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 eighteenth Ligas Data Report, containing data from July 1, 2022, through December 31, 2022. 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 as of 12/31/22 |
| 1 |
Living at Home |
15,215 |
15,969 |
16,360 |
16,812 |
17,345 |
| 2 |
ICF/DD after 6/15/11 |
313 |
322 |
323 |
339 |
365 |
| 3 |
ICF/DD on 6/15/11 with an Affirmative Statement to Move |
1,351 |
1,343 |
1,335 |
1,334 |
1,333 |
| 3a |
-DD PAS 10 |
9 |
9 |
9 |
9 |
9 |
| 3b |
-DHS 1243/1238 |
952 |
947 |
941 |
940 |
940 |
| 3c |
-EFE Form |
168 |
166 |
165 |
165 |
165 |
| 3d |
-OSG Request |
202 |
201 |
200 |
200 |
199 |
| 3e |
-Other Guardian Request |
20 |
20 |
20 |
20 |
20 |
| 4 |
# At End of the Fiscal Year |
16,879 |
17,634 |
18,018 |
18,485 |
19,043 |
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 as of 12/31/22 |
| Individuals in ICFs/DD on 6/15/11 |
- |
- |
- |
- |
- |
| Individuals in ICF/DDs after 6/15/11 |
70 |
15 |
17 |
22 |
31 |
| Individuals in Community Settings |
1,753 |
1,709 |
1,574 |
1,662 |
900 |
| Total Additions |
1,823 |
1,724 |
1,591 |
1,684 |
931 |
| Removals |
Removals in FY19 |
Removals in FY20 |
Removals in FY21 |
Removals in FY22 |
Removals in FY23 as of 12/31/22 |
| Individual Moved Out of State |
104 |
75 |
97 |
100 |
41 |
| Determined Clinically Ineligible |
22 |
9 |
26 |
22 |
9 |
| Determined Financially Ineligible |
3 |
2 |
2 |
- |
1 |
| Withdrew-Reason Not Given |
88 |
91 |
116 |
121 |
38 |
| Individual Deceased |
63 |
50 |
47 |
45 |
19 |
| Objector |
- |
- |
- |
- |
- |
| Other |
627 |
518 |
662 |
725 |
192 |
| Incorrect SSN (Duplicate Record) |
4 |
1 |
6 |
15 |
5 |
| Ineligible Setting |
3 |
- |
- |
- |
- |
| Unable to Locate Individual |
290 |
208 |
239 |
175 |
63 |
| Stay in ICFDD |
13 |
4 |
2 |
3 |
1 |
| Submitted in Error |
- |
- |
- |
- |
- |
| Move to ICFDD |
36 |
11 |
10 |
11 |
4 |
| Total Removals |
1,253 |
969 |
1,207 |
1,217 |
373 |
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 |
FY21 |
FY22 |
FY23 as of 12/31/22 |
Cumulative Total to Date |
| 1 |
# of Class Members with Waiver Capacity Award Letters |
31 |
0 |
1 |
2 |
1,470 |
| 2 |
*Total Class Members Who Have Moved to Waiver Services (per billing data) |
32 |
0 |
0 |
2 |
1,469 |
| 2a |
Subtotal Who Received CILA Services |
32 |
0 |
0 |
2 |
1,442 |
| 2b |
Subtotal Who Received HBS Services |
0 |
0 |
0 |
0 |
4 |
| 2c |
Subtotal Who Received CLF Services |
0 |
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). |
12,508 |
| 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 |
6,872 |
| 4 |
Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) |
