Bill Text: IL HB3569 | 2023-2024 | 103rd General Assembly | Introduced


Bill Title: Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that for community-based providers serving persons with intellectual or developmental disabilities, the rates taking effect for services delivered on or after January 1, 2024 shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in 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. 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 January 1, 2024 shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in 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. Amends the Illinois Administrative Procedure Act. Grants the Departments of Human Services and Healthcare and Family Services emergency rulemaking authority. Effective immediately.

Spectrum: Partisan Bill (Democrat 29-1)

Status: (Introduced) 2023-05-19 - Rule 19(a) / Re-referred to Rules Committee [HB3569 Detail]

Download: Illinois-2023-HB3569-Introduced.html


103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB3569

Introduced 2/17/2023, by Rep. Michelle Mussman

SYNOPSIS AS INTRODUCED:
5 ILCS 100/5-45.35 new
5 ILCS 100/5-45.36 new
20 ILCS 1705/74
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4

Amends the Mental Health and Developmental Disabilities Administrative Act. Provides that for community-based providers serving persons with intellectual or developmental disabilities, the rates taking effect for services delivered on or after January 1, 2024 shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in 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 in by the Department of Human Services. 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 January 1, 2024 shall be increased sufficiently to: (i) provide a minimum $4.00 per hour wage increase over the wages in 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 in rule by the Department of Healthcare and Family Services. Amends the Illinois Administrative Procedure Act. Grants the Departments of Human Services and Healthcare and Family Services emergency rulemaking authority. Effective immediately.
LRB103 28364 SPS 54744 b

A BILL FOR

HB3569LRB103 28364 SPS 54744 b
1 AN ACT concerning State government.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Illinois Administrative Procedure Act is
5amended by adding Sections 5-45.35 and 5-45.36 as follows:
6 (5 ILCS 100/5-45.35 new)
7 Sec. 5-45.35. Emergency rulemaking; Mental Health and
8Developmental Disabilities Administrative Act. To provide for
9the expeditious and timely implementation of the changes made
10to Section 74 of the Mental Health and Developmental
11Disabilities Administrative Act by this amendatory Act of the
12103rd General Assembly, emergency rules implementing the
13changes made to Section 74 of the Mental Health and
14Developmental Disabilities Administrative Act by this
15amendatory Act of the 103rd General Assembly may be adopted in
16accordance with Section 5-45 by the Department of Human
17Services. The adoption of emergency rules authorized by
18Section 5-45 and this Section is deemed to be necessary for the
19public interest, safety, and welfare.
20 This Section is repealed one year after the effective date
21of this amendatory Act of the 103rd General Assembly.
22 (5 ILCS 100/5-45.36 new)

HB3569- 2 -LRB103 28364 SPS 54744 b
1 Sec. 5-45.36. Emergency rulemaking; Illinois Public Aid
2Code. To provide for the expeditious and timely implementation
3of the changes made to Section 5-5.4 of the Illinois Public Aid
4Code by this amendatory Act of the 103rd General Assembly,
5emergency rules implementing the changes made to Section 5-5.4
6of the Illinois Public Aid Code by this amendatory Act of the
7103rd General Assembly may be adopted in accordance with
8Section 5-45 by the Department of Healthcare and Family
9Services. The adoption of emergency rules authorized by
10Section 5-45 and this Section is deemed to be necessary for the
11public interest, safety, and welfare.
12 This Section is repealed one year after the effective date
13of this amendatory Act of the 103rd General Assembly.
14 Section 10. The Mental Health and Developmental
15Disabilities Administrative Act is amended by changing Section
1674 as follows:
17 (20 ILCS 1705/74)
18 Sec. 74. Rates and reimbursements.
19 (a) Within 30 days after July 6, 2017 (the effective date
20of Public Act 100-23), the Department shall increase rates and
21reimbursements to fund a minimum of a $0.75 per hour wage
22increase for front-line personnel, including, but not limited
23to, direct support professionals, aides, front-line
24supervisors, qualified intellectual disabilities

HB3569- 3 -LRB103 28364 SPS 54744 b
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

HB3569- 5 -LRB103 28364 SPS 54744 b
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

