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| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB3607 Introduced 1/19/2022, by Sen. Celina Villanueva SYNOPSIS AS INTRODUCED:
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| 5 ILCS 100/5-45.21 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 | |
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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, 2022 shall be increased sufficiently to: (i)
provide a minimum $3.50 per hour wage increase over the wages
in effect on June 30, 2022 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, 2022, shall be increased sufficiently to: (i) provide a minimum $3.50 per hour wage increase over the wages in effect on June 30, 2022 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.
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| | A BILL FOR |
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| 1 | | AN ACT concerning care for persons with developmental |
| 2 | | disabilities.
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| 3 | | Be it enacted by the People of the State of Illinois,
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| 4 | | represented in the General Assembly:
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| 5 | | Section 1. This Act may be referred to as the Community |
| 6 | | Disability Living Wage Act.
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| 7 | | Section 2. Findings. |
| 8 | | (1) An estimated 27,000 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) According to the most recent Illinois industry |
| 16 | | surveys, the median DSP wage in Illinois is just $12.04 |
| 17 | | per hour, below the U.S. Department of Health and Human |
| 18 | | Services poverty threshold of $12.60 for a family of 4 and |
| 19 | | one out of every 4 DSP jobs in provider agencies are going |
| 20 | | unfilled; low wages often compel DSPs to work many |
| 21 | | overtime hours or hold down a second job to support their |
| 22 | | families; research by the American Network of Community |
| 23 | | Options and Resources (ANCOR), inclusive of Illinois, |
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| 1 | | reveals 56% of DSPs rely on public assistance to make ends |
| 2 | | meet, creating additional expenditures for State |
| 3 | | government; low wages are a consequence of the |
| 4 | | historically low reimbursement rates paid by the State of |
| 5 | | Illinois to community-based service providers.
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| 6 | | (3) Starting wages at many provider agencies are below |
| 7 | | $12 per hour, the scheduled State minimum wage rate as of |
| 8 | | January
1, 2022. |
| 9 | | (4) The lack of adequate wages for employees who |
| 10 | | perform the challenging work of supporting persons with |
| 11 | | intellectual and developmental disabilities results in |
| 12 | | high employee turnover, which in turn negatively impacts |
| 13 | | the quality of services provided, higher wages are proven |
| 14 | | to reduce staff turnover, improving stability and quality |
| 15 | | of services while reducing employer training costs. |
| 16 | |
(5) Rising wages in other sectors now mean, despite |
| 17 | | the modest wage increase and strenuous efforts to recruit |
| 18 | | new workers, agencies are experiencing staff vacancy rates |
| 19 | | of up to 40%; excessive vacancies force employers to rely |
| 20 | | more on overtime, leading to staff burnout and driving up |
| 21 | | costs; for the fourth year in a row the federal court |
| 22 | | monitor documented how this growing hiring crisis impedes |
| 23 | | the ability of community disability agencies to expand to |
| 24 | | accommodate persons newly approved for services as part of |
| 25 | | the Ligas Consent Decree. |
| 26 | | (6) A December 2020 report issued by an independent |
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| 1 | | consulting group commissioned by the State to propose |
| 2 | | changes to the State's reimbursement for community |
| 3 | | disability agencies recommended that addressing DSP wages |
| 4 | | was the number one priority for ensuring compliance with |
| 5 | | the mandates of the Ligas Consent Decree, and further |
| 6 | | recommended that wages for DSPs should be fixed at 150% of |
| 7 | | the prevailing minimum wage plus additional funding for |
| 8 | | benefits. |
| 9 | | (7) The difference between 150% of the State minimum |
| 10 | | wage on January 1, 2022 and the hourly DSP wage rate set by |
| 11 | | the State amounts to $3.50 per hour. |
| 12 | | (8) The General Assembly finds that in order to reduce |
| 13 | | turnover, increase retention, fill vacancies, and ensure |
| 14 | | DSPs are adequately compensated for the critically |
| 15 | | important work they do, an increase in rates and |
| 16 | | reimbursements to community-based service providers to |
| 17 | | effectuate an increase in the hourly wage paid to DSPs is |
| 18 | | needed.
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| 19 | | Section 3. Purpose and intent. It is the purpose of this |
| 20 | | Act to increase the wages of DSPs and other frontline staff in |
| 21 | | community disability agencies beyond the poverty level and to |
| 22 | | a level competitive with rival employers and above the State |
| 23 | | minimum wage, in an effort to improve the lives of DSPs and the |
| 24 | | lives of the vulnerable persons they support. |
| 25 | | It is the intent of the General Assembly to ensure that all |
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| 1 | | funds resulting from rate increases provided to community |
| 2 | | disability agencies are allocated to front-line employee wages |
| 3 | | in order to address the current workforce crisis which is the |
| 4 | | primary obstacle to the availability of community-based |
| 5 | | services for people with disabilities.
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| 6 | | Section 5. The Illinois Administrative Procedure Act is |
| 7 | | amended by adding Section 5-45.21 as follows:
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| 8 | | (5 ILCS 100/5-45.21 new) |
| 9 | | Sec. 5-45.21. Emergency rulemaking; Departments of Human |
| 10 | | Services and Healthcare and Family Services. To provide for |
| 11 | | the expeditious and timely implementation of changes made by |
| 12 | | this amendatory Act of the 102nd General Assembly to Section |
| 13 | | 74 of the Mental Health and Developmental Disabilities |
| 14 | | Administrative Act and to Sections 5-5.4 and 5-5.4i of the |
| 15 | | Illinois Public Aid Code, emergency rules implementing the |
| 16 | | changes made by this amendatory Act of the 102nd General |
| 17 | | Assembly to Section 74 of the Mental Health and Developmental |
| 18 | | Disabilities Administrative Act and to Sections 5-5.4 and |
| 19 | | 5-5.4i of the Illinois Public Aid Code may be adopted in |
| 20 | | accordance with Section 5-45 by the respective Department. The |
| 21 | | adoption of emergency rules authorized by Section 5-45 and |
| 22 | | this Section is deemed to be necessary for the public |
| 23 | | interest, safety, and welfare. |
| 24 | | This Section is repealed one year after the effective date |
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| 1 | | of this amendatory Act of the 102nd General Assembly.