6,767 |
| 5 |
Total Class Members Who Have Received Waiver Services (per billing data) |
6,276 |
| 5a |
-Subtotal Who Received CILA Services (per billing data) |
1,386 |
| 5b |
-Subtotal Who Received HBS Services (per billing data) |
5,278 |
| 5c |
-Subtotal Who Received CLF Services (per billing data) |
9 |
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 12/31/2022
Most recent CILA log, all persons currently in CILA
| Type of CILA |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Total |
| 24HR |
43 |
60 |
572 |
1,975 |
931 |
1,881 |
777 |
3,624 |
9,863 |
| Host Family |
45 |
199 |
35 |
7 |
0 |
0 |
0 |
0 |
286 |
| Intermittent* |
670 |
132 |
46 |
61 |
18 |
24 |
6 |
55 |
1,012 |
| Total |
758 |
391 |
653 |
2,043 |
949 |
1,905 |
783 |
3,679 |
11,161 |
Ligas Placements into CILA (from either an ICF/DD or from the PUNS list) as of 12/31/2022
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 |
12 |
113 |
532 |
186 |
276 |
87 |
836 |
2,048 |
| Host Family |
2 |
21 |
1 |
0 |
0 |
0 |
0 |
0 |
24 |
| Intermittent * |
157 |
13 |
6 |
10 |
4 |
1 |
2 |
4 |
197 |
| Total |
165 |
46 |
120 |
542 |
190 |
277 |
89 |
840 |
2,269 |
Crisis Placements in CILA as of 12/31/2022
Updates the last 6-month report with Crisis approvals from 7/1/2022 to 12/31/2022
| Type of CILA /Size of Home |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
Total |
| 24HR |
6 |
11 |
146 |
318 |
123 |
264 |
124 |
568 |
1,560 |
| Host Family |
11 |
39 |
3 |
0 |
0 |
0 |
0 |
0 |
53 |
| Intermittent * |
151 |
28 |
1 |
9 |
1 |
4 |
1 |
5 |
200 |
| Total |
168 |
78 |
150 |
327 |
124 |
268 |
125 |
573 |
1,813 |
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 as of 12/31/22 |
Cumulative Total to Date |
| 1 |
Total # of Crisis Requests Received |
304 |
293 |
251 |
190 |
112 |
4,045 |
| 2 |
Total # of Class Members Approved |
280 |
283 |
249 |
188 |
112 |
3,802 |
| 2a |
- # of Class Members Approved for CILA |
194 |
165 |
164 |
132 |
45 |
2,407 |
| 2b |
- # of Class Members Approved for HBS |
86 |
118 |
85 |
56 |
62 |
1,390 |
| 3 |
Total # of Class Members Who Received Services |
277 |
283 |
249 |
186 |
112 |
3,784 |
| 3a |
- # of Class Members Who Received CILA Services |
193 |
165 |
164 |
132 |
42 |
2,393 |
| 3b |
- # of Class Members Who Received HBS Services |
84 |
118 |
85 |
54 |
62 |
1,383 |
| 4 |
Total # of Class Members Denied Crisis Approvals |
24 |
10 |
2 |
2 |
0 |
243 |
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 |
FY21 |
FY22 |
FY23 |
Cumulative Total to date |
| 1 |
# of Agreements Initiated |
9 |
5 |
0 |
2 |
1 |
81 |
| 2 |
Total # Licensed Capacity |
127 |
