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Illinois Senate Bill SB1690

Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1690 Compare Versions

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11 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1690 Introduced 2/5/2025, by Sen. David Koehler 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 10113 KTG 20185 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1690 Introduced 2/5/2025, by Sen. David Koehler 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 10113 KTG 20185 b LRB104 10113 KTG 20185 b A BILL FOR
22 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1690 Introduced 2/5/2025, by Sen. David Koehler SYNOPSIS AS INTRODUCED:
33 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
44 5 ILCS 100/5-45.65 new
55 20 ILCS 1705/74
66 305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
77 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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1313 1 AN ACT concerning State government.
1414 2 Be it enacted by the People of the State of Illinois,
1515 3 represented in the General Assembly:
1616 4 Section 1. The Illinois Administrative Procedure Act is
1717 5 amended by adding Section 5-45.65 as follows:
1818 6 (5 ILCS 100/5-45.65 new)
1919 7 Sec. 5-45.65. Emergency rulemaking; wage increase for
2020 8 direct support personnel. To provide for the expeditious and
2121 9 timely implementation of subsection (h) of Section 74 of the
2222 10 Mental Health and Developmental Disabilities Administrative
2323 11 Act, emergency rules implementing the changes may be adopted
2424 12 in accordance with Section 5-45 by the Department of Human
2525 13 Services. The adoption of emergency rules authorized by
2626 14 Section 5-45 and this Section is deemed to be necessary for the
2727 15 public interest, safety, and welfare.
2828 16 This Section is repealed one year after the effective date
2929 17 of this amendatory Act of the 104th General Assembly.
3030 18 Section 5. The Mental Health and Developmental
3131 19 Disabilities Administrative Act is amended by changing Section
3232 20 74 as follows:
3333 21 (20 ILCS 1705/74)
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3737 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1690 Introduced 2/5/2025, by Sen. David Koehler SYNOPSIS AS INTRODUCED:
3838 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
3939 5 ILCS 100/5-45.65 new
4040 20 ILCS 1705/74
4141 305 ILCS 5/5-5.4 from Ch. 23, par. 5-5.4
4242 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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7272 1 Sec. 74. Rates and reimbursements.
7373 2 (a) Within 30 days after July 6, 2017 (the effective date
7474 3 of Public Act 100-23), the Department shall increase rates and
7575 4 reimbursements to fund a minimum of a $0.75 per hour wage
7676 5 increase for front-line personnel, including, but not limited
7777 6 to, direct support professionals, aides, front-line
7878 7 supervisors, qualified intellectual disabilities
7979 8 professionals, nurses, and non-administrative support staff
8080 9 working in community-based provider organizations serving
8181 10 individuals with developmental disabilities. The Department
8282 11 shall adopt rules, including emergency rules under subsection
8383 12 (y) of Section 5-45 of the Illinois Administrative Procedure
8484 13 Act, to implement the provisions of this Section.
8585 14 (b) Rates and reimbursements. Within 30 days after June 4,
8686 15 2018 (the effective date of Public Act 100-587), the
8787 16 Department shall increase rates and reimbursements to fund a
8888 17 minimum of a $0.50 per hour wage increase for front-line
8989 18 personnel, including, but not limited to, direct support
9090 19 professionals, aides, front-line supervisors, qualified
9191 20 intellectual disabilities professionals, nurses, and
9292 21 non-administrative support staff working in community-based
9393 22 provider organizations serving individuals with developmental
9494 23 disabilities. The Department shall adopt rules, including
9595 24 emergency rules under subsection (bb) of Section 5-45 of the
9696 25 Illinois Administrative Procedure Act, to implement the
9797 26 provisions of this Section.
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108108 1 (c) Rates and reimbursements. Within 30 days after June 5,
109109 2 2019 (the effective date of Public Act 101-10), subject to
110110 3 federal approval, the Department shall increase rates and
111111 4 reimbursements in effect on June 30, 2019 for community-based
112112 5 providers for persons with Developmental Disabilities by 3.5%
113113 6 The Department shall adopt rules, including emergency rules
114114 7 under subsection (jj) of Section 5-45 of the Illinois
115115 8 Administrative Procedure Act, to implement the provisions of
116116 9 this Section, including wage increases for direct care staff.
117117 10 (d) For community-based providers serving persons with
118118 11 intellectual/developmental disabilities, subject to federal
119119 12 approval of any relevant Waiver Amendment, the rates taking
120120 13 effect for services delivered on or after January 1, 2022,
121121 14 shall include an increase in the rate methodology sufficient
122122 15 to provide a $1.50 per hour wage increase for direct support
123123 16 professionals in residential settings and sufficient to
124124 17 provide wages for all residential non-executive direct care
125125 18 staff, excluding direct support professionals, at the federal
126126 19 Department of Labor, Bureau of Labor Statistics' average wage
127127 20 as defined in rule by the Department.
128128 21 The establishment of and any changes to the rate
129129 22 methodologies for community-based services provided to persons
130130 23 with intellectual/developmental disabilities are subject to
131131 24 federal approval of any relevant Waiver Amendment and shall be
132132 25 defined in rule by the Department. The Department shall adopt
133133 26 rules, including emergency rules as authorized by Section 5-45
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144144 1 of the Illinois Administrative Procedure Act, to implement the
145145 2 provisions of this subsection (d).
