Bill Text: IL SB3399 | 2023-2024 | 103rd General Assembly | Introduced


Bill Title: 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, 2024 shall be increased sufficiently to: (i) provide a minimum $3.00 per hour wage increase over the wages in effect on June 30, 2024 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support professionals, 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, 2024, shall be increased sufficiently to: (i) provide a minimum $3.00 per hour wage increase over the wages in effect on June 30, 2024 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support professionals, 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.

Spectrum: Partisan Bill (Democrat 8-0)

Status: (Introduced) 2024-05-15 - Added as Co-Sponsor Sen. Michael E. Hastings [SB3399 Detail]

Download: Illinois-2023-SB3399-Introduced.html

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3399

Introduced 2/8/2024, by Sen. Celina Villanueva

SYNOPSIS AS INTRODUCED:
5 ILCS 100/5-45.55 new
20 ILCS 1705/55.5 new
20 ILCS 1705/74
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
305 ILCS 5/5-5.4i

Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Human Services to establish reimbursement rates that build toward livable wages for front-line personnel in residential and day programs and service coordination agencies serving persons with intellectual and developmental disabilities. Provides that for community-based providers serving persons with intellectual or developmental disabilities, subject to federal approval, the rates taking effect for services delivered on or after July 1, 2024 shall be increased sufficiently to: (i) provide a minimum $3.00 per hour wage increase over the wages in effect on June 30, 2024 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support professionals, 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, 2024, shall be increased sufficiently to: (i) provide a minimum $3.00 per hour wage increase over the wages in effect on June 30, 2024 for front-line personnel; and (ii) provide wages for all other residential non-executive direct care staff, excluding direct support professionals, at the U.S. Department of Labor's average wage as defined, by rule, by the Department. Requires the same increase for front-line personnel employed at community-based providers serving persons with intellectual or developmental disabilities. Amends the Illinois Administrative Procedure Act. Grants the Departments of Human Services and Healthcare and Family Services emergency rulemaking authority. Effective immediately.
LRB103 37183 KTG 67302 b

A BILL FOR

SB3399LRB103 37183 KTG 67302 b
1 AN ACT concerning care for persons with developmental
2disabilities.
3 Be it enacted by the People of the State of Illinois,
4represented in the General Assembly:
5 Section 1. This Act may be referred to as the Community
6Disability Living Wage Act.
7 Section 2. Findings.
8 (1) An estimated 22,000 children and adults with
9 intellectual and developmental disabilities are supported
10 in community-based settings in Illinois; direct support
11 professionals (DSPs), are trained paraprofessional staff
12 who are engaged in activities of daily living and
13 community support; too many of these employees earn wages
14 that place them and their families below the poverty
15 level.
16 (2) In Illinois, nearly half of direct care workers
17 rely on public assistance to make ends meet, creating
18 additional expenditures for State government; low wages
19 are a consequence of the historically low reimbursement
20 rates paid by the State of Illinois to community-based
21 service providers.
22 (3) The lack of adequate wages for employees who
23 perform the challenging work of supporting persons with

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1 intellectual and developmental disabilities results in
2 high employee turnover, which in turn negatively impacts
3 the quality of services provided, higher wages are proven
4 to reduce staff turnover, improving stability and quality
5 of services while reducing employer training costs.
6 (4) Rising wages in other sectors now mean, despite
7 the modest wage increase and strenuous efforts to recruit
8 new workers, agencies are experiencing DSP vacancy rates
9 of 25%; excessive vacancies force employers to rely more
10 on overtime, leading to staff burnout and driving up
11 costs.
12 (5) A December 2020 report issued by an independent
13 consulting group commissioned by the State to propose
14 changes to the State's reimbursement for community
15 disability agencies recommended that addressing DSP wages
16 was the number one priority for ensuring compliance with
17 the mandates of the Ligas Consent Decree, and further
18 recommended that wages for DSPs should be fixed at 150% of
19 the prevailing minimum wage plus additional funding for
20 benefits.
21 (6) The difference between 150% of the State minimum
22 wage on January 1, 2025 and the hourly DSP wage rate set by
23 the State amounts to $3.00 per hour.
24 (7) The General Assembly finds that in order to reduce
25 turnover, increase retention, fill vacancies, and ensure
26 DSPs are adequately compensated for the critically

