LIGAS DATA REPORT - December 31, 2023

February 15, 2024

Paragraph 33 of the Ligas Consent Decree: …Not less than every six (6) months, Defendants shall provide to the Monitor, Plaintiffs, Class Counsel, Intervenors and Intervenors' Counsel and make publicly available, a detailed report containing data and information sufficient to evaluate Defendants' compliance with the Decree and Defendants progress toward achieving compliance…

This is the twentieth Ligas Data Report, containing data from July 1, 2023, through December 31, 2023. Per the Ligas Consent Decree, the Division of Developmental Disabilities (DDD) will produce reports of data and information regarding implementation of the provisions of the Ligas Consent Decree every six months. The due dates for these reports will typically be February 15th and August 15th of each year.

Class Member List

The DDD maintains a centralized, master Class Member list as described in the Ligas Implementation Plan. Individual records are categorized into three separate areas: individuals living at home in the community, individuals living in an ICF/DD who were admitted after June 15, 2011, and individuals living in an ICF/DD who were there on June 15, 2011 (the date of the Court's approval of the Consent Decree). Written statements documenting a desire to be a part of the Class are obtained for each individual in the latter category. Individuals are added to or removed from the Class list as appropriate.

	Class Members	FY19	FY20	FY21	FY22	FY23	FY24 as of 12/31/23
1	Living at Home	15,215	15,969	16,360	16,812	17,893	18,512
2	ICF/DD after 6/15/11	313	322	323	339	425	454
3	ICF/DD on 6/15/11 with an Affirmative Statement to Move	1,351	1,343	1,335	1,334	1,333	1,333
3a	-DD PAS 10	9	9	9	9	9	9
3b	-DHS 1243/1238	952	947	941	940	940	940
3c	-EFE Form	168	166	165	165	165	165
3d	-OSG Request	202	201	200	200	199	199
3e	-Other Guardian Request	20	20	20	20	20	20
4	# At End of the Fiscal Year	16,879	17,634	18,018	18,485	19,651	20,299

Individuals were added to or removed from the Class Member List as follows:

Additions	Additions in FY19	Additions in FY20	Additions in FY21	Additions in FY22	Additions in FY23	Additions in FY24 as of 12/31/23
Individuals in ICFs/DD on 6/15/11	-	-	-	-	-	-
Individuals in ICF/DDs after 6/15/11	70	15	17	22	93	33
Individuals in Community Settings	1,753	1,709	1,574	1,662	1,790	924
Total Additions	1,823	1,724	1,591	1,684	1,883	957

Removals	Removals in FY19	Removals in FY20	Removals in FY21	Removals in FY22	Removals in FY23	Removals in FY24 (as of 12/31/23)
Individual Moved Out of State	104	75	97	100	89	43
Determined Clinically Ineligible	22	9	26	22	12	1
Determined Financially Ineligible	3	2	2	-	1	1
Withdrew-Reason Not Given	88	91	116	121	80	42
Individual Deceased	63	50	47	45	40	14
Objector	-	-	-	-	-	-
Other	627	518	662	725	340	122
Incorrect SSN (Duplicate Record)	4	1	6	15	7	10
Ineligible Setting	3	-	-	-	-	-
Unable to Locate Individual	290	208	239	175	141	69
Stay in ICFDD	13	4	2	3	1	1
Submitted in Error	-	-	-	-	-	-
Move to ICFDD	36	11	10	11	6	6
Total Removals	1,253	969	1,207	1,217	717	309

Notes:

Prior Fiscal Year numbers may change from previous reports due to updates made in Class Member types and effective dates. The total number of removals and additions will not reconcile to the net increase or decrease in Class Members due to some individuals changing Class status from year to year.
"Other" in the above chart represents a variety of situations including, but not limited to, individual or family was unresponsive or signed PUNS form was not returned.

ICFs/DD Resident Outreach

Outreach to all individuals residing in ICF/DDs was required under the Decree. This was completed via a contract with The Council on Quality and Leadership (CQL), which conducted Outreach during FY14, FY15 and FY16. CQL's contract ended on January 31, 2016. No other Outreach activities were required or conducted during this reporting period.