146146 3 (e) For community-based providers serving persons with
147147 4 intellectual/developmental disabilities, subject to federal
148148 5 approval of any relevant Waiver Amendment, the rates taking
149149 6 effect for services delivered on or after January 1, 2023,
150150 7 shall include an increase in the rate methodology sufficient
151151 8 to provide a $1.00 per hour wage increase for all direct
152152 9 support professionals and all other frontline personnel who
153153 10 are not subject to the Bureau of Labor Statistics' average
154154 11 wage increases, who work in residential and community day
155155 12 services settings, with at least $0.50 of those funds to be
156156 13 provided as a direct increase to base wages, with the
157157 14 remaining $0.50 to be used flexibly for base wage increases.
158158 15 In addition, the rates taking effect for services delivered on
159159 16 or after January 1, 2023 shall include an increase sufficient
160160 17 to provide wages for all residential non-executive direct care
161161 18 staff, excluding direct support professionals, at the federal
162162 19 Department of Labor, Bureau of Labor Statistics' average wage
163163 20 as defined in rule by the Department.
164164 21 The establishment of and any changes to the rate
165165 22 methodologies for community-based services provided to persons
166166 23 with intellectual/developmental disabilities are subject to
167167 24 federal approval of any relevant Waiver Amendment and shall be
168168 25 defined in rule by the Department. The Department shall adopt
169169 26 rules, including emergency rules as authorized by Section 5-45
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180180 1 of the Illinois Administrative Procedure Act, to implement the
181181 2 provisions of this subsection.
182182 3 (f) For community-based providers serving persons with
183183 4 intellectual/developmental disabilities, subject to federal
184184 5 approval of any relevant Waiver Amendment, the rates taking
185185 6 effect for services delivered on or after January 1, 2024
186186 7 shall include an increase in the rate methodology sufficient
187187 8 to provide a $2.50 per hour wage increase for all direct
188188 9 support professionals and all other frontline personnel who
189189 10 are not subject to the Bureau of Labor Statistics' average
190190 11 wage increases and who work in residential and community day
191191 12 services settings. At least $1.25 of the per hour wage
192192 13 increase shall be provided as a direct increase to base wages,
193193 14 and the remaining $1.25 of the per hour wage increase shall be
194194 15 used flexibly for base wage increases. In addition, the rates
195195 16 taking effect for services delivered on or after January 1,
196196 17 2024 shall include an increase sufficient to provide wages for
197197 18 all residential non-executive direct care staff, excluding
198198 19 direct support professionals, at the federal Department of
199199 20 Labor, Bureau of Labor Statistics' average wage as defined in
200200 21 rule by the Department.
201201 22 The establishment of and any changes to the rate
202202 23 methodologies for community-based services provided to persons
203203 24 with intellectual/developmental disabilities are subject to
204204 25 federal approval of any relevant Waiver Amendment and shall be
205205 26 defined in rule by the Department. The Department shall adopt
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216216 1 rules, including emergency rules as authorized by Section 5-45
217217 2 of the Illinois Administrative Procedure Act, to implement the
218218 3 provisions of this subsection.
219219 4 (g) For community-based providers serving persons with
220220 5 intellectual or developmental disabilities, subject to federal
221221 6 approval of any relevant Waiver Amendment, the rates taking
222222 7 effect for services delivered on or after January 1, 2025
223223 8 shall include an increase in the rate methodology sufficient
224224 9 to provide a $1 per hour wage rate increase for all direct
225225 10 support personnel and all other frontline personnel who are
226226 11 not subject to the Bureau of Labor Statistics' average wage
227227 12 increases and who work in residential and community day
228228 13 services settings, with at least $0.75 of those funds to be
229229 14 provided as a direct increase to base wages and the remaining
230230 15 $0.25 to be used flexibly for base wage increases. These
231231 16 increases shall not be used by community-based providers for
232232 17 operational or administrative expenses. In addition, the rates
233233 18 taking effect for services delivered on or after January 1,
234234 19 2025 shall include an increase sufficient to provide wages for
235235 20 all residential non-executive direct care staff, excluding
236236 21 direct support personnel, at the federal Department of Labor,
237237 22 Bureau of Labor Statistics' average wage as defined by rule by
238238 23 the Department. For services delivered on or after January 1,
239239 24 2025, the rates shall include adjustments to
240240 25 employment-related expenses as defined by rule by the
241241 26 Department.
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252252 1 The establishment of and any changes to the rate
253253 2 methodologies for community-based services provided to persons
254254 3 with intellectual or developmental disabilities are subject to
255255 4 federal approval of any relevant Waiver Amendment and shall be
256256 5 defined in rule by the Department. The Department shall adopt
257257 6 rules, including emergency rules as authorized by Section 5-45
258258 7 of the Illinois Administrative Procedure Act, to implement the
259259 8 provisions of this subsection.
260260 9 (h) For community-based providers serving persons with
261261 10 intellectual or developmental disabilities, by no later than
262262 11 January 1, 2026, the Department of Healthcare and Family
263263 12 Services, in collaboration with the Department of Human
264264 13 Services, shall file an amendment to the Home and
265265 14 Community-Based Services Waiver Program for Adults with
266266 15 Developmental Disabilities authorized under Section 1915(c) of
267267 16 the Social Security Act that shall include an increase in the
268268 17 rate methodology sufficient to provide for a wage rate of 150%
269269 18 of the statewide, regional, or local minimum wage for services
270270 19 delivered on or after January 1, 2026, for all direct support
271271 20 personnel and all other frontline personnel who are not
272272 21 subject to the Bureau of Labor Statistics' average wage
273273 22 increases and who work in residential and community day
274274 23 services settings. The amendment shall also include an
275275 24 increase in the rate methodology sufficient to provide wage
276276 25 increases for all residential non-executive direct care staff,
277277 26 excluding direct support personnel, at the federal Department
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288288 1 of Labor, Bureau of Labor Statistics' average wage as defined
289289 2 by rule by the Department of Human Services for services
290290 3 delivered on or after January 1, 2026. For services delivered
291291 4 on or after January 1, 2026, the rates shall include
292292 5 adjustments to employment-related expenses as defined by rule
293293 6 by the Department of Human Services. The Department of Human
294294 7 Services shall adopt rules, including emergency rules as
295295 8 authorized by Section 5-45 of the Illinois Administrative
296296 9 Procedure Act, to implement the provisions of this subsection.