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1 important work they do, an increase in rates and
2 reimbursements to community-based service providers to
3 effectuate an increase in the hourly wage paid to DSPs is
4 needed.
5 Section 3. Purpose and intent. It is the purpose of this
6Act to increase the wages of DSPs and other front-line staff in
7community disability agencies beyond the poverty level and to
8a level competitive with rival employers and above the State
9minimum wage, in an effort to improve the lives of DSPs and the
10lives of the vulnerable persons they support.
11 It is the intent of the General Assembly to ensure that all
12funds resulting from rate increases provided to community
13disability agencies are allocated to front-line employee wages
14in order to address the current workforce crisis which is the
15primary obstacle to the availability of community-based
16services for people with disabilities.
17 Section 5. The Illinois Administrative Procedure Act is
18amended by adding Section 5-45.55 as follows:
19 (5 ILCS 100/5-45.55 new)
20 Sec. 5-45.55 Emergency rulemaking; Departments of Human
21Services and Healthcare and Family Services. To provide for
22the expeditious and timely implementation of changes made by
23this amendatory Act of the 103rd General Assembly to Section

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174 of the Mental Health and Developmental Disabilities
2Administrative Act and to Sections 5-5.4 and 5-5.4i of the
3Illinois Public Aid Code, emergency rules implementing the
4changes made by this amendatory Act of the 103rd General
5Assembly to Section 74 of the Mental Health and Developmental
6Disabilities Administrative Act and to Sections 5-5.4 and
75-5.4i of the Illinois Public Aid Code may be adopted in
8accordance with Section 5-45 by the respective Department. The
9adoption of emergency rules authorized by Section 5-45 and
10this Section is deemed to be necessary for the public
11interest, 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 and by adding Section 55.5 as follows:
17 (20 ILCS 1705/55.5 new)
18 Sec. 55.5. Increased wages for front-line personnel. As
19used in this Section, "front-line personnel" means direct
20support professionals, aides, front-line supervisors, and
21non-administrative support staff working in service settings
22outlined in this Section.
23 The Department shall establish reimbursement rates that
24build toward livable wages for front-line personnel in

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1residential and day programs and service coordination agencies
2serving persons with intellectual and developmental
3disabilities under Section 54 of this Act, including, but not
4limited to, intermediate care for the developmentally disabled
5facilities, medically complex for the developmentally disabled
6facilities, community-integrated living arrangements,
7community day services, employment, and other residential and
8day programs for persons with intellectual and developmental
9disabilities supported by State funds or funding under Title
10XIX of the federal Social Security Act.
11 The Department shall increase rates and reimbursements so
12that by July 1, 2024 direct support professionals wages shall
13be increased by $3.00 per hour, and so that other front-line
14personnel earn a commensurate wage.
15 (20 ILCS 1705/74)
16 Sec. 74. Rates and reimbursements.
17 (a) Within 30 days after July 6, 2017 (the effective date
18of Public Act 100-23), the Department shall increase rates and
19reimbursements to fund a minimum of a $0.75 per hour wage
20increase for front-line personnel, including, but not limited
21to, direct support professionals, aides, front-line
22supervisors, qualified intellectual disabilities
23professionals, nurses, and non-administrative support staff
24working in community-based provider organizations serving
25individuals with developmental disabilities. The Department

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1shall adopt rules, including emergency rules under subsection
2(y) of Section 5-45 of the Illinois Administrative Procedure
3Act, to implement the provisions of this Section.
4 (b) Rates and reimbursements. Within 30 days after June 4,
52018 (the effective date of Public Act 100-587), the
6Department shall increase rates and reimbursements to fund a
7minimum of a $0.50 per hour wage increase for front-line
8personnel, including, but not limited to, direct support
9professionals, aides, front-line supervisors, qualified
10intellectual disabilities professionals, nurses, and
11non-administrative support staff working in community-based
12provider organizations serving individuals with developmental
13disabilities. The Department shall adopt rules, including
14emergency rules under subsection (bb) of Section 5-45 of the
15Illinois Administrative Procedure Act, to implement the
16provisions of this Section.
17 (c) Rates and reimbursements. Within 30 days after June 5,
182019 (the effective date of Public Act 101-10), subject to
19federal approval, the Department shall increase rates and
20reimbursements in effect on June 30, 2019 for community-based
21providers for persons with Developmental Disabilities by 3.5%
22The Department shall adopt rules, including emergency rules
23under subsection (jj) of Section 5-45 of the Illinois
24Administrative Procedure Act, to implement the provisions of
25this Section, including wage increases for direct care staff.
26 (d) For community-based providers serving persons with