164 |
0 |
115 |
16 |
1,609 |
| 3 |
Total # of People to Move |
91 |
127 |
0 |
83 |
14 |
1,300 |
| 3a |
-Moved to CILAs |
75 |
88 |
0 |
1 |
30 |
1,206 |
| 3b |
-Moved to HBS |
0 |
2 |
0 |
0 |
1 |
3 |
| 3c |
-Transferred to other ICFs/DD |
11 |
29 |
0 |
13 |
15 |
74 |
| 3d |
-Other |
5 |
8 |
0 |
3 |
6 |
55 |
| 3e |
-Move Pending |
0 |
0 |
0 |
24 |
0 |
0 |
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 as of 12/31/22 |
Cumulative Total to Date |
| 1 |
Total Class Members Appeals (Rows 2,3,4,5 = Row 1) |
32 |
25 |
31 |
15 |
539 |
| 1a |
Crisis Appeals |
3 |
1 |
2 |
1 |
185 |
| 1b |
Eligibility Appeals |
29 |
24 |
29 |
14 |
354 |
| 2 |
Subtotal Appeals Upheld |
7 |
7 |
4 |
3 |
162 |
| 3 |
Subtotal Appeals Denied |
18 |
9 |
20 |
4 |
302 |
| 4 |
Subtotal Appeals Pending |
1 |
2 |
7 |
8 |
17 |
| 5 |
Subtotal Appeals Withdrawn/Closed |
6 |
3 |
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 |
1,281 |
1,162 |
Total number of individuals who entered services from any PUNS selection
| Individuals who entered services from any PUNS selection |
FY20 |
FY21 |
FY22 |
FY23 as of 12/31/22 |
| # of Individuals |
602 |
708 |
764 |
359 |
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 |
9 |
FY24 |
| 59.99 months to 48 months |
15 |
FY24 |
| 47.99 months to 36 months |
1,054 |
FY24/FY25 |
| 35.99 months to 24 months |
1,154 |
FY25/FY26 |
| 23.99 months to 12 months |
1,547 |
FY26/FY27 |
| 11.99 months and less |
1,453 |
Beyond FY27 |
| Total |
6,119 |
|
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 as of 12/31/22 |
| Adult HBS to Intermittent CILA |
5 |
2 |
1 |
2 |
4 |
| Adult HBS to Family CILA |
2 |
4 |
6 |
0 |
0 |
| Adult HBS to Host Family CILA |
0 |
0 |
1 |
0 |
0 |
| Adult HBS to 24-Hour CILA |
27 |
56 |
67 |
55 |
48 |
| HBS to CILA Denials |
0 |
0 |
0 |
0 |
0 |
| HBS to CILA Appeals |
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 12/31/22.
| ISC |
Services Initiated |
Level II Complete/ Eligibility Confirmed |
Contact Made |
Stay ICF/DD |
Grand Total |
| CAU (Area B) |
0 |
8 |
25 |
4 |
37 |
| CISA (Area I) |
0 |
1 |
1 |
0 |
2 |
| CSO (Area C) |
0 |
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 12/31/22.
| ISC |
Services Initiated |
Level II Complete/Eligibility Confirmed |
Contact Made |
Stay ICFDD |
Grand Total |
| CAU (Area B) |
0 |
2 |
24 |
4 |
30 |
| CSO (Area C) |
0 |
0 |
1 |
0 |
1 |
| Prairieland (Area J) |
2 |
0 |
0 |
0 |
2 |
| SAI (Area D) |
0 |
1 |
0 |
0 |
1 |
| Service (Area A) |
0 |
4 |
1 |
2 |
7 |
| SICCS (Area L) |
0 |
1 |
0 |
0 |
1 |
| Grand Total |
2 |
8 |
26 |
6 |
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.
