Bill Text: IL HB0503 | 2009-2010 | 96th General Assembly | Engrossed

---

Bill Title: Amends the Illinois Public Aid Code. Provides that under the medical assistance program, beginning January 1, 2009, the Department of Healthcare and Family Services may reimburse a skilled nursing facility, intermediate care facility, or institution for mental diseases providing long-term care services, based upon patient days reported in the facility's most recent cost report, for spending incurred to provide health care benefits to its employees serving the vulnerable populations residing in the facility, in order to attract and retain a qualified and healthy workforce. Provides that subject to available appropriations, the reimbursement shall be made according to certain criteria. Provides that the reimbursement is subject to audit by the Department and shall be reduced or eliminated in the case of any facility that does not honor its commitment to increase spending to improve the health of its employees or that decreases such spending. Effective July 1, 2009.

Spectrum: Partisan Bill (Democrat 18-0)

Status: (Introduced - Dead) 2009-04-03 - Rule 19(a) / Re-referred to Rules Committee [HB0503 Detail]

Download: Illinois-2009-HB0503-Engrossed.html

---

HB0503 Engrossed LRB096 05782 DRJ 15857 b
AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Public Aid Code is amended by
changing Section 5-5.5 as follows:
(305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
Sec. 5-5.5. Elements of Payment Rate.
(a) The The Department of Healthcare and Family Services
shall develop a prospective method for determining payment
rates for skilled nursing and intermediate care services in
nursing facilities composed of the following cost elements:
(1) Standard Services, with the cost of this component
being determined by taking into account the actual costs to
the facilities of these services subject to cost ceilings
to be defined in the Department's rules.
(2) Resident Services, with the cost of this component
being determined by taking into account the actual costs,
needs and utilization of these services, as derived from an
assessment of the resident needs in the nursing facilities.
The Department shall adopt rules governing reimbursement
for resident services as listed in Section 5-1.1. Surveys
or assessments of resident needs under this Section shall
include a review by the facility of the results of such

HB0503 Engrossed - 2 - LRB096 05782 DRJ 15857 b
assessments and a discussion of issues in dispute with
authorized survey staff, unless the facility elects not to
participate in such a review process. Surveys or
assessments of resident needs under this Section may be
conducted semi-annually and payment rates relating to
resident services may be changed on a semi-annual basis.
The Illinois Department shall initiate a project, either on
a pilot basis or Statewide, to reimburse the cost of
resident services based on a methodology which utilizes an
assessment of resident needs to determine the level of
reimbursement. This methodology shall be different from
the payment criteria for resident services utilized by the
Illinois Department on July 1, 1981. On March 1, 1982, and
each year thereafter, until such time when the Illinois
Department adopts the methodology used in such project for
use statewide, the Illinois Department shall report to the
General Assembly on the implementation and progress of such
project. The report shall include:
(A) A statement of the Illinois Department's goals
and objectives for such project;
(B) A description of such project, including the
number and type of nursing facilities involved in the
project;
(C) A description of the methodology used in such
project;
(D) A description of the Illinois Department's

HB0503 Engrossed - 3 - LRB096 05782 DRJ 15857 b
application of the methodology;
(E) A statement on the methodology's effect on the
quality of care given to residents in the sample
nursing facilities; and
(F) A statement on the cost of the methodology used
in such project and a comparison of this cost with the
cost of the current payment criteria.
(3) Ancillary Services, with the payment rate being
developed for each individual type of service. Payment
shall be made only when authorized under procedures
developed by the Department of Healthcare and Family
Services.
(4) Nurse's Aide Training, with the cost of this
component being determined by taking into account the
actual cost to the facilities of such training.
(5) Real Estate Taxes, with the cost of this component
being determined by taking into account the figures
contained in the most currently available cost reports
(with no imposition of maximums) updated to the midpoint of
the current rate year for long term care services rendered
between July 1, 1984 and June 30, 1985, and with the cost
of this component being determined by taking into account
the actual 1983 taxes for which the nursing homes were
assessed (with no imposition of maximums) updated to the
midpoint of the current rate year for long term care
services rendered between July 1, 1985 and June 30, 1986.

HB0503 Engrossed - 4 - LRB096 05782 DRJ 15857 b
(b) In developing a prospective method for determining
payment rates for skilled nursing and intermediate care
services in nursing facilities, the Department of Healthcare
and Family Services shall consider the following cost elements:
(1) Reasonable capital cost determined by utilizing
incurred interest rate and the current value of the
investment, including land, utilizing composite rates, or
by utilizing such other reasonable cost related methods
determined by the Department. However, beginning with the
rate reimbursement period effective July 1, 1987, the
Department shall be prohibited from establishing,
including, and implementing any depreciation factor in
calculating the capital cost element.
(2) Profit, with the actual amount being produced and
accruing to the providers in the form of a return on their
total investment, on the basis of their ability to
economically and efficiently deliver a type of service. The
method of payment may assure the opportunity for a profit,
but shall not guarantee or establish a specific amount as a
cost.
(c) The Illinois Department may implement the amendatory
changes to this Section made by this amendatory Act of 1991
through the use of emergency rules in accordance with the
provisions of Section 5.02 of the Illinois Administrative
Procedure Act. For purposes of the Illinois Administrative
Procedure Act, the adoption of rules to implement the

HB0503 Engrossed - 5 - LRB096 05782 DRJ 15857 b
amendatory changes to this Section made by this amendatory Act
of 1991 shall be deemed an emergency and necessary for the
public interest, safety and welfare.
(d) No later than January 1, 2001, the Department of Public
Aid shall file with the Joint Committee on Administrative
Rules, pursuant to the Illinois Administrative Procedure Act, a
proposed rule, or a proposed amendment to an existing rule,
regarding payment for appropriate services, including
assessment, care planning, discharge planning, and treatment
provided by nursing facilities to residents who have a serious
mental illness.
(Source: P.A. 95-331, eff. 8-21-07.)