Illinois Department of Human Services
Information Bulletin
Division of Developmental Disabilities
DD.23.001
Purpose:
This Information Bulletin serves as a notice of rate changes pursuant to House Bill 4700/Public Act 102-0699.
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 2022, Governor Pritzker introduced his Fiscal Year 2023 (FY23) 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 approved the Governor's FY23 proposed DDD Budget which appropriates funding sufficient to implement the 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 Guidehouse study recommendations in FY23 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 (CILAs)
- $1.00 per hour wage increase in the rate methodology for Direct Support Professional (DSP) wages for adult Community Integrated Living Arrangement (CILA)
- Wage increases for other frontline staff wages to the federal Department of Labor's (DOL) Bureau of Labor Statistics (BLS) average wages for those positions included below
- Implement a Chicago Metro Regional Reimbursement Factor of fifteen percent (15%) for staff wages for CILAs 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 CILA types including Intermittent (61H, 62H, 63H), Host Family 60D (including HF Stipends) and 24-Hour 60D.
- Adjust ERE (Fringe Benefit) reimbursement for 24-Hour CILA to 29.9% for DSPs, 24.1% for RNs, 28.1% for QIDPs and Supervisor and 25% for Dietician. Intermittent and Host Family rate methodologies already contain these ERE percentages.
- Implement a Program Support Component for 24-Hour CILAs. Intermittent and Host Family rate methodologies already contain this rate component.
- NOTE: As the Program Support rate component is part of the implementation of the rate methodology changes for CILA, providers will no longer be paid for most staff training as those costs are built into the Program Support component of the CILA rate methodology. CILA providers will be able to continue billing for staff training completed (including all required OJT hours) until June 30, 2023. Billing by CILA providers for all training reimbursement requests must be submitted and received by the end of the State lapse period (August 1, 2023) for Fiscal Year 2023. Beginning July 1, 2023 (FY24), CILA providers will no longer be able to be paid separately for most staff training. Only staff training for some medical and behavioral training will be funded separately. Additional information on these training reimbursements will be forthcoming in the Spring of 2023 and can be found on the DDD Rate Table.
- Implement Guidehouse Staffing Tables for 24-Hour CILA. The new Guidehouse Staffing Tables effective January 1, 2023, come directly from the Guidehouse Rate Study (pages 55 through 63). The Guidehouse Staffing Tables incorporate an individual's ICAP Score and Health Risk Screening Tool (HRST) Health Care Level (HCL) Score to develop a Resource Use Level (RUL) which determines an individual's funded staff hours. Differences between the previously used Staffing Tables and the Guidehouse Staffing Tables are possible. Additional information regarding the Guidehouse Staffing Tables is forthcoming.
- Implement the HCL multiplier for determining nursing hour calculations for Base Nursing, Medication Administration Oversight and Nursing Treatments and Oversight for all CILAs.
- Fund all nursing reimbursements at the RN Wage Rate.
- Increase mileage reimbursement to $0.655 per mile.
- Change the Administration Allowance from a fixed amount to 15% of the Program Portion of the CILA Rate for 24 Hour CILAs. Intermittent and Host Family rate methodologies already contain the change to the Administration Allowance.
- Update rate input factors for the rate methodology for Intermittent CILA (Intermittent CILA (ICILA) Services and Supports Clarification of Program Scope and Billing Revised Information Bulletin).
- Update rate input factors for the rate methodology for Host Family CILA - Revised Information Bulletin.
- Revise the Restraint and Restrictive Intervention sections.
- Enhanced Residential Day Program (formerly At-Home Day Program):
- Update rate input factors for rate methodology.
- $1.00 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.
- Community Day Services (CDS):
- Update rate input factors for rate methodology.
- $1.00 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.
- Supported Employment:
- Adult Day Services:
- Updated reimbursement to align with current Department on Aging rates.
- Self-Direction Assistance
- Implement a two percent (2%) Cost of Living Adjustment (COLA) increase.
- Physical Therapy, Occupational Therapy and Speech Therapy:
- The Illinois Department of Healthcare and Family Services has increased the reimbursement rate under the Illinois State Plan for these three therapy services to $111.00 per hour.
