Illinois Department of Human Services
Information Bulletin
Division of Developmental Disabilities
DD.21.O25 FINAL
Purpose:
This Information Bulletin serves as a notice of rate changes pursuant to Senate Bill 2017/Public Act 102-0016.
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. This 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 study was the result of 2 years' worth of work completed by the Ligas Rate Oversight Committee and its 7 subcommittees made up of stakeholders across the intellectual and developmental disabilities system. In February 2021, Governor Pritzker introduced his FY22 proposed budget to the General Assembly. The proposed budget included new funding for the DDD to implement several of the recommendations in the study. The General Assembly, in their final FY22 budget signed by the Governor, appropriated funding, above the Governor's introduced budget, sufficient to implement additional study recommendations that will provide increases to the rates and reimbursements within the I/DD system.
Increase Overview:
Waiver Changes:
The implementation of many of the Guidehouse study recommendations in State Fiscal Year 2022 include rate and reimbursement increases, updates/changes to rate methodologies, and the creation of rate methodologies as follows (*Note: implementation guidance is below):
- Adult Community Integrated Living Arrangements (CILA)
- Enhanced Residential Day Program (formerly At-Home Day Program):
- Implement new rate methodology
- $1.50 per hour wage increase in the rate methodology for DSP wages
- Wage increases for other frontline staff wages to the federal Department of Labor's (DOL) Bureau of Labor Statistics (BLS) average wages.
- Community Day Services (CDS):
- Implement new rate methodology
- $1.50 per hour wage increase in the rate methodology for DSP wages
- Wage increases for other frontline staff wages to the federal Department of Labor's (DOL) Bureau of Labor Statistics (BLS) average wages.
- Increase reimbursement for Employee Related Expenses (ERE) for CDS staff wages to 29.9% for DSPs and comparable ERE reimbursement for supervisor wages.
- Increase the annual limit of day program hours to allow providers to bill up to 1,200 hours per year to reimburse for the number of required days and hours of operation.
- CDS, Enhanced Residential Day Program (fka At-Home Day), and Supported Employment. For Enhanced Residential Day Program, CDS, and Supported Employment, this includes updated cost components as recommended by Guidehouse.
- As part of the implementation of the rate methodology for CDS, providers will no longer be paid for staff training as those costs are built into the Program Support component of the methodology. CDS providers will be able to continue billing for staff training completed (including all required OJT hours) by June 30, 2022. Billing by CDS providers for all training reimbursement requests must be submitted and received by the end of the state's lapse period (August 1, 2022) for fiscal year 2022. Beginning July 1, 2022 (FY23), CDS providers will no longer be able to be paid separately for staff training.
- Create an occupancy factor for CILA and CDS services.
- Create a staff productivity factor for CDS services.
- Specify a transportation reimbursement factor for CDS services.
- Supported Employment:
- Behavior Intervention & Counseling
- Wage increases for other frontline staff wages to the federal Department of Labor's (DOL) Bureau of Labor Statistics (BLS) average wages.
- Intermediate Care Facilities (ICF/IID) and Medically Complex for the Developmentally Disabled (MC/DD) facilities:
- $1.50 per hour wage increase to DSP wages for ICF/IID and ICF/IID CDS programs.
- Effective July 1, 2021, facilities receive a $0.50/hour increase for ICF Aides
- Effective January 1, 2022, facilities receive a $1.00 per hour increase for ICF Aides
- Wage increases for other frontline staff wages to the federal Department of Labor's Bureau of Labor Statistics average wages for those positions included below (effective January 1, 2022):
- State Operated Developmental Centers (SODC) CDS:
- Update the rate methodology for Community Day Services provided to State-Operated Developmental Center (SODC) residents. While the SODCs were not included in the Guidehouse study, CDS was and, as such, the Division is implementing the rate methodology to be consistent.
- Implement hourly (15-minute increments) billing.
- Implement the waiver CDS hourly billing rates for SODC.
Implementation Guidelines:
Because the federal CMS approval process for rate changes for ICF/IID facilities is done via a State Plan Amendment (SPA), which is a different process than a Waiver Amendment, the wage increases were proposed to be implemented differently. The Department of Healthcare and Family Services (HFS) was notified in late October that the SPA was approved. The July increase is being implemented retroactive to July 1; the January increases will go into effect January 1.
