UPDATED - COVID 19 Community Day Services (CDS) & Residential Rates and Reimbursement

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.20.003

Purpose:

This Information Bulletin is a guide to Rates, Billing and Payments for The Division of Developmental Disabilities (DDD) Services during the COVID 19 time period. For more information please contact:

POS: Nikki Carnes-Peter at 217.524.8489 or Nikki.Carnes-Peter@Illinois.Gov

CILA & CDS: George Bengel at 217.782.3398 or George.Bengel@Illinois.Gov


Overarching:

The DDD is working with sister state agencies and all levels of government as well as all our partner providers during these unprecedented times. The DDD's utmost concern is for the health, safety and wellbeing of the people we serve and the staff who provide all aspects of care and support to the people we serve.

The DDD expects staff who normally work in CDS settings be redirected to help fill staff positions and cover additional staffing hours in residential settings as possible. Providers should ask their current CDS staff to do other work they have within their agencies during this time if no residential work is available. Staff should continue to work to help keep the agency running. If no work is available, providers should continue to pay their staff.

In addition, we also suggest that trained staff should be connected to other agencies that provide residential services and supports. It will be up to each agency to determine the logistics of these working arrangements with their staff and the other agency.

IDHS will be issuing further administrative guidance on documentation required for payment during the CDS period of closure. DDD reserves the right to request additional documentation to verify payment was provided.


Community Integrated Living Arrangements (CILA):

  1. CILA Rates for people funded for 24-hour shift staff and Foster Care / Host Family rates will be adjusted to account and pay for the hours usually deducted for CDS services. This means the COVID 19 CILA Rates for these two CILA types will be adjusted for the normal five (5) or seven (7) hours a day Community Day Services (CDS) exclusion.
  2. The average CILA Rate will increase by approximately 20 percent to account for the additional staff time for CDS hours.
  3. People authorized for Intermittent and Family Intermittent CILA will be authorized for an additional 15 hours per week of billable 53R supports during the time day programs are closed. At this time the DDD is authorizing 120 billable 53R hours which should cover at least 8 weeks beginning March 17, 2020. These additional Direct Support Provider (DSP) hours are to be used on an as needed basis to help assure the health, welfare and safety of people funded for Intermittent CILA who normally participate in some type of day services.
  4. People authorized for additional staff support to a person in a CDS (53D) are being authorized for 53R hours in the person's residential program. Residential providers should only bill for 53R hours during the time the person would have regularly participated in a community day program AND only if the residential provider has staff providing the addition staff supports to the person on an individual basis.
  5. During the time COVID 19 CILA Rates are in effect CILA Agencies should not bill for 37U At-Home Day Program as these "Day Program" hours will be temporarily part of each person's CILA residential rate.
  6. There should be no 30U, 31U, 31C, 35U or 37U billing during this period.
  7. Supported Employment 39U or 39G would only be billed IF the person is required to work by their employer.
  8. Individuals who have additional staff supports as part of their CILA funding and billable 53R hours will also be recalculated and additional billable 53R hours will be authorized based on the increased number of residential hours. The calculation we are using is to multiply the person's 53R hours by 20% and award 3.5 months of the 20% total. As an example, if a person had 2,000 hours of 53R the calculation would be 2,000 x 0.20 = 400 / 12 months x 3.5 months = 116 additional 53R hours.
  9. DDD will prepare a summary list of new CILA Rates for each person for each agency. DDD will NOT be generating individual rate sheets.
  10. Increased COVID 19 CILA Rates are being transmitted to the billing and payment system the week of March 23, 2020 and will be in place in the billing system in time for agencies submitting March billing the first week of April.
  11. CILA Agencies on Advance and Reconcile will generate advance payments for May with the March billing and June for the April billing. Depending upon when the CDS Closure ends and CILA Rates return to rates without the CDS hour(s), agencies on Advance and Reconcile will have Advance Reimbursements over what the final reconciliation payment will be. This means Advance & Reconcile agencies will have over payments recouped during the reconciliation billing for May and June.


Child Group Homes - 17D (CGH) & Child Care Institutions - 19D (CCI):

  1. Both CGH & CCI Rates for children funded for these two programs will be adjusted to account and pay for the staff hours children in these residential programs would be participating in a school program.
  2. Both CGH & CCI Rates are calculated on an agency's previous expenses. As such, there is not a rate methodology for either program's rates which can be adjusted.
  3. Since both rate methodologies depend upon past expenses the DDD will be adjusting each child's CGH or CCI Rate by 20 percent to account for the additional staff time while school programs are closed.
  4. DDD will prepare a summary list of new CGH & CCI Rates for each person for each agency. DDD will NOT be generating individual rate sheets.
  5. Increased COVID 19 CHG & CCI Rates are being transmitted to the billing and payment system the week of March 23, 2020 and will be in place in the billing system in time for agencies submitting March billing the first week of April.