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1intellectual/developmental disabilities, subject to federal
2approval of any relevant Waiver Amendment, the rates taking
3effect for services delivered on or after January 1, 2022,
4shall include an increase in the rate methodology sufficient
5to provide a $1.50 per hour wage increase for direct support
6professionals in residential settings and sufficient to
7provide wages for all residential non-executive direct care
8staff, excluding direct support professionals, at the federal
9Department of Labor, Bureau of Labor Statistics' average wage
10as defined in rule by the Department.
11 The establishment of and any changes to the rate
12methodologies for community-based services provided to persons
13with intellectual/developmental disabilities are subject to
14federal approval of any relevant Waiver Amendment and shall be
15defined in rule by the Department. The Department shall adopt
16rules, including emergency rules as authorized by Section 5-45
17of the Illinois Administrative Procedure Act, to implement the
18provisions of this subsection (d).
19 (e) For community-based providers serving persons with
20intellectual/developmental disabilities, subject to federal
21approval of any relevant Waiver Amendment, the rates taking
22effect for services delivered on or after January 1, 2023,
23shall include an increase in the rate methodology sufficient
24to provide a $1.00 per hour wage increase for all direct
25support professionals and all other frontline personnel who
26are not subject to the Bureau of Labor Statistics' average

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1wage increases, who work in residential and community day
2services settings, with at least $0.50 of those funds to be
3provided as a direct increase to base wages, with the
4remaining $0.50 to be used flexibly for base wage increases.
5In addition, the rates taking effect for services delivered on
6or after January 1, 2023 shall include an increase sufficient
7to provide wages for all residential non-executive direct care
8staff, excluding direct support professionals, at the federal
9Department of Labor, Bureau of Labor Statistics' average wage
10as defined in rule by the Department.
11 The establishment of and any changes to the rate
12methodologies for community-based services provided to persons
13with intellectual/developmental disabilities are subject to
14federal approval of any relevant Waiver Amendment and shall be
15defined in rule by the Department. The Department shall adopt
16rules, including emergency rules as authorized by Section 5-45
17of the Illinois Administrative Procedure Act, to implement the
18provisions of this subsection.
19 (f) For community-based providers serving persons with
20intellectual/developmental disabilities, subject to federal
21approval of any relevant Waiver Amendment, the rates taking
22effect for services delivered on or after January 1, 2024
23shall include an increase in the rate methodology sufficient
24to provide a $2.50 per hour wage increase for all direct
25support professionals and all other frontline personnel who
26are not subject to the Bureau of Labor Statistics' average

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1wage increases and who work in residential and community day
2services settings. At least $1.25 of the per hour wage
3increase shall be provided as a direct increase to base wages,
4and the remaining $1.25 of the per hour wage increase shall be
5used flexibly for base wage increases. In addition, the rates
6taking effect for services delivered on or after January 1,
72024 shall include an increase sufficient to provide wages for
8all residential non-executive direct care staff, excluding
9direct support professionals, at the federal Department of
10Labor, Bureau of Labor Statistics' average wage as defined in
11rule by the Department.
12 The establishment of and any changes to the rate
13methodologies for community-based services provided to persons
14with intellectual/developmental disabilities are subject to
15federal approval of any relevant Waiver Amendment and shall be
16defined in rule by the Department. The Department shall adopt
17rules, including emergency rules as authorized by Section 5-45
18of the Illinois Administrative Procedure Act, to implement the
19provisions of this subsection.
20 (g) For community-based providers serving persons with
21intellectual or developmental disabilities, subject to federal
22approval, the rates taking effect for services delivered on or
23after July 1, 2024 shall be increased sufficiently to provide
24a minimum $3.00 per hour wage increase over the wages in effect
25on June 30, 2024 for front-line personnel, including, but not
26limited to, direct support professionals, aides, front-line

