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

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.20.008 FINAL

Purpose:

This Information Bulletin is an updated guide to Rates, Billing and Payments for The Division of Developmental Disabilities (DDD) Services.

For more information please contact:

POS: Jim Eddings at 217.557.6335 or Jim.Eddings@Illinois.Gov

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

Overarching:

The DDD made a number of temporary changes to assist agencies in providing services safely during the COVID-19 crisis period. The DDD is working towards returning to pre-COVID-19 rules and regulations.

Providers should keep in mind that even though a wage increase has been approved for FY 21, it cannot be implemented until the State's Technical Waiver Amendment is approved by Federal Centers for Medicare and Medicaid Services (CMS).

Community Integrated Living Arrangements (CILA):

  1. The CILA 10% COVID-19 rate increase will end June 30, 2020. A 5% rate increase will stay in effect from July 1 to December 31, 2020.
  2. Resuming July 1, 2020, all CILA rates will return to pre-COVID-19 rates.
  3. Starting July 1, 2020, each person enrolled in 60D CILA and 65H Hourly CILA will be authorized for At-Home Day program, bill code 37U. Providers may begin using the 37U bill code when a person is not participating in another day program or supported employment.
  4. Since COVID-19 Rates remain in effect until June 30, 2020, July & August Advance & Reconcile payments will be issued at a higher rate. CILA providers should expect that the difference will be recouped the following month.

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

  1. The Division will continue to utilize rate setting authority and implement 17D and 19D COVID rates through August 2020.

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

  1. Resuming July 1, 2020, all in-state CLF Rates (67D & 67 E) will return to pre-COVID-19 rates.
  2. Beginning July 1, 2020, all people authorized for 67D & 67E will be automatically authorized for 37U At-Home Day Program. This will allow people who may not immediately return to a CDS site to participate in day activities.

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

  1. CDS services will remain closed through July 31, 2020 with a soft opening August 1, 2020 and a full opening September 1, 2020.
  2. Starting July 1, 2020, each person enrolled in 60D CILA, 65H Hourly CILA and CLF 67D & 67E will be authorized for At-Home Day program, bill code 37U. Providers may begin using the 37U bill code when a person is not participating in another day program or supported employment.
  3. ISCs will need to edit the Personal Plan to include the 37U service and providers should include it in person's Implementation Strategy.
  4. Resuming July 1, 2020, 37U billing will count against the individual's 1100-hour capacity for all day program services.
  5. CDS providers for 31U and 31C billing will receive Reinvention Payments for July and August services.
  6. Supported Employment Program (SEP) 39U or 39G should only be billed if the person is engaged in employment. DDD Billing Guidance should be followed as participants return to their place of employment.
  7. All authorizations for Other Day Program (30U) will end June 30, 2020.

Grant Funded Programs:

Resuming July 1, 2020, all grant funded programming will return to operating under pre-COVID-19 guidance.

Providers should continue to provide remote and virtual support as appropriate.

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

The Illinois Department of Healthcare and Family Services (HFS) has provided rate information and billing specifics both for additional residential funding, as well as CDS payment during this time.

See: https://www.illinois.gov/hfs/MedicalProviders/notices/Pages/default.aspx

 ICF/DDs will continue to receive the additional 20% funding to cover hours traditionally provided by CDS sites through July 25, 2020 with the possibility of extension in alignment with CDS closure.


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