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| 2 | | Section 10. The Mental Health and Developmental |
| 3 | | Disabilities Administrative Act is amended by changing Section |
| 4 | | 74 and by adding Section 55.5 as follows:
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| 5 | | (20 ILCS 1705/55.5 new) |
| 6 | | Sec. 55.5. Increased wages for front-line personnel. As |
| 7 | | used in this Section, "front-line personnel" means direct |
| 8 | | support persons, aides, front-line supervisors, and |
| 9 | | non-administrative support staff working in service settings |
| 10 | | outlined in this Section. |
| 11 | | The Department shall establish reimbursement rates that |
| 12 | | build toward livable wages for front-line personnel in |
| 13 | | residential and day programs and service coordination agencies |
| 14 | | serving persons with intellectual and developmental |
| 15 | | disabilities under Section 54 of this Act, including, but not |
| 16 | | limited to, intermediate care for the developmentally disabled |
| 17 | | facilities, medically complex for the developmentally disabled |
| 18 | | facilities, community-integrated living arrangements, |
| 19 | | community day services, employment, and other residential and |
| 20 | | day programs for persons with intellectual and developmental |
| 21 | | disabilities supported by State funds or funding under Title |
| 22 | | XIX of the federal Social Security Act. |
| 23 | | The Department shall increase rates and reimbursements so |
| 24 | | that by July 1, 2022 direct support persons wages shall be |
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| 1 | | increased by $3.50 per hour, and so that other front-line |
| 2 | | personnel earn a commensurate wage.
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| 3 | | (20 ILCS 1705/74) |
| 4 | | Sec. 74. Rates and reimbursements. |
| 5 | | (a) Within 30 days after July 6, 2017 (the effective date |
| 6 | | of Public Act 100-23), the Department shall increase rates and |
| 7 | | reimbursements to fund a minimum of a $0.75 per hour wage |
| 8 | | increase for front-line personnel, including, but not limited |
| 9 | | to, direct support persons, aides, front-line supervisors, |
| 10 | | qualified intellectual disabilities professionals, nurses, and |
| 11 | | non-administrative support staff working in community-based |
| 12 | | provider organizations serving individuals with developmental |
| 13 | | disabilities. The Department shall adopt rules, including |
| 14 | | emergency rules under subsection (y) of Section 5-45 of the |
| 15 | | Illinois Administrative Procedure Act, to implement the |
| 16 | | provisions of this Section. |
| 17 | | (b) Rates and reimbursements. Within 30 days after the |
| 18 | | effective date of this amendatory Act of the 100th General |
| 19 | | Assembly, the Department shall increase rates and |
| 20 | | reimbursements to fund a minimum of a $0.50 per hour wage |
| 21 | | increase for front-line personnel, including, but not limited |
| 22 | | to, direct support persons, aides, front-line supervisors, |
| 23 | | qualified intellectual disabilities professionals, nurses, and |
| 24 | | non-administrative support staff working in community-based |
| 25 | | provider organizations serving individuals with developmental |
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| 1 | | disabilities. The Department shall adopt rules, including |
| 2 | | emergency rules under subsection (bb) of Section 5-45 of the |
| 3 | | Illinois Administrative Procedure Act, to implement the |
| 4 | | provisions of this Section. |
| 5 | | (c) Rates and reimbursements. Within 30 days after the |
| 6 | | effective date of this amendatory Act of the 101st General |
| 7 | | Assembly, subject to federal approval, the Department shall |
| 8 | | increase rates and reimbursements in effect on June 30, 2019 |
| 9 | | for community-based providers for persons with Developmental |
| 10 | | Disabilities by 3.5% The Department shall adopt rules, |
| 11 | | including emergency rules under subsection (jj) of Section |
| 12 | | 5-45 of the Illinois Administrative Procedure Act, to |
| 13 | | implement the provisions of this Section, including wage |
| 14 | | increases for direct care staff. |
| 15 | | (d) For community-based providers serving persons with |
| 16 | | intellectual/developmental disabilities, subject to federal |
| 17 | | approval of any relevant Waiver Amendment, the rates taking |
| 18 | | effect for services delivered on or after January 1, 2022, |
| 19 | | shall include an increase in the rate methodology sufficient |
| 20 | | to provide a $1.50 per hour wage increase for direct support |
| 21 | | personnel in residential settings and sufficient to provide |
| 22 | | wages for all residential non-executive direct care staff, |
| 23 | | excluding direct support personnel, at the federal Department |
| 24 | | of Labor, Bureau of Labor Statistics' average wage as defined |
| 25 | | in rule by the Department. |
| 26 | | The establishment of and any changes to the rate |
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| 1 | | methodologies for community-based services provided to persons |
| 2 | | with intellectual/developmental disabilities are subject to |
| 3 | | federal approval of any relevant Waiver Amendment and shall be |
| 4 | | defined in rule by the Department. The Department shall adopt |
| 5 | | rules, including emergency rules as authorized by Section 5-45 |
| 6 | | of the Illinois Administrative Procedure Act, to implement the |
| 7 | | provisions of this subsection (d).
