Illinois Department of Human Services
Division of Developmental Disabilities
This Information Bulletin informs Division of Developmental Disabilities (DDD) providers of changes to services and billing under the Host Family Community Integrated Living Arrangement (HF CILA) program, effective January 1, 2022. The Host Family CILA model discussed in this IB was previously referred to as Host Family and Foster Care CILA. Effective January 1, 2022, this model will only be referred to as Host Family CILA.
In December 2020, the Illinois Department of Human Services (IDHS), Division of Developmental Disabilities (DDD) released the final report from Guidehouse Inc., Developmental Disability Services Rate Study. This study made recommendations to improve the intellectual and developmental disabilities (I/DD) system via updates to the system's rates, rate methodologies, and reimbursements, which included the Host Family rate methodology.
Host Family is a residential setting within a full-time residence of the paid caregivers. The home can be owned, leased or rented by the individual served, provider agency or host family. The live-in paid caregivers arrange relief and vacation staff on their own schedule. Relief and vacation staff are required to be Direct Support Professionals (DSP).
HF CILA services may be appropriate for waiver funded individuals who express interest in non-institutional, independent living options and who have a current Personal Plan which documents the individual requires continuous staff supervision (24/7 supports). Host families consist of one or more persons who are unrelated to the individual receiving services and who are under contract with the provider agency to provide host family services. No more than two (2) individuals with developmental disabilities may reside with any single host family.
Note: HF CILAs which have an approved capacity waiver to serve more than two (2) individuals may continue to serve those previously approved under the capacity waiver. At such time as any of the individuals served at a HF CILA site with an approved capacity waiver move to another CILA or leave CILA services, the capacity waiver will not be renewed.
HF CILA services and supports may occur across a variety of settings (in and out of the home) and should enhance individual skill development and retention, leading to increased independence, integration and inclusion.
Host Family Rate Components:
- Host Family
- Stipend (ie. Payment to the host family)
- Relief and vacation staff coverage
- QIDP & Supervisor
- Base nursing
- Misc. consultant(s)
- Other supplies
- Program support factor
- Occupancy factor
Note: There is no Room and Board rate component included in the rate. Room and Board is collected directly from the individual from their earned and unearned income as outlined below.
Room and Board:
Room and Board is not included in the rate for Host Family CILA and is collected directly from the individual from their earned and unearned income.
Room and Board is made up of two components.
- ROOM: All residential occupancy costs inclusive of, but not limited to: utilities (gas and electric), communications (telephone, basic television and internet), maintenance, housekeeping, homeowners or renters insurance, property taxes, homeowners and/or condominium fees and/or assessments
- BOARD: Food supplies and non-food supplies
The DDD realizes CILA agencies have different types of agreements with the HF providers they contract with. How Room and Board is treated between the CILA agency, the HF provider and individual served with HF supports is determined by the contractual agreement between the CILA agency and the HF provider.
Effective, 1/1/22 Room and Board is not part of the Host Family (HF) Rate Methodology as funded by the DDD to CILA agencies for HF CILA supports. Current Room and Board agreements as documented in the contract may be honored through the expiration date of the current agreement, however, future Room and Board agreements should conform to the standards as outlined below.
Collecting Earned & Unearned Income for Room and Board
The CILA agency or the HF provider may calculate and collect from the individual served with HF supports an appropriate amount from the individual's unearned and/or earned income for "Room and Board" expenses, but only up to the maximums as specified below for all contracts established after 1/1/22.
Unearned Income Determination:
- Unearned Income Example #1: An individual has monthly Earned Income of $2,000 per month and is not eligible for any Unearned Income. The maximum amount of Earned Income which may be taken into consideration for payment of Room and Board may not exceed the current SSA minus the individual's PNA.
- Unearned Income Example #2: An individual has monthly Earned Income of $750 per month and is only eligible for Unearned Income of $420.00 (50% of the SSA amount). The maximum amount of Earned Income + Unearned Income which may be taken into consideration for payment of Room and Board may not be more than the current SSA minus the individual's PNA. The individual will retain $389.00 of their earned and unearned income (For example, $750 Earned + $420 Unearned - $781.00 (PNA offset included) = $389)
Room and Board Calculation:
Note: While $781 per month is the (CURRENT MAXIMUM) allowable Room and Board amount, it may be less than that amount based on the HUD FMR calculation plus the Board allowance as defined in the following sections.