297297 10 (Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
298298 11 102-830, eff. 1-1-23; 103-8, eff. 6-7-23; 103-154, eff.
299299 12 6-30-23; 103-588, eff. 6-5-24.)
300300 13 Section 10. The Illinois Public Aid Code is amended by
301301 14 changing Section 5-5.4 as follows:
302302 15 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
303303 16 Sec. 5-5.4. Standards of payment; Department of Healthcare
304304 17 and Family Services. The Department of Healthcare and Family
305305 18 Services shall develop standards of payment of nursing
306306 19 facility and ICF/DD services in facilities providing such
307307 20 services under this Article which:
308308 21 (1) Provide for the determination of a facility's payment
309309 22 for nursing facility or ICF/DD services on a prospective
310310 23 basis. The amount of the payment rate for all nursing
311311 24 facilities certified by the Department of Public Health under
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322322 1 the ID/DD Community Care Act or the Nursing Home Care Act as
323323 2 Intermediate Care for the Developmentally Disabled facilities,
324324 3 Long Term Care for Under Age 22 facilities, Skilled Nursing
325325 4 facilities, or Intermediate Care facilities under the medical
326326 5 assistance program shall be prospectively established annually
327327 6 on the basis of historical, financial, and statistical data
328328 7 reflecting actual costs from prior years, which shall be
329329 8 applied to the current rate year and updated for inflation,
330330 9 except that the capital cost element for newly constructed
331331 10 facilities shall be based upon projected budgets. The annually
332332 11 established payment rate shall take effect on July 1 in 1984
333333 12 and subsequent years. No rate increase and no update for
334334 13 inflation shall be provided on or after July 1, 1994, unless
335335 14 specifically provided for in this Section. The changes made by
336336 15 Public Act 93-841 extending the duration of the prohibition
337337 16 against a rate increase or update for inflation are effective
338338 17 retroactive to July 1, 2004.
339339 18 For facilities licensed by the Department of Public Health
340340 19 under the Nursing Home Care Act as Intermediate Care for the
341341 20 Developmentally Disabled facilities or Long Term Care for
342342 21 Under Age 22 facilities, the rates taking effect on July 1,
343343 22 1998 shall include an increase of 3%. For facilities licensed
344344 23 by the Department of Public Health under the Nursing Home Care
345345 24 Act as Skilled Nursing facilities or Intermediate Care
346346 25 facilities, the rates taking effect on July 1, 1998 shall
347347 26 include an increase of 3% plus $1.10 per resident-day, as
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358358 1 defined by the Department. For facilities licensed by the
359359 2 Department of Public Health under the Nursing Home Care Act as
360360 3 Intermediate Care Facilities for the Developmentally Disabled
361361 4 or Long Term Care for Under Age 22 facilities, the rates taking
362362 5 effect on January 1, 2006 shall include an increase of 3%. For
363363 6 facilities licensed by the Department of Public Health under
364364 7 the Nursing Home Care Act as Intermediate Care Facilities for
365365 8 the Developmentally Disabled or Long Term Care for Under Age
366366 9 22 facilities, the rates taking effect on January 1, 2009
367367 10 shall include an increase sufficient to provide a $0.50 per
368368 11 hour wage increase for non-executive staff. For facilities
369369 12 licensed by the Department of Public Health under the ID/DD
370370 13 Community Care Act as ID/DD Facilities the rates taking effect
371371 14 within 30 days after July 6, 2017 (the effective date of Public
372372 15 Act 100-23) shall include an increase sufficient to provide a
373373 16 $0.75 per hour wage increase for non-executive staff. The
374374 17 Department shall adopt rules, including emergency rules under
375375 18 subsection (y) of Section 5-45 of the Illinois Administrative
376376 19 Procedure Act, to implement the provisions of this paragraph.
377377 20 For facilities licensed by the Department of Public Health
378378 21 under the ID/DD Community Care Act as ID/DD Facilities and
379379 22 under the MC/DD Act as MC/DD Facilities, the rates taking
380380 23 effect within 30 days after June 5, 2019 (the effective date of
381381 24 Public Act 101-10) shall include an increase sufficient to
382382 25 provide a $0.50 per hour wage increase for non-executive
383383 26 front-line personnel, including, but not limited to, direct
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394394 1 support persons, aides, front-line supervisors, qualified
395395 2 intellectual disabilities professionals, nurses, and
396396 3 non-administrative support staff. The Department shall adopt
397397 4 rules, including emergency rules under subsection (bb) of
398398 5 Section 5-45 of the Illinois Administrative Procedure Act, to
399399 6 implement the provisions of this paragraph.