Ligas Estimated Cost
Projection updated December 2022
| Ligas Activities |
FY2019 |
FY2020 |
FY2021 |
FY2022 |
FY2023 Est. |
| PUNS Placements |
$120,979,448 |
$142,169,132 |
$170,266,255 |
$199,946,201 |
$249,509,523 |
| to CILA |
$47,062,776 |
$56,563,866 |
$69,140,993 |
$88,414,039 |
$113,950,192 |
| to HBSS |
$73,916,673 |
$85,605,266 |
$101,125,262 |
$111,532,162 |
$135,559,331 |
| Transitions from ICF/DD's |
$93,917,401 |
$101,492,568 |
$110,749,919 |
$129,070,490 |
$153,891,587 |
| to CILA |
$93,239,974 |
$100,812,701 |
$110,057,804 |
$128,422,862 |
$153,195,756 |
| to HBSS |
$677,427 |
$679,867 |
$692,115 |
$647,628 |
$695,831 |
| ISSA |
$6,232,266 |
$7,208,020 |
$8,592,405 |
$9,688,319 |
$10,605,392 |
| Other Costs |
$3,262,850 |
$4,074,546 |
$4,326,775 |
$4,963,785 |
$5,289,250 |
| Court Monitor |
$213,250 |
$243,135 |
$256,500 |
$284,850 |
$284,850 |
| HBSS Fiscal Agent |
$2,677,000 |
$3,084,300 |
$3,574,100 |
$4,205,400 |
$4,754,400 |
| Family Advocate Initiative |
$250,000 |
$250,000 |
$250,000 |
$250,000 |
$250,000 |
| Ligas Compliance Monitoring |
$101,203 |
$149,941 |
$0 |
$0 |
$0 |
| Ligas Training |
$21,397 |
$25,000 |
$0 |
$0 |
$0 |
| DD Scorecards |
$0 |
$43,920 |
$0 |
$0 |
$0 |
| Rate Study |
$0 |
$278,250 |
$246,175 |
$6,078 |
$0 |
| Person Centered Planning |
$0 |
$0 |
$0 |
$217,457 |
$0 |
| Total |
$224,391,965 |
$254,944,266 |
$293,935,354 |
$343,668,795 |
$419,295,752 |
| End of year Persons in Service: |
FY2019 |
FY2020 |
FY2021 |
FY2022 |
FY2023 Est. |
| PUNS Placements |
| PUNS to CILA |
840 |
946 |
1,071 |
1,155 |
1,250 |
| PUNS to HBSS |
3,140 |
3,631 |
4,260 |
4,964 |
5,500 |
| Subtotal |
3,980 |
4,577 |
5,331 |
6,119 |
6,750 |
| Transitions from ICF/DD's |
|
|
|
|
|
| ICFDD to CILA |
1,601 |
1,621 |
1,627 |
1,628 |
1,628 |
| ICFDD to HBSS |
27 |
27 |
27 |
27 |
27 |
| Subtotal |
1,628 |
1,648 |
1,654 |
1,655 |
1,655 |
| Total (all receive ISSA) |
5,608 |
6,225 |
6,985 |
7,774 |
8,405 |
| ICF/DD Bed Reduction |
FY2019 |
FY2020 |
FY2021 |
FY2022 |
FY2023 Est. |
| Beds Closed in FY |
44 |
16 |
5 |
- |
- |
| Cumulative Beds Closed |
1,015 |
1,031 |
1,036 |
1,036 |
1,036 |
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 |
FY2020 |
FY2021 |
FY2022 |
FY2023 Proj. |
| Cost in Millions |
*$287.2 |
$278.60 |
$285.70 |
$310.40 |
| $ Change from Prior Yr. |
|
($8.60) |
$7.10 |
$24.70 |
| Average Persons |
3,837 |
3,586 |
3,382 |
3,341 |
| Persons Change from Prior Yr. |
|
-251 |
-204 |
-41 |
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 Claims Accepted |
FY2020 |
FY2021 |
FY2022 |
FY2023 Est. |
| Adult Waiver Claims (millions) |
$852.30 |
$911.20 |
$912.30 |
$1,030.40 |
| $ Change from Prior Yr. |
|
$58.90 |
$1.10 |
$118.10 |
| Unduplicated Persons |
21,862 |
22,358 |
22,797 |
23,245 |
| Persons Change from Prior Yr. |
|
496 |
439 |
448 |
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 Est. |
| DD CILA Services Billings (millions) |
$784.30 |
$845.60 |
$935.80 |
$1,056.89 |
| $ Change from Prior Yr. |
|
$61.30 |
$90.20 |
$121.09 |
| Authorized CILA persons |
11,352 |
11,277 |
11,134 |
11,097 |
| Persons Change from Prior Yr. |
|
-75 |
-143 |
-37 |
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.
