UPDATED V.3 – COVID-19 Community Day Services (CDS) & Residential Rates and Reimbursement - DD.21.011

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.21.011

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: Nikki Carnes at nikki.carnes-peter@illinois.gov.

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

Overarching:

The Division is clarifying temporary changes implemented during the COVID-19 pandemic to assist agencies to operate. 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 December 31, 2021.
  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 and reach out to Kathy Ward with DDD. 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  and reach out to Kathy Ward with DDD. BALC forms are posted on the DDD COVID-19 webpage.

Individual Choice to Continue At-Home Day Program:

  1. At-Home Day program (37U) will no longer be automatically authorized after 7/1/21. Prior approval must be sought using the Alternative Day Program Request Form and process for individuals interested in continuing to be authorized for and participate in utilizing 37U due to the following:
    • Concerns about return to a regular CDS program in response to COVID-19; or
    • Desire to spend more time at the residential site, either part-time or full-time. The expectation is there will be individualized programming that is community integrated during 37U.
  2. The CILA provider in cooperation with the ISC case manager will be required to complete an Alternative Day Program Request Form for At-Home Day Program.
    • Note: The decision to receive 37U is the individual's, and guardian, if applicable, choice, not for the benefit of the residential provider.
  3. 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, there must be an individualized explanation as to the individual's use of At-Home Day program.
  4. The DDD recognizes that some individuals across an agency may need access to 37U due to the following reasons (not exhaustive):
    • The individual's CDS program has closed and/or does not have capacity to have individuals return.
    • The individual's residential provider also operates their CDS program and it is not operating at full capacity for reasons such as safety, staffing levels or other identified reasons.
  5. Providers supporting individuals in need of temporary authorization for 37U should reach out directly to the Division, by email, including a cc to their ISC, to discuss options. These emails can be directed to joy.decker@illinois.gov. 
  6. The Division will request the following information:
    • Reason for a blanket request for At-Home Day Program to be provided by individual's CILA site(s) or agency.
    • Timeline for transition to CDS or the individual's chosen day activities.
  7. The Division will issue time limited blanket approval for the identified CILA site(s) or agency for 3 months, with the possibility to extend an additional 3 months.
    • The initial time limited blanket approval will automatically end on September 30, 2021 unless the agency requests and is approved for another 3-month extension.
    • All time limited blanket approvals for At Home Day Services will automatically end on December 31, 2021.
  8. Beginning 7/1/21, ISCs will be conducting in person visits in accordance with the Information Bulletin posted regarding the restarting of in person ISC visits to 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.
    •  For individuals who previously requested At Home Day Services through the Request for Alternative Day Program Process and were authorized for 37U prior to or during 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:

  1. At-Home Day program (37U) will no longer be automatically authorized effective 7/1/21. After this date, prior approval must be sought for individuals interested in utilizing 37U due to the following:
    • Concerns about return to a regular CDS program in response to COVID-19
    • Desire to spend more time at the residential site, either part-time or full-time. The expectation is there will be individualized programming that is community integrated.
  2. The ISC case manager will be required to complete a request for At-Home Day program. Note: The decision to receive 37U is the individual's, and guardian, if applicable, choice, not for the benefit of the residential provider.
  3. 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, there must be an individualized explanation as to the individual's use of At-Home Day program. 
  4. The DDD recognizes that some individuals across an agency may need access to 37U due to the following reasons (not exhaustive):
    • The individual's CDS program has closed and/or does not have capacity to have individuals return.
  5. Providers supporting individuals in this situation should reach out directly to the Division, by email, including a cc to their ISC, to discuss options. These emails can be directed to joy.decker@illinois.gov.
  6. The Division will request the following:
    • Reason for a blanket request for At-Home day to be provided by individual's CLF site(s) or agency.
    • Timeline for transition to CDS or the individual's chosen day activities.
  7. The Division will issue blanket approval for the identified CLF site(s) or agency for 3 months, with the possibility to extend an additional 3 months.
  8.  Beginning 7/1/21, ISCs will be conducting in person visits in accordance with the Information Bulletin posted regarding the restarting of in person ISC visits to 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.
    • 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. 
  1. At-Home Day program (37U) will no longer be automatically authorized effective 7/1/21. After this date, prior approval must be sought for individuals interested in utilizing 37U due to the following:
    • Concerns about return to a regular CDS program in response to COVID-19.
    • Desire to spend more time at the residential site, either part-time or full-time. The expectation is there will be individualized programming that is community integrated.
  2. The ISC case manager will be required to complete a request for At-Home Day program.
    • Note: The decision to receive 37U is the individual's, and guardian, if applicable, choice, not for the benefit of the residential provider
  3. 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, there must be an individualized explanation as to the individual's use of At-Home Day program.
  4. The DDD recognizes that some individuals across an agency may need access to 37U due to the following reasons (not exhaustive):
    • The individual's CDS program has closed and/or does not have capacity to have individuals return.
  5. Providers supporting individuals in this situation should reach out directly to the Division, by email, including a cc to their ISC, to discuss options. These emails can be directed to joy.decker@illinois.gov.
  6. The Division will request the following:
    • Reason for a blanket request for At-Home day to be provided by individual's CLF site(s) or agency.
    • Timeline for transition to CDS or the individual's chosen day activities.
  7. The Division will issue blanket approval for the identified CLF site(s) or agency for 3 months, with the possibility to extend an additional 3 months.
  8. Beginning 7/1/21, ISCs will be conducting in person visits in accordance with the Information Bulletin posted regarding the restarting of in person ISC visits to 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.
    • 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 Day Services (CDS) Multiple Types 31C, 31U, 31V, 31S, 35U, 37U, 39U, 39G:

  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 December 31, 2021.

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.

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

Effective Date:

7/8/2021