Illinois 2025-2026 Regular Session

Illinois House Bill HB2788 Latest Draft

Bill / Introduced Version Filed 02/05/2025

                            104TH GENERAL ASSEMBLY
 State of Illinois
 2025 and 2026 HB2788 Introduced , by Rep. Laura Faver Dias SYNOPSIS AS INTRODUCED: 5 ILCS 100/5-45.65 new20 ILCS 1705/74305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4 Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately. LRB104 10112 KTG 20184 b   A BILL FOR 104TH GENERAL ASSEMBLY
 State of Illinois
 2025 and 2026 HB2788 Introduced , by Rep. Laura Faver Dias SYNOPSIS AS INTRODUCED:  5 ILCS 100/5-45.65 new20 ILCS 1705/74305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4 5 ILCS 100/5-45.65 new  20 ILCS 1705/74  305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4 Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.  LRB104 10112 KTG 20184 b     LRB104 10112 KTG 20184 b   A BILL FOR
104TH GENERAL ASSEMBLY
 State of Illinois
 2025 and 2026 HB2788 Introduced , by Rep. Laura Faver Dias SYNOPSIS AS INTRODUCED:
5 ILCS 100/5-45.65 new20 ILCS 1705/74305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4 5 ILCS 100/5-45.65 new  20 ILCS 1705/74  305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
5 ILCS 100/5-45.65 new
20 ILCS 1705/74
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.
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A BILL FOR
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1  AN ACT concerning State government.
2  Be it enacted by the People of the State of Illinois,
3  represented in the General Assembly:
4  Section 1. The Illinois Administrative Procedure Act is
5  amended by adding Section 5-45.65 as follows:
6  (5 ILCS 100/5-45.65 new)
7  Sec. 5-45.65. Emergency rulemaking; wage increase for
8  direct support personnel. To provide for the expeditious and
9  timely implementation of subsection (h) of Section 74 of the
10  Mental Health and Developmental Disabilities Administrative
11  Act, emergency rules implementing the changes may be adopted
12  in accordance with Section 5-45 by the Department of Human
13  Services. The adoption of emergency rules authorized by
14  Section 5-45 and this Section is deemed to be necessary for the
15  public interest, safety, and welfare.
16  This Section is repealed one year after the effective date
17  of this amendatory Act of the 104th General Assembly.
18  Section 5. The Mental Health and Developmental
19  Disabilities Administrative Act is amended by changing Section
20  74 as follows:
21  (20 ILCS 1705/74)

 

104TH GENERAL ASSEMBLY
 State of Illinois
 2025 and 2026 HB2788 Introduced , by Rep. Laura Faver Dias SYNOPSIS AS INTRODUCED:
5 ILCS 100/5-45.65 new20 ILCS 1705/74305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4 5 ILCS 100/5-45.65 new  20 ILCS 1705/74  305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
5 ILCS 100/5-45.65 new
20 ILCS 1705/74
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.
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    LRB104 10112 KTG 20184 b
A BILL FOR

 

 

5 ILCS 100/5-45.65 new
20 ILCS 1705/74
305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4



    LRB104 10112 KTG 20184 b

 

 



 

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1  Sec. 74. Rates and reimbursements.
2  (a) Within 30 days after July 6, 2017 (the effective date
3  of Public Act 100-23), the Department shall increase rates and
4  reimbursements to fund a minimum of a $0.75 per hour wage
5  increase for front-line personnel, including, but not limited
6  to, direct support professionals, aides, front-line
7  supervisors, qualified intellectual disabilities
8  professionals, nurses, and non-administrative support staff
9  working in community-based provider organizations serving
10  individuals with developmental disabilities. The Department
11  shall adopt rules, including emergency rules under subsection
12  (y) of Section 5-45 of the Illinois Administrative Procedure
13  Act, to implement the provisions of this Section.
14  (b) Rates and reimbursements. Within 30 days after June 4,
15  2018 (the effective date of Public Act 100-587), the
16  Department shall increase rates and reimbursements to fund a
17  minimum of a $0.50 per hour wage increase for front-line
18  personnel, including, but not limited to, direct support
19  professionals, aides, front-line supervisors, qualified
20  intellectual disabilities professionals, nurses, and
21  non-administrative support staff working in community-based
22  provider organizations serving individuals with developmental
23  disabilities. The Department shall adopt rules, including
24  emergency rules under subsection (bb) of Section 5-45 of the
25  Illinois Administrative Procedure Act, to implement the
26  provisions of this Section.