Waiver Funded Services:
Pursuant to Public Act 102-0016 and subject to federal approval of the rate increases, providers of community-based services and supports to individuals with intellectual and developmental disabilities shall increase wages as follows:
- Effective January 1, 2022 or upon federal approval, for Direct Support Personnel (DSPs), by $1.50 per hour, with at least $0.75 of those funds to be provided for a $0.75/hour direct increase to all DSP wages, with the remaining 50% ($0.75) to be used flexibly for wage increases for DSPs and other frontline staff, not covered in subpart B; and
- Effective January 1, 2022 or upon federal approval, for non-executive direct care staff, excluding DSPs, to the federal Department of Labor Statistics' mean hourly wage based on the same or similar occupation title.
Any increases provided to DSP wages on or after July 1, 2021, that a provider has voluntarily provided or been required to provide based on local minimum wage requirements, will be inclusive towards the DSP wage increase required.
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:
- Effective July 1, 2021, facilities will receive an increase to their reimbursement rates sufficient to provide a $0.50 per hour wage increase for ICF Aides, with at least $0.25 of those funds to be provided for a $0.25/hour direct increase to all ICF Aide wages, with the remaining 50% ($0.25) to be used flexibly for wage increases for ICF Aides and other frontline staff, not covered in subpart (3).
- Effective January 1, 2022, facilities will receive an increase to their reimbursement rates sufficient to provide a $1.00 per hour wage increase for ICF Aides, with at least $0.50 of those funds to be provided for a $0.50/hour direct increase to all ICF Aide wages, with the remaining 50% ($0.50) to be used flexibly for wage increases to ICF Aides and other frontline staff, not covered in subpart (3).
- Effective January 1, 2022, 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 Department of Labor Statistics' mean hourly wage based on the same or similar occupation title.
Rate Calculations:
The programs impacted by the above rate and reimbursement changes are depicted on the recently released DDD Rate Table (effective January 1, 2022, or upon federal CMS approval) as well as in the below tables.
The Division 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, 2022 or subject to federal approval.
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 updates to ICF/IID day program rates have been announced, and the July 1, 2021 increase is currently being implemented. The January 1, 2022 increase should be able to be implemented by HFS prior to billing for January services.
Rate Table - Waiver & SODC (Effective 1/1/2022)
| Bill Code |
Program Name |
Hourly Rate |
| 31U |
Community Day Services (On-Site) |
$14.33 |
| 31C |
Community Day Services (Off-Site) |
$15.96 |
| 33G |
Supported Employment - Small Group |
$12.93 |
| 36G |
Supported Employment - Large Group |
$6.58 |
| 36U |
Supported Employment - Individual |
$38.30 |
| 37U |
At-Home Day Program |
$17.49 |
| 38U |
SODC Day Training (On-Site) |
$14.33 |
| 38C |
SODC Day Training (Off-Site) |
$15.96 |
| 60D |
Community Integrated Living Arrangement (CILA) - Individual Rate Model |
Varies |
| 61H |
Community Integrated Living Arrangement (CILA) - Intermittent Hourly Supports 1:1 |
$48.48 |
| 62H |
Community Integrated Living Arrangement (CILA) - Intermittent Hourly Supports 1:2 |
$24.24 |
| 63H |
Community Integrated Living Arrangement (CILA) - Intermittent Hourly Supports 1:3 |
$16.80 |
| Behavior Intervention and Treatment: |
| 56U - L1 |