- Intermediate Care Facilities (ICF/IID), ICF/IID development training and Medically Complex for the Developmentally Disabled (MC/DD) facilities:
- $1.00 per hour wage increase to Aide wages for ICF/IID, ICF/IID developmental training programs and MC/DD facilities.
- Effective January 1, 2023, ERE (Fringe Benefit) percentage increases from 21% to 29.9% for Aides in ICF/IID,ICF/IID developmental training programs and MC/DD facilities.
- Wage and ERE increases for other frontline staff wages to the federal DOL BLS average wages for those positions included below (effective January 1, 2023)
- QIDP (ERE 28.1%
- Nurse (ERE 24.9%)
OTHER Rates/Rate Methodologies
- State Operated Developmental Centers (SODC) CDS:$1.00 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):
- Make permanent the 10 percent (10% rate increase for Child Group Homes (CGHs) to achieve parity with the CGHs under the Department of Children and Family Services (DCFS). This increase has been implemented through Appendix K since March 2022;
- Implement an additional two percent (2%) COLA for CGHs; and
- Revise the Restraint and Restrictive Intervention Sections.
- Independent Service Coordination (ISC) Agencies:
- Implements a two percent (2%) COLA increase for all ISC services: Pre-Admission Screening (PAS), Individual Service and Support Advocacy (ISSA), Independent Service Coordination and Bogard Service Coordination.
Implementation Guidelines:
The federal Centers for Medicare and Medicaid Services (CMS) approval process for changes within the Children's Residential Waiver, the Children's Support Waiver and the Adults with Developmental Disabilities Waiver requires the submission of a Waiver Amendment. The three (3) waiver amendments submitted to implement the above changes, one amendment for each waiver, have all received federal CMS approval.
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 go into effect January 1, 2023, pending federal CMS approval.
Waiver Funded Services:
Pursuant to House Bill 4700/Public Act 102-0699 and with federal CMS' approval of the rate increases, received in December 2022, providers of community-based services and supports to individuals with intellectual and developmental disabilities shall increase wages as follows:
- Effective January 1, 2023, for DSPs, by $1.00 per hour, with at least $0.50 of those funds to be provided for a $0.50/hour direct increase to all DSP wages, with the remaining 50% ($0.50) to be used flexibly for wage increases for DSPs and other frontline staff not covered by the federal DOL BLS average wage increases.
- Effective January 1, 2023, for non-executive direct care staff, excluding DSPs, to the federal DOL BLS mean hourly wage based on the same or similar occupation title.
- Effective January 1, 2023, a fifteen percent (15%) Regionalization Factor is being implemented for CILAs in Chicago, suburban Cook County, and the collar counties (list provided below). While the DDD is not prescribing how the Regionalization Factor is to be implemented, the DDD does strongly encourage 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 CILAs both within and outside the Chicago, suburban Cook County, and the 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 operation. 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.
- Providers can also refer to the DDD Communication from November 11, 2022: DSP and ICF Aide Wage Guidance.
- Any increases provided to DSP wages between July 1, 2022, and December 31, 2022, 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, the DDD is required to create a process whereby provider agencies must certify they are passing the wage increases on to their direct care staff as mandated by the DDD. Information on this certification requirement and provider expectations for it will be forthcoming.
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 State Plan Amendment:
- Effective January 1, 2023, subject to federal approval of the State Plan Amendment, 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 50% ($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 by the federal DOL BLS average wage increases.
- Effective January 1, 2023, subject to federal approval of the State Plan Amendment, 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 mean hourly wage based on the same or similar occupation title.
- Pursuant to House Bill 4647/Public Act 102-0944, the DDD is required to create a process whereby provider agencies must certify that they are passing the wage increases on to their direct care staff as mandated by the DDD. Information on this requirement and provider expectations for it will be forthcoming.
Rate Calculations:
The programs impacted by the above rate and reimbursement changes are depicted on the recently released DDD Rate Table (effective January 1, 2023, 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, 2023, 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, 2023, will be implemented by HFS as soon as federal approval is received.