Community Living Facilities - (CLF) 67D & 67E:

  1. All in-state CLF Rates (67D & 67E) for people funded in these two programs will be adjusted to account and pay for the staff hours people in these residential programs would normally be participating in a day program.
  2. Any out-of-state CLF provider will have to inform the State of Illinois of any special rate adjustments granted by their respective state for addressing issues related to COVID 19.
  3. In State CLF Rates (67D & 67E) are calculated on an agency's previous expenses. As such, there is not a rate methodology for either program's rates which can be adjusted.
  4. Since both 67D & 67E Rate methodologies depend upon past expenses the DDD will be adjusting each person's CLF Rate by 20 percent to account for the additional staff time while day programs are closed. 
  5. DDD will prepare a summary list of new 67D & 67E CLF Rates for each person for each agency. DDD will NOT be generating individual rate sheets.
  6. Increased COVID 19 CLF Rates are being transmitted to the billing and payment system the week of March 23, 2020 and will be in place in the billing system in time for agencies submitting March billing the first week of April.


Community Day Services (CDS) Multiple Types 30U, 31C, 31U, 31S, 35U, 37U, 39U, 37G:

  1. Providers are to continue billing for CDS services provided before March 17, 2020.  There should be no 30U, 31U, 31C, 35U or 37U billing after March 17, 2020 and until notified by the Division to reopen CDS programs.
  2. Supported Employment 39U or 39G would only be billed IF the person is required to work by their employer.
  3. Providers of day services for people from SODCs (31S) will get paid for the month of March by billing the days of service for each person served during March. In the event day programs can reopen and resume services in April 2020, then April payments should process as normal. If day programs are not able to reopen or resume operations until a later date, then the DDD will issue payments through social services delivery system safety net described below.
  4. From March 17 through mid-April (and longer as needed), in the event fee-for-service billings are less than normal, IDHS is committed to providing funding to make up the lost revenues from reduced billings to ensure the preservation of Illinois' social services delivery system and safety net. This difference would include lost revenue from people who are funded through Adult Home-Based Services who are currently participating in CDS. The Division of Developmental Disabilities has calculated average expenditures based on the last 6 months of billing (NOTE: Not to exceed the average billing total, 115 hours per month, and/or 1100 hours per year) for each Community Day Service provider. The estimated CDS amounts coming from DDD will NOT count against the HBS person's monthly allocation.  We are currently processing these payments to get them in provider hands as quickly as possible.  Providers must submit their quarterly IDES Form UI-3/40 to corroborate their personnel costs to the program within 90 days after filing with IDES.
  5. In the event that CDS programs are re-opened prior to the end of the FY waiver funded providers will bill for those hours and DDD will reconcile payment already made against the 1100-hour cap.
  6. The Division expects CDS funds will be used to pay staff salaries. These funds should not be used for incentives to hire staff. We ask that in these extraordinary circumstances that you use professional courtesy and not undermine other agencies ability to provide essential services.


Grant Funded Programs:

  1. The federal guidance permits grantees to continue to charge salaries and benefits to currently active awards. In addition, grantees can continue to charge Facility and Administrative costs such as occupancy, insurance, taxes, and utilities. The federal guidance is being applied to state-funded grants.  For Dental, Latino Outreach, Group Respite, Voucher Respite, PUNS, PAS, Epilepsy, Best Buddies, and Autism IDHS will continue to make payments for expense-based grants as normal.
    • For Dental, Latino Outreach, Group Respite, Voucher Respite, PUNS, PAS, Epilepsy, Best Buddies, and Autism IDHS will continue to make payments for expense-based grants as normal. 
  2. ISSA providers, please continue to submit billing information for services provided. IDHS will supplement grant payments equal to "average monthly billings x reimbursement rate." The portion of the grant payment not supported by service billings will need to be expended for costs (e.g. salaries and benefits, facility and administrative costs).  Providers must submit their quarterly IDES Form UI-3/40 to corroborate their personnel costs to the program within 90 days after filing with IDES.


ICF/DD & ICF/DD CDS Programs (formerly Developmental Training):

 


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:

Upon Final Posting