SB3399- 10 -LRB103 37183 KTG 67302 b
1supervisors, and non-administrative support staff working in
2community-based provider organizations serving individuals
3with developmental disabilities, and sufficient to provide
4wages for all other residential non-executive direct care
5staff, excluding direct support professionals, at the U.S.
6Department of Labor, Bureau of Labor Statistics' average wage
7as defined, by rule, by the Department. The Department shall
8adopt rules, including emergency rules in accordance with the
9Illinois Administrative Procedure Act, to implement the
10provisions of this subsection.
11(Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
12102-830, eff. 1-1-23; 103-8, eff. 6-7-23; 103-154, eff.
136-30-23.)
14 Section 15. The Illinois Public Aid Code is amended by
15changing Sections 5-5.4 and 5-5.4i as follows:
16 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
17 Sec. 5-5.4. Standards of Payment - Department of
18Healthcare and Family Services. The Department of Healthcare
19and Family Services shall develop standards of payment of
20nursing facility and ICF/DD services in facilities providing
21such services under this Article which:
22 (1) Provide for the determination of a facility's payment
23for nursing facility or ICF/DD services on a prospective
24basis. The amount of the payment rate for all nursing

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1facilities certified by the Department of Public Health under
2the ID/DD Community Care Act or the Nursing Home Care Act as
3Intermediate Care for the Developmentally Disabled facilities,
4Long Term Care for Under Age 22 facilities, Skilled Nursing
5facilities, or Intermediate Care facilities under the medical
6assistance program shall be prospectively established annually
7on the basis of historical, financial, and statistical data
8reflecting actual costs from prior years, which shall be
9applied to the current rate year and updated for inflation,
10except that the capital cost element for newly constructed
11facilities shall be based upon projected budgets. The annually
12established payment rate shall take effect on July 1 in 1984
13and subsequent years. No rate increase and no update for
14inflation shall be provided on or after July 1, 1994, unless
15specifically provided for in this Section. The changes made by
16Public Act 93-841 extending the duration of the prohibition
17against a rate increase or update for inflation are effective
18retroactive to July 1, 2004.
19 For facilities licensed by the Department of Public Health
20under the Nursing Home Care Act as Intermediate Care for the
21Developmentally Disabled facilities or Long Term Care for
22Under Age 22 facilities, the rates taking effect on July 1,
231998 shall include an increase of 3%. For facilities licensed
24by the Department of Public Health under the Nursing Home Care
25Act as Skilled Nursing facilities or Intermediate Care
26facilities, the rates taking effect on July 1, 1998 shall

SB3399- 12 -LRB103 37183 KTG 67302 b
1include an increase of 3% plus $1.10 per resident-day, as
2defined by the Department. For facilities licensed by the
3Department of Public Health under the Nursing Home Care Act as
4Intermediate Care Facilities for the Developmentally Disabled
5or Long Term Care for Under Age 22 facilities, the rates taking
6effect on January 1, 2006 shall include an increase of 3%. For
7facilities licensed by the Department of Public Health under
8the Nursing Home Care Act as Intermediate Care Facilities for
9the Developmentally Disabled or Long Term Care for Under Age
1022 facilities, the rates taking effect on January 1, 2009
11shall include an increase sufficient to provide a $0.50 per
12hour wage increase for non-executive staff. For facilities
13licensed by the Department of Public Health under the ID/DD
14Community Care Act as ID/DD Facilities the rates taking effect
15within 30 days after July 6, 2017 (the effective date of Public
16Act 100-23) shall include an increase sufficient to provide a
17$0.75 per hour wage increase for non-executive staff. The
18Department shall adopt rules, including emergency rules under
19subsection (y) of Section 5-45 of the Illinois Administrative
20Procedure Act, to implement the provisions of this paragraph.
21For facilities licensed by the Department of Public Health
22under the ID/DD Community Care Act as ID/DD Facilities and
23under the MC/DD Act as MC/DD Facilities, the rates taking
24effect within 30 days after June 5, 2019 (the effective date of
25Public Act 101-10) shall include an increase sufficient to
26provide a $0.50 per hour wage increase for non-executive

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1front-line personnel, including, but not limited to, direct
2support persons, aides, front-line supervisors, qualified
3intellectual disabilities professionals, nurses, and
4non-administrative support staff. The Department shall adopt
5rules, including emergency rules under subsection (bb) of
6Section 5-45 of the Illinois Administrative Procedure Act, to
7implement the provisions of this paragraph.
8 For facilities licensed by the Department of Public Health
9under the ID/DD Community Care Act as ID/DD facilities and
10under the MC/DD Act as MC/DD facilities, subject to federal
11approval, the rates taking effect for services delivered on or
12after July 1, 2024, shall be increased sufficiently to provide
13a minimum $3.00 per hour wage increase over the wages in effect
14on June 30, 2024 for front-line personnel, including, but not
15limited to, direct support professionals, aides, front-line
16supervisors, and non-administrative support staff working in
17community-based provider organizations serving individuals
18with developmental disabilities, and sufficient to provide
19wages for all other residential non-executive direct care
20staff, excluding direct support professionals, at the U.S.
21Department of Labor, Bureau of Labor Statistics' average wage
22as defined, by rule, by the Department. The Department shall
23adopt rules, including emergency rules in accordance with the
24Illinois Administrative Procedure Act, to implement the
25provisions of this paragraph.
26 For facilities licensed by the Department of Public Health