 

 

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1  (c) Rates and reimbursements. Within 30 days after June 5,
2  2019 (the effective date of Public Act 101-10), subject to
3  federal approval, the Department shall increase rates and
4  reimbursements in effect on June 30, 2019 for community-based
5  providers for persons with Developmental Disabilities by 3.5%
6  The Department shall adopt rules, including emergency rules
7  under subsection (jj) of Section 5-45 of the Illinois
8  Administrative Procedure Act, to implement the provisions of
9  this Section, including wage increases for direct care staff.
10  (d) For community-based providers serving persons with
11  intellectual/developmental disabilities, subject to federal
12  approval of any relevant Waiver Amendment, the rates taking
13  effect for services delivered on or after January 1, 2022,
14  shall include an increase in the rate methodology sufficient
15  to provide a $1.50 per hour wage increase for direct support
16  professionals in residential settings and sufficient to
17  provide wages for all residential non-executive direct care
18  staff, excluding direct support professionals, at the federal
19  Department of Labor, Bureau of Labor Statistics' average wage
20  as defined in rule by the Department.
21  The establishment of and any changes to the rate
22  methodologies for community-based services provided to persons
23  with intellectual/developmental disabilities are subject to
24  federal approval of any relevant Waiver Amendment and shall be
25  defined in rule by the Department. The Department shall adopt
26  rules, including emergency rules as authorized by Section 5-45

 

 

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1  of the Illinois Administrative Procedure Act, to implement the
2  provisions of this subsection (d).
3  (e) For community-based providers serving persons with
4  intellectual/developmental disabilities, subject to federal
5  approval of any relevant Waiver Amendment, the rates taking
6  effect for services delivered on or after January 1, 2023,
7  shall include an increase in the rate methodology sufficient
8  to provide a $1.00 per hour wage increase for all direct
9  support professionals and all other frontline personnel who
10  are not subject to the Bureau of Labor Statistics' average
11  wage increases, who work in residential and community day
12  services settings, with at least $0.50 of those funds to be
13  provided as a direct increase to base wages, with the
14  remaining $0.50 to be used flexibly for base wage increases.
15  In addition, the rates taking effect for services delivered on
16  or after January 1, 2023 shall include an increase sufficient
17  to provide wages for all residential non-executive direct care
18  staff, excluding direct support professionals, at the federal
19  Department of Labor, Bureau of Labor Statistics' average wage
20  as defined in rule by the Department.
21  The establishment of and any changes to the rate
22  methodologies for community-based services provided to persons
23  with intellectual/developmental disabilities are subject to
24  federal approval of any relevant Waiver Amendment and shall be
25  defined in rule by the Department. The Department shall adopt
26  rules, including emergency rules as authorized by Section 5-45

 

 

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1  of the Illinois Administrative Procedure Act, to implement the
2  provisions of this subsection.
3  (f) For community-based providers serving persons with
4  intellectual/developmental disabilities, subject to federal
5  approval of any relevant Waiver Amendment, the rates taking
6  effect for services delivered on or after January 1, 2024
7  shall include an increase in the rate methodology sufficient
8  to provide a $2.50 per hour wage increase for all direct
9  support professionals and all other frontline personnel who
10  are not subject to the Bureau of Labor Statistics' average
11  wage increases and who work in residential and community day
12  services settings. At least $1.25 of the per hour wage
13  increase shall be provided as a direct increase to base wages,
14  and the remaining $1.25 of the per hour wage increase shall be
15  used flexibly for base wage increases. In addition, the rates
16  taking effect for services delivered on or after January 1,
17  2024 shall include an increase sufficient to provide wages for
18  all residential non-executive direct care staff, excluding
19  direct support professionals, at the federal Department of
20  Labor, Bureau of Labor Statistics' average wage as defined in
21  rule by the Department.
22  The establishment of and any changes to the rate
23  methodologies for community-based services provided to persons
24  with intellectual/developmental disabilities are subject to
25  federal approval of any relevant Waiver Amendment and shall be
26  defined in rule by the Department. The Department shall adopt

 

 