HB3569- 6 -LRB103 28364 SPS 54744 b
1approval of any relevant Waiver Amendment, the rates taking
2effect for services delivered on or after January 1, 2024,
3shall include an increase in the rate methodology sufficient
4to provide a $4.00 per hour wage rate increase for all direct
5support professionals and all other frontline personnel who
6are not subject to the Bureau of Labor Statistics' average
7wage increases, who work in residential and community day
8services settings, with at least $2.00 of those funds to be
9provided as a direct increase to base wages, with the
10remaining $2.00 to be used flexibly for base wage increases.
11In addition, the rates taking effect for services delivered on
12or after January 1, 2024, shall include an increase sufficient
13to provide wages for all residential non-executive direct care
14staff, excluding direct support professionals, at the federal
15Department of Labor, Bureau of Labor Statistics' average wage
16as defined in rule by the Department. For services delivered
17on or after January 1, 2024, the rates shall include
18adjustments to employment-related expenses as defined in rule
19by the Department.
20 The establishment of and any changes to the rate
21methodologies for community-based services provided to persons
22with intellectual or developmental disabilities are subject to
23federal approval of any relevant Waiver Amendment and shall be
24defined in rule by the Department. The Department shall adopt
25rules, including emergency rules as authorized by Section 5-45
26of the Illinois Administrative Procedure Act, to implement the

HB3569- 7 -LRB103 28364 SPS 54744 b
1provisions of this subsection.
2(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
3102-699, eff. 4-19-22; 102-830, eff. 1-1-23; revised
412-13-22.)
5 Section 15. The Illinois Public Aid Code is amended by
6changing Section 5-5.4 as follows:
7 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
8 Sec. 5-5.4. Standards of Payment - Department of
9Healthcare and Family Services. The Department of Healthcare
10and Family Services shall develop standards of payment of
11nursing facility and ICF/DD services in facilities providing
12such services under this Article which:
13 (1) Provide for the determination of a facility's payment
14for nursing facility or ICF/DD services on a prospective
15basis. The amount of the payment rate for all nursing
16facilities certified by the Department of Public Health under
17the ID/DD Community Care Act or the Nursing Home Care Act as
18Intermediate Care for the Developmentally Disabled facilities,
19Long Term Care for Under Age 22 facilities, Skilled Nursing
20facilities, or Intermediate Care facilities under the medical
21assistance program shall be prospectively established annually
22on the basis of historical, financial, and statistical data
23reflecting actual costs from prior years, which shall be
24applied to the current rate year and updated for inflation,

HB3569- 8 -LRB103 28364 SPS 54744 b
1except that the capital cost element for newly constructed
2facilities shall be based upon projected budgets. The annually
3established payment rate shall take effect on July 1 in 1984
4and subsequent years. No rate increase and no update for
5inflation shall be provided on or after July 1, 1994, unless
6specifically provided for in this Section. The changes made by
7Public Act 93-841 extending the duration of the prohibition
8against a rate increase or update for inflation are effective
9retroactive to July 1, 2004.
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 July 1,
141998 shall include an increase of 3%. For facilities licensed
15by the Department of Public Health under the Nursing Home Care
16Act as Skilled Nursing facilities or Intermediate Care
17facilities, the rates taking effect on July 1, 1998 shall
18include an increase of 3% plus $1.10 per resident-day, as
19defined by the Department. For facilities licensed by the
20Department of Public Health under the Nursing Home Care Act as
21Intermediate Care Facilities for the Developmentally Disabled
22or Long Term Care for Under Age 22 facilities, the rates taking
23effect on January 1, 2006 shall include an increase of 3%. For
24facilities licensed by the Department of Public Health under
25the Nursing Home Care Act as Intermediate Care Facilities for
26the Developmentally Disabled or Long Term Care for Under Age

