UPDATED V.3 – COVID-19 Community Day Services (CDS) & Residential Rates and Reimbursement

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.21.006 DRAFT

Purpose:

This Information Bulletin replaces policy/guidance previously given in DD.20.025 and DD.20.008.

The Illinois Department of Human Services (IDHS) Division of Developmental Disabilities (DDD) is committed to protecting individuals with developmental disabilities in Illinois. This communication is intended to provide updated guidance on Rates, Billing, and Payments for the Division of Developmental Disabilities (DDD) services.

For more information please contact:

POS: Therese Sheehy at therese.sheehy@Illinois.Gov

CILA & CDS: Diane Garbin at diane.garbin@illinois.gov.

Overarching:

The Division is clarifying temporary changes to assist agencies to operate during the COVID-19 pandemic. The changes are allowed only during effective dates as defined by the Division.

Community Integrated Living Arrangements (CILA):

  1. A 5% rate increase went into effect on July 1, 2020 and will remain in effect until June 30, 2021, subject to extension based on appropriation.
  2. If you are a CILA provider who is in an emergency situation where an alternative site must be used to protect the health and safety of individuals served, please submit required forms to BALC (DHS.BALC@illinois.gov) and reach out to Kathy Ward with DDD at kathy.ward@illinois.gov. BALC forms are posted on the DDD COVID-19 webpage.
  3. If you are a CILA provider who is in an emergency situation and you need to temporarily evacuate individuals from their home into another home you operate and it will exceed the maximum allowable occupancy of the evacuation destination site, please submit required forms to BALC (DHS.BALC@illinois.gov) and reach out to Kathy Ward with DDD at kathy.ward@illinois.gov. BALC forms will be posted on the DDD COVID-19 webpage.
  4. At-Home Day program (37U) will no longer be automatically authorized effective 7/1/21. Individuals interested in utilizing 37U due to concerns with COVID -19 or if you want to use a hybrid of 37U and regular CDS programming, should work with their providers, guardians if applicable, and ISC to complete the prior approval process. The decision to receive 37U is the individual's, and guardian, if applicable, choice, not for the benefit of the residential provider. When completing the "Request for Alternative Day Programs Form (IL462-0285)", the individual, with the assistance of the provider and/or ISC, should choose the first option in Section 3. of the form. Additionally, you will need to provide an individualized explanation as to why the individual doesn't want to return to CDS. ISCs will ensure the individual's choice is being respected in this decision.

NOTE:

  • As the ISCs begin to start in person services, they will prioritize their visits with individuals who have requested to continue receiving 37U services. Approvals for 37U will be limited to 6-month approvals.
  • For individuals who were authorized for 37U prior to the COVID-19 pandemic, they will continue to be authorized for 37U and won't have to apply again.

The Service requests for Additional Staff Support (53R) will resume to a prior approval process effective 7/1/21. Individuals who were approved for 53R to be used with At-Home Day will maintain the service until they return to regular CDS (31U/31C) services.

Community Living Facilities - (CLF) 67D & 67E:

At-Home Day program (37U) will no longer be automatically authorized effective 7/1/21. Individuals interested in utilizing 37U due to concerns with COVID -19 or if you want to use a hybrid of 37U and regular CDS programming should work with their providers and ISCs to complete the prior approval process. The decision to receive 37U is the individual, and guardian, if applicable, choice, not for the benefit of the residential provider. When completing the "Request for Alternative Day Programs Form (IL462-0285)", the individual, with the assistance of the provider and/or ISC, should choose the first option in Section 3. of the form. Additionally, you will need to provide an individualized explanation as to why the individual doesn't want to return to CDS. ISCs will ensure the individual's choice is being respected in this decision.

NOTE:

  • As the ISCs begin to start in person services, they will prioritize their visits with individuals who have requested to continue receiving 37U services. Approvals for 37U will be limited to 6-month approvals.
  • For individuals who were authorized for 37U prior to the COVID-19 pandemic, they will continue to be authorized for 37U and won't have to apply again.

Community Day Services (CDS) Multiple Types 30U, 31C, 31U, 31V, 31S, 35U, 37U, 39U, 37G:

  1. CDS services (31U/31C) were authorized to reopen fully effective September 1, 2020. Please follow guidance posted in DDD Information Bulletins for guidance specific to these services.
  2. As a reminder, 37U billing counts against the individual's 1100-hour service limit for all day program services.
  3. Supported Employment Program (SEP) 39U or 39G should only be billed if the person is engaged in community-integrated employment (CIE) or actively seeking or preparing for CIE.
  4. The 15% rate increase given to 31C, 31U, will remain in effect until 6/31/21, subject to extension based on appropriation.

Grant Funded Programs:

Effective July 1, 2021, all grant funded programming must return to operating under pre-COVID-19 guidance. If a participant or guardian, if applicable, refuses to allow services to be provided in person, it must be documented and the provider should continue to provide services remotely via electronic, phone, and/or video communications.

ICF/DD & ICF/DD Day Programs (formerly Developmental Training, also known as CDS):

The Illinois Department of Healthcare and Family Services (HFS) has provided rate information and billing specifics both for additional residential funding, as well as CDS payment during this time.

See: https://www.illinois.gov/hfs/MedicalProviders/notices/Pages/default.aspx

The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.