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1  rules, including emergency rules as authorized by Section 5-45
2  of the Illinois Administrative Procedure Act, to implement the
3  provisions of this subsection.
4  (g) For community-based providers serving persons with
5  intellectual or developmental disabilities, subject to federal
6  approval of any relevant Waiver Amendment, the rates taking
7  effect for services delivered on or after January 1, 2025
8  shall include an increase in the rate methodology sufficient
9  to provide a $1 per hour wage rate increase for all direct
10  support personnel and all other frontline personnel who are
11  not subject to the Bureau of Labor Statistics' average wage
12  increases and who work in residential and community day
13  services settings, with at least $0.75 of those funds to be
14  provided as a direct increase to base wages and the remaining
15  $0.25 to be used flexibly for base wage increases. These
16  increases shall not be used by community-based providers for
17  operational or administrative expenses. In addition, the rates
18  taking effect for services delivered on or after January 1,
19  2025 shall include an increase sufficient to provide wages for
20  all residential non-executive direct care staff, excluding
21  direct support personnel, at the federal Department of Labor,
22  Bureau of Labor Statistics' average wage as defined by rule by
23  the Department. For services delivered on or after January 1,
24  2025, the rates shall include adjustments to
25  employment-related expenses as defined by rule by the
26  Department.

 

 

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1  The establishment of and any changes to the rate
2  methodologies for community-based services provided to persons
3  with intellectual or developmental disabilities are subject to
4  federal approval of any relevant Waiver Amendment and shall be
5  defined in rule by the Department. The Department shall adopt
6  rules, including emergency rules as authorized by Section 5-45
7  of the Illinois Administrative Procedure Act, to implement the
8  provisions of this subsection.
9  (h) For community-based providers serving persons with
10  intellectual or developmental disabilities, by no later than
11  January 1, 2026, the Department of Healthcare and Family
12  Services, in collaboration with the Department of Human
13  Services, shall file an amendment to the Home and
14  Community-Based Services Waiver Program for Adults with
15  Developmental Disabilities authorized under Section 1915(c) of
16  the Social Security Act that shall include an increase in the
17  rate methodology sufficient to provide for a wage rate of 150%
18  of the statewide, regional, or local minimum wage for services
19  delivered on or after January 1, 2026, for all direct support
20  personnel and all other frontline personnel who are not
21  subject to the Bureau of Labor Statistics' average wage
22  increases and who work in residential and community day
23  services settings. The amendment shall also include an
24  increase in the rate methodology sufficient to provide wage
25  increases for all residential non-executive direct care staff,
26  excluding direct support personnel, at the federal Department

 

 

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1  of Labor, Bureau of Labor Statistics' average wage as defined
2  by rule by the Department of Human Services for services
3  delivered on or after January 1, 2026. For services delivered
4  on or after January 1, 2026, the rates shall include
5  adjustments to employment-related expenses as defined by rule
6  by the Department of Human Services. The Department of Human
7  Services shall adopt rules, including emergency rules as
8  authorized by Section 5-45 of the Illinois Administrative
9  Procedure Act, to implement the provisions of this subsection.
10  (Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
11  102-830, eff. 1-1-23; 103-8, eff. 6-7-23; 103-154, eff.
12  6-30-23; 103-588, eff. 6-5-24.)
13  Section 10. The Illinois Public Aid Code is amended by
14  changing Section 5-5.4 as follows:
15  (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
16  Sec. 5-5.4. Standards of payment; Department of Healthcare
17  and Family Services. The Department of Healthcare and Family
18  Services shall develop standards of payment of nursing
19  facility and ICF/DD services in facilities providing such
20  services under this Article which:
21  (1) Provide for the determination of a facility's payment
22  for nursing facility or ICF/DD services on a prospective
23  basis. The amount of the payment rate for all nursing
24  facilities certified by the Department of Public Health under

 

 

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1  the ID/DD Community Care Act or the Nursing Home Care Act as
2  Intermediate Care for the Developmentally Disabled facilities,
3  Long Term Care for Under Age 22 facilities, Skilled Nursing
4  facilities, or Intermediate Care facilities under the medical
5  assistance program shall be prospectively established annually
6  on the basis of historical, financial, and statistical data
7  reflecting actual costs from prior years, which shall be
8  applied to the current rate year and updated for inflation,
9  except that the capital cost element for newly constructed
10  facilities shall be based upon projected budgets. The annually
11  established payment rate shall take effect on July 1 in 1984
12  and subsequent years. No rate increase and no update for
13  inflation shall be provided on or after July 1, 1994, unless
14  specifically provided for in this Section. The changes made by
15  Public Act 93-841 extending the duration of the prohibition
16  against a rate increase or update for inflation are effective
17  retroactive to July 1, 2004.
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 Long Term Care for
21  Under Age 22 facilities, the rates taking effect on July 1,
22  1998 shall include an increase of 3%. For facilities licensed
23  by the Department of Public Health under the Nursing Home Care
24  Act as Skilled Nursing facilities or Intermediate Care
25  facilities, the rates taking effect on July 1, 1998 shall
26  include an increase of 3% plus $1.10 per resident-day, as