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122 facilities, the rates taking effect on January 1, 2009
2shall include an increase sufficient to provide a $0.50 per
3hour wage increase for non-executive staff. For facilities
4licensed by the Department of Public Health under the ID/DD
5Community Care Act as ID/DD Facilities the rates taking effect
6within 30 days after July 6, 2017 (the effective date of Public
7Act 100-23) shall include an increase sufficient to provide a
8$0.75 per hour wage increase for non-executive staff. The
9Department shall adopt rules, including emergency rules under
10subsection (y) of Section 5-45 of the Illinois Administrative
11Procedure Act, to implement the provisions of this paragraph.
12For facilities licensed by the Department of Public Health
13under the ID/DD Community Care Act as ID/DD Facilities and
14under the MC/DD Act as MC/DD Facilities, the rates taking
15effect within 30 days after the effective date of this
16amendatory Act of the 100th General Assembly shall include an
17increase sufficient to provide a $0.50 per hour wage increase
18for non-executive front-line personnel, including, but not
19limited to, direct support persons, aides, front-line
20supervisors, qualified intellectual disabilities
21professionals, nurses, and non-administrative support staff.
22The Department shall adopt rules, including emergency rules
23under subsection (bb) of Section 5-45 of the Illinois
24Administrative Procedure Act, to implement the provisions of
25this paragraph.
26 For facilities licensed by the Department of Public Health

HB3569- 10 -LRB103 28364 SPS 54744 b
1under the Nursing Home Care Act as Intermediate Care for the
2Developmentally Disabled facilities or Long Term Care for
3Under Age 22 facilities, the rates taking effect on July 1,
41999 shall include an increase of 1.6% plus $3.00 per
5resident-day, as defined by the Department. For facilities
6licensed by the Department of Public Health under the Nursing
7Home Care Act as Skilled Nursing facilities or Intermediate
8Care facilities, the rates taking effect on July 1, 1999 shall
9include an increase of 1.6% and, for services provided on or
10after October 1, 1999, shall be increased by $4.00 per
11resident-day, as defined by the Department.
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 Long Term Care for
15Under Age 22 facilities, the rates taking effect on July 1,
162000 shall include an increase of 2.5% per resident-day, as
17defined by the Department. For facilities licensed by the
18Department of Public Health under the Nursing Home Care Act as
19Skilled Nursing facilities or Intermediate Care facilities,
20the rates taking effect on July 1, 2000 shall include an
21increase of 2.5% per resident-day, as defined by the
22Department.
23 For facilities licensed by the Department of Public Health
24under the Nursing Home Care Act as skilled nursing facilities
25or intermediate care facilities, a new payment methodology
26must be implemented for the nursing component of the rate

HB3569- 11 -LRB103 28364 SPS 54744 b
1effective July 1, 2003. The Department of Public Aid (now
2Healthcare and Family Services) shall develop the new payment
3methodology using the Minimum Data Set (MDS) as the instrument
4to collect information concerning nursing home resident
5condition necessary to compute the rate. The Department shall
6develop the new payment methodology to meet the unique needs
7of Illinois nursing home residents while remaining subject to
8the appropriations provided by the General Assembly. A
9transition period from the payment methodology in effect on
10June 30, 2003 to the payment methodology in effect on July 1,
112003 shall be provided for a period not exceeding 3 years and
12184 days after implementation of the new payment methodology
13as follows:
14 (A) For a facility that would receive a lower nursing
15 component rate per patient day under the new system than
16 the facility received effective on the date immediately
17 preceding the date that the Department implements the new
18 payment methodology, the nursing component rate per
19 patient day for the facility shall be held at the level in
20 effect on the date immediately preceding the date that the
21 Department implements the new payment methodology until a
22 higher nursing component rate of reimbursement is achieved
23 by that facility.
24 (B) For a facility that would receive a higher nursing
25 component rate per patient day under the payment
26 methodology in effect on July 1, 2003 than the facility