Services for Class Members in ICFs/DD

The DDD informed Independent Service Coordination (ISC) agencies of the confirmed Class Members residing in ICFs/DD as of June 15, 2011 and instructed the agencies to complete eligibility determinations and facilitate the choice and selection process. ISC agencies reported progress made in assisting the individuals with their options to the DDD on a monthly basis. All previous transition benchmarks for transitions from ICF/DS were met, with the limited exception of the final benchmark of June 30, 2017, just prior to which 310 OSG wards were added to the Class. This benchmark was not fully achieved, but the DDD, OSG and the ISC Agencies worked to evaluate and transition those individuals in a timely manner.

The following chart represents the number of ICF/DD Class Members approved for and/or receiving Waiver services:

	Target Dates from Consent Decree:	FY20	FY22	FY23	Cumulative Total to Date
1	# of Class Members with Waiver Capacity Award Letters	31	1	4	1,472
2	*Total Class Members Who Have Moved to Waiver Services (per billing data)	32	0	3	1,471
2a	Subtotal Who Received CILA Services	32	0	3	1,444
2b	Subtotal Who Received HBS Services	0	0	0	4
2c	Subtotal Who Received CLF Services	0	0	0	3

Note: The above data includes individuals who moved/are moving due to ICF/DD downsizing and closure agreements.

Services for Class Members from the Waiting List

Twelve selections have been completed from the PUNS database (the Division's waiting list) since the approval of the Consent Decree using the criteria specified in the Ligas Implementation Plan and subsequent amendments. Upon selection, Class Members are notified and the ISC agencies complete eligibility determinations and facilitate the choice and provider selection process utilizing Person-Centered Planning. A set of tables is maintained that provides summary information regarding the results of the selections. These tables are available on the Division's website at PUNS Selection Data & Ligas PUNS Selection Data

	Ligas Benchmarks	Total
1	# of Class Members Selected from the Waiting List (PUNS).	13,850
2	# of Class Members in ICF/DDs After 6/15/11 Who were Part of a Downsizing	176
3	Total Class Members with Waiver Capacity Award Letters	7,678
4	Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers)	7,578
5	Total Class Members Who Have Received Waiver Services (per billing data)	7,484
5a	-Subtotal Who Received CILA Services (per billing data)	1,457
5b	-Subtotal Who Received HBS Services (per billing data)	6,012
5c	-Subtotal Who Received CLF Services (per billing data)	15

Transition Service Plans

An initial version of a standardized format and accompanying instructions was developed with input from the Monitor, Plaintiff's Counsel, ISC agencies, and other advocates throughout the system and implemented during FY13. In 2018, the DDD transitioned to a more person-centered process for Ligas Class Members. The initial phase of the person-centered planning process involves development of a Discovery Tool, which identifies what is important to and for the Class Member. The second step is the creation of the Personal Plan, which focuses on the individual's strengths, preferences, needs and desires. Finally, an Implementation Strategy is created based on the content of the Personal Plan, which identifies the services and supports needed and which the provider will implement to achieve the outcomes identified in the Personal Plan. This new process began January 1, 2018 for Ligas Class Members. All Ligas Class Members began receiving Personal Plans in lieu of the Ligas Transition Plan (either as initial plans, or annual plans) as of January 1, 2018. Note: The person-centered planning process is used, not just for Ligas Class Members, but all waiver participants within the Adults with Developmental Disabilities Waiver.

Transitions to CILA by CILA Size of Home

All Persons - Currently in CILA (per CILA Log) as of 12/31/2023
Most recent CILA log, all persons currently in CILA

Type of CILA	1	2	3	4	5	6	7	8	Total
24HR	43	58	599	1,957	963	1,865	789	3,490	9,764
Host Family	41	190	31	2	0	0	0	0	264
Intermittent*	622	132	46	64	20	18	5	48	969
Total	706	380	653	2,023	981	1,885	794	3,538	10,984

Ligas Placements into CILA (from either an ICF/DD or from the PUNS list) as of 12/31/2023
Compares all Ligas placements over time to the most recent CILA log

Type of CILA	1	2	3	4	5	6	7	8	Total
24HR	6	13	140	548	215	318	96	861	2,197
Host Family	2	24	1	0	0	0	0	0	27
Intermittent *	151	19	8	12	3	2	2	3	200
Total	159	56	149	560	218	320	98	864	2,424