Level 1 - Licensed Professional - Statewide Rate |
$99.11 |
| 56U - L2 |
Level 2 - Other Credentials or No Level Specified - Statewide Rate |
$78.07 |
| 57U |
Individual Counseling |
$50.41 |
| 57G |
Group Counseling |
$16.80 |
| 58U |
Individual Therapy |
$69.71 |
| 58G |
Group Therapy |
$23.24 |
| 53D |
Temporary Intensive Staffing - Day (CDS only) |
$20.78 |
| 53R |
Temporary Intensive Staffing - Residential (60D only) |
$20.00 |
Staffing Hourly Wage Table (CILA & Day Programs)
| Position Statewide |
Wage Rate (without Fringe) |
Fringe Percentage |
| DSP Residential - Awake, Asleep & Substitute |
$16.00 |
25.00% |
| Supervisor - Residential |
$17.90 |
25.00% |
| QIDP - Residential |
$20.40 |
25.00% |
| LPN - Residential |
$25.35 |
25.00% |
| RN - Residential |
$36.33 |
25.00% |
| Dietician - Residential |
$29.29 |
25.00% |
| DSP - Community Day Services (CDS) |
$16.00 |
29.90% |
| Supported Employment - Job Coach |
$17.23 |
29.90% |
| Supervisor - CDS |
$17.90 |
28.10% |
| QIDP - CDS |
$20.40 |
28.10% |
Staffing Hourly Rate Table (ICF/IID Without 21% Fringe, Effective 7/1/2021)
| - |
- |
AIDE |
Nurse |
QIDP |
| - |
DFL |
$15.00 |
$21.16 |
$20.21 |
| HSA 1 |
1.0357162 |
$15.46 |
$22.54 |
$21.46 |
| HSA 2 |
0.9892171 |
$14.86 |
$21.69 |
$20.66 |
| HSA 3 |
0.972812 |
$14.65 |
$21.38 |
$20.38 |
| HSA 4 |
0.9892171 |
$14.86 |
$21.69 |
$20.66 |
| HSA 5 |
0.9049194 |
$13.79 |
$20.16 |
$19.19 |
| HSA 6 |
1.2014172 |
$17.57 |
$25.57 |
$24.34 |
| HSA 7 |
1.2014172 |
$17.57 |
$25.57 |
$24.34 |
| HSA 8 |
1.2014172 |
$17.57 |
$25.57 |
$24.34 |
| HSA 9 |
1.1169271 |
$16.49 |
$24.01 |
$22.87 |
| HSA 10 |
1.0357162 |
$15.46 |
$22.54 |
$21.46 |
| HSA 11 |
0.9722287 |
$14.65 |
$21.37 |
$20.37 |
Staffing Hourly Rate Table (ICF/D Without 21% Fringe, Effective 1/1/2022)
| - |
- |
AIDE |
Nurse |
QIDP |
| - |
DFL |
$16.00 |
$28.38 |
$20.40 |
| HSA 1 |
1.0357162 |
$16.46 |
$29.39 |
$21.13 |
| HSA 2 |
0.9892171 |
$15.86 |
$28.07 |
$20.18 |
| HSA 3 |
0.972812 |
$15.65 |
$27.61 |
$19.85 |
| HSA 4 |
0.9892171 |
$15.86 |
$28.07 |
$20.18 |
| HSA 5 |
0.9049194 |
$14.79 |
$25.68 |
$18.46 |
| HSA 6 |
1.2014172 |
$18.57 |
$34.10 |
$24.51 |
| HSA 7 |
1.2014172 |
$18.57 |
$34.10 |
$24.51 |
| HSA 8 |
1.2014172 |
$18.57 |
$34.10 |
$24.51 |
| HSA 9 |
1.1169271 |
$17.49 |
$31.70 |
$22.79 |
| HSA 10 |
1.0357162 |
$16.46 |
$29.39 |
$21.13 |
| HSA 11 |
0.9722287 |
$15.65 |
$27.59 |
$19.83 |
Table Notes:
As a reminder, the following programs are NOT included in the wage increase as they were not part of the Guidehouse study:
- 19D Child Care Institution
- 17D Children's Group Home*
- 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
*Note: Children's Group Home providers received a 3% increase to their per-diem effective 7/1/21 in line with DCFS rate increases
Home-Based Services/Purchase of Services:
Standard statewide rates used within the Home-Based Services and Support (HBS) Program, e.g., rates for Community Day Services and Supported Employment, will be impacted by this increase. As was noted in the Final Information Bulletin DD.21.023, Increases in the Home-Based Support Services Program (HBS), the monthly allocation for HBS will also be increasing effective January 1, 2022 by 5.9% due to the Social Security Administration's announced 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 DDD Rate Table to complete HBS service plans beginning with January 2022.
Effective Date:
The rate changes outlined in this IB are effective January 1, 2022, or upon federal CMS approval, with the exception of both the initial $0.50/hour and $1.00/hour wage increases for ICF/IID Aides which are effective July 1, 2021 and January 1, 2022 respectively.