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| 8 | | (e) For community-based providers serving persons with |
| 9 | | intellectual or developmental disabilities, subject to federal
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| 10 | | approval, the rates taking effect for services delivered on or
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| 11 | | after July 1, 2022 shall be increased sufficiently to
provide |
| 12 | | a minimum $3.50 per hour wage increase over the wages
in effect |
| 13 | | on June 30, 2022 for front-line personnel, including, but not |
| 14 | | limited to, direct support persons, aides, front-line |
| 15 | | supervisors, and non-administrative support staff working in |
| 16 | | community-based provider organizations serving individuals |
| 17 | | with developmental disabilities, and sufficiently to provide |
| 18 | | wages for all other residential non-executive direct care |
| 19 | | staff, excluding direct support personnel, at the U.S. |
| 20 | | Department of Labor, Bureau of Labor Statistics' average wage |
| 21 | | as defined, by rule, by the Department. The Department shall |
| 22 | | adopt rules, including emergency rules in accordance with the |
| 23 | | Illinois Administrative Procedure Act, to implement the |
| 24 | | provisions of this subsection. |
| 25 | | (Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21.)
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| 1 | | Section 15. The Illinois Public Aid Code is amended by |
| 2 | | changing Sections 5-5.4 and 5-5.4i as follows:
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| 3 | | (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
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| 4 | | Sec. 5-5.4. Standards of Payment - Department of |
| 5 | | Healthcare and Family Services.
The Department of Healthcare |
| 6 | | and Family Services shall develop standards of payment of
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| 7 | | nursing facility and ICF/DD services in facilities providing |
| 8 | | such services
under this Article which:
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| 9 | | (1) Provide for the determination of a facility's payment
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| 10 | | for nursing facility or ICF/DD services on a prospective |
| 11 | | basis.
The amount of the payment rate for all nursing |
| 12 | | facilities certified by the
Department of Public Health under |
| 13 | | the ID/DD Community Care Act or the Nursing Home Care Act as |
| 14 | | Intermediate
Care for the Developmentally Disabled facilities, |
| 15 | | Long Term Care for Under Age
22 facilities, Skilled Nursing |
| 16 | | facilities, or Intermediate Care facilities
under the
medical |
| 17 | | assistance program shall be prospectively established annually |
| 18 | | on the
basis of historical, financial, and statistical data |
| 19 | | reflecting actual costs
from prior years, which shall be |
| 20 | | applied to the current rate year and updated
for inflation, |
| 21 | | except that the capital cost element for newly constructed
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| 22 | | facilities shall be based upon projected budgets. The annually |
| 23 | | established
payment rate shall take effect on July 1 in 1984 |
| 24 | | and subsequent years. No rate
increase and no
update for |
| 25 | | inflation shall be provided on or after July 1, 1994, unless |
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| 1 | | specifically provided for in this
Section.
The changes made by |
| 2 | | Public Act 93-841
extending the duration of the prohibition |
| 3 | | against a rate increase or update for inflation are effective |
| 4 | | retroactive to July 1, 2004.
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| 5 | | For facilities licensed by the Department of Public Health |
| 6 | | under the Nursing
Home Care Act as Intermediate Care for the |
| 7 | | Developmentally Disabled facilities
or Long Term Care for |
| 8 | | Under Age 22 facilities, the rates taking effect on July
1, |
| 9 | | 1998 shall include an increase of 3%. For facilities licensed |
| 10 | | by the
Department of Public Health under the Nursing Home Care |
| 11 | | Act as Skilled Nursing
facilities or Intermediate Care |
| 12 | | facilities, the rates taking effect on July 1,
1998 shall |
| 13 | | include an increase of 3% plus $1.10 per resident-day, as |
| 14 | | defined by
the Department. For facilities licensed by the |
| 15 | | Department of Public Health under the Nursing Home Care Act as |
| 16 | | Intermediate Care Facilities for the Developmentally Disabled |
| 17 | | or Long Term Care for Under Age 22 facilities, the rates taking |
| 18 | | effect on January 1, 2006 shall include an increase of 3%.
For |
| 19 | | facilities licensed by the Department of Public Health under |
| 20 | | the Nursing Home Care Act as Intermediate Care Facilities for |
| 21 | | the Developmentally Disabled or Long Term Care for Under Age |
| 22 | | 22 facilities, the rates taking effect on January 1, 2009 |
| 23 | | shall include an increase sufficient to provide a $0.50 per |
| 24 | | hour wage increase for non-executive staff. For facilities |
| 25 | | licensed by the Department of Public Health under the ID/DD |
| 26 | | Community Care Act as ID/DD Facilities the rates taking effect |
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| 1 | | within 30 days after July 6, 2017 (the effective date of Public |
| 2 | | Act 100-23) shall include an increase sufficient to provide a |
| 3 | | $0.75 per hour wage increase for non-executive staff. The |
| 4 | | Department shall adopt rules, including emergency rules under |
| 5 | | subsection (y) of Section 5-45 of the Illinois Administrative |
| 6 | | Procedure Act, to implement the provisions of this paragraph. |
| 7 | | For facilities licensed by the Department of Public Health |
| 8 | | under the ID/DD Community Care Act as ID/DD Facilities and |
| 9 | | under the MC/DD Act as MC/DD Facilities, the rates taking |
| 10 | | effect within 30 days after the effective date of this |
| 11 | | amendatory Act of the 100th General Assembly shall include an |
| 12 | | increase sufficient to provide a $0.50 per hour wage increase |
| 13 | | for non-executive front-line personnel, including, but not |
| 14 | | limited to, direct support persons, aides, front-line |
| 15 | | supervisors, qualified intellectual disabilities |