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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

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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

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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 February 16, 2011 (the effective date of Public Act
12 96-1530), $416,500,000 or an amount as may be necessary to
13 complete the transition to the MDS methodology for the
14 nursing component of the rate. Increased payments under
15 this item (iv) are not due and payable, however, until (i)
16 the methodologies described in this paragraph are approved
17 by the federal government in an appropriate State Plan
18 amendment and (ii) the assessment imposed by Section 5B-2
19 of this Code is determined to be a permissible tax under
20 Title XIX of the Social Security Act.
21 Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, the support component of the
25rates taking effect on January 1, 2008 shall be computed using
26the most recent cost reports on file with the Department of

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1Healthcare and Family Services no later than April 1, 2005,
2updated for inflation to January 1, 2006.
3 For facilities licensed by the Department of Public Health
4under the Nursing Home Care Act as Intermediate Care for the
5Developmentally Disabled facilities or Long Term Care for
6Under Age 22 facilities, the rates taking effect on April 1,
72002 shall include a statewide increase of 2.0%, as defined by
8the Department. This increase terminates on July 1, 2002;
9beginning July 1, 2002 these rates are reduced to the level of
10the rates in effect on March 31, 2002, as defined by the
11Department.
12 For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as skilled nursing facilities
14or intermediate care facilities, the rates taking effect on
15July 1, 2001 shall be computed using the most recent cost
16reports on file with the Department of Public Aid no later than
17April 1, 2000, updated for inflation to January 1, 2001. For
18rates effective July 1, 2001 only, rates shall be the greater
19of the rate computed for July 1, 2001 or the rate effective on
20June 30, 2001.
21 Notwithstanding any other provision of this Section, for
22facilities licensed by the Department of Public Health under
23the Nursing Home Care Act as skilled nursing facilities or
24intermediate care facilities, the Illinois Department shall
25determine by rule the rates taking effect on July 1, 2002,
26which shall be 5.9% less than the rates in effect on June 30,

SB3399- 19 -LRB103 37183 KTG 67302 b
12002.
2 Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, if the payment methodologies
6required under Section 5A-12 and the waiver granted under 42
7CFR 433.68 are approved by the United States Centers for
8Medicare and Medicaid Services, the rates taking effect on
9July 1, 2004 shall be 3.0% greater than the rates in effect on
10June 30, 2004. These rates shall take effect only upon
11approval and implementation of the payment methodologies
12required under Section 5A-12.
13 Notwithstanding any other provisions of this Section, for
14facilities licensed by the Department of Public Health under
15the Nursing Home Care Act as skilled nursing facilities or
16intermediate care facilities, the rates taking effect on
17January 1, 2005 shall be 3% more than the rates in effect on
18December 31, 2004.
19 Notwithstanding any other provision of this Section, for
20facilities licensed by the Department of Public Health under
21the Nursing Home Care Act as skilled nursing facilities or
22intermediate care facilities, effective January 1, 2009, the
23per diem support component of the rates effective on January
241, 2008, computed using the most recent cost reports on file
25with the Department of Healthcare and Family Services no later
26than April 1, 2005, updated for inflation to January 1, 2006,

SB3399- 20 -LRB103 37183 KTG 67302 b
1shall be increased to the amount that would have been derived
2using standard Department of Healthcare and Family Services
3methods, procedures, and inflators.
4 Notwithstanding any other provisions of this Section, for
5facilities licensed by the Department of Public Health under
6the Nursing Home Care Act as intermediate care facilities that
7are federally defined as Institutions for Mental Disease, or
8facilities licensed by the Department of Public Health under
9the Specialized Mental Health Rehabilitation Act of 2013, a
10socio-development component rate equal to 6.6% of the
11facility's nursing component rate as of January 1, 2006 shall
12be established and paid effective July 1, 2006. The
13socio-development component of the rate shall be increased by
14a factor of 2.53 on the first day of the month that begins at
15least 45 days after January 11, 2008 (the effective date of
16Public Act 95-707). As of August 1, 2008, the
17socio-development component rate shall be equal to 6.6% of the
18facility's nursing component rate as of January 1, 2006,
19multiplied by a factor of 3.53. For services provided on or
20after April 1, 2011, or the first day of the month that begins
21at least 45 days after February 16, 2011 (the effective date of
22Public Act 96-1530), whichever is later, the Illinois
23Department may by rule adjust these socio-development
24component rates, and may use different adjustment
25methodologies for those facilities participating, and those
26not participating, in the Illinois Department's demonstration