400400 7 For facilities licensed by the Department of Public Health
401401 8 under the Nursing Home Care Act as Intermediate Care for the
402402 9 Developmentally Disabled facilities or Long Term Care for
403403 10 Under Age 22 facilities, the rates taking effect on July 1,
404404 11 1999 shall include an increase of 1.6% plus $3.00 per
405405 12 resident-day, as defined by the Department. For facilities
406406 13 licensed by the Department of Public Health under the Nursing
407407 14 Home Care Act as Skilled Nursing facilities or Intermediate
408408 15 Care facilities, the rates taking effect on July 1, 1999 shall
409409 16 include an increase of 1.6% and, for services provided on or
410410 17 after October 1, 1999, shall be increased by $4.00 per
411411 18 resident-day, as defined by the Department.
412412 19 For facilities licensed by the Department of Public Health
413413 20 under the Nursing Home Care Act as Intermediate Care for the
414414 21 Developmentally Disabled facilities or Long Term Care for
415415 22 Under Age 22 facilities, the rates taking effect on July 1,
416416 23 2000 shall include an increase of 2.5% per resident-day, as
417417 24 defined by the Department. For facilities licensed by the
418418 25 Department of Public Health under the Nursing Home Care Act as
419419 26 Skilled Nursing facilities or Intermediate Care facilities,
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430430 1 the rates taking effect on July 1, 2000 shall include an
431431 2 increase of 2.5% per resident-day, as defined by the
432432 3 Department.
433433 4 For facilities licensed by the Department of Public Health
434434 5 under the Nursing Home Care Act as skilled nursing facilities
435435 6 or intermediate care facilities, a new payment methodology
436436 7 must be implemented for the nursing component of the rate
437437 8 effective July 1, 2003. The Department of Public Aid (now
438438 9 Healthcare and Family Services) shall develop the new payment
439439 10 methodology using the Minimum Data Set (MDS) as the instrument
440440 11 to collect information concerning nursing home resident
441441 12 condition necessary to compute the rate. The Department shall
442442 13 develop the new payment methodology to meet the unique needs
443443 14 of Illinois nursing home residents while remaining subject to
444444 15 the appropriations provided by the General Assembly. A
445445 16 transition period from the payment methodology in effect on
446446 17 June 30, 2003 to the payment methodology in effect on July 1,
447447 18 2003 shall be provided for a period not exceeding 3 years and
448448 19 184 days after implementation of the new payment methodology
449449 20 as follows:
450450 21 (A) For a facility that would receive a lower nursing
451451 22 component rate per patient day under the new system than
452452 23 the facility received effective on the date immediately
453453 24 preceding the date that the Department implements the new
454454 25 payment methodology, the nursing component rate per
455455 26 patient day for the facility shall be held at the level in
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466466 1 effect on the date immediately preceding the date that the
467467 2 Department implements the new payment methodology until a
468468 3 higher nursing component rate of reimbursement is achieved
469469 4 by that facility.
470470 5 (B) For a facility that would receive a higher nursing
471471 6 component rate per patient day under the payment
472472 7 methodology in effect on July 1, 2003 than the facility
473473 8 received effective on the date immediately preceding the
474474 9 date that the Department implements the new payment
475475 10 methodology, the nursing component rate per patient day
476476 11 for the facility shall be adjusted.
477477 12 (C) Notwithstanding paragraphs (A) and (B), the
478478 13 nursing component rate per patient day for the facility
479479 14 shall be adjusted subject to appropriations provided by
480480 15 the General Assembly.
481481 16 For facilities licensed by the Department of Public Health
482482 17 under the Nursing Home Care Act as Intermediate Care for the
483483 18 Developmentally Disabled facilities or Long Term Care for
484484 19 Under Age 22 facilities, the rates taking effect on March 1,
485485 20 2001 shall include a statewide increase of 7.85%, as defined
486486 21 by the Department.
487487 22 Notwithstanding any other provision of this Section, for
488488 23 facilities licensed by the Department of Public Health under
489489 24 the Nursing Home Care Act as skilled nursing facilities or
490490 25 intermediate care facilities, except facilities participating
491491 26 in the Department's demonstration program pursuant to the
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502502 1 provisions of Title 77, Part 300, Subpart T of the Illinois
503503 2 Administrative Code, the numerator of the ratio used by the
504504 3 Department of Healthcare and Family Services to compute the
505505 4 rate payable under this Section using the Minimum Data Set
506506 5 (MDS) methodology shall incorporate the following annual
507507 6 amounts as the additional funds appropriated to the Department
508508 7 specifically to pay for rates based on the MDS nursing
509509 8 component methodology in excess of the funding in effect on
510510 9 December 31, 2006:
511511 10 (i) For rates taking effect January 1, 2007,
512512 11 $60,000,000.
513513 12 (ii) For rates taking effect January 1, 2008,
514514 13 $110,000,000.
515515 14 (iii) For rates taking effect January 1, 2009,
516516 15 $194,000,000.
517517 16 (iv) For rates taking effect April 1, 2011, or the
518518 17 first day of the month that begins at least 45 days after
519519 18 February 16, 2011 (the effective date of Public Act
520520 19 96-1530), $416,500,000 or an amount as may be necessary to
521521 20 complete the transition to the MDS methodology for the
522522 21 nursing component of the rate. Increased payments under
523523 22 this item (iv) are not due and payable, however, until (i)
524524 23 the methodologies described in this paragraph are approved
525525 24 by the federal government in an appropriate State Plan
526526 25 amendment and (ii) the assessment imposed by Section 5B-2
527527 26 of this Code is determined to be a permissible tax under
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538538 1 Title XIX of the Social Security Act.