HB3569- 12 -LRB103 28364 SPS 54744 b
1 received effective on the date immediately preceding the
2 date that the Department implements the new payment
3 methodology, the nursing component rate per patient day
4 for the facility shall be adjusted.
5 (C) Notwithstanding paragraphs (A) and (B), the
6 nursing component rate per patient day for the facility
7 shall be adjusted subject to appropriations provided by
8 the General Assembly.
9 For facilities licensed by the Department of Public Health
10under the Nursing Home Care Act as Intermediate Care for the
11Developmentally Disabled facilities or Long Term Care for
12Under Age 22 facilities, the rates taking effect on March 1,
132001 shall include a statewide increase of 7.85%, as defined
14by the Department.
15 Notwithstanding any other provision of this Section, for
16facilities licensed by the Department of Public Health under
17the Nursing Home Care Act as skilled nursing facilities or
18intermediate care facilities, except facilities participating
19in the Department's demonstration program pursuant to the
20provisions of Title 77, Part 300, Subpart T of the Illinois
21Administrative Code, the numerator of the ratio used by the
22Department of Healthcare and Family Services to compute the
23rate payable under this Section using the Minimum Data Set
24(MDS) methodology shall incorporate the following annual
25amounts as the additional funds appropriated to the Department
26specifically to pay for rates based on the MDS nursing

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1component methodology in excess of the funding in effect on
2December 31, 2006:
3 (i) For rates taking effect January 1, 2007,
4 $60,000,000.
5 (ii) For rates taking effect January 1, 2008,
6 $110,000,000.
7 (iii) For rates taking effect January 1, 2009,
8 $194,000,000.
9 (iv) For rates taking effect April 1, 2011, or the
10 first day of the month that begins at least 45 days after
11 the effective date of this amendatory Act of the 96th
12 General Assembly, $416,500,000 or an amount as may be
13 necessary to complete the transition to the MDS
14 methodology for the nursing component of the rate.
15 Increased payments under this item (iv) are not due and
16 payable, however, until (i) the methodologies described in
17 this paragraph are approved by the federal government in
18 an appropriate State Plan amendment and (ii) the
19 assessment imposed by Section 5B-2 of this Code is
20 determined to be a permissible tax under Title XIX of the
21 Social Security Act.
22 Notwithstanding any other provision of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as skilled nursing facilities or
25intermediate care facilities, the support component of the
26rates taking effect on January 1, 2008 shall be computed using

HB3569- 14 -LRB103 28364 SPS 54744 b
1the most recent cost reports on file with the Department of
2Healthcare and Family Services no later than April 1, 2005,
3updated for inflation to January 1, 2006.
4 For facilities licensed by the Department of Public Health
5under the Nursing Home Care Act as Intermediate Care for the
6Developmentally Disabled facilities or Long Term Care for
7Under Age 22 facilities, the rates taking effect on April 1,
82002 shall include a statewide increase of 2.0%, as defined by
9the Department. This increase terminates on July 1, 2002;
10beginning July 1, 2002 these rates are reduced to the level of
11the rates in effect on March 31, 2002, as defined by the
12Department.
13 For facilities licensed by the Department of Public Health
14under the Nursing Home Care Act as skilled nursing facilities
15or intermediate care facilities, the rates taking effect on
16July 1, 2001 shall be computed using the most recent cost
17reports on file with the Department of Public Aid no later than
18April 1, 2000, updated for inflation to January 1, 2001. For
19rates effective July 1, 2001 only, rates shall be the greater
20of the rate computed for July 1, 2001 or the rate effective on
21June 30, 2001.
22 Notwithstanding any other provision of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as skilled nursing facilities or
25intermediate care facilities, the Illinois Department shall
26determine by rule the rates taking effect on July 1, 2002,

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1which shall be 5.9% less than the rates in effect on June 30,
22002.
3 Notwithstanding any other provision of this Section, for
4facilities licensed by the Department of Public Health under
5the Nursing Home Care Act as skilled nursing facilities or
6intermediate care facilities, if the payment methodologies
7required under Section 5A-12 and the waiver granted under 42
8CFR 433.68 are approved by the United States Centers for
9Medicare and Medicaid Services, the rates taking effect on
10July 1, 2004 shall be 3.0% greater than the rates in effect on
11June 30, 2004. These rates shall take effect only upon
12approval and implementation of the payment methodologies
13required under Section 5A-12.
14 Notwithstanding any other provisions 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 rates taking effect on
18January 1, 2005 shall be 3% more than the rates in effect on
19December 31, 2004.
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, effective January 1, 2009, the
24per diem support component of the rates effective on January
251, 2008, computed using the most recent cost reports on file
26with the Department of Healthcare and Family Services no later