Crisis Placements in CILA as of 12/31/2023
Updates the last 6-month report with Crisis approvals from 07/01/2023 to 12/31/2023

Type of CILA	1	2	3	4	5	6	7	8	Total
24HR	0	1	1	12	2	5	1	12	14
Host Family	1	2	3	4	5	6	0	8	29
Intermittent *	7	13	140	548	215	318	96	861	2,198
Total	8	16	144	564	222	329	97	881	2,261

Note: As of January 1, 2022, Family CILA (displayed on previous reports) has been rolled into Intermittent CILA.

Crisis Services

The DDD continues to process service requests for individuals in crisis situations. Below is summary data regarding the requests processed.

	Service Request for Individuals in Crisis	FY19	FY20	FY21	FY22	FY23	FY24 as of 12/31/2023	Cumulative Total to Date
1	Total # of Crisis Requests Received	304	293	251	190	202	87	3,998
2	Total # of Class Members Approved	280	283	249	188	201	87	3,758
2a	- # of Class Members Approved for CILA	194	165	164	132	100	49	2,361
2b	- # of Class Members Approved for HBS	86	118	85	56	101	38	1,392
3	Total # of Class Members Who Received Services	277	283	249	186	201	83	3,738
3a	- # of Class Members Who Received CILA Services	193	165	164	132	100	49	2,350
3b	- # of Class Members Who Received HBS Services	84	118	85	54	101	*36	1,385
4	Total # of Class Members Denied Crisis Approvals	24	10	2	2	1	0	240

Notes:

The Total # of Crisis Request Received (1) reflects Class Members in crisis and for whom a packet was submitted for DDD Waiver services. This number does not include people who temporarily go into an ICF/DD or SODC but still want crisis services.
*In FY24 two Class Members were approved for AHBS (2b) but did not begin services (3b). One Class Member chose to remain in a Mental Health facility and is receiving therapy and learning coping skills while the facility is adjusting his medications. The other Class Member remains at home with the family and is deciding between AHBS, CILA and a provider.

Voluntary ICFs/DD Closure/Downsizing Agreements

The DDD continues to work with ICF/DD providers that wish to downsize or close their facilities on a voluntary basis. The information below represents ICF/DD Closures or Downsizing agreements for the current reporting period, as well as a cumulative figure since inception (FY13).

In rare instances, some individuals who are part of closure/downsizing agreements are determined to be ineligible for the Adult Developmental Disabilities Medicaid Waiver. In such instances, the individuals are funded in Community-Based Services with only State funding and are not eligible for membership in the Ligas Class.

In comparing this data with that in the section entitled "Services for Class Members in ICFs/DD," note that the data source for whether an individual has moved is different between the two sections. This section uses self-reported information from the ICF/DD providers regarding the status of their closure/downsizing agreements; the section entitled "Services for Class Members in ICFs/DD" uses billing data. Typically, there is a greater lag time in the billing data.

	ICF/DD Closures or Downsizing agreements	FY19	FY20	FY22	FY23	FY24 as of 12/31/2023	Cumulative Total to date
1	# of Agreements Initiated	9	5	2	2	1	84
2	Total # Licensed Capacity	127	164	115	31	15	1,655
3	Total # of People to Move	91	127	83	28	12	1,340
3a	-Moved to CILAs	75	88	1	0	0	1,206
3b	-Moved to HBS	0	2	0	0	0	3
3c	-Transferred to other ICFs/DD	11	29	13	0	0	74
3d	-Other	5	8	3	0	0	55
3e	-Move Pending	0	0	24	28	12	64

Note: Numbers and outcomes are recorded in the Fiscal Year in which the agreement was initiated.

Appeals

The DDD continues to process appeals of eligibility and crisis denials for services under the Adults with Developmental Disabilities Waiver. Below is summary data regarding such appeals.