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1program pursuant to the provisions of Title 77, Part 300,
2Subpart T of the Illinois Administrative Code, but in no case
3may such rates be diminished below those in effect on August 1,
42008.
5 For facilities licensed by the Department of Public Health
6under the Nursing Home Care Act as Intermediate Care for the
7Developmentally Disabled facilities or as long-term care
8facilities for residents under 22 years of age, the rates
9taking effect on July 1, 2003 shall include a statewide
10increase of 4%, as defined by the Department.
11 For facilities licensed by the Department of Public Health
12under the Nursing Home Care Act as Intermediate Care for the
13Developmentally Disabled facilities or Long Term Care for
14Under Age 22 facilities, the rates taking effect on the first
15day of the month that begins at least 45 days after January 11,
162008 (the effective date of Public Act 95-707) shall include a
17statewide increase of 2.5%, as defined by the Department.
18 Notwithstanding any other provision of this Section, for
19facilities licensed by the Department of Public Health under
20the Nursing Home Care Act as skilled nursing facilities or
21intermediate care facilities, effective January 1, 2005,
22facility rates shall be increased by the difference between
23(i) a facility's per diem property, liability, and malpractice
24insurance costs as reported in the cost report filed with the
25Department of Public Aid and used to establish rates effective
26July 1, 2001 and (ii) those same costs as reported in the

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1facility's 2002 cost report. These costs shall be passed
2through to the facility without caps or limitations, except
3for adjustments required under normal auditing procedures.
4 Rates established effective each July 1 shall govern
5payment for services rendered throughout that fiscal year,
6except that rates established on July 1, 1996 shall be
7increased by 6.8% for services provided on or after January 1,
81997. Such rates will be based upon the rates calculated for
9the year beginning July 1, 1990, and for subsequent years
10thereafter until June 30, 2001 shall be based on the facility
11cost reports for the facility fiscal year ending at any point
12in time during the previous calendar year, updated to the
13midpoint of the rate year. The cost report shall be on file
14with the Department no later than April 1 of the current rate
15year. Should the cost report not be on file by April 1, the
16Department shall base the rate on the latest cost report filed
17by each skilled care facility and intermediate care facility,
18updated to the midpoint of the current rate year. In
19determining rates for services rendered on and after July 1,
201985, fixed time shall not be computed at less than zero. The
21Department shall not make any alterations of regulations which
22would reduce any component of the Medicaid rate to a level
23below what that component would have been utilizing in the
24rate effective on July 1, 1984.
25 (2) Shall take into account the actual costs incurred by
26facilities in providing services for recipients of skilled

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

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1but need not be limited to, ventilator care and traumatic
2brain injury care. The enhanced payments for exceptional need
3residents under this paragraph are not due and payable,
4however, until (i) the methodologies described in this
5paragraph are approved by the federal government in an
6appropriate State Plan amendment and (ii) the assessment
7imposed by Section 5B-2 of this Code is determined to be a
8permissible tax under Title XIX of the Social Security Act.
9 Beginning January 1, 2014 the methodologies for
10reimbursement of nursing facility services as provided under
11this Section 5-5.4 shall no longer be applicable for services
12provided on or after January 1, 2014.
13 No payment increase under this Section for the MDS
14methodology, exceptional care residents, or the
15socio-development component rate established by Public Act
1696-1530 of the 96th General Assembly and funded by the
17assessment imposed under Section 5B-2 of this Code shall be
18due and payable until after the Department notifies the
19long-term care providers, in writing, that the payment
20methodologies to long-term care providers required under this
21Section have been approved by the Centers for Medicare and
22Medicaid Services of the U.S. Department of Health and Human
23Services and the waivers under 42 CFR 433.68 for the
24assessment imposed by this Section, if necessary, have been
25granted by the Centers for Medicare and Medicaid Services of
26the U.S. Department of Health and Human Services. Upon