 

 

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1  defined by the Department. For facilities licensed by the
2  Department of Public Health under the Nursing Home Care Act as
3  Intermediate Care Facilities for the Developmentally Disabled
4  or Long Term Care for Under Age 22 facilities, the rates taking
5  effect on January 1, 2006 shall include an increase of 3%. For
6  facilities licensed by the Department of Public Health under
7  the Nursing Home Care Act as Intermediate Care Facilities for
8  the Developmentally Disabled or Long Term Care for Under Age
9  22 facilities, the rates taking effect on January 1, 2009
10  shall include an increase sufficient to provide a $0.50 per
11  hour wage increase for non-executive staff. For facilities
12  licensed by the Department of Public Health under the ID/DD
13  Community Care Act as ID/DD Facilities the rates taking effect
14  within 30 days after July 6, 2017 (the effective date of Public
15  Act 100-23) shall include an increase sufficient to provide a
16  $0.75 per hour wage increase for non-executive staff. The
17  Department shall adopt rules, including emergency rules under
18  subsection (y) of Section 5-45 of the Illinois Administrative
19  Procedure Act, to implement the provisions of this paragraph.
20  For facilities licensed by the Department of Public Health
21  under the ID/DD Community Care Act as ID/DD Facilities and
22  under the MC/DD Act as MC/DD Facilities, the rates taking
23  effect within 30 days after June 5, 2019 (the effective date of
24  Public Act 101-10) shall include an increase sufficient to
25  provide a $0.50 per hour wage increase for non-executive
26  front-line personnel, including, but not limited to, direct

 

 

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1  support persons, aides, front-line supervisors, qualified
2  intellectual disabilities professionals, nurses, and
3  non-administrative support staff. The Department shall adopt
4  rules, including emergency rules under subsection (bb) of
5  Section 5-45 of the Illinois Administrative Procedure Act, to
6  implement the provisions of this paragraph.
7  For facilities licensed by the Department of Public Health
8  under the Nursing Home Care Act as Intermediate Care for the
9  Developmentally Disabled facilities or Long Term Care for
10  Under Age 22 facilities, the rates taking effect on July 1,
11  1999 shall include an increase of 1.6% plus $3.00 per
12  resident-day, as defined by the Department. For facilities
13  licensed by the Department of Public Health under the Nursing
14  Home Care Act as Skilled Nursing facilities or Intermediate
15  Care facilities, the rates taking effect on July 1, 1999 shall
16  include an increase of 1.6% and, for services provided on or
17  after October 1, 1999, shall be increased by $4.00 per
18  resident-day, as defined by the Department.
19  For facilities licensed by the Department of Public Health
20  under the Nursing Home Care Act as Intermediate Care for the
21  Developmentally Disabled facilities or Long Term Care for
22  Under Age 22 facilities, the rates taking effect on July 1,
23  2000 shall include an increase of 2.5% per resident-day, as
24  defined by the Department. For facilities licensed by the
25  Department of Public Health under the Nursing Home Care Act as
26  Skilled Nursing facilities or Intermediate Care facilities,

 

 

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1  the rates taking effect on July 1, 2000 shall include an
2  increase of 2.5% per resident-day, as defined by the
3  Department.
4  For facilities licensed by the Department of Public Health
5  under the Nursing Home Care Act as skilled nursing facilities
6  or intermediate care facilities, a new payment methodology
7  must be implemented for the nursing component of the rate
8  effective July 1, 2003. The Department of Public Aid (now
9  Healthcare and Family Services) shall develop the new payment
10  methodology using the Minimum Data Set (MDS) as the instrument
11  to collect information concerning nursing home resident
12  condition necessary to compute the rate. The Department shall
13  develop the new payment methodology to meet the unique needs
14  of Illinois nursing home residents while remaining subject to
15  the appropriations provided by the General Assembly. A
16  transition period from the payment methodology in effect on
17  June 30, 2003 to the payment methodology in effect on July 1,
18  2003 shall be provided for a period not exceeding 3 years and
19  184 days after implementation of the new payment methodology
20  as follows:
21  (A) For a facility that would receive a lower nursing
22  component rate per patient day under the new system than
23  the facility received effective on the date immediately
24  preceding the date that the Department implements the new
25  payment methodology, the nursing component rate per
26  patient day for the facility shall be held at the level in

 

 