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1than April 1, 2005, updated for inflation to January 1, 2006,
2shall be increased to the amount that would have been derived
3using standard Department of Healthcare and Family Services
4methods, procedures, and inflators.
5 Notwithstanding any other provisions of this Section, for
6facilities licensed by the Department of Public Health under
7the Nursing Home Care Act as intermediate care facilities that
8are federally defined as Institutions for Mental Disease, or
9facilities licensed by the Department of Public Health under
10the Specialized Mental Health Rehabilitation Act of 2013, a
11socio-development component rate equal to 6.6% of the
12facility's nursing component rate as of January 1, 2006 shall
13be established and paid effective July 1, 2006. The
14socio-development component of the rate shall be increased by
15a factor of 2.53 on the first day of the month that begins at
16least 45 days after January 11, 2008 (the effective date of
17Public Act 95-707). As of August 1, 2008, the
18socio-development component rate shall be equal to 6.6% of the
19facility's nursing component rate as of January 1, 2006,
20multiplied by a factor of 3.53. For services provided on or
21after April 1, 2011, or the first day of the month that begins
22at least 45 days after the effective date of this amendatory
23Act of the 96th General Assembly, whichever is later, the
24Illinois Department may by rule adjust these socio-development
25component rates, and may use different adjustment
26methodologies for those facilities participating, and those

HB3569- 17 -LRB103 28364 SPS 54744 b
1not participating, in the Illinois Department's demonstration
2program pursuant to the provisions of Title 77, Part 300,
3Subpart T of the Illinois Administrative Code, but in no case
4may such rates be diminished below those in effect on August 1,
52008.
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 as long-term care
9facilities for residents under 22 years of age, the rates
10taking effect on July 1, 2003 shall include a statewide
11increase of 4%, as defined by the Department.
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 Long Term Care for
15Under Age 22 facilities, the rates taking effect on the first
16day of the month that begins at least 45 days after the
17effective date of this amendatory Act of the 95th General
18Assembly shall include a statewide increase of 2.5%, as
19defined by the Department.
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, effective January 1, 2005,
24facility rates shall be increased by the difference between
25(i) a facility's per diem property, liability, and malpractice
26insurance costs as reported in the cost report filed with the

HB3569- 18 -LRB103 28364 SPS 54744 b
1Department of Public Aid and used to establish rates effective
2July 1, 2001 and (ii) those same costs as reported in the
3facility's 2002 cost report. These costs shall be passed
4through to the facility without caps or limitations, except
5for adjustments required under normal auditing procedures.
6 Rates established effective each July 1 shall govern
7payment for services rendered throughout that fiscal year,
8except that rates established on July 1, 1996 shall be
9increased by 6.8% for services provided on or after January 1,
101997. Such rates will be based upon the rates calculated for
11the year beginning July 1, 1990, and for subsequent years
12thereafter until June 30, 2001 shall be based on the facility
13cost reports for the facility fiscal year ending at any point
14in time during the previous calendar year, updated to the
15midpoint of the rate year. The cost report shall be on file
16with the Department no later than April 1 of the current rate
17year. Should the cost report not be on file by April 1, the
18Department shall base the rate on the latest cost report filed
19by each skilled care facility and intermediate care facility,
20updated to the midpoint of the current rate year. In
21determining rates for services rendered on and after July 1,
221985, fixed time shall not be computed at less than zero. The
23Department shall not make any alterations of regulations which
24would reduce any component of the Medicaid rate to a level
25below what that component would have been utilizing in the
26rate effective on July 1, 1984.

HB3569- 19 -LRB103 28364 SPS 54744 b
1 (2) Shall take into account the actual costs incurred by
2facilities in providing services for recipients of skilled
3nursing and intermediate care services under the medical
4assistance program.
5 (3) Shall take into account the medical and psycho-social
6characteristics and needs of the patients.
7 (4) Shall take into account the actual costs incurred by
8facilities in meeting licensing and certification standards
9imposed and prescribed by the State of Illinois, any of its
10political subdivisions or municipalities and by the U.S.
11Department of Health and Human Services pursuant to Title XIX
12of the Social Security Act.
13 The Department of Healthcare and Family Services shall
14develop precise standards for payments to reimburse nursing
15facilities for any utilization of appropriate rehabilitative
16personnel for the provision of rehabilitative services which
17is authorized by federal regulations, including reimbursement
18for services provided by qualified therapists or qualified
19assistants, and which is in accordance with accepted
20professional practices. Reimbursement also may be made for
21utilization of other supportive personnel under appropriate
22supervision.
23 The Department shall develop enhanced payments to offset
24the additional costs incurred by a facility serving
25exceptional need residents and shall allocate at least
26$4,000,000 of the funds collected from the assessment

