DDD COMMUNICATION MARCH 8, 2023
GOVERNOR ANNOUNCES FY24 PROPOSED BUDGET
On February 15, 2023, Governor J.B. Pritzker presented his Budget Address and State of the State. In it, he provided specifics on the Division and Developmental Disabilities (DDD) FY24 proposed budget. The DDD budget includes the following in new funding:
- Guidehouse Rate Study Increases
- $53.1M for $1.50/hour DSP (waiver and ICF) wage increase (effective January 1, 2024, subject to the federal Centers for Medicare and Medicaid Services (CMS) approval)
- $10M for CDS regionalization (also effective January 1, 2024, subject to federal CMS approval)
- $56.7M for annualize the FY23 wage increases, regionality and CILA rate calculator
- PUNS
- $26M for PUNS placements for children and adults (annualization of FY23 placements and new FY24 placements)
- 500 children's PUNS placements
- 700 adult PUNS placements
- SSI
- $28M for SSI increase (annualization of FY23 increase and any potential Jan. 1, 2024, increase)
CILA BILLING UPDATES
Please see below for several updates on Community-Integrated Living Arrangement (CILA) billing issues. Thank you to all providers for your patience as the DDD works through these issues.
60D BILLING ISSUES
The DDD was made aware of payment issues specific to the 60D (CILA) billing for some providers resulting in their MOBIUS Remittance Reports showing a reimbursement of $0.00 for January 2023 60D services. The DDD worked closely with the Department of Innovation and Technology (DoIT) and impacted providers to isolate the problem and provide guidance to those providers. At this time, all issues that the DDD was/is aware of related to 60D billing have been corrected.
CILA RATE SHEETS
Given the ongoing review of the CILA Rate Calculator and the temporary nature of the current rates, at this time, the DDD is not planning to send rate sheets to CILA providers. Instead, the DDD will send updated rate summaries that will include the following data: Individual Name, Social Security Number, Funded DSP Hours, DSP Wages, DSP ERE (fringe) and Topline CILA Rate.
HOST FAMILY & INTERMITTENT CILA RATES
In addition to the changes to 24-Hour CILA, the DDD found, through an internal review, a few minor errors in the Host Family and Intermittent CILA Rate Methodologies. The errors, found in the Program Support percentage and the ERE percentage for QIDP and Supervisor, have been corrected and were also transmitted to and processed in the payment system last week. Adjustments to previous payments for January Host Family and Intermittent CILA services are also shown on this week's MOBIUS Remittance Reports. New Intermittent CILA Rates for bill codes 61H, 62H and 63H have been updated and are now reflected on the DDD Rates Table.
HFS ISSUES PUBLIC NOTICE REGARDING APPROVAL OF ILLINOIS' FINAL STATEWIDE TRANSITION PLAN
The Department of Healthcare and Family Services (HFS) released the following provider notice on February 24, 2023: Public Notice - Final Statewide Transition Plan (STP) Approval. All HFS Public Notices can be viewed online.
On December 8, 2022, the State submitted a revised Statewide Transition Plan (STP) to the Federal Centers for Medicare & Medicaid Services (CMS) after completing updates in response to public comments on the STP presented on September 30, 2022. The State completed several technical changes based on CMS feedback received on December 29, 2022, then resubmitted the STP to CMS on January 31, 2023. CMS granted the State final STP approval on February 15, 2023. This approval represents CMS endorsement of the State's plan to align Home and Community-Based Services (HCBS) Waiver systems and practices with federal HCBS Settings requirements. The State will continue collaboration with CMS to address compliance among Illinois Heightened Scrutiny locations, fulfillment of required remediation activities, and enhancing ongoing compliance monitoring processes toward best practices. The State wishes to thank all of the groups and individuals who assisted the State in achieving this milestone.