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1  effect on the date immediately preceding the date that the
2  Department implements the new payment methodology until a
3  higher nursing component rate of reimbursement is achieved
4  by that facility.
5  (B) For a facility that would receive a higher nursing
6  component rate per patient day under the payment
7  methodology in effect on July 1, 2003 than the facility
8  received effective on the date immediately preceding the
9  date that the Department implements the new payment
10  methodology, the nursing component rate per patient day
11  for the facility shall be adjusted.
12  (C) Notwithstanding paragraphs (A) and (B), the
13  nursing component rate per patient day for the facility
14  shall be adjusted subject to appropriations provided by
15  the General Assembly.
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 March 1,
20  2001 shall include a statewide increase of 7.85%, as defined
21  by the Department.
22  Notwithstanding any other provision of this Section, for
23  facilities licensed by the Department of Public Health under
24  the Nursing Home Care Act as skilled nursing facilities or
25  intermediate care facilities, except facilities participating
26  in the Department's demonstration program pursuant to the

 

 

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1  provisions of Title 77, Part 300, Subpart T of the Illinois
2  Administrative Code, the numerator of the ratio used by the
3  Department of Healthcare and Family Services to compute the
4  rate payable under this Section using the Minimum Data Set
5  (MDS) methodology shall incorporate the following annual
6  amounts as the additional funds appropriated to the Department
7  specifically to pay for rates based on the MDS nursing
8  component methodology in excess of the funding in effect on
9  December 31, 2006:
10  (i) For rates taking effect January 1, 2007,
11  $60,000,000.
12  (ii) For rates taking effect January 1, 2008,
13  $110,000,000.
14  (iii) For rates taking effect January 1, 2009,
15  $194,000,000.
16  (iv) For rates taking effect April 1, 2011, or the
17  first day of the month that begins at least 45 days after
18  February 16, 2011 (the effective date of Public Act
19  96-1530), $416,500,000 or an amount as may be necessary to
20  complete the transition to the MDS methodology for the
21  nursing component of the rate. Increased payments under
22  this item (iv) are not due and payable, however, until (i)
23  the methodologies described in this paragraph are approved
24  by the federal government in an appropriate State Plan
25  amendment and (ii) the assessment imposed by Section 5B-2
26  of this Code is determined to be a permissible tax under

 

 

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1  Title XIX of the Social Security Act.
2  Notwithstanding any other provision of this Section, for
3  facilities licensed by the Department of Public Health under
4  the Nursing Home Care Act as skilled nursing facilities or
5  intermediate care facilities, the support component of the
6  rates taking effect on January 1, 2008 shall be computed using
7  the most recent cost reports on file with the Department of
8  Healthcare and Family Services no later than April 1, 2005,
9  updated for inflation to January 1, 2006.
10  For facilities licensed by the Department of Public Health
11  under the Nursing Home Care Act as Intermediate Care for the
12  Developmentally Disabled facilities or Long Term Care for
13  Under Age 22 facilities, the rates taking effect on April 1,
14  2002 shall include a statewide increase of 2.0%, as defined by
15  the Department. This increase terminates on July 1, 2002;
16  beginning July 1, 2002 these rates are reduced to the level of
17  the rates in effect on March 31, 2002, as defined by the
18  Department.
19  For facilities licensed by the Department of Public Health
20  under the Nursing Home Care Act as skilled nursing facilities
21  or intermediate care facilities, the rates taking effect on
22  July 1, 2001 shall be computed using the most recent cost
23  reports on file with the Department of Public Aid no later than
24  April 1, 2000, updated for inflation to January 1, 2001. For
25  rates effective July 1, 2001 only, rates shall be the greater
26  of the rate computed for July 1, 2001 or the rate effective on

 

 