HB3569- 20 -LRB103 28364 SPS 54744 b
1established by Section 5B-2 of this Code for such payments.
2For the purpose of this Section, "exceptional needs" means,
3but need not be limited to, ventilator care and traumatic
4brain injury care. The enhanced payments for exceptional need
5residents under this paragraph are not due and payable,
6however, until (i) the methodologies described in this
7paragraph are approved by the federal government in an
8appropriate State Plan amendment and (ii) the assessment
9imposed by Section 5B-2 of this Code is determined to be a
10permissible tax under Title XIX of the Social Security Act.
11 Beginning January 1, 2014 the methodologies for
12reimbursement of nursing facility services as provided under
13this Section 5-5.4 shall no longer be applicable for services
14provided on or after January 1, 2014.
15 No payment increase under this Section for the MDS
16methodology, exceptional care residents, or the
17socio-development component rate established by Public Act
1896-1530 of the 96th General Assembly and funded by the
19assessment imposed under Section 5B-2 of this Code shall be
20due and payable until after the Department notifies the
21long-term care providers, in writing, that the payment
22methodologies to long-term care providers required under this
23Section have been approved by the Centers for Medicare and
24Medicaid Services of the U.S. Department of Health and Human
25Services and the waivers under 42 CFR 433.68 for the
26assessment imposed by this Section, if necessary, have been

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1granted by the Centers for Medicare and Medicaid Services of
2the U.S. Department of Health and Human Services. Upon
3notification to the Department of approval of the payment
4methodologies required under this Section and the waivers
5granted under 42 CFR 433.68, all increased payments otherwise
6due under this Section prior to the date of notification shall
7be due and payable within 90 days of the date federal approval
8is received.
9 On and after July 1, 2012, the Department shall reduce any
10rate of reimbursement for services or other payments or alter
11any methodologies authorized by this Code to reduce any rate
12of reimbursement for services or other payments in accordance
13with Section 5-5e.
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 August 1, 2019 shall be increased by 3.5% over the rates
19in effect on June 30, 2019. The Department shall adopt rules,
20including emergency rules under subsection (ii) of Section
215-45 of the Illinois Administrative Procedure Act, to
22implement the provisions of this Section, including wage
23increases for direct care staff.
24 For facilities licensed by the Department of Public Health
25under the ID/DD Community Care Act as ID/DD Facilities and
26under the MC/DD Act as MC/DD Facilities, subject to federal

HB3569- 22 -LRB103 28364 SPS 54744 b
1approval, the rates taking effect on the latter of the
2approval date of the State Plan Amendment for these facilities
3or the Waiver Amendment for the home and community-based
4services settings shall include an increase sufficient to
5provide a $0.26 per hour wage increase to the base wage for
6non-executive staff. The Department shall adopt rules,
7including emergency rules as authorized by Section 5-45 of the
8Illinois Administrative Procedure Act, to implement the
9provisions of this Section, including wage increases for
10direct care staff.
11 For facilities licensed by the Department of Public Health
12under the ID/DD Community Care Act as ID/DD Facilities and
13under the MC/DD Act as MC/DD Facilities, subject to federal
14approval of the State Plan Amendment and the Waiver Amendment
15for the home and community-based services settings, the rates
16taking effect for the services delivered on or after July 1,
172020 shall include an increase sufficient to provide a $1.00
18per hour wage increase for non-executive staff. For services
19delivered on or after January 1, 2021, subject to federal
20approval of the State Plan Amendment and the Waiver Amendment
21for the home and community-based services settings, shall
22include an increase sufficient to provide a $0.50 per hour
23increase for non-executive staff. The Department shall adopt
24rules, including emergency rules as authorized by Section 5-45
25of the Illinois Administrative Procedure Act, to implement the
26provisions of this Section, including wage increases for