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1notification to the Department of approval of the payment
2methodologies required under this Section and the waivers
3granted under 42 CFR 433.68, all increased payments otherwise
4due under this Section prior to the date of notification shall
5be due and payable within 90 days of the date federal approval
6is received.
7 On and after July 1, 2012, the Department shall reduce any
8rate of reimbursement for services or other payments or alter
9any methodologies authorized by this Code to reduce any rate
10of reimbursement for services or other payments in accordance
11with Section 5-5e.
12 For 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, subject to federal
15approval, the rates taking effect for services delivered on or
16after August 1, 2019 shall be increased by 3.5% over the rates
17in effect on June 30, 2019. The Department shall adopt rules,
18including emergency rules under subsection (ii) of Section
195-45 of the Illinois Administrative Procedure Act, to
20implement the provisions of this Section, including wage
21increases for direct care staff.
22 For facilities licensed by the Department of Public Health
23under the ID/DD Community Care Act as ID/DD Facilities and
24under the MC/DD Act as MC/DD Facilities, subject to federal
25approval, the rates taking effect on the latter of the
26approval date of the State Plan Amendment for these facilities

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1or the Waiver Amendment for the home and community-based
2services settings shall include an increase sufficient to
3provide a $0.26 per hour wage increase to the base wage for
4non-executive staff. The Department shall adopt rules,
5including emergency rules as authorized by Section 5-45 of the
6Illinois Administrative Procedure Act, to implement the
7provisions of this Section, including wage increases for
8direct care staff.
9 For facilities licensed by the Department of Public Health
10under the ID/DD Community Care Act as ID/DD Facilities and
11under the MC/DD Act as MC/DD Facilities, subject to federal
12approval of the State Plan Amendment and the Waiver Amendment
13for the home and community-based services settings, the rates
14taking effect for the services delivered on or after July 1,
152020 shall include an increase sufficient to provide a $1.00
16per hour wage increase for non-executive staff. For services
17delivered on or after January 1, 2021, subject to federal
18approval of the State Plan Amendment and the Waiver Amendment
19for the home and community-based services settings, shall
20include an increase sufficient to provide a $0.50 per hour
21increase for non-executive staff. 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 Section, including wage increases for
25direct care staff.
26 For facilities licensed by the Department of Public Health

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1under the ID/DD Community Care Act as ID/DD Facilities and
2under the MC/DD Act as MC/DD Facilities, subject to federal
3approval of the State Plan Amendment, the rates taking effect
4for the residential services delivered on or after July 1,
52021, shall include an increase sufficient to provide a $0.50
6per hour increase for aides in the rate methodology. For
7facilities licensed by the Department of Public Health under
8the ID/DD Community Care Act as ID/DD Facilities and under the
9MC/DD Act as MC/DD Facilities, subject to federal approval of
10the State Plan Amendment, the rates taking effect for the
11residential services delivered on or after January 1, 2022
12shall include an increase sufficient to provide a $1.00 per
13hour increase for aides in the rate methodology. In addition,
14for residential services delivered on or after January 1, 2022
15such rates shall include an increase sufficient to provide
16wages for all residential non-executive direct care staff,
17excluding aides, at the federal Department of Labor, Bureau of
18Labor Statistics' average wage as defined in rule by the
19Department. The Department shall adopt rules, including
20emergency rules as authorized by Section 5-45 of the Illinois
21Administrative Procedure Act, to implement the provisions of
22this 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

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1for services delivered on or after January 1, 2023, shall
2include a $1.00 per hour wage increase for all direct support
3personnel and all other frontline personnel who are not
4subject to the Bureau of Labor Statistics' average wage
5increases, who work in residential and community day services
6settings, with at least $0.50 of those funds to be provided as
7a direct increase to all aide base wages, with the remaining
8$0.50 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, 2023 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, 2023, 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 For facilities licensed by the Department of Public Health
22under the ID/DD Community Care Act as ID/DD facilities and
23under the MC/DD Act as MC/DD facilities, subject to federal
24approval of the State Plan Amendment, the rates taking effect
25for services delivered on or after January 1, 2024 shall
26include a $2.50 per hour wage increase for all direct support

