Illinois Department of Human Services
Information Bulletin
Division of Developmental Disabilities
DD.24.001
Purpose:
This Information Bulletin serves as a notice of rate changes pursuant to House Bill 3817/Public Act 103-0008.
Background:
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 (Rate Study). This Rate Study made recommendations to improve the intellectual and developmental disabilities (I/DD) system via updates to the system's rates, rate methodologies, and reimbursements. The Rate Study was the result of 2 years' worth of work completed by the Ligas Rates Oversight Committee and its 7 subcommittees made up of stakeholders across the I/DD system. In February 2023, Governor Pritzker introduced his Fiscal Year 2024 (FY24) proposed budget to the Illinois General Assembly. The proposed budget included new funding for the DDD to implement several of the recommendations in the Rate Study. The appropriation bill passed by the Illinois General Assembly and signed into law by the Governor, appropriated funding above the Governor's introduced budget sufficient to implement additional Rate Study recommendations that will provide increases to the rates and reimbursements within the I/DD system as laid out below.
Increase Overview:
Waiver Changes:
The implementation of many of the Rate Study recommendations in FY24 include rate and reimbursement increases and updates/changes to rate methodologies as follows (*Note: implementation guidance is below):
- Adult Community Integrated Living Arrangements (CILAs)
- Enhanced Residential Day Program:
- Update rate input factors for rate methodology Developmental Disability Services Rate Study (Rate Study).
- $2.50 per hour wage increase in the rate methodology for DSP wages.
- Wage increases for other frontline staff wages to the federal DOL BLS average wages.
- Implement a Chicago Metro Regional Reimbursement Factor of fifteen percent (15%) for staff wages for Enhanced Residential Service providers located in Chicago, suburban Cook, DuPage, Kane, Lake, McHenry and Will counties. Other named staff positions will also receive a 15% increase added to their respective wage reimbursement levels.
- Community Day Services (CDS):
- Update rate input factors for rate methodology Developmental Disability Services Rate Study (Rate Study).
- $2.50 per hour wage increase in the rate methodology for DSP wages.
- Wage increases for other frontline staff wages to the federal DOL BLS average wages.
- Implement a Chicago Metro Regional Reimbursement Factor of fifteen percent (15%) for staff wages for CDS providers located in Chicago, suburban Cook, DuPage, Kane, Lake, McHenry and Will counties. Other named staff positions will also receive a 15% increase added to their respective wage reimbursement levels.
- The Chicago Metro Regional Reimbursement Factor is being applied to all CDS types including facility based (31U) and community based (31C).
- Supported Employment Program (SEP):
- Update rate input factors for rate methodology Developmental Disability Services Rate Study (Rate Study).
- Wage increases for Job Coaches and other frontline staff to the federal DOL BLS average wages.
- Implement a Chicago Metro Regional Reimbursement Factor of fifteen percent (15%) for staff wages for SEP providers located in Chicago, suburban Cook, DuPage, Kane, Lake, McHenry and Will counties. Other named staff positions will also receive a 15% increase added to their respective wage reimbursement levels.
- The Chicago Metro Regional Reimbursement Factor is being applied to all SEP types including Individual (36U), small group (33G) and large group (36G).
- Adult Day Services:
- Updated reimbursement to align with current Department on Aging rates.
- Self-Direction Assistance
- Implement rate input factors to establish a new rate methodology.
- Intermediate Care Facilities (ICF/IID), ICF/IID development training, and Medically Complex for the Developmentally Disabled (MC/DD) facilities:
- $2.50 per hour wage increase to Aide wages for ICF/IID, ICF/IID developmental training programs, and MC/DD facilities.
OTHER Rates/Rate Methodologies
- State Operated Developmental Centers (SODC): Created new program bill codes for both Individual and Group Supported Employment. The new program bill codes are as follows:
- 34U - SEP Individual
- 32G - SEP Small Group
- 34G - SEP Large Group
- State Operated Developmental Centers (SODC) CDS (31S): $2.50 per hour wage increase in the rate methodology for DSP wages.
- Update the rate input factors for the rate methodology for CDS provided to SODC residents.
- Child Group Homes (17D):
- Effective October 1, 2023, implemented a 7.5% rate increase to align with a rate increase approved by the Department of Children and Family Services (DCFS).