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1  June 30, 2001.
2  Notwithstanding any other provision of this Section, for
3  facilities licensed by the Department of Public Health under
4  the Nursing Home Care Act as skilled nursing facilities or
5  intermediate care facilities, the Illinois Department shall
6  determine by rule the rates taking effect on July 1, 2002,
7  which shall be 5.9% less than the rates in effect on June 30,
8  2002.
9  Notwithstanding any other provision of this Section, for
10  facilities licensed by the Department of Public Health under
11  the Nursing Home Care Act as skilled nursing facilities or
12  intermediate care facilities, if the payment methodologies
13  required under Section 5A-12 and the waiver granted under 42
14  CFR 433.68 are approved by the United States Centers for
15  Medicare and Medicaid Services, the rates taking effect on
16  July 1, 2004 shall be 3.0% greater than the rates in effect on
17  June 30, 2004. These rates shall take effect only upon
18  approval and implementation of the payment methodologies
19  required under Section 5A-12.
20  Notwithstanding any other provisions of this Section, for
21  facilities licensed by the Department of Public Health under
22  the Nursing Home Care Act as skilled nursing facilities or
23  intermediate care facilities, the rates taking effect on
24  January 1, 2005 shall be 3% more than the rates in effect on
25  December 31, 2004.
26  Notwithstanding any other provision 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, effective January 1, 2009, the
4  per diem support component of the rates effective on January
5  1, 2008, computed using the most recent cost reports on file
6  with the Department of Healthcare and Family Services no later
7  than April 1, 2005, updated for inflation to January 1, 2006,
8  shall be increased to the amount that would have been derived
9  using standard Department of Healthcare and Family Services
10  methods, procedures, and inflators.
11  Notwithstanding any other provisions of this Section, for
12  facilities licensed by the Department of Public Health under
13  the Nursing Home Care Act as intermediate care facilities that
14  are federally defined as Institutions for Mental Disease, or
15  facilities licensed by the Department of Public Health under
16  the Specialized Mental Health Rehabilitation Act of 2013, a
17  socio-development component rate equal to 6.6% of the
18  facility's nursing component rate as of January 1, 2006 shall
19  be established and paid effective July 1, 2006. The
20  socio-development component of the rate shall be increased by
21  a factor of 2.53 on the first day of the month that begins at
22  least 45 days after January 11, 2008 (the effective date of
23  Public Act 95-707). As of August 1, 2008, the
24  socio-development component rate shall be equal to 6.6% of the
25  facility's nursing component rate as of January 1, 2006,
26  multiplied by a factor of 3.53. For services provided on or

 

 

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1  after April 1, 2011, or the first day of the month that begins
2  at least 45 days after February 16, 2011 (the effective date of
3  Public Act 96-1530), whichever is later, the Illinois
4  Department may by rule adjust these socio-development
5  component rates, and may use different adjustment
6  methodologies for those facilities participating, and those
7  not participating, in the Illinois Department's demonstration
8  program pursuant to the provisions of Title 77, Part 300,
9  Subpart T of the Illinois Administrative Code, but in no case
10  may such rates be diminished below those in effect on August 1,
11  2008.
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 as long-term care
15  facilities for residents under 22 years of age, the rates
16  taking effect on July 1, 2003 shall include a statewide
17  increase of 4%, as defined by the Department.
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 Long Term Care for
21  Under Age 22 facilities, the rates taking effect on the first
22  day of the month that begins at least 45 days after January 11,
23  2008 (the effective date of Public Act 95-707) shall include a
24  statewide increase of 2.5%, as defined by the Department.
25  Notwithstanding any other provision of this Section, for
26  facilities licensed by the Department of Public Health under

 

 

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1  the Nursing Home Care Act as skilled nursing facilities or
2  intermediate care facilities, effective January 1, 2005,
3  facility rates shall be increased by the difference between
4  (i) a facility's per diem property, liability, and malpractice
5  insurance costs as reported in the cost report filed with the
6  Department of Public Aid and used to establish rates effective
7  July 1, 2001 and (ii) those same costs as reported in the
8  facility's 2002 cost report. These costs shall be passed
9  through to the facility without caps or limitations, except
10  for adjustments required under normal auditing procedures.
11  Rates established effective each July 1 shall govern
12  payment for services rendered throughout that fiscal year,
13  except that rates established on July 1, 1996 shall be
14  increased by 6.8% for services provided on or after January 1,
15  1997. Such rates will be based upon the rates calculated for
16  the year beginning July 1, 1990, and for subsequent years
17  thereafter until June 30, 2001 shall be based on the facility
18  cost reports for the facility fiscal year ending at any point
19  in time during the previous calendar year, updated to the
20  midpoint of the rate year. The cost report shall be on file
21  with the Department no later than April 1 of the current rate
22  year. Should the cost report not be on file by April 1, the
23  Department shall base the rate on the latest cost report filed
24  by each skilled care facility and intermediate care facility,
25  updated to the midpoint of the current rate year. In
26  determining rates for services rendered on and after July 1,

 

 