	Appeals of eligibility and Crisis Denials	FY20	FY21	FY22	FY23	FY24 as of 12/31/2023	Cumulative Total to Date
1	Total Class Members Appeals (Rows 2,3,4,5 = Row 1)	32	25	31	25	10	559
1a	Crisis Appeals	3	1	2	1	0	185
1b	Eligibility Appeals	29	24	29	24	10	374
2	Subtotal Appeals Upheld	7	7	4	4	1	164
3	Subtotal Appeals Denied	18	9	20	10	5	314
4	Subtotal Appeals Pending	1	2	7	11	4	23
5	Subtotal Appeals Withdrawn/Closed	6	3	0	0	0	58

Reasonable Pace

Pursuant to the FY19 Implementation Plan, the DDD agreed to a process by which to ensure individuals on the PUNS waiting list enter services "at a reasonable pace." In addition, the DDD agreed to ensure a minimum of 600 individuals enter services during FY20. This includes individuals selected during FY20 or any prior PUNS selection. For FY20 only, this may include individuals transitioning from one Waiver-funded service to another (i.e. HBCS to CILA). For FY21-FY25, a minimum of 630 individuals will be required to enter services each year, excluding transitions from one Waiver service to another (HBCS to CILA).

PUNS Selection date	Number of Selection letters sent	Contact made
8/12/19	1,251	1,234
7/12/20	1,561	1,540
7/12/21	1,596	1,557
7/11/22	1,272	1,221
7/18/23	1,342	1,098

Total number of individuals who entered services from any PUNS selection

Individuals who entered services from any PUNS selection	FY20	FY21	FY22	FY23	FY24 as of 12/31/23
# of Individuals	602	708	764	759	352

Adults on PUNS Seeking Services as of December 31, 2022

Time Waiting while Seeking Services as of December 31, 2022	Persons	Est. FY for Services
Over 60 months	8	FY24
59.99 months to 48 months	2	FY24/FY25
47.99 months to 36 months	929	FY25/FY26
35.99 months to 24 months	1,282	*FY26/FY27
23.99 months to 12 months	1,552	*FY27/FY28
11.99 months and less	1,618	*FY28/FY29
Total	5,391

Note: *Expected to be selected between these 2 fiscal years. The actual number of people who are selected in a given year is an estimate at the time of this report.

Waiver Service Transitions from AHBS to CILA

The following data represents the number of Waiver-funded individuals who transitioned from the Adult Home-Based Support (AHBS) program to the Community-Integrated Living Arrangement (CILA) program for the period specified below. Initially, these service changes were a result of an individual's increased need for such services, and not the result of a selection from the PUNS list. A new process for transitions between Waiver services was developed and was effective April 6, 2021. The DDD released a final Information Bulletin on the new Waiver Service Transition process (and the Crisis process); the new process took the place of the increased need process.

Type of service request	FY19 (1/1/19 - 6/30/19)	FY20	F21	FY 22	FY23	FY24 as of 12/31/23
Adult HBS to Intermittent CILA	5	2	1	2	7	4
Adult HBS to Family CILA	2	4	6	0	0	0
Adult HBS to Host Family CILA	0	0	1	0	0	0
Adult HBS to 24-Hour CILA	27	56	67	55	66	55
HBS to CILA Denials	0	0	0	0	0	0
HBS to CILA Appeals	0	0	0	0	0	0

ICF/DD residents with no award as of 5/1/22

As of May 1, 2022, there were 56 Ligas Class Members who reside in an ICF/DDs and have not yet received award letters. These individuals have not received an award letter because they had not accepted a specific DD Waiver service. Per the FY23 Ligas Implementation Plan, DDD will track these individuals and provide the following data:

Status of the 56 individuals who reside in ICFs/DD as of 12/31/23.

ISC	Services Initiated	Level II Complete/ Eligibility Confirmed	Contact Made	Stay ICF/DD	Grand Total
CAU (Area B)	1	6	25	4	37
CISA (Area I)	0	1	1	0	2
CSO (Area C)	1	0	1	0	1
Prairieland (Area J)	2	1	0	0	3
Prairieland (Area K)	0	2	0	0	2
SAI (Area D)	0	1	0	2	3
Service (Area A)	0	4	1	2	7
SICCS (Area L)	0	1	0	0	1
Grand Total	2	18	28	8	56

Of the 56 individuals above, 42 are under the guardianship of the Office of State Guardian (OSG). Below is the status of the 42 as of 12/31/23.