| 16 | | professionals, nurses, and non-administrative support staff. |
| 17 | | The Department shall adopt rules, including emergency rules |
| 18 | | under subsection (bb) of Section 5-45 of the Illinois |
| 19 | | Administrative Procedure Act, to implement the provisions of |
| 20 | | this paragraph. |
| 21 | | For facilities licensed by the Department of Public Health |
| 22 | | under the ID/DD Community Care Act as ID/DD facilities and |
| 23 | | under the MC/DD Act as MC/DD facilities, the rates taking |
| 24 | | effect for services delivered on or after July 1, 2022, shall |
| 25 | | be increased sufficiently to provide a minimum $3.50 per hour |
| 26 | | wage increase over the wages in effect on June 30, 2022 for |
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| 1 | | front-line personnel, including, but not limited to, direct |
| 2 | | support persons, aides, front-line supervisors, and |
| 3 | | non-administrative support staff working in community-based |
| 4 | | provider organizations serving individuals with developmental |
| 5 | | disabilities, and sufficiently to provide wages for all other |
| 6 | | residential non-executive direct care staff, excluding direct |
| 7 | | support personnel, at the U.S. Department of Labor, Bureau of |
| 8 | | Labor Statistics' average wage as defined, by rule, by the |
| 9 | | Department. The Department shall adopt rules, including |
| 10 | | emergency rules in accordance with the Illinois Administrative |
| 11 | | Procedure Act, to implement the provisions of this paragraph. |
| 12 | | For facilities licensed by the Department of Public Health |
| 13 | | under the
Nursing Home Care Act as Intermediate Care for the |
| 14 | | Developmentally Disabled
facilities or Long Term Care for |
| 15 | | Under Age 22 facilities, the rates taking
effect on July 1, |
| 16 | | 1999 shall include an increase of 1.6% plus $3.00 per
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| 17 | | resident-day, as defined by the Department. For facilities |
| 18 | | licensed by the
Department of Public Health under the Nursing |
| 19 | | Home Care Act as Skilled Nursing
facilities or Intermediate |
| 20 | | Care facilities, the rates taking effect on July 1,
1999 shall |
| 21 | | include an increase of 1.6% and, for services provided on or |
| 22 | | after
October 1, 1999, shall be increased by $4.00 per |
| 23 | | resident-day, as defined by
the Department.
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| 24 | | For facilities licensed by the Department of Public Health |
| 25 | | under the
Nursing Home Care Act as Intermediate Care for the |
| 26 | | Developmentally Disabled
facilities or Long Term Care for |
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| 1 | | Under Age 22 facilities, the rates taking
effect on July 1, |
| 2 | | 2000 shall include an increase of 2.5% per resident-day,
as |
| 3 | | defined by the Department. For facilities licensed by the |
| 4 | | Department of
Public Health under the Nursing Home Care Act as |
| 5 | | Skilled Nursing facilities or
Intermediate Care facilities, |
| 6 | | the rates taking effect on July 1, 2000 shall
include an |
| 7 | | increase of 2.5% per resident-day, as defined by the |
| 8 | | Department.
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| 9 | | For facilities licensed by the Department of Public Health |
| 10 | | under the
Nursing Home Care Act as skilled nursing facilities |
| 11 | | or intermediate care
facilities, a new payment methodology |
| 12 | | must be implemented for the nursing
component of the rate |
| 13 | | effective July 1, 2003. The Department of Public Aid
(now |
| 14 | | Healthcare and Family Services) shall develop the new payment |
| 15 | | methodology using the Minimum Data Set
(MDS) as the instrument |
| 16 | | to collect information concerning nursing home
resident |
| 17 | | condition necessary to compute the rate. The Department
shall |
| 18 | | develop the new payment methodology to meet the unique needs |
| 19 | | of
Illinois nursing home residents while remaining subject to |
| 20 | | the appropriations
provided by the General Assembly.
A |
| 21 | | transition period from the payment methodology in effect on |
| 22 | | June 30, 2003
to the payment methodology in effect on July 1, |
| 23 | | 2003 shall be provided for a
period not exceeding 3 years and |
| 24 | | 184 days after implementation of the new payment
methodology |
| 25 | | as follows:
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| 26 | | (A) For a facility that would receive a lower
nursing |
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| 1 | | component rate per patient day under the new system than |
| 2 | | the facility
received
effective on the date immediately |
| 3 | | preceding the date that the Department
implements the new |
| 4 | | payment methodology, the nursing component rate per |
| 5 | | patient
day for the facility
shall be held at
the level in |
| 6 | | effect on the date immediately preceding the date that the
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| 7 | | Department implements the new payment methodology until a |
| 8 | | higher nursing
component rate of
reimbursement is achieved |
| 9 | | by that
facility.
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| 10 | | (B) For a facility that would receive a higher nursing |
| 11 | | component rate per
patient day under the payment |
| 12 | | methodology in effect on July 1, 2003 than the
facility |
| 13 | | received effective on the date immediately preceding the |
| 14 | | date that the
Department implements the new payment |
| 15 | | methodology, the nursing component rate
per patient day |
| 16 | | for the facility shall be adjusted.
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| 17 | | (C) Notwithstanding paragraphs (A) and (B), the |
| 18 | | nursing component rate per
patient day for the facility |
| 19 | | shall be adjusted subject to appropriations
provided by |
| 20 | | the General Assembly.
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| 21 | | For facilities licensed by the Department of Public Health |
| 22 | | under the
Nursing Home Care Act as Intermediate Care for the |
| 23 | | Developmentally Disabled
facilities or Long Term Care for |
| 24 | | Under Age 22 facilities, the rates taking
effect on March 1, |
| 25 | | 2001 shall include a statewide increase of 7.85%, as
defined |
| 26 | | by the Department.