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1  1985, fixed time shall not be computed at less than zero. The
2  Department shall not make any alterations of regulations which
3  would reduce any component of the Medicaid rate to a level
4  below what that component would have been utilizing in the
5  rate effective on July 1, 1984.
6  (2) Shall take into account the actual costs incurred by
7  facilities in providing services for recipients of skilled
8  nursing and intermediate care services under the medical
9  assistance program.
10  (3) Shall take into account the medical and psycho-social
11  characteristics and needs of the patients.
12  (4) Shall take into account the actual costs incurred by
13  facilities in meeting licensing and certification standards
14  imposed and prescribed by the State of Illinois, any of its
15  political subdivisions or municipalities and by the U.S.
16  Department of Health and Human Services pursuant to Title XIX
17  of the Social Security Act.
18  The Department of Healthcare and Family Services shall
19  develop precise standards for payments to reimburse nursing
20  facilities for any utilization of appropriate rehabilitative
21  personnel for the provision of rehabilitative services which
22  is authorized by federal regulations, including reimbursement
23  for services provided by qualified therapists or qualified
24  assistants, and which is in accordance with accepted
25  professional practices. Reimbursement also may be made for
26  utilization of other supportive personnel under appropriate

 

 

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1  supervision.
2  The Department shall develop enhanced payments to offset
3  the additional costs incurred by a facility serving
4  exceptional need residents and shall allocate at least
5  $4,000,000 of the funds collected from the assessment
6  established by Section 5B-2 of this Code for such payments.
7  For the purpose of this Section, "exceptional needs" means,
8  but need not be limited to, ventilator care and traumatic
9  brain injury care. The enhanced payments for exceptional need
10  residents under this paragraph are not due and payable,
11  however, until (i) the methodologies described in this
12  paragraph are approved by the federal government in an
13  appropriate State Plan amendment and (ii) the assessment
14  imposed by Section 5B-2 of this Code is determined to be a
15  permissible tax under Title XIX of the Social Security Act.
16  Beginning January 1, 2014 the methodologies for
17  reimbursement of nursing facility services as provided under
18  this Section 5-5.4 shall no longer be applicable for services
19  provided on or after January 1, 2014.
20  No payment increase under this Section for the MDS
21  methodology, exceptional care residents, or the
22  socio-development component rate established by Public Act
23  96-1530 of the 96th General Assembly and funded by the
24  assessment imposed under Section 5B-2 of this Code shall be
25  due and payable until after the Department notifies the
26  long-term care providers, in writing, that the payment

 

 

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

 

 

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1  implement the provisions of this Section, including wage
2  increases for direct care staff.
3  For facilities licensed by the Department of Public Health
4  under the ID/DD Community Care Act as ID/DD Facilities and
5  under the MC/DD Act as MC/DD Facilities, subject to federal
6  approval, the rates taking effect on the latter of the
7  approval date of the State Plan Amendment for these facilities
8  or the Waiver Amendment for the home and community-based
9  services settings shall include an increase sufficient to
10  provide a $0.26 per hour wage increase to the base wage for
11  non-executive staff. The Department shall adopt rules,
12  including emergency rules as authorized by Section 5-45 of the
13  Illinois Administrative Procedure Act, to implement the
14  provisions of this Section, including wage increases for
15  direct care staff.
16  For facilities licensed by the Department of Public Health
17  under the ID/DD Community Care Act as ID/DD Facilities and
18  under the MC/DD Act as MC/DD Facilities, subject to federal
19  approval of the State Plan Amendment and the Waiver Amendment
20  for the home and community-based services settings, the rates
21  taking effect for the services delivered on or after July 1,
22  2020 shall include an increase sufficient to provide a $1.00
23  per hour wage increase for non-executive staff. For services
24  delivered on or after January 1, 2021, subject to federal
25  approval of the State Plan Amendment and the Waiver Amendment
26  for the home and community-based services settings, shall

 

 

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1  include an increase sufficient to provide a $0.50 per hour
2  increase for non-executive staff. The Department shall adopt
3  rules, including emergency rules as authorized by Section 5-45
4  of the Illinois Administrative Procedure Act, to implement the
5  provisions of this Section, including wage increases for
6  direct care staff.
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, subject to federal
10  approval of the State Plan Amendment, the rates taking effect
11  for the residential services delivered on or after July 1,
12  2021, shall include an increase sufficient to provide a $0.50
13  per hour increase for aides in the rate methodology. For
14  facilities licensed by the Department of Public Health under
15  the ID/DD Community Care Act as ID/DD Facilities and under the
16  MC/DD Act as MC/DD Facilities, subject to federal approval of
17  the State Plan Amendment, the rates taking effect for the
18  residential services delivered on or after January 1, 2022
19  shall include an increase sufficient to provide a $1.00 per
20  hour increase for aides in the rate methodology. In addition,
21  for residential services delivered on or after January 1, 2022
22  such rates shall include an increase sufficient to provide
23  wages for all residential non-executive direct care staff,
24  excluding aides, at the federal Department of Labor, Bureau of
25  Labor Statistics' average wage as defined in rule by the
26  Department. The Department shall adopt rules, including