ISC	Services Initiated	Level II Complete/Eligibility Confirmed	Contact Made	Stay ICFDD	Deceased	Grand Total
CAU (Area B)	0	1	24	4	1	30
CSO (Area C)	1	0	0	0	0	1
Prairieland (Area J)	2	0	0	0	0	2
SAI (Area D)	0	1	0	0	0	1
Service (Area A)	0	2	0	5	0	7
SICCS (Area L)	0	0	0	1	0	1
Grand Total	3	4	24	9	1	42

Note: CISA (Area I) and Prairieland (Area K) do not serve any of the 42 individuals and as such, are not included in this data.

Housing Related Efforts: Housing Navigator Pilot

In efforts to assist individuals with developmental disabilities in finding affordable housing options, the Division of Developmental Disabilities in partnership with the Illinois Council on Developmental Disabilities is overseeing a Housing Navigator project. The Independent Service Coordination Agency Housing Navigator position was created to cultivate and pursue community-based, independent housing options for people with DD who are already in the waiver and those newly selected from the PUNS list. The key activities of the ISC Housing Navigator are to cultivate landlord and affordable housing relationships across various communities and to identify housing stock. In addition, the Housing Navigator will work with individuals with DD and their families to maintain a localized list of people interested in independent supportive housing as an option to ultimately make the match between independent housing options and people with DD.

Housing Navigator Summary

-	FY23	FY24 as of 12/31/23
Referred	242	95
Enrolled	237	296 (Cumulative to date)
Applied to Non-SRN Housing	10	20
Enrolled in SRN	175	261 (Cumulative to date)
Ineligible for SRN	22	29
68Housed	31	68
Ou84treach Contacts to Housing Owners	90+	84

* Notes: Data should be seen as a "snapshot" as opposed to actual reporting (which is not uniform yet). Please note May and June data has not yet been reported.

Supported Employment Program

DDD has implemented, and will continue to directly monitor, an efficient and clear process for Medicaid Waiver funded individuals, including Class Members, to request and revalidate DDD Supported Employment Program (SEP) funding. This process involves persons receiving services and supports, the Independent Service Coordination entity and DDD. All requests are directly reviewed by the DDD Supported Employment Administrator.

DDD SEP Administration:

Allows individuals to obtain and sustain long term employment supports once DRS funding has been successfully exhausted (DDD SEP Individual) or when DRS successful outcome is not necessary (DDD SEP Group); and
Ensures alignment with the Medicaid Waiver and the HCBS Settings Rule; and
Maximizes likelihood of appropriate implementation of supports to all eligible individuals.

FY24 New/Initial Authorizations

Type of Request	Submitted	Approved
Individual	51	38
Group	36	27
Both	0	0
Total	87	65

Annual Revalidation. Annual Revalidation of all DDD SEP Awards was completed by the end of FY23. All individuals previously authorized for DDD SEP continued to be eligible for FY24.

Type of Request	Submitted	Approved
Individual	253	236
Group	146	108
Both	4	4
Total	403	348

Notes:

The rationale for denial of New/Initial Authorizations includes ineligibility, lapsed timeframes, and missing or erroneous information/forms. Individuals can reapply if eligibility criteria are met.
The rationale for denial of Revalidations includes DDD SEP Group Location is Provider Controlled, Owned or Operated; Improper Request (missing data or not currently authorized).

Revalidation Data

-	FY23	FY24 as of 12/31/23
Average Age of DDD SEP Recipient	47	44
Average Hourly Wage	$14.18	$13.86
Average Hours Worked per Month	54	40
Average Percentage of Hours of Work Supported by DDD SEP	56%	74%
DDD SEP Recipients with Multiple Jobs	29	3
Average Annualized Pre-tax Earnings	$9,260.78	$6,809.29

Revalidation Request by Independent Service Coordination (ISC) Agency (Received request in FY23 for services in FY24)

ISC Agency	Number of Request Received	Percentage of Total Request
Central Illinois Service Access	34	8%
Champaign County Regional Planning Commission	39	10%
Community Alternatives Unlimited	113	28%
Community Service Options	53	12%
Prairieland Service Coordination Inc	57	14%
Service Inc	60	15%
Southern Illinois Case Coordination Services	11	3%
Suburban Access	28	7%
No ISC Oversight	3	1%
Unknown	5	1%