Interested individuals may view the State's approved STP and CMS Approval letter at this link: Illinois Statewide Transition Plan. Requests for hard copies of the STP and corresponding documents may be submitted by calling HFS at (217) 524-4148 or e-mailing HFS.SWTransitionPlan@illinois.gov
UPDATED INFORMATION - REPRESENTATIVE PAYEE RESONSIBILITIES AND REVIEWS
On February 14, 2023, the DDD sent out the following information in which we miscommunicated the agency who is completing the onsite reviews. The following is updated with the correct agency:
Equip for Equality's (EFE) Representative Payee Oversight program conducts onsite reviews of representative payees in Illinois on behalf of the Social Security Administration. While onsite, EFE also educates providers on the requirements when the provider is the representative payee. The DDD has been receiving a lot of questions and concerns about their responsibilities in the program and the individuals' rights in relation to their Supplemental Security Income (SSI) or other social security benefits. The DDD met with EFE's Representative Payee Oversight Program Manager to discuss concerns and gain a better understanding of the program requirements. We wanted to share the information below to help providers understand their responsibilities as a representative payee. Additionally, the DDD is working with EFE's Representative Payee Oversight program to provide a presentation on this topic in early May. Please be on the lookout for details on the webinar.
In a residential services program (CILA, CLF, ICF/DD, CGH, CCI), an individual who receives SSI or other social security benefits retains a minimum of $60 each month for personal spending. Social Security refers to such funds as a "personal needs allowance" or PNA. Providers who act as an individual's representative payee must maintain their fiduciary status for the individual's PNA if they hold the funds or assist the individual in managing those funds. For instance, if the provider retains control of the individual's PNA in cash form or in a collective account, it must maintain funds that are not in the individual's possession in a secure manner and maintain adequate records to account for the individual's funds and spending.
Likewise, if the individual's PNA goes into an individual bank account and staff assist the individual in managing those funds, the provider must maintain adequate records to account for the individual's funds and spending. Further, the bank account must be set up as a fiduciary account, and the individual cannot have direct access to the account. The bank account title must reflect that the beneficiary owns the funds in the account and that the provider has the fiduciary interest (i.e., "[Provider name] for Joe Smith," or "[Provider Name], representative payee for Joe Smith"). By titling accounts this way, the providers' involvement in managing the funds is reflected.
If the individual is able to manage their own bank account or cash, the provider is allowed to help the individual set up a checking account in their own name, or give them their cash, but provider staff must not have any access to those accounts or cash. For more information about Social Security's requirements for representative payees, please review theGuide for Organizational Representative Payees.
NEW WEBINAR - MEETING YOUR OBLIGATIONS AS A REP PAYEE WHILE COMPLYING WITH THE SETTINGS RULE AND OTHER LAWS
This DDD-hosted webinar is designed to help providers and guardians understand the obligations of a representative payee for social security benefits, who also serves as a residential services provider. Serving in both roles implicates fiduciary responsibilities and an individual's right to access their funds and make spending decisions under the Home and Community-Based Services (HCBS) Settings Rule and other laws impacting individual rights. The information in this webinar will be useful to residential services programs (CILA, CLF, ICF/DD, CGH, CCI), ISCs and guardians.
Date: May 2, 2023
Time: 1:00 pm - 2:30 pm
Registration: Registration Link
NCI STATE OF THE WORKFORCE SURVEY RELEASED
The annual invitation to complete the National Core Indicators (NCI) - IDD State of the Workforce Survey, formerly the Staff Stability Survey, was distributed to providers in February. The Survey congregates data on the workforce of Direct Service Professionals (DSPs) serving adults with intellectual and developmental disabilities, ages 18 and older. The Survey will inquire about the status of a provider's DSP workforce employed between January 1, 2022 - December 31, 2022. The Survey is completed online using the link provided in the email invitation. Each provider is assigned a unique link which should not be shared outside of the provider agency. The email will come from staffstability@hsri.org and the subject line will be "Illinois National Core Indicators®-IDD (NCI®-IDD) State of the Workforce in 2022 Survey". The DDD is requesting that providers complete the Survey upon receipt of the email. The information provided is important to state policymakers and advocates who will use the data to guide decisions. For additional information on the Survey, please contact Gary Holman, BQM Administrator, at gary.holman@illinois.gov.