539539 2 Notwithstanding any other provision of this Section, for
540540 3 facilities licensed by the Department of Public Health under
541541 4 the Nursing Home Care Act as skilled nursing facilities or
542542 5 intermediate care facilities, the support component of the
543543 6 rates taking effect on January 1, 2008 shall be computed using
544544 7 the most recent cost reports on file with the Department of
545545 8 Healthcare and Family Services no later than April 1, 2005,
546546 9 updated for inflation to January 1, 2006.
547547 10 For facilities licensed by the Department of Public Health
548548 11 under the Nursing Home Care Act as Intermediate Care for the
549549 12 Developmentally Disabled facilities or Long Term Care for
550550 13 Under Age 22 facilities, the rates taking effect on April 1,
551551 14 2002 shall include a statewide increase of 2.0%, as defined by
552552 15 the Department. This increase terminates on July 1, 2002;
553553 16 beginning July 1, 2002 these rates are reduced to the level of
554554 17 the rates in effect on March 31, 2002, as defined by the
555555 18 Department.
556556 19 For facilities licensed by the Department of Public Health
557557 20 under the Nursing Home Care Act as skilled nursing facilities
558558 21 or intermediate care facilities, the rates taking effect on
559559 22 July 1, 2001 shall be computed using the most recent cost
560560 23 reports on file with the Department of Public Aid no later than
561561 24 April 1, 2000, updated for inflation to January 1, 2001. For
562562 25 rates effective July 1, 2001 only, rates shall be the greater
563563 26 of the rate computed for July 1, 2001 or the rate effective on
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574574 1 June 30, 2001.
575575 2 Notwithstanding any other provision of this Section, for
576576 3 facilities licensed by the Department of Public Health under
577577 4 the Nursing Home Care Act as skilled nursing facilities or
578578 5 intermediate care facilities, the Illinois Department shall
579579 6 determine by rule the rates taking effect on July 1, 2002,
580580 7 which shall be 5.9% less than the rates in effect on June 30,
581581 8 2002.
582582 9 Notwithstanding any other provision of this Section, for
583583 10 facilities licensed by the Department of Public Health under
584584 11 the Nursing Home Care Act as skilled nursing facilities or
585585 12 intermediate care facilities, if the payment methodologies
586586 13 required under Section 5A-12 and the waiver granted under 42
587587 14 CFR 433.68 are approved by the United States Centers for
588588 15 Medicare and Medicaid Services, the rates taking effect on
589589 16 July 1, 2004 shall be 3.0% greater than the rates in effect on
590590 17 June 30, 2004. These rates shall take effect only upon
591591 18 approval and implementation of the payment methodologies
592592 19 required under Section 5A-12.
593593 20 Notwithstanding any other provisions of this Section, for
594594 21 facilities licensed by the Department of Public Health under
595595 22 the Nursing Home Care Act as skilled nursing facilities or
596596 23 intermediate care facilities, the rates taking effect on
597597 24 January 1, 2005 shall be 3% more than the rates in effect on
598598 25 December 31, 2004.
599599 26 Notwithstanding any other provision of this Section, for
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610610 1 facilities licensed by the Department of Public Health under
611611 2 the Nursing Home Care Act as skilled nursing facilities or
612612 3 intermediate care facilities, effective January 1, 2009, the
613613 4 per diem support component of the rates effective on January
614614 5 1, 2008, computed using the most recent cost reports on file
615615 6 with the Department of Healthcare and Family Services no later
616616 7 than April 1, 2005, updated for inflation to January 1, 2006,
617617 8 shall be increased to the amount that would have been derived
618618 9 using standard Department of Healthcare and Family Services
619619 10 methods, procedures, and inflators.
620620 11 Notwithstanding any other provisions of this Section, for
621621 12 facilities licensed by the Department of Public Health under
622622 13 the Nursing Home Care Act as intermediate care facilities that
623623 14 are federally defined as Institutions for Mental Disease, or
624624 15 facilities licensed by the Department of Public Health under
625625 16 the Specialized Mental Health Rehabilitation Act of 2013, a
626626 17 socio-development component rate equal to 6.6% of the
627627 18 facility's nursing component rate as of January 1, 2006 shall
628628 19 be established and paid effective July 1, 2006. The
629629 20 socio-development component of the rate shall be increased by
630630 21 a factor of 2.53 on the first day of the month that begins at
631631 22 least 45 days after January 11, 2008 (the effective date of
632632 23 Public Act 95-707). As of August 1, 2008, the
633633 24 socio-development component rate shall be equal to 6.6% of the
634634 25 facility's nursing component rate as of January 1, 2006,
635635 26 multiplied by a factor of 3.53. For services provided on or
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646646 1 after April 1, 2011, or the first day of the month that begins
647647 2 at least 45 days after February 16, 2011 (the effective date of
648648 3 Public Act 96-1530), whichever is later, the Illinois
649649 4 Department may by rule adjust these socio-development
650650 5 component rates, and may use different adjustment
651651 6 methodologies for those facilities participating, and those
652652 7 not participating, in the Illinois Department's demonstration
653653 8 program pursuant to the provisions of Title 77, Part 300,
654654 9 Subpart T of the Illinois Administrative Code, but in no case
655655 10 may such rates be diminished below those in effect on August 1,
656656 11 2008.
657657 12 For facilities licensed by the Department of Public Health
658658 13 under the Nursing Home Care Act as Intermediate Care for the
659659 14 Developmentally Disabled facilities or as long-term care
660660 15 facilities for residents under 22 years of age, the rates
661661 16 taking effect on July 1, 2003 shall include a statewide
662662 17 increase of 4%, as defined by the Department.