Implementation Guidelines:
The federal Centers for Medicare and Medicaid Services (CMS) approval process for changes within the Adults with Developmental Disabilities Waiver requires the submission of a Waiver Amendment. The Adults with Developmental Disabilities Waiver has received federal CMS approval of its recent Waiver Amendment.
The federal CMS approval process for rate changes for ICF/IID, ICF/IID developmental training facilities, and Medically Complex for the Developmentally Disabled (MC/DD) facilities is done via State Plan Amendment (SPA), which is a different process than a waiver amendment. The Department of Healthcare and Family Services (HFS) is awaiting SPA approval from federal CMS. The ICF/IID, ICF/IID developmental training facilities and MC/DD facility increases are anticipated to be effective January 1, 2024, pending federal CMS approval.
Waiver Funded Services:
Pursuant to House Bill 3817/Public Act 103-0008 and with federal CMS' approval of the Waiver Amendment in December 2023 to implement rate increases, providers of community-based services and supports to individuals with I/DD shall increase wages as follows:
- Effective January 1, 2024, for DSPs, by $2.50 per hour, with at least $1.25 of those funds to be provided for a $1.25/hour direct increase to all DSP wages, with the remaining 50% ($1.25/hour) to be used flexibly for wage increases for DSPs and other frontline staff not covered by the federal DOL BLS average wage increases.
- As it relates to the wage language that comes directly from Public Act 103-0008, please note:
- "Base wages" refers to the current wage you are paying each DSP or ICF Aide across your organization; and
- The phrase "flexibly for base wage increases" refers to other options for providing increases, examples include wage increases targeted to specific DSPs or ICF Aides based on longevity, new employees, certain CILAs or ICFs, etc.
- Effective January 1, 2024, non-executive direct care staff, excluding DSPs, will be adjusted to the federal DOL BLS mean hourly wage based on the same or similar occupation title.
- Effective January 1, 2024, a fifteen percent (15%) Regionalization Factor is being implemented for CDS, Enhanced Residential, and Supported Employment Programs in Chicago, suburban Cook County, and the collar counties (list provided previously and again below). While DDD is not prescribing how the Regionalization Factor is to be implemented, DDD strongly encourages all providers receiving the Regionalization Factor to utilize the additional funding towards direct care staff wages.
- The Regionalization Factor will not impact an agency operating wholly outside of Chicago, suburban Cook, and the collar counties (Lake, McHenry, Kane, DuPage, and Will). For any agency operating CDS, Enhanced Residential, and Supported Employment Programs both within and outside the Chicago, suburban Cook County, and collar counties region, the 15% Regionalization Factor will only be received on the Chicago, suburban Cook County, and collar counties part of that agency's CILA (as was implemented effective January 1, 2023), CDS, Enhanced Residential and Supported Employment operations. As such, it will be up to each agency based on the percentage of their operations that qualify for the Regionalization Factor to determine the implementation of the additional revenue for staff wages or other operational needs. These are issues that impacted agencies will have to consider, evaluate, and make determinations on to ensure the continuation of quality services and supports within their organization moving forward.
- Any increases provided to DSP wages between July 1, 2023, and December 31, 2023, that a provider has voluntarily provided or been required to provide based on local minimum wage requirements will be inclusive towards the required DSP wage increase.
- Pursuant to House Bill 4647/Public Act 102-0944, DDD created a process whereby CILA provider agencies are required to certify they are passing the wage increases on to their direct care staff as mandated by DDD. DDD will issue guidance with the wage attestation forms in the Spring. DDD has the discretion to require other Waiver-funded programs/providers receiving the DSP wage increases to complete the wage attestation forms.
ICF Services:
Notwithstanding the provisions set forth in Section 153.100, facilities licensed by the Department of Public Health under the ID/DD Community Care Act (210 ILCS 47) or MC/DD Act (210 ILCS 46) will receive an increase to their facility rate upon receipt of federal approval of the SPA:
- Effective January 1, 2024, subject to federal approval of the State Plan Amendment, facilities will receive an increase to their reimbursement rates sufficient to provide a $2.50 per hour wage increase for ICF Aides, with at least 50% ($1.25/hour) of those funds to be provided for a $1.25/hour direct increase to all ICF Aide wages, with the remaining 50% ($1.25/hour) to be used flexibly for wage increases to ICF Aides and other frontline staff not covered by the federal DOL BLS average wage increases.