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| 1 | | Notwithstanding any other provision of this Section, for |
| 2 | | facilities licensed by the Department of Public Health under |
| 3 | | the
Nursing Home Care Act as skilled nursing facilities or |
| 4 | | intermediate care
facilities, except facilities participating |
| 5 | | in the Department's demonstration program pursuant to the |
| 6 | | provisions of Title 77, Part 300, Subpart T of the Illinois |
| 7 | | Administrative Code, the numerator of the ratio used by the |
| 8 | | Department of Healthcare and Family Services to compute the |
| 9 | | rate payable under this Section using the Minimum Data Set |
| 10 | | (MDS) methodology shall incorporate the following annual |
| 11 | | amounts as the additional funds appropriated to the Department |
| 12 | | specifically to pay for rates based on the MDS nursing |
| 13 | | component methodology in excess of the funding in effect on |
| 14 | | December 31, 2006: |
| 15 | | (i) For rates taking effect January 1, 2007, |
| 16 | | $60,000,000. |
| 17 | | (ii) For rates taking effect January 1, 2008, |
| 18 | | $110,000,000. |
| 19 | | (iii) For rates taking effect January 1, 2009, |
| 20 | | $194,000,000. |
| 21 | | (iv) For rates taking effect April 1, 2011, or the |
| 22 | | first day of the month that begins at least 45 days after |
| 23 | | the effective date of this amendatory Act of the 96th |
| 24 | | General Assembly, $416,500,000 or an amount as may be |
| 25 | | necessary to complete the transition to the MDS |
| 26 | | methodology for the nursing component of the rate. |
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| 1 | | Increased payments under this item (iv) are not due and |
| 2 | | payable, however, until (i) the methodologies described in |
| 3 | | this paragraph are approved by the federal government in |
| 4 | | an appropriate State Plan amendment and (ii) the |
| 5 | | assessment imposed by Section 5B-2 of this Code is |
| 6 | | determined to be a permissible tax under Title XIX of the |
| 7 | | Social Security Act. |
| 8 | | Notwithstanding any other provision of this Section, for |
| 9 | | facilities licensed by the Department of Public Health under |
| 10 | | the Nursing Home Care Act as skilled nursing facilities or |
| 11 | | intermediate care facilities, the support component of the |
| 12 | | rates taking effect on January 1, 2008 shall be computed using |
| 13 | | the most recent cost reports on file with the Department of |
| 14 | | Healthcare and Family Services no later than April 1, 2005, |
| 15 | | updated for inflation to January 1, 2006. |
| 16 | | For facilities licensed by the Department of Public Health |
| 17 | | under the
Nursing Home Care Act as Intermediate Care for the |
| 18 | | Developmentally Disabled
facilities or Long Term Care for |
| 19 | | Under Age 22 facilities, the rates taking
effect on April 1, |
| 20 | | 2002 shall include a statewide increase of 2.0%, as
defined by |
| 21 | | the Department.
This increase terminates on July 1, 2002;
|
| 22 | | beginning July 1, 2002 these rates are reduced to the level of |
| 23 | | the rates
in effect on March 31, 2002, as defined by the |
| 24 | | Department.
|
| 25 | | For facilities licensed by the Department of Public Health |
| 26 | | under the
Nursing Home Care Act as skilled nursing facilities |
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| 1 | | or intermediate care
facilities, the rates taking effect on |
| 2 | | July 1, 2001 shall be computed using the most recent cost |
| 3 | | reports
on file with the Department of Public Aid no later than |
| 4 | | April 1, 2000,
updated for inflation to January 1, 2001. For |
| 5 | | rates effective July 1, 2001
only, rates shall be the greater |
| 6 | | of the rate computed for July 1, 2001
or the rate effective on |
| 7 | | June 30, 2001.
|
| 8 | | Notwithstanding any other provision of this Section, for |
| 9 | | facilities
licensed by the Department of Public Health under |
| 10 | | the Nursing Home Care Act
as skilled nursing facilities or |
| 11 | | intermediate care facilities, the Illinois
Department shall |
| 12 | | determine by rule the rates taking effect on July 1, 2002,
|
| 13 | | which shall be 5.9% less than the rates in effect on June 30, |
| 14 | | 2002.
|
| 15 | | Notwithstanding any other provision of this Section, for |
| 16 | | facilities
licensed by the Department of Public Health under |
| 17 | | the Nursing Home Care Act as
skilled nursing
facilities or |
| 18 | | intermediate care facilities, if the payment methodologies |
| 19 | | required under Section 5A-12 and the waiver granted under 42 |
| 20 | | CFR 433.68 are approved by the United States Centers for |
| 21 | | Medicare and Medicaid Services, the rates taking effect on |
| 22 | | July 1, 2004 shall be 3.0% greater than the rates in effect on |
| 23 | | June 30, 2004. These rates shall take
effect only upon |
| 24 | | approval and
implementation of the payment methodologies |
| 25 | | required under Section 5A-12.
|
| 26 | | Notwithstanding any other provisions of this Section, for |
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| 1 | | facilities licensed by the Department of Public Health under |
| 2 | | the Nursing Home Care Act as skilled nursing facilities or |
| 3 | | intermediate care facilities, the rates taking effect on |
| 4 | | January 1, 2005 shall be 3% more than the rates in effect on |
| 5 | | December 31, 2004.