ROOM: Shall not exceed the individual served portion of the HUD Fair Market Rents (FMR) plus a 20% modifier for the county the CILA site is located divided by the total of all full and part-time people residing in the home including all members of the HF provider's family. HUD FMR Table for Illinois Counties is available. The HUD FMR rates in this table are estimates of 40th percentile gross rents for standard quality units within a metropolitan area or nonmetropolitan county. The provider agency or HF provider is allowed to add a 20% modifier to the rates listed in this table when determining the rent amount.
- Room Example #1: If there are five (5) individuals, including the individual, HF provider, their spouse and two children, residing in a four (4) bedroom home and the HUD FMR rate (plus 20% modifier) for a four (4) bedroom home is $1,000 a month, the rent for the individual served may not exceed $200 a month.
- Room Example #2: If there are three (3) individuals, including the individual, HF provider and their spouse, residing in a two (2) bedroom apartment and the HUD FMR rate (plus 20% modifier) for a two (2) bedroom home is $750 a month, the rent for the individual served may not exceed $250 a month.
- Room Example #3: If there are two (2) individuals, including the individual and the HF provider residing in a two (2) bedroom apartment and the HUD FMR rate (plus 20% modifier) for a two (2) bedroom unit is $1,450 a month, the rent for the individual served may not exceed $725 a month.
BOARD: Shall not exceed the 2020 Guidehouse Rate Study Food and Non-Food Supplies allowance. The Food Supplies benchmark is $3,175.50 per year or $264.65 per month. Non-Food Consumable allowance $482.12 or $40.17 per month. Combined, the total for both Food Supplies and Non-Food consumable supplies may not exceed $304.80 per month.
In the examples listed above, the individual's maximum portion for Room and Board are as follows:
- Room and Board Example 1: Would be $200 for rent plus $304.80 for food and non-consumable supplies for a total maximum individual Room and Board charge of $504.80 per month. The $504.80 would be the amount the individual is charged because it is less than the SSA limit of $781 per month.
- Room and Board Example 2: Would be $250 for rent plus $304.80 for food and non-consumable supplies for a total maximum individual Room and Board charge of $554.80 per month. The $554.80 would be the amount the individual is charged because it is less than the SSA limit of $781 per month.
- Room and Board Example 3: Would be $725 for rent plus $304.80 for food and non-consumable supplies for a total of $1029.80 for Room and Board. However, in this example the SSA limit of $781 per month is the lesser of the 2 amounts and therefore is what the individual would be charged for Room and Board.
Impact of Control of the Residential Site:
Residential Site is Controlled by the Individual:
- If the HF residential site is controlled by the individual, payment will be determined between the individual served and the landlord. It is recommended when the HF residential site is controlled by the individual, the CILA agency's contract with the HF provider specify compensation for the time the HF provider is responsible for delivering services. Residential Site is Controlled by the CILA agency or HF Provider:
Residential Site is Controlled by the CILA agency or HF Provider:
- If the HF residential site is controlled by the CILA agency or the HF provider, then Room and Board may be calculated, charged, and collected from the individual's unearned and/or earned income.
Program Support - HF Stipend:
The stipend is based on the assessed needs of the individual based on their ICAP score.
- Low (ICAP 100 - 70) $70/day
- Moderate (ICAP 69 - 40) $80/day
- High (ICAP 39 - 1) $90/day
Program Support - Relief Staff:
- Relief staff are authorized at 20 hours per month per person served.
- Vacation staff are authorized 2 weeks per year.
- Relief and vacation staff are authorized 15 miles per day at the 2020 IRS mileage allowance rate.
- Staff mileage allowances for QIDP, supervisor, relief and vacation staff are authorized at 46 miles per week.
- Host Family staff are authorized ten 7.5-mile trips per week.
- All mileage is calculated at the 2020 IRS mileage allowance rate.
HF CILA Bill Code:
HF CILA Billing:
Host Family CILA services will continue to be billed and paid on a per diem basis. Host Family CILA services are reported as "P" for present or an applicable Occupancy Code of A, C, F, H, I, or S. Please see the Occupancy Factor IB.
Providers must maintain and be able to produce documentation of all services and supports. The Division may audit the documentation to verify billing.