing services for  recipients  of  skilled
29    nursing  and  intermediate  care  services  under the medical
30    assistance program.
31        (3)  Shall   take   into   account   the   medical    and
32    psycho-social characteristics and needs of the patients.
33        (4)  Shall take into account the actual costs incurred by
34    facilities  in  meeting licensing and certification standards
 
SB608 Engrossed            -4-                 LRB9203291DJgc
 1    imposed and prescribed by the State of Illinois, any  of  its
 2    political  subdivisions  or  municipalities  and  by the U.S.
 3    Department of Health and Human Services pursuant to Title XIX
 4    of the Social Security Act.
 5        The  Department  of  Public  Aid  shall  develop  precise
 6    standards for payments to reimburse  nursing  facilities  for
 7    any  utilization  of appropriate rehabilitative personnel for
 8    the provision of rehabilitative services which is  authorized
 9    by  federal regulations, including reimbursement for services
10    provided by qualified therapists or qualified assistants, and
11    which is in accordance with accepted professional  practices.
12    Reimbursement  also  may  be  made  for  utilization of other
13    supportive personnel under appropriate supervision.
14    (Source: P.A. 90-9, eff. 7-1-97; 90-588, eff. 7-1-98;  91-24,
15    eff. 7-1-99; 91-712, eff. 7-1-00.)

16        Section  99.  Effective date.  This Act takes effect upon
17    becoming law.

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