|
| 6 | | Notwithstanding any other provision of this Section, for |
| 7 | | facilities licensed by the Department of Public Health under |
| 8 | | the Nursing Home Care Act as skilled nursing facilities or |
| 9 | | intermediate care facilities, effective January 1, 2009, the |
| 10 | | per diem support component of the rates effective on January |
| 11 | | 1, 2008, computed using the most recent cost reports on file |
| 12 | | with the Department of Healthcare and Family Services no later |
| 13 | | than April 1, 2005, updated for inflation to January 1, 2006, |
| 14 | | shall be increased to the amount that would have been derived |
| 15 | | using standard Department of Healthcare and Family Services |
| 16 | | methods, procedures, and inflators. |
| 17 | | Notwithstanding any other provisions of this Section, for |
| 18 | | facilities licensed by the Department of Public Health under |
| 19 | | the Nursing Home Care Act as intermediate care facilities that |
| 20 | | are federally defined as Institutions for Mental Disease, or |
| 21 | | facilities licensed by the Department of Public Health under |
| 22 | | the Specialized Mental Health Rehabilitation Act of 2013, a |
| 23 | | socio-development component rate equal to 6.6% of the |
| 24 | | facility's nursing component rate as of January 1, 2006 shall |
| 25 | | be established and paid effective July 1, 2006. The |
| 26 | | socio-development component of the rate shall be increased by |
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| 1 | | a factor of 2.53 on the first day of the month that begins at |
| 2 | | least 45 days after January 11, 2008 (the effective date of |
| 3 | | Public Act 95-707). As of August 1, 2008, the |
| 4 | | socio-development component rate shall be equal to 6.6% of the |
| 5 | | facility's nursing component rate as of January 1, 2006, |
| 6 | | multiplied by a factor of 3.53. For services provided on or |
| 7 | | after April 1, 2011, or the first day of the month that begins |
| 8 | | at least 45 days after the effective date of this amendatory |
| 9 | | Act of the 96th General Assembly, whichever is later, the |
| 10 | | Illinois Department may by rule adjust these socio-development |
| 11 | | component rates, and may use different adjustment |
| 12 | | methodologies for those facilities participating, and those |
| 13 | | not participating, in the Illinois Department's demonstration |
| 14 | | program pursuant to the provisions of Title 77, Part 300, |
| 15 | | Subpart T of the Illinois Administrative Code, but in no case |
| 16 | | may such rates be diminished below those in effect on August 1, |
| 17 | | 2008.
|
| 18 | | For facilities
licensed
by the
Department of Public Health |
| 19 | | under the Nursing Home Care Act as Intermediate
Care for
the |
| 20 | | Developmentally Disabled facilities or as long-term care |
| 21 | | facilities for
residents under 22 years of age, the rates |
| 22 | | taking effect on July 1,
2003 shall
include a statewide |
| 23 | | increase of 4%, as defined by the Department.
|
| 24 | | For facilities licensed by the Department of Public Health |
| 25 | | under the
Nursing Home Care Act as Intermediate Care for the |
| 26 | | Developmentally Disabled
facilities or Long Term Care for |
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| 1 | | Under Age 22 facilities, the rates taking
effect on the first |
| 2 | | day of the month that begins at least 45 days after the |
| 3 | | effective date of this amendatory Act of the 95th General |
| 4 | | Assembly shall include a statewide increase of 2.5%, as
|
| 5 | | defined by the Department. |
| 6 | | Notwithstanding any other provision of this Section, for |
| 7 | | facilities licensed by the Department of Public Health under |
| 8 | | the Nursing Home Care Act as skilled nursing facilities or |
| 9 | | intermediate care facilities, effective January 1, 2005, |
| 10 | | facility rates shall be increased by the difference between |
| 11 | | (i) a facility's per diem property, liability, and malpractice |
| 12 | | insurance costs as reported in the cost report filed with the |
| 13 | | Department of Public Aid and used to establish rates effective |
| 14 | | July 1, 2001 and (ii) those same costs as reported in the |
| 15 | | facility's 2002 cost report. These costs shall be passed |
| 16 | | through to the facility without caps or limitations, except |
| 17 | | for adjustments required under normal auditing procedures.
|
| 18 | | Rates established effective each July 1 shall govern |
| 19 | | payment
for services rendered throughout that fiscal year, |
| 20 | | except that rates
established on July 1, 1996 shall be |
| 21 | | increased by 6.8% for services
provided on or after January 1, |
| 22 | | 1997. Such rates will be based
upon the rates calculated for |
| 23 | | the year beginning July 1, 1990, and for
subsequent years |
| 24 | | thereafter until June 30, 2001 shall be based on the
facility |
| 25 | | cost reports
for the facility fiscal year ending at any point |
| 26 | | in time during the previous
calendar year, updated to the |
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| 1 | | midpoint of the rate year. The cost report
shall be on file |
| 2 | | with the Department no later than April 1 of the current
rate |
| 3 | | year. Should the cost report not be on file by April 1, the |
| 4 | | Department
shall base the rate on the latest cost report filed |
| 5 | | by each skilled care
facility and intermediate care facility, |
| 6 | | updated to the midpoint of the
current rate year. In |
| 7 | | determining rates for services rendered on and after
July 1, |
| 8 | | 1985, fixed time shall not be computed at less than zero. The
|
| 9 | | Department shall not make any alterations of regulations which |
| 10 | | would reduce
any component of the Medicaid rate to a level |
| 11 | | below what that component would
have been utilizing in the |
| 12 | | rate effective on July 1, 1984.
|
| 13 | | (2) Shall take into account the actual costs incurred by |
| 14 | | facilities
in providing services for recipients of skilled |
| 15 | | nursing and intermediate
care services under the medical |
| 16 | | assistance program.
|
| 17 | | (3) Shall take into account the medical and psycho-social
|
| 18 | | characteristics and needs of the patients.
|
| 19 | | (4) Shall take into account the actual costs incurred by |
| 20 | | facilities in
meeting licensing and certification standards |
| 21 | | imposed and prescribed by the
State of Illinois, any of its |
| 22 | | political subdivisions or municipalities and by
the U.S. |
| 23 | | Department of Health and Human Services pursuant to Title XIX |
| 24 | | of the
Social Security Act.
|
| 25 | | The Department of Healthcare and Family Services
shall |
| 26 | | develop precise standards for
payments to reimburse nursing |
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| 1 | | facilities for any utilization of
appropriate rehabilitative |
| 2 | | personnel for the provision of rehabilitative
services which |
| 3 | | is authorized by federal regulations, including
reimbursement |
| 4 | | for services provided by qualified therapists or qualified
|
| 5 | | assistants, and which is in accordance with accepted |
| 6 | | professional
practices. Reimbursement also may be made for |
| 7 | | utilization of other
supportive personnel under appropriate |
| 8 | | supervision.