- Effective January 1, 2024, subject to federal approval of the SPA, facilities will receive an increase to their reimbursement rates sufficient to provide wage increases for non-executive direct care staff, excluding ICF Aides, to the federal DOL BLS average hourly wage based on the same or similar occupation title.
- Pursuant to House Bill 4647/Public Act 102-0944, DDD created a process whereby ICF/IID provider agencies are required to certify they are passing the wage increases on to their direct care staff as mandated by DDD. DDD will issue guidance with the wage attestation forms in the Spring. DDD has the discretion to require other ICF/IID programs/providers, including MC/DD facilities, receiving the DSP wage increases to complete the wage attestation forms.
Rate Calculations:
The programs impacted by the above rate and reimbursement changes are depicted on the recently released IDHS: DDD Proposed Rate Table - Effective January 1, 2024 (state.il.us) (effective January 1, 2024, as well as in the below tables).
DDD will recalculate rates for all individuals in those applicable programs who use individual rates and all facilities for those programs that use provider rates. The rate recalculation will take approximately 90 days to complete, however, the increases are effective January 1, 2024, for waiver funded services and subject to federal approval for ICF/IID, ICF/IID developmental training programs, and MC/DD facilities.
ICF/IID and MC/DD rates are adjusted as a percentage. Because they are regionalized rates, they are not able to be reflected in the table below. Additionally, they are not adjusted by Health Service Area (HSA). The increases to ICF/IID developmental training program rates for January 1, 2024, will be implemented by HFS as soon as federal approval is received.
Rate Table - Waiver & SODC (Effective 1/1/2024)
| Bill Code |
Program Name |
Statewide Hourly Rate |
Chicago Metro Hourly Rate |
| 31U |
Community Day Services (On-Site) |
$16.98 |
$19.28 |
| 31C |
Community Day Services (Off-Site) |
$19.20 |
$22.02 |
| 33G |
Supported Employment - Small Group |
$15.72 |
$18.04 |
| 36G |
Supported Employment - Large Group |
$8.00 |
$9.16 |
| 36U |
Supported Employment - Individual |
$46.62 |
$53.57 |
| 35U |
Adult Day Services |
$21.82 |
$21.82 |
| 37U |
Enhanced Residential Habilitation |
$21.24 |
$24.32 |
| 38U |
SODC Community Day Services (On-Site) |
$16.98 |
$19.28 |
| 38C |
SODC Community Day Services (Off-Site) |
$19.20 |
$22.02 |
| 17D |
Children's Group Home |
Varies |
Varies |
| 60D |
Community Integrated Living Arrangement (CILA) - Individual Rate Model |
Varies |
Varies |
| 60D |
CILA Host Family Stipend - High |
$100.00 |
$115.00 |
| 60D |
CILA Host Family Stipend - Mod |
$90.00 |
$103.50 |
| 60D |
CILA Host Family Stipend - Low |
$80.00 |
$92.00 |
| 60D |
CILA Host Family Mileage - Per Diem |
$6.68 |
$6.68 |
| 61H |
Community Integrated Living Arrangement (CILA) |
$56.41 |
$64.29 |
|
- Intermittent Hourly Supports 1:1 |
|
|
| 62H |
Community Integrated Living Arrangement (CILA) |
$28.20 |
$32.14 |
|
- Intermittent Hourly Supports 1:2 |
|
|
| 63H |
Community Integrated Living Arrangement (CILA) |
$18.80 |
$21.43 |
|
- Intermittent Hourly Supports 1:3 |
|
|
| Behavior Intervention and Treatment: |
| 56U - L1 |
Level 1 - Licensed Professional - Statewide Rate |
$99.11 |
$99.11 |
| 56U - L2 |
Level 2 - Other Credentials or No Level Specified |
$78.07 |
$78.07 |
| 57U |
Individual Counseling |
$50.41 |
$50.41 |
| 57G |
Group Counseling |
$16.80 |
$16.80 |
| 58U |