Ligas Estimated Cost

Projection updated 12/31/23

Ligas Activities	FY2019	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj.
PUNS Placements	$120,979,448	$142,169,132	$170,266,255	$206,235,879	$276,375,406	$345,281,467	$394,021,085
to CILA	$47,062,776	$56,563,866	$69,140,993	$88,414,039	$123,208,718	$159,384,363	$183,003,653
to HBSS	$73,916,673	$85,605,266	$101,125,262	$111,532,162	$153,116,688	$185,897,104	$211,017,432
Transitions from ICF/DD's	$93,917,401	$101,492,568	$110,749,919	$129,070,490	$166,279,832	$201,096,497	$215,409,517
to CILA	$93,239,974	$100,812,701	$110,057,804	$128,422,862	$165,512,195	$200,260,949	$214,537,989
to HBSS	$677,427	$679,867	$692,115	$647,628	$767,637	$835,548	$871,528
ISSA	$6,232,266	$7,208,020	$8,592,405	$9,688,319	$15,072,359	$16,526,192	$17,690,842
Other Costs	$3,262,850	$4,074,546	$4,326,775	$4,963,785	$5,401,050	$5,982,250	$6,464,650
Court Monitor	$213,250	$243,135	$256,500	$284,850	$284,850	$305,850	$305,850
HBSS Fiscal Agent	$2,677,000	$3,084,300	$3,574,100	$4,205,400	$4,866,200	$5,426,400	$5,908,800
Family Advocate Initiative	$250,000	$250,000	$250,000	$250,000	$250,000	$250,000	$250,000
Ligas Compliance Monitoring	$101,203	$149,941	$0	$0	$0	$0	$0
Ligas Training	$21,397	$25,000	$0	$0	$0	$0	$0
DD Scorecards	$0	$43,920	$0	$0	$0	$0	$0
Rate Study	$0	$278,250	$246,175	$6,078	$0	$0	$0
Person Centered Planning	$0	$0	$0	$217,457	$0	$0	$0
Total	$224,391,965	$254,944,266	$293,935,354	$350,123,740	$463,128,647	$552,167,324	$633,586,094

End of year Persons in Service:	FY2019	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj.
PUNS Placements
PUNS to CILA	841	947	1,072	1,162	1,243	1,338	1,143
PUNS to HBSS	3,140	3,631	4,260	4,984	5,711	6,247	8,216
Subtotal	3,981	4,578	5,332	6,146	6,954	7,585	9,874
Transitions from ICF/DD's
ICFDD to CILA	1,601	1,621	1,627	1,628	1,631	1,631	1,631
ICFDD to HBSS	27	27	27	27	27	27	27
Subtotal	1,628	1,648	1,654	1,655	1,658	1,658	1,658
Total (all receive ISSA)	5,609	6,226	6,986	7,801	8,612	9,243	9,874
ICF/DD Bed Reduction	FY2019	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj.
Beds Closed in FY	44	16	5	-	-	-
Cumulative Beds Closed	941	957	962	962	962	962	962

Note: The estimated amounts are anticipated spending based on approved appropriations for the current fiscal year. The projected amounts are anticipated spending not yet appropriated.

Additional Budget Related Information

DD Long Term Care Service System Cost

Overall spending for the DDLTC System is described below:

Overall spending for the DDLTC System	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj.
Cost in Millions	*$287.2	$279.00	$289.50	$308.20	$341.50	$361.20
$ Change from Prior Yr.		($8.20)	$10.50	$18.70	$33.30	$19.70
Average Persons	3,837	3,588	3,446	3,332	3,311	3,311
Persons Change from Prior Yr.		-249	-142	-114	-21	0

Source: Est. Liability per HFS Reports DHS Budget Office.

*MC/DD (former SNF/PEDs) were transferred to HFS effective 4/1/2019 (PA100-0646).