663663 18 For facilities licensed by the Department of Public Health
664664 19 under the Nursing Home Care Act as Intermediate Care for the
665665 20 Developmentally Disabled facilities or Long Term Care for
666666 21 Under Age 22 facilities, the rates taking effect on the first
667667 22 day of the month that begins at least 45 days after January 11,
668668 23 2008 (the effective date of Public Act 95-707) shall include a
669669 24 statewide increase of 2.5%, as defined by the Department.
670670 25 Notwithstanding any other provision of this Section, for
671671 26 facilities licensed by the Department of Public Health under
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682682 1 the Nursing Home Care Act as skilled nursing facilities or
683683 2 intermediate care facilities, effective January 1, 2005,
684684 3 facility rates shall be increased by the difference between
685685 4 (i) a facility's per diem property, liability, and malpractice
686686 5 insurance costs as reported in the cost report filed with the
687687 6 Department of Public Aid and used to establish rates effective
688688 7 July 1, 2001 and (ii) those same costs as reported in the
689689 8 facility's 2002 cost report. These costs shall be passed
690690 9 through to the facility without caps or limitations, except
691691 10 for adjustments required under normal auditing procedures.
692692 11 Rates established effective each July 1 shall govern
693693 12 payment for services rendered throughout that fiscal year,
694694 13 except that rates established on July 1, 1996 shall be
695695 14 increased by 6.8% for services provided on or after January 1,
696696 15 1997. Such rates will be based upon the rates calculated for
697697 16 the year beginning July 1, 1990, and for subsequent years
698698 17 thereafter until June 30, 2001 shall be based on the facility
699699 18 cost reports for the facility fiscal year ending at any point
700700 19 in time during the previous calendar year, updated to the
701701 20 midpoint of the rate year. The cost report shall be on file
702702 21 with the Department no later than April 1 of the current rate
703703 22 year. Should the cost report not be on file by April 1, the
704704 23 Department shall base the rate on the latest cost report filed
705705 24 by each skilled care facility and intermediate care facility,
706706 25 updated to the midpoint of the current rate year. In
707707 26 determining rates for services rendered on and after July 1,
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718718 1 1985, fixed time shall not be computed at less than zero. The
719719 2 Department shall not make any alterations of regulations which
720720 3 would reduce any component of the Medicaid rate to a level
721721 4 below what that component would have been utilizing in the
722722 5 rate effective on July 1, 1984.
723723 6 (2) Shall take into account the actual costs incurred by
724724 7 facilities in providing services for recipients of skilled
725725 8 nursing and intermediate care services under the medical
726726 9 assistance program.
727727 10 (3) Shall take into account the medical and psycho-social
728728 11 characteristics and needs of the patients.
729729 12 (4) Shall take into account the actual costs incurred by
730730 13 facilities in meeting licensing and certification standards
731731 14 imposed and prescribed by the State of Illinois, any of its
732732 15 political subdivisions or municipalities and by the U.S.
733733 16 Department of Health and Human Services pursuant to Title XIX
734734 17 of the Social Security Act.
735735 18 The Department of Healthcare and Family Services shall
736736 19 develop precise standards for payments to reimburse nursing
737737 20 facilities for any utilization of appropriate rehabilitative
738738 21 personnel for the provision of rehabilitative services which
739739 22 is authorized by federal regulations, including reimbursement
740740 23 for services provided by qualified therapists or qualified
741741 24 assistants, and which is in accordance with accepted
742742 25 professional practices. Reimbursement also may be made for
743743 26 utilization of other supportive personnel under appropriate
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754754 1 supervision.
755755 2 The Department shall develop enhanced payments to offset
756756 3 the additional costs incurred by a facility serving
757757 4 exceptional need residents and shall allocate at least
758758 5 $4,000,000 of the funds collected from the assessment
759759 6 established by Section 5B-2 of this Code for such payments.
760760 7 For the purpose of this Section, "exceptional needs" means,
761761 8 but need not be limited to, ventilator care and traumatic
762762 9 brain injury care. The enhanced payments for exceptional need
763763 10 residents under this paragraph are not due and payable,
764764 11 however, until (i) the methodologies described in this
765765 12 paragraph are approved by the federal government in an
766766 13 appropriate State Plan amendment and (ii) the assessment
767767 14 imposed by Section 5B-2 of this Code is determined to be a
768768 15 permissible tax under Title XIX of the Social Security Act.
769769 16 Beginning January 1, 2014 the methodologies for
770770 17 reimbursement of nursing facility services as provided under
771771 18 this Section 5-5.4 shall no longer be applicable for services
772772 19 provided on or after January 1, 2014.
773773 20 No payment increase under this Section for the MDS
774774 21 methodology, exceptional care residents, or the
775775 22 socio-development component rate established by Public Act
776776 23 96-1530 of the 96th General Assembly and funded by the
777777 24 assessment imposed under Section 5B-2 of this Code shall be
778778 25 due and payable until after the Department notifies the
779779 26 long-term care providers, in writing, that the payment
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790790 1 methodologies to long-term care providers required under this
791791 2 Section have been approved by the Centers for Medicare and
792792 3 Medicaid Services of the U.S. Department of Health and Human
793793 4 Services and the waivers under 42 CFR 433.68 for the
794794 5 assessment imposed by this Section, if necessary, have been
795795 6 granted by the Centers for Medicare and Medicaid Services of
796796 7 the U.S. Department of Health and Human Services. Upon
797797 8 notification to the Department of approval of the payment
798798 9 methodologies required under this Section and the waivers
799799 10 granted under 42 CFR 433.68, all increased payments otherwise
800800 11 due under this Section prior to the date of notification shall
801801 12 be due and payable within 90 days of the date federal approval
802802 13 is received.