Rate Table - Waiver & SODC (Effective 1/1/2023)
| Bill Code |
Program Name |
Statewide Hourly Rate |
Chicago Metro Hourly Rate |
| 31U |
Community Day Services (On-Site) |
$15.03 |
$15.03 |
| 31C |
Community Day Services (Off-Site) |
$16.82 |
$16.82 |
| 33G |
Supported Employment - Small Group |
$13.73 |
$13.73 |
| 36G |
Supported Employment - Large Group |
$7.00 |
$7.00 |
| 36U |
Supported Employment - Individual |
$40.67 |
$40.67 |
| 35U |
Adult Day Services |
$19.82 |
$19.82 |
| 37U |
Enhanced Residential Habilitation |
|
|
| (FKA At-Home Day Program) |
$18.53 |
$18.53 |
|
| 38U |
SODC Day Training (On-Site) |
$15.03 |
$15.03 |
| 38C |
SODC Day Training (Off-Site) |
$16.82 |
$16.82 |
| 17D |
Children's Group Home (CGH) |
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)
- Intermittent Hourly Supports 1:1 |
$50.76 |
$57.81 |
| 62H |
Community Integrated Living Arrangement (CILA)
- Intermittent Hourly Supports 1:2 |
$25.38 |
$28.90 |
| 63H |
Community Integrated Living Arrangement (CILA)
- Intermittent Hourly Supports 1:3 |
$16.92 |
$19.27 |
| 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
- Statewide Rate |
$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 |
$51.27 |
$51.27 |
| 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 |
$22.08 |
$22.08 |
| 53D |
Temporary Intensive Staffing - Day (CDS only) |
$22.08 |
$22.08 |
| 53R |
Temporary Intensive Staffing - Residential (60D only) |
$22.08 |
$25.40 |
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,
Asleep & Substitute |
$17.00/$19.55 |
29.90% |
| Supervisor - Residential |
$19.02/$21.87 |
28.10% |
| QIDP - Residential |
$21.68/$23.93 |
28.10% |
| RN - Residential |
$37.30/$42.90 |
24.10% |
| Dietician - Residential |
$30.25/$34.79 |
25.00% |
| DSP - Community Day Services (CDS) |
$17.00/$17.00 |
29.90% |
| Supported Employment - Job Coach |
$18.31/$18.31 |
29.90% |
| Supervisor - CDS |
$19.02/$19.02 |
28.10% |
| QIDP - CDS |
$21.68/$21.68 |
28.10% |
Staffing Hourly Rate Table (ICF/IID Without ERE (Fringe), Effective 1/1/2023)
| - |
- |
AIDE |
Nurse |
QIDP |
| - |
DFL |
$17.00 |
$28.46 |
$21.68 |
| HSA 1 |
1.0357162 |
$17.46 |
$29.48 |
$22.45 |
| HSA 2 |
0.9892171 |
$16.86 |
$28.15 |
$21.45 |
| HSA 3 |
0.972812 |
$16.65 |
$27.69 |
$21.09 |
| HSA 4 |
0.9892171 |
$16.86 |
$28.15 |
$21.45 |
| HSA 5 |
0.9049194 |
$15.79 |
$25.75 |
$19.62 |
| HSA 6 |
1.2014172 |
$19.57 |
$34.19 |
$26.05 |
| HSA 7 |
1.2014172 |
$19.57 |
$34.19 |
$26.05 |
| HSA 8 |
1.2014172 |
$19.57 |
$34.19 |
$26.05 |
| HSA 9 |
1.1169271 |
$18.49 |
$31.79 |
$24.21 |
| HSA 10 |
1.0357162 |
$17.46 |
$29.48 |
$22.45 |
| HSA 11 |
0.9722287 |
$16.65 |
$27.67 |
$21.08 |
Table Notes:
As a reminder, the following programs are NOT included in the rate adjustments specific to the Guidehouse recommendations. Some of the programs listed did receive increases beginning January 1, 2023, as stated in this Bulletin as well as listed in the tables above:
- 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
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.22.013, Increases in the Home-Based Support Services Program (HBS), the monthly allocation for HBS will also be increasing effective January 1, 2023 by 8.7% 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 beginning January 1, 2023.
Effective Date:
The waiver rate changes outlined in this IB are effective January 1, 2023. 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, 2023, subject to federal State Plan Amendment approval.