Adult Waiver Services

Adult Waiver "Accepted Claims" is described below:

Adult Waiver Claims Accepted	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj.
Adult Waiver Claims (millions)	$852.30	$911.20	$1,006.90	$1,258.40	$1,522.66	$1,674.93
$ Change from Prior Yr.		$58.90	$95.70	$221.30	$234.26	$152.27
Unduplicated Persons	21,862	22,358	22,728	23,128	23,428	23,728
Persons Change from Prior Yr.		496	370	400	300	300

FY2020 Source: Accepted Claims Reports (Mobius).

FY2021 thru FY2023 are estimates based on growth in adult waiver services.

DD CILA Waiver Services

A subset of Adult Waiver services, spending for CILA services, including residential, day and ISSA is described below:

Spending for CILA Services	FY2020	FY2021	FY2022	FY2023	FY2024 Est.	FY2025 Proj
DD CILA Services Billings (millions)	$784.30	$845.60	$935.80	$1,079.30	$1,305.95	$1,403.90
$ Change from Prior Yr.		$61.30	$90.20	$144.70	$226.65	$97.95
Authorized CILA persons	11,352	11,277	11,134	11,006	11,044	$11,130
Persons Change from Prior Yr.		-75	-143	-128	38	86

Source: Billing System & Authorized Client Report (Cl Type C)

Rates Oversight Committee/Rate Development

The Rates Oversight Committee was established in August 2018 to address concerns regarding the rate structure for CILA and ICF/DD providers. The Committee oversaw seven sub-committees around the following subject areas: ICF/DD, staffing, assistive technology, employment and training, nursing, transportation, and behavioral supports. These subcommittees provided reports and recommendations to the Committee. The Final Report of the Committee was issued on November 13, 2019, at which point a contractor (Guidehouse) was hired to conduct a rate study and make recommendations for a revised rate methodology. The contract was extended through the end of November 2020 to finalize recommendations and produce the final report, including the rate calculators. The Final Rates Report from Guidehouse was released December 8, 2020 and is available online.

Expansion of Short-Term Stabilization Homes

The DDD initially utilized four Short-Term Stabilization Homes with a total capacity of 16 beds (4 per home) to provide temporary stabilization services to Class Members experiencing extraordinary behavioral issues preventing their continued stay in their Community-Based Setting. We entered into an agreement with Envision and Individual Advocacy Group, the current providers, to expand the previously contracted four Short-Term Stabilization Homes by two homes each, creating an increased total capacity of 32 beds (4 per home) to provide temporary stabilization services for the increased need among Class Members experiencing extraordinary behavioral issues, jeopardizing their continued stay in their community-Based Setting.

Each agency opened their respective third homes in 2021. In addition, Envision opened their fourth home at a capacity of 3 beds on January 1st. These additional homes provide the short-term stabilization capacity with an additional 11 beds. IAG is projected to open their fourth home in FY23 and Envision's fourth home is anticipated to increase the capacity of their fourth home to support 4 beds, reaching the total capacity of 32 beds.

Implementation Plan Updates and Amendments

The original Implementation Plan was completed and filed with the Court with input from the Monitor, Plaintiffs, and Intervenors. Subsequent annual updates are completed each year. The original Implementation Plan and the subsequent updates are posted on the DHS website at.

Coronavirus (COVID-19)

In March of 2020, the Governor of Illinois issued a Stay-at-Home Order as a result of the Coronavirus (COVID-19). The DDD worked with Healthcare and Family Services (HFS) to file an Appendix K amendment to the Waiver to support policy and rate changes to stabilize the system. Subsequently, the Department of Human Services temporarily suspended all site-based Community

Day Services (CDS) attendance in effort to prevent the spread of the virus. CDS reopened fully on September 1, 2020, under guidance from the DDD, including reduced capacity and infection control measures, consistent with guidance from both the Centers for Disease Control (CDS) and the Illinois Department of Public Health (IDPH). Effective October 1, 2020, the DDD implemented a new waiver service, Virtual Day Services (VDS), to allow individuals to receive day services virtually during the pandemic.

Data for Agency-Reported COVID-19 Positive Cases in DDD Community-Integrated Living Arrangements (CILAs) is available on the Department's website. IDPH tracks statistics for Illinois at large as well as for long-term care facilities, which is available at online.