803803 14 On and after July 1, 2012, the Department shall reduce any
804804 15 rate of reimbursement for services or other payments or alter
805805 16 any methodologies authorized by this Code to reduce any rate
806806 17 of reimbursement for services or other payments in accordance
807807 18 with Section 5-5e.
808808 19 For facilities licensed by the Department of Public Health
809809 20 under the ID/DD Community Care Act as ID/DD Facilities and
810810 21 under the MC/DD Act as MC/DD Facilities, subject to federal
811811 22 approval, the rates taking effect for services delivered on or
812812 23 after August 1, 2019 shall be increased by 3.5% over the rates
813813 24 in effect on June 30, 2019. The Department shall adopt rules,
814814 25 including emergency rules under subsection (ii) of Section
815815 26 5-45 of the Illinois Administrative Procedure Act, to
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826826 1 implement the provisions of this Section, including wage
827827 2 increases for direct care staff.
828828 3 For facilities licensed by the Department of Public Health
829829 4 under the ID/DD Community Care Act as ID/DD Facilities and
830830 5 under the MC/DD Act as MC/DD Facilities, subject to federal
831831 6 approval, the rates taking effect on the latter of the
832832 7 approval date of the State Plan Amendment for these facilities
833833 8 or the Waiver Amendment for the home and community-based
834834 9 services settings shall include an increase sufficient to
835835 10 provide a $0.26 per hour wage increase to the base wage for
836836 11 non-executive staff. The Department shall adopt rules,
837837 12 including emergency rules as authorized by Section 5-45 of the
838838 13 Illinois Administrative Procedure Act, to implement the
839839 14 provisions of this Section, including wage increases for
840840 15 direct care staff.
841841 16 For facilities licensed by the Department of Public Health
842842 17 under the ID/DD Community Care Act as ID/DD Facilities and
843843 18 under the MC/DD Act as MC/DD Facilities, subject to federal
844844 19 approval of the State Plan Amendment and the Waiver Amendment
845845 20 for the home and community-based services settings, the rates
846846 21 taking effect for the services delivered on or after July 1,
847847 22 2020 shall include an increase sufficient to provide a $1.00
848848 23 per hour wage increase for non-executive staff. For services
849849 24 delivered on or after January 1, 2021, subject to federal
850850 25 approval of the State Plan Amendment and the Waiver Amendment
851851 26 for the home and community-based services settings, shall
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862862 1 include an increase sufficient to provide a $0.50 per hour
863863 2 increase for non-executive staff. The Department shall adopt
864864 3 rules, including emergency rules as authorized by Section 5-45
865865 4 of the Illinois Administrative Procedure Act, to implement the
866866 5 provisions of this Section, including wage increases for
867867 6 direct care staff.
868868 7 For facilities licensed by the Department of Public Health
869869 8 under the ID/DD Community Care Act as ID/DD Facilities and
870870 9 under the MC/DD Act as MC/DD Facilities, subject to federal
871871 10 approval of the State Plan Amendment, the rates taking effect
872872 11 for the residential services delivered on or after July 1,
873873 12 2021, shall include an increase sufficient to provide a $0.50
874874 13 per hour increase for aides in the rate methodology. For
875875 14 facilities licensed by the Department of Public Health under
876876 15 the ID/DD Community Care Act as ID/DD Facilities and under the
877877 16 MC/DD Act as MC/DD Facilities, subject to federal approval of
878878 17 the State Plan Amendment, the rates taking effect for the
879879 18 residential services delivered on or after January 1, 2022
880880 19 shall include an increase sufficient to provide a $1.00 per
881881 20 hour increase for aides in the rate methodology. In addition,
882882 21 for residential services delivered on or after January 1, 2022
883883 22 such rates shall include an increase sufficient to provide
884884 23 wages for all residential non-executive direct care staff,
885885 24 excluding aides, at the federal Department of Labor, Bureau of
886886 25 Labor Statistics' average wage as defined in rule by the
887887 26 Department. The Department shall adopt rules, including
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898898 1 emergency rules as authorized by Section 5-45 of the Illinois
899899 2 Administrative Procedure Act, to implement the provisions of
900900 3 this Section.
901901 4 For facilities licensed by the Department of Public Health
902902 5 under the ID/DD Community Care Act as ID/DD facilities and
903903 6 under the MC/DD Act as MC/DD facilities, subject to federal
904904 7 approval of the State Plan Amendment, the rates taking effect
905905 8 for services delivered on or after January 1, 2023, shall
906906 9 include a $1.00 per hour wage increase for all direct support
907907 10 personnel and all other frontline personnel who are not
908908 11 subject to the Bureau of Labor Statistics' average wage
909909 12 increases, who work in residential and community day services
910910 13 settings, with at least $0.50 of those funds to be provided as
911911 14 a direct increase to all aide base wages, with the remaining
912912 15 $0.50 to be used flexibly for base wage increases to the rate
913913 16 methodology for aides. In addition, for residential services
914914 17 delivered on or after January 1, 2023 the rates shall include
915915 18 an increase sufficient to provide wages for all residential
916916 19 non-executive direct care staff, excluding aides, at the
917917 20 federal Department of Labor, Bureau of Labor Statistics'
918918 21 average wage as determined by the Department. Also, for
919919 22 services delivered on or after January 1, 2023, the rates will
920920 23 include adjustments to employment-related expenses as defined
921921 24 in rule by the Department. The Department shall adopt rules,
922922 25 including emergency rules as authorized by Section 5-45 of the
923923 26 Illinois Administrative Procedure Act, to implement the
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934934 1 provisions of this Section.