HB3569- 23 -LRB103 28364 SPS 54744 b
1direct care staff.
2 For facilities licensed by the Department of Public Health
3under the ID/DD Community Care Act as ID/DD Facilities and
4under the MC/DD Act as MC/DD Facilities, subject to federal
5approval of the State Plan Amendment, the rates taking effect
6for the residential services delivered on or after July 1,
72021, shall include an increase sufficient to provide a $0.50
8per hour increase for aides in the rate methodology. For
9facilities licensed by the Department of Public Health under
10the ID/DD Community Care Act as ID/DD Facilities and under the
11MC/DD Act as MC/DD Facilities, subject to federal approval of
12the State Plan Amendment, the rates taking effect for the
13residential services delivered on or after January 1, 2022
14shall include an increase sufficient to provide a $1.00 per
15hour increase for aides in the rate methodology. In addition,
16for residential services delivered on or after January 1, 2022
17such rates shall include an increase sufficient to provide
18wages for all residential non-executive direct care staff,
19excluding aides, at the federal Department of Labor, Bureau of
20Labor Statistics' average wage as defined in rule by the
21Department. The Department shall adopt rules, including
22emergency rules as authorized by Section 5-45 of the Illinois
23Administrative Procedure Act, to implement the provisions of
24this Section.
25 For facilities licensed by the Department of Public Health
26under the ID/DD Community Care Act as ID/DD facilities and

HB3569- 24 -LRB103 28364 SPS 54744 b
1under the MC/DD Act as MC/DD facilities, subject to federal
2approval of the State Plan Amendment, the rates taking effect
3for services delivered on or after January 1, 2023, shall
4include a $1.00 per hour wage increase for all direct support
5personnel and all other frontline personnel who are not
6subject to the Bureau of Labor Statistics' average wage
7increases, who work in residential and community day services
8settings, with at least $0.50 of those funds to be provided as
9a direct increase to all aide base wages, with the remaining
10$0.50 to be used flexibly for base wage increases to the rate
11methodology for aides. In addition, for residential services
12delivered on or after January 1, 2023 the rates shall include
13an increase sufficient to provide wages for all residential
14non-executive direct care staff, excluding aides, at the
15federal Department of Labor, Bureau of Labor Statistics'
16average wage as determined by the Department. Also, for
17services delivered on or after January 1, 2023, the rates will
18include adjustments to employment-related expenses as defined
19in rule by the Department. The Department shall adopt rules,
20including emergency rules as authorized by Section 5-45 of the
21Illinois Administrative Procedure Act, to implement the
22provisions of this Section.
23 For facilities licensed by the Department of Public Health
24under the ID/DD Community Care Act as ID/DD facilities and
25under the MC/DD Act as MC/DD facilities, subject to federal
26approval of the State Plan Amendment, the rates taking effect

HB3569- 25 -LRB103 28364 SPS 54744 b
1for services delivered on or after January 1, 2024, shall
2include a $4.00 per hour wage rate increase for all direct
3support personnel and all other frontline personnel who are
4not subject to the Bureau of Labor Statistics' average wage
5increases, who work in residential and community day services
6settings, with at least $2.00 of those funds to be provided as
7a direct increase to all aide base wages, with the remaining
8$2.00 to be used flexibly for base wage increases to the rate
9methodology for aides. In addition, for residential services
10delivered on or after January 1, 2024, the rates shall include
11an increase sufficient to provide wages for all residential
12non-executive direct care staff, excluding aides, at the
13federal Department of Labor, Bureau of Labor Statistics'
14average wage as determined by the Department. Also, for
15services delivered on or after January 1, 2024, the rates will
16include adjustments to employment-related expenses as defined
17in rule by the Department. The Department shall adopt rules,
18including emergency rules as authorized by Section 5-45 of the
19Illinois Administrative Procedure Act, to implement the
20provisions of this Section.
21(Source: P.A. 101-10, eff. 6-5-19; 101-636, eff. 6-10-20;
22102-16, eff. 6-17-21; 102-699, eff. 4-19-22.)
23 Section 99. Effective date. This Act takes effect upon
24becoming law.
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