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1personnel and all other frontline personnel who are not
2subject to the Bureau of Labor Statistics' average wage
3increases and who work in residential and community day
4services settings. At least $1.25 of the per hour wage
5increase shall be provided as a direct increase to all aide
6base wages, and the remaining $1.25 of the per hour wage
7increase shall be used flexibly for base wage increases to the
8rate methodology for aides. In addition, for residential
9services delivered on or after January 1, 2024, the rates
10shall include an increase sufficient to provide wages for all
11residential non-executive direct care staff, excluding aides,
12at the federal Department of Labor, Bureau of Labor
13Statistics' average wage as determined by the Department.
14Also, for services delivered on or after January 1, 2024, the
15rates will include adjustments to employment-related expenses
16as defined in rule by the Department. The Department shall
17adopt rules, including emergency rules as authorized by
18Section 5-45 of the Illinois Administrative Procedure Act, to
19implement the provisions of this Section.
20 For facilities licensed by the Department of Public Health
21under the ID/DD Community Care Act as ID/DD facilities and
22under the MC/DD Act as MC/DD facilities, subject to federal
23approval, the rates taking effect for services delivered on or
24after July 1, 2024, shall be increased sufficiently to provide
25a minimum $3.00 per hour wage increase over the wages in effect
26on June 30, 2024 for front-line personnel, including, but not

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1limited to, direct support professionals, aides, front-line
2supervisors, and non-administrative support staff working in
3community-based provider organizations serving individuals
4with developmental disabilities, and sufficient to provide
5wages for all other residential non-executive direct care
6staff, excluding direct support professionals, at the U.S.
7Department of Labor, Bureau of Labor Statistics' average wage
8as defined, by rule, by the Department. The Department shall
9adopt rules, including emergency rules in accordance with the
10Illinois Administrative Procedure Act, to implement the
11provisions of this paragraph.
12(Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
13103-8, eff. 6-7-23.)
14 (305 ILCS 5/5-5.4i)
15 Sec. 5-5.4i. Rates and reimbursements.
16 (a) Within 30 days after July 6, 2017 (the effective date
17of Public Act 100-23), the Department shall increase rates and
18reimbursements to fund a minimum of a $0.75 per hour wage
19increase for front-line personnel, including, but not limited
20to, direct support persons, aides, front-line supervisors,
21qualified intellectual disabilities professionals, nurses, and
22non-administrative support staff working in community-based
23provider organizations serving individuals with developmental
24disabilities. The Department shall adopt rules, including
25emergency rules under subsection (y) of Section 5-45 of the

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1Illinois Administrative Procedure Act, to implement the
2provisions of this Section.
3 (b) Within 30 days after June 4, 2018 (the effective date
4of Public Act 100-587), the Department shall increase rates
5and reimbursements to fund a minimum of a $0.50 per hour wage
6increase for front-line personnel, including, but not limited
7to, direct support persons, aides, front-line supervisors,
8qualified intellectual disabilities professionals, nurses, and
9non-administrative support staff working in community-based
10provider organizations serving individuals with developmental
11disabilities. The Department shall adopt rules, including
12emergency rules under subsection (bb) of Section 5-45 of the
13Illinois Administrative Procedure Act, to implement the
14provisions of this Section.
15 (c) Within 30 days after the effective date of this
16amendatory Act of the 101st General Assembly, subject to
17federal approval, the Department shall increase rates and
18reimbursements in effect on June 30, 2019 for community-based
19providers for persons with Developmental Disabilities by 3.5%.
20The Department shall adopt rules, including emergency rules
21under subsection (ii) of Section 5-45 of the Illinois
22Administrative Procedure Act, to implement the provisions of
23this Section, including wage increases for direct care staff.
24 (d) For community-based providers serving persons with
25intellectual or developmental disabilities, subject to federal
26approval, the rates taking effect for services delivered on or

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1after July 1, 2024, shall be increased sufficiently to provide
2a minimum $3.00 per hour wage increase over the wages in effect
3on June 30, 2024 for front-line personnel, including, but not
4limited to, direct support professionals, aides, front-line
5supervisors, and non-administrative support staff working in
6community-based provider organizations serving individuals
7with developmental disabilities, and sufficient to provide
8wages for all other residential non-executive direct care
9staff, excluding direct support professionals, at the U.S.
10Department of Labor, Bureau of Labor Statistics' average wage
11as defined, by rule, by the Department. The Department shall
12adopt rules, including emergency rules in accordance with the
13Illinois Administrative Procedure Act, to implement the
14provisions of this subsection.
15(Source: P.A. 100-23, eff. 7-6-17; 100-587, eff. 6-4-18;
16101-10, eff. 6-5-19.)
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