935935 2 For facilities licensed by the Department of Public Health
936936 3 under the ID/DD Community Care Act as ID/DD facilities and
937937 4 under the MC/DD Act as MC/DD facilities, subject to federal
938938 5 approval of the State Plan Amendment, the rates taking effect
939939 6 for services delivered on or after January 1, 2024 shall
940940 7 include a $2.50 per hour wage increase for all direct support
941941 8 personnel and all other frontline personnel who are not
942942 9 subject to the Bureau of Labor Statistics' average wage
943943 10 increases and who work in residential and community day
944944 11 services settings. At least $1.25 of the per hour wage
945945 12 increase shall be provided as a direct increase to all aide
946946 13 base wages, and the remaining $1.25 of the per hour wage
947947 14 increase shall be used flexibly for base wage increases to the
948948 15 rate methodology for aides. In addition, for residential
949949 16 services delivered on or after January 1, 2024, the rates
950950 17 shall include an increase sufficient to provide wages for all
951951 18 residential non-executive direct care staff, excluding aides,
952952 19 at the federal Department of Labor, Bureau of Labor
953953 20 Statistics' average wage as determined by the Department.
954954 21 Also, for services delivered on or after January 1, 2024, the
955955 22 rates will include adjustments to employment-related expenses
956956 23 as defined in rule by the Department. The Department shall
957957 24 adopt rules, including emergency rules as authorized by
958958 25 Section 5-45 of the Illinois Administrative Procedure Act, to
959959 26 implement the provisions of this Section.
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970970 1 For facilities licensed by the Department of Public Health
971971 2 under the ID/DD Community Care Act as ID/DD facilities and
972972 3 under the MC/DD Act as MC/DD facilities, subject to federal
973973 4 approval of a State Plan Amendment, the rates taking effect
974974 5 for services delivered on or after January 1, 2025 shall
975975 6 include a $1.00 per hour wage increase for all direct support
976976 7 personnel and all other frontline personnel who are not
977977 8 subject to the Bureau of Labor Statistics' average wage
978978 9 increases and who work in residential and community day
979979 10 services settings, with at least $0.75 of those funds to be
980980 11 provided as a direct increase to all aide base wages and the
981981 12 remaining $0.25 to be used flexibly for base wage increases to
982982 13 the rate methodology for aides. These increases shall not be
983983 14 used by facilities for operational and administrative
984984 15 expenses. In addition, for residential services delivered on
985985 16 or after January 1, 2025, the rates shall include an increase
986986 17 sufficient to provide wages for all residential non-executive
987987 18 direct care staff, excluding aides, at the federal Department
988988 19 of Labor, Bureau of Labor Statistics' average wage as
989989 20 determined by the Department. Also, for services delivered on
990990 21 or after January 1, 2025, the rates will include adjustments
991991 22 to employment-related expenses as defined in rule by the
992992 23 Department. The Department shall adopt rules, including
993993 24 emergency rules as authorized by Section 5-45 of the Illinois
994994 25 Administrative Procedure Act, to implement the provisions of
995995 26 this Section.
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10061006 1 Notwithstanding any other provision of this Section to the
10071007 2 contrary, any regional wage adjuster for facilities located
10081008 3 outside of the counties of Cook, DuPage, Kane, Lake, McHenry,
10091009 4 and Will shall be no lower than 1.00, and any regional wage
10101010 5 adjuster for facilities located within the counties of Cook,
10111011 6 DuPage, Kane, Lake, McHenry, and Will shall be no lower than
10121012 7 1.15.
10131013 8 For facilities licensed by the Department of Public Health
10141014 9 under the ID/DD Community Care Act as ID/DD facilities and
10151015 10 under the MC/DD Act as MC/DD facilities, no later than January
10161016 11 1, 2026, the Department of Healthcare and Family Services must
10171017 12 submit a Title XIX State Plan amendment to the federal Centers
10181018 13 for Medicare and Medicaid Services that shall include an
10191019 14 increase in the rate methodology sufficient to provide for a
10201020 15 wage rate of 150% of the statewide, regional, or local minimum
10211021 16 wage for services delivered on or after January 1, 2026, for
10221022 17 all direct support personnel and all other frontline personnel
10231023 18 who are not subject to the Bureau of Labor Statistics' average
10241024 19 wage increases and who work in residential and community day
10251025 20 services settings. The State Plan amendment shall also include
10261026 21 an increase in the rate methodology sufficient to provide wage
10271027 22 increases for all residential non-executive direct care staff,
10281028 23 excluding direct support personnel, at the federal Department
10291029 24 of Labor, Bureau of Labor Statistics' average wage as defined
10301030 25 by rule by the Department for services delivered on or after
10311031 26 January 1, 2026. For services delivered on or after January 1,
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10421042 1 2026, the rates shall include adjustments to
10431043 2 employment-related expenses as defined by rule by the
10441044 3 Department.
10451045 4 (Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
10461046 5 103-8, eff. 6-7-23; 103-588, eff. 7-1-24.)
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