|
| 9 | | The Department shall develop enhanced payments to offset |
| 10 | | the additional costs incurred by a
facility serving |
| 11 | | exceptional need residents and shall allocate at least |
| 12 | | $4,000,000 of the funds
collected from the assessment |
| 13 | | established by Section 5B-2 of this Code for such payments. |
| 14 | | For
the purpose of this Section, "exceptional needs" means, |
| 15 | | but need not be limited to, ventilator care and traumatic |
| 16 | | brain injury care. The enhanced payments for exceptional need |
| 17 | | residents under this paragraph are not due and payable, |
| 18 | | however, until (i) the methodologies described in this |
| 19 | | paragraph are approved by the federal government in an |
| 20 | | appropriate State Plan amendment and (ii) the assessment |
| 21 | | imposed by Section 5B-2 of this Code is determined to be a |
| 22 | | permissible tax under Title XIX of the Social Security Act. |
| 23 | | Beginning January 1, 2014 the methodologies for |
| 24 | | reimbursement of nursing facility services as provided under |
| 25 | | this Section 5-5.4 shall no longer be applicable for services |
| 26 | | provided on or after January 1, 2014. |
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| 1 | | No payment increase under this Section for the MDS |
| 2 | | methodology, exceptional care residents, or the |
| 3 | | socio-development component rate established by Public Act |
| 4 | | 96-1530 of the 96th General Assembly and funded by the |
| 5 | | assessment imposed under Section 5B-2 of this Code shall be |
| 6 | | due and payable until after the Department notifies the |
| 7 | | long-term care providers, in writing, that the payment |
| 8 | | methodologies to long-term care providers required under this |
| 9 | | Section have been approved by the Centers for Medicare and |
| 10 | | Medicaid Services of the U.S. Department of Health and Human |
| 11 | | Services and the waivers under 42 CFR 433.68 for the |
| 12 | | assessment imposed by this Section, if necessary, have been |
| 13 | | granted by the Centers for Medicare and Medicaid Services of |
| 14 | | the U.S. Department of Health and Human Services. Upon |
| 15 | | notification to the Department of approval of the payment |
| 16 | | methodologies required under this Section and the waivers |
| 17 | | granted under 42 CFR 433.68, all increased payments otherwise |
| 18 | | due under this Section prior to the date of notification shall |
| 19 | | be due and payable within 90 days of the date federal approval |
| 20 | | is received. |
| 21 | | On and after July 1, 2012, the Department shall reduce any |
| 22 | | rate of reimbursement for services or other payments or alter |
| 23 | | any methodologies authorized by this Code to reduce any rate |
| 24 | | of reimbursement for services or other payments in accordance |
| 25 | | with Section 5-5e. |
| 26 | | For facilities licensed by the Department of Public Health |
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| 1 | | under the ID/DD Community Care Act as ID/DD Facilities and |
| 2 | | under the MC/DD Act as MC/DD Facilities, subject to federal |
| 3 | | approval, the rates taking effect for services delivered on or |
| 4 | | after August 1, 2019 shall be increased by 3.5% over the rates |
| 5 | | in effect on June 30, 2019. The Department shall adopt rules, |
| 6 | | including emergency rules under subsection (ii) of Section |
| 7 | | 5-45 of the Illinois Administrative Procedure Act, to |
| 8 | | implement the provisions of this Section, including wage |
| 9 | | increases for direct care staff. |
| 10 | | For facilities licensed by the Department of Public Health |
| 11 | | under the ID/DD Community Care Act as ID/DD Facilities and |
| 12 | | under the MC/DD Act as MC/DD Facilities, subject to federal |
| 13 | | approval, the rates taking effect on the latter of the |
| 14 | | approval date of the State Plan Amendment for these facilities |
| 15 | | or the Waiver Amendment for the home and community-based |
| 16 | | services settings shall include an increase sufficient to |
| 17 | | provide a $0.26 per hour wage increase to the base wage for |
| 18 | | non-executive staff. The Department shall adopt rules, |
| 19 | | including emergency rules as authorized by Section 5-45 of the |
| 20 | | Illinois Administrative Procedure Act, to implement the |
| 21 | | provisions of
this Section, including wage increases for |
| 22 | | direct care staff. |
| 23 | | For facilities licensed by the Department of Public Health |
| 24 | | under the ID/DD Community Care Act as ID/DD Facilities and |
| 25 | | under the MC/DD Act as MC/DD Facilities, subject to federal |
| 26 | | approval of the State Plan Amendment and the Waiver Amendment |
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| 1 | | for the home and community-based services settings, the rates |
| 2 | | taking effect for the services delivered on or after July 1, |
| 3 | | 2020 shall include an increase sufficient to provide a $1.00 |
| 4 | | per hour wage increase for non-executive staff. For services |
| 5 | | delivered on or after January 1, 2021, subject to federal |
| 6 | | approval of the State Plan Amendment and the Waiver Amendment |
| 7 | | for the home and community-based services settings, shall |
| 8 | | include an increase sufficient to provide a $0.50 per hour |
| 9 | | increase for non-executive staff. The Department shall adopt |
| 10 | | rules, including emergency rules as authorized by Section 5-45 |
| 11 | | of the Illinois Administrative Procedure Act, to implement the |
| 12 | | provisions of this Section, including wage increases for |
| 13 | | direct care staff. |
| 14 | | For facilities licensed by the Department of Public Health |
| 15 | | under the ID/DD Community Care Act as ID/DD Facilities and |
| 16 | | under the MC/DD Act as MC/DD Facilities, subject to federal |
| 17 | | approval of the State Plan Amendment, the rates taking effect |
| 18 | | for the residential services delivered on or after July 1, |
| 19 | | 2021, shall include an increase sufficient to provide a $0.50 |
| 20 | | per hour increase for aides in the rate methodology. For |