 

 

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

 

 

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1  provisions of this Section.
2  For facilities licensed by the Department of Public Health
3  under the ID/DD Community Care Act as ID/DD facilities and
4  under the MC/DD Act as MC/DD facilities, subject to federal
5  approval of the State Plan Amendment, the rates taking effect
6  for services delivered on or after January 1, 2024 shall
7  include a $2.50 per hour wage increase for all direct support
8  personnel and all other frontline personnel who are not
9  subject to the Bureau of Labor Statistics' average wage
10  increases and who work in residential and community day
11  services settings. At least $1.25 of the per hour wage
12  increase shall be provided as a direct increase to all aide
13  base wages, and the remaining $1.25 of the per hour wage
14  increase shall be used flexibly for base wage increases to the
15  rate methodology for aides. In addition, for residential
16  services delivered on or after January 1, 2024, the rates
17  shall include an increase sufficient to provide wages for all
18  residential non-executive direct care staff, excluding aides,
19  at the federal Department of Labor, Bureau of Labor
20  Statistics' average wage as determined by the Department.
21  Also, for services delivered on or after January 1, 2024, the
22  rates will include adjustments to employment-related expenses
23  as defined in rule by the Department. The Department shall
24  adopt rules, including emergency rules as authorized by
25  Section 5-45 of the Illinois Administrative Procedure Act, to
26  implement the provisions of this Section.

 

 

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1  For facilities licensed by the Department of Public Health
2  under the ID/DD Community Care Act as ID/DD facilities and
3  under the MC/DD Act as MC/DD facilities, subject to federal
4  approval of a State Plan Amendment, the rates taking effect
5  for services delivered on or after January 1, 2025 shall
6  include a $1.00 per hour wage increase for all direct support
7  personnel and all other frontline personnel who are not
8  subject to the Bureau of Labor Statistics' average wage
9  increases and who work in residential and community day
10  services settings, with at least $0.75 of those funds to be
11  provided as a direct increase to all aide base wages and the
12  remaining $0.25 to be used flexibly for base wage increases to
13  the rate methodology for aides. These increases shall not be
14  used by facilities for operational and administrative
15  expenses. In addition, for residential services delivered on
16  or after January 1, 2025, the rates shall include an increase
17  sufficient to provide wages for all residential non-executive
18  direct care staff, excluding aides, at the federal Department
19  of Labor, Bureau of Labor Statistics' average wage as
20  determined by the Department. Also, for services delivered on
21  or after January 1, 2025, the rates will include adjustments
22  to employment-related expenses as defined in rule by the
23  Department. The Department shall adopt rules, including
24  emergency rules as authorized by Section 5-45 of the Illinois
25  Administrative Procedure Act, to implement the provisions of
26  this Section.

 

 

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1  Notwithstanding any other provision of this Section to the
2  contrary, any regional wage adjuster for facilities located
3  outside of the counties of Cook, DuPage, Kane, Lake, McHenry,
4  and Will shall be no lower than 1.00, and any regional wage
5  adjuster for facilities located within the counties of Cook,
6  DuPage, Kane, Lake, McHenry, and Will shall be no lower than
7  1.15.
8  For facilities licensed by the Department of Public Health
9  under the ID/DD Community Care Act as ID/DD facilities and
10  under the MC/DD Act as MC/DD facilities, no later than January
11  1, 2026, the Department of Healthcare and Family Services must
12  submit a Title XIX State Plan amendment to the federal Centers
13  for Medicare and Medicaid Services that shall include an
14  increase in the rate methodology sufficient to provide for a
15  wage rate of 150% of the statewide, regional, or local minimum
16  wage for services delivered on or after January 1, 2026, for
17  all direct support personnel and all other frontline personnel
18  who are not subject to the Bureau of Labor Statistics' average
19  wage increases and who work in residential and community day
20  services settings. The State Plan amendment shall also include
21  an increase in the rate methodology sufficient to provide wage
22  increases 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  by rule by the Department for services delivered on or after
26  January 1, 2026. For services delivered on or after January 1,

 

 

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1  2026, the rates shall include adjustments to
2  employment-related expenses as defined by rule by the
3  Department.
4  (Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
5  103-8, eff. 6-7-23; 103-588, eff. 7-1-24.)

 

 

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