Individual Therapy |
$69.71 |
$69.71 |
| 58G |
Group Therapy |
$23.24 |
$23.24 |
| 51A-L |
ISSA |
$51.27 |
$51.27 |
| 55A |
HBS Self Directed Assistance |
$54.59 |
$54.59 |
| 52P |
Physical Therapy |
$111.00 |
$111.00 |
| 52O |
Occupational Therapy |
$111.00 |
$111.00 |
| 52S |
Speech Therapy |
$111.00 |
$111.00 |
| 53S |
Temporary Intensive Staffing - SODC CDS |
$25.33 |
$29.14 |
| 53D |
Temporary Intensive Staffing - Day (CDS only) |
$25.33 |
$29.14 |
| 53R |
Temporary Intensive Staffing - Residential (60D only) |
$25.33 |
$29.14 |
Staffing Hourly Wage Table (CILA & Day Programs)
| Position Statewide |
Wage Rates Statewide/Chicago Metro (without ERE Fringe) |
Employer Required Expenses(ERE) (Fringe) Percentages |
| DSP Residential - Awake, |
$19.50/$22.43 |
29.90% |
| Asleep & Substitute |
|
|
| Supervisor - Residential |
$21.82/$25.09 |
29.00% |
| QIDP - Residential |
$24.86/$28.59 |
28.10% |
| RN - Residential |
$37.97/$43.67 |
24.90% |
| Dietician - Residential |
$30.75/$35.36 |
26.00% |
| DSP - Community Day Services (CDS) |
$19.50/$22.43 |
29.90% |
| Supported Employment - Job Coach |
$21.00/$24.15 |
29.00% |
| Supervisor - CDS |
$21.82/$25.09 |
29.00% |
| QIDP - CDS |
$24.86/$28.59 |
28.10% |
Staffing Hourly Rate Table (ICF/IID Without ERE (Fringe), Effective 1/1/2024)
| - |
- |
AIDE |
Nurse |
QIDP |
| - |
DFL |
$19.50 |
$31.69 |
$24.86 |
| HSA 1 |
1.0357162 |
$19.96 |
$32.82 |
$25.75 |
| HSA 2 |
0.9892171 |
$19.36 |
$31.35 |
$24.59 |
| HSA 3 |
0.972812 |
$19.15 |
$30.83 |
$24.18 |
| HSA 4 |
0.9892171 |
$19.36 |
$31.35 |
$24.59 |
| HSA 5 |
0.9049194 |
$18.29 |
$28.68 |
$22.50 |
| HSA 6 |
1.2014172 |
$22.07 |
$38.07 |
$29.87 |
| HSA 7 |
1.2014172 |
$22.07 |
$38.07 |
$29.87 |
| HSA 8 |
1.2014172 |
$22.07 |
$38.07 |
$29.87 |
| HSA 9 |
1.1169271 |
$20.99 |
$35.40 |
$27.77 |
| HSA 10 |
1.0357162 |
$19.96 |
$32.82 |
$25.75 |
| HSA 11 |
0.9722287 |
$19.15 |
$30.81 |
$24.17 |
Table Notes:
As a reminder, the following programs are NOT included in the rate adjustments specific to the Rate Study recommendations. Some of the programs listed did receive increases beginning January 1, 2024, as stated in this Bulletin as well as listed in the tables above:
- 17D Child Group Home
- 19D Child Care Institution
- 35U Adult Day Services
- 51A-L ISSA
- 55A Self Direction Assistance
- 55D Personal Support Worker (rates set by individual consumer)
- 67D CLF - Waiver
- 67E CLF - Non-Waiver
- 87D Respite
- 89D Respite
- 880 Grant Group Respite
- 50D Grant ISSA
- 500 Grant ISC
- 780 Grant PAS
- 781 Grant Bogard
Home-Based Services/Purchase of Services:
Standard statewide rates used within the Home-Based Services and Support (HBS) Program, e.g., rates for CDS and SEP, will be impacted by this increase. As was noted in the Final Information Bulletin DD.23.012, IDHS: Increases in the Home-Based Support Services Program (HBS) (state.il.us), the monthly allocation for HBS will also be increasing effective January 1, 2024 by 3.2% due to the Social Security Administration's rate increase to the Supplemental Security Income individual benefit.
Please refer to the above-linked Information Bulletin for information on the SSI increase as well as the above-linked DDD Rate Table to complete HBS service authorizations effective January 1, 2024.
Effective Date:
The waiver rate changes outlined in this IB are effective January 1, 2024. For ICF Aides and other front-line staff in ICF/IID, ICF/IID developmental training facilities, and MC/DD facilities, those rate changes are effective January 1, 2024, subject to federal SPA approval.