| 21 | | facilities licensed by the Department of Public Health under |
| 22 | | the ID/DD Community Care Act as ID/DD Facilities and under the |
| 23 | | MC/DD Act as MC/DD Facilities, subject to federal approval of |
| 24 | | the State Plan Amendment, the rates taking effect for the |
| 25 | | residential services delivered on or after January 1, 2022 |
| 26 | | shall include an increase sufficient to provide a $1.00 per |
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| 1 | | hour increase for aides in the rate methodology. In addition, |
| 2 | | for residential services delivered on or after January 1, 2022 |
| 3 | | such rates shall include an increase sufficient to provide |
| 4 | | wages for all residential non-executive direct care staff, |
| 5 | | excluding aides, at the federal Department of Labor, Bureau of |
| 6 | | Labor Statistics' average wage as defined in rule by the |
| 7 | | Department. The Department shall adopt rules, including |
| 8 | | emergency rules as authorized by Section 5-45 of the Illinois |
| 9 | | Administrative Procedure Act, to implement the provisions of |
| 10 | | this Section. |
| 11 | | For facilities licensed by the Department of Public Health
|
| 12 | | under the ID/DD Community Care Act as ID/DD facilities and
|
| 13 | | under the MC/DD Act as MC/DD facilities, subject to federal
|
| 14 | | approval, the rates taking effect
for services delivered on or
|
| 15 | | after July 1, 2022, shall be increased sufficiently to
provide |
| 16 | | a minimum $3.50 per hour wage increase over the wages
in effect |
| 17 | | on June 30, 2022 for front-line personnel, including, but not |
| 18 | | limited to, direct support persons, aides, front-line |
| 19 | | supervisors, and non-administrative support staff working in |
| 20 | | community-based provider organizations serving individuals |
| 21 | | with developmental disabilities, and sufficiently to provide |
| 22 | | wages for all other residential non-executive direct care |
| 23 | | staff, excluding direct support personnel, at the U.S. |
| 24 | | Department of Labor, Bureau of Labor Statistics' average wage |
| 25 | | as defined, by rule, by the Department. The Department shall |
| 26 | | adopt rules, including emergency rules in accordance with the |
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| 1 | | Illinois Administrative Procedure Act, to implement the |
| 2 | | provisions of this paragraph. |
| 3 | | (Source: P.A. 101-10, eff. 6-5-19; 101-636, eff. 6-10-20; |
| 4 | | 102-16, eff. 6-17-21.)
|
| 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 |
| 8 | | of Public Act 100-23), the Department shall increase rates and |
| 9 | | reimbursements to fund a minimum of a $0.75 per hour wage |
| 10 | | increase for front-line personnel, including, but not limited |
| 11 | | to, direct support persons, aides, front-line supervisors, |
| 12 | | qualified intellectual disabilities professionals, nurses, and |
| 13 | | non-administrative support staff working in community-based |
| 14 | | provider organizations serving individuals with developmental |
| 15 | | disabilities. The Department shall adopt rules, including |
| 16 | | emergency rules under subsection (y) of Section 5-45 of the |
| 17 | | Illinois Administrative Procedure Act, to implement the |
| 18 | | provisions of this Section. |
| 19 | | (b) Within 30 days after June 4, 2018 (the effective date |
| 20 | | of Public Act 100-587), the Department shall increase rates |
| 21 | | and reimbursements to fund a minimum of a $0.50 per hour wage |
| 22 | | increase for front-line personnel, including, but not limited |
| 23 | | to, direct support persons, aides, front-line supervisors, |
| 24 | | qualified intellectual disabilities professionals, nurses, and |
| 25 | | non-administrative support staff working in community-based |
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| 1 | | provider organizations serving individuals with developmental |
| 2 | | disabilities. The Department shall adopt rules, including |
| 3 | | emergency rules under subsection (bb) of Section 5-45 of the |
| 4 | | Illinois Administrative Procedure Act, to implement the |
| 5 | | provisions of this Section. |
| 6 | | (c) Within 30 days after the effective date of this |
| 7 | | amendatory Act of the 101st General Assembly, subject to |
| 8 | | federal approval, the Department shall increase rates and |
| 9 | | reimbursements in effect on June 30, 2019 for community-based |
| 10 | | providers for persons with Developmental Disabilities by 3.5%. |
| 11 | | The Department shall adopt rules, including emergency rules |
| 12 | | under subsection (ii) of Section 5-45 of the Illinois |
| 13 | | Administrative Procedure Act, to implement the provisions of |
| 14 | | this Section, including wage increases for direct care staff.
|
| 15 | | (d) For community-based providers serving persons with |
| 16 | | intellectual or developmental disabilities, subject to federal
|
| 17 | | approval, the rates taking effect for services delivered on or
|
| 18 | | after July 1, 2022, shall be increased sufficiently to
provide |
| 19 | | a minimum $3.50 per hour wage increase over the wages
in effect |
| 20 | | on June 30, 2022 for front-line personnel, including, but not |
| 21 | | limited to, direct support persons, aides, front-line |
| 22 | | supervisors, and non-administrative support staff working in |
| 23 | | community-based provider organizations serving individuals |
| 24 | | with developmental disabilities, and sufficient to provide |
| 25 | | wages for all other residential non-executive direct care |
| 26 | | staff, excluding direct support personnel, at the U.S. |
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| 1 | | Department of Labor, Bureau of Labor Statistics' average wage |
| 2 | | as defined, by rule, by the Department. The Department shall |
| 3 | | adopt rules, including emergency rules in accordance with the |
| 4 | | Illinois Administrative Procedure Act, to implement the |
| 5 | | provisions of this subsection. |
| 6 | | (Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18; |
| 7 | | 101-10, eff. 6-5-19.)
|
| 8 | | Section 99. Effective date. This Act takes effect upon |
| 9 | | becoming law.
|