LIGAS DATA REPORT - August 15, 2023

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 nineteenth Ligas Data Report, containing data from January 1, 2023, through June 30, 2023. 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
1 Living at Home 15,215 15,969 16,360 16,812 17,893
2 ICF/DD after 6/15/11 313 322 323 339 425
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 19,651

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 93
Individuals in Community Settings 1,753 1,709 1,574 1,662 1,790
Total Additions 1,823 1,724 1,591 1,684 1,883
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 89
Determined Clinically Ineligible 22 9 26 22 12
Determined Financially Ineligible 3 2 2 - 1
Withdrew-Reason Not Given 88 91 116 121 80
Individual Deceased 63 50 47 45 40
Objector - - - - -
Other 627 518 662 725 340
Incorrect SSN (Duplicate Record) 4 1 6 15 7
Ineligible Setting 3 - - - -
Unable to Locate Individual 290 208 239 175 141
Stay in ICFDD 13 4 2 3 1
Submitted in Error - - - - -
Move to ICFDD 36 11 10 11 6
Total Removals 1,253 969 1,207 1,217 717

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 Cumulative Total to Date
1 # of Class Members with Waiver Capacity Award Letters 31 0 1 4 1,472
2 *Total Class Members Who Have Moved to Waiver Services (per billing data) 32 0 0 3 1,471
2a Subtotal Who Received CILA Services 32 0 0 3 1,444
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 7,290
4 Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) 7,160
5 Total Class Members Who Have Received Waiver Services (per billing data) 7,070
5a -Subtotal Who Received CILA Services (per billing data) 1,416
5b -Subtotal Who Received HBS Services (per billing data) 5,642
5c -Subtotal Who Received CLF Services (per billing data) 12

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 06/30/2023
Most recent CILA log, all persons currently in CILA 

Type of CILA 1 2 3 4 5 6 7 8 Total
24HR 42 59 571 1,956 942 1,839 782 3,504 9,695
Host Family 46 189 36 2 0 0 0 0 273
Intermittent* 639 127 46 62 20 20 6 49 969
Total 727 375 653 2,020 962 1,859 783 3,553 10,937

Ligas Placements into CILA (from either an ICF/DD or from the PUNS list) as of 06/30/2023
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 12 114 525 193 286 82 813 2,031
Host Family 2 19 1 0 0 0 0 0 22
Intermittent * 151 13 6 11 4 1 2 4 192
Total 159 44 121 536 197 287 84 817 2,245

Crisis Placements in CILA as of 12/31/2022
Updates the last 6-month report with Crisis approvals from 01/01/2023 to 06/30/2023

Type of CILA /Size of Home 1 2 3 4 5 6 7 8 Total
24HR 6 12 147 321 123 267 125 578 1,579
Host Family 11 39 3 0 0 0 0 0 53
Intermittent * 153 28 1 9 1 4 1 5 202
Total 170 79 151 330 124 271 126 583 1,834

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 Cumulative Total to Date
1 Total # of Crisis Requests Received 304 293 251 190 202 3,911
2 Total # of Class Members Approved 280 283 249 188 201 3,671
2a - # of Class Members Approved for CILA 194 165 164 132 100 2,312
2b - # of Class Members Approved for HBS 86 118 85 56 101 1,354
3 Total # of Class Members Who Received Services 277 283 249 186 201 3,655
3a - # of Class Members Who Received CILA Services 193 165 164 132 100 2,301
3b - # of Class Members Who Received HBS Services 84 118 85 54 101 1,349
4 Total # of Class Members Denied Crisis Approvals 24 10 2 2 1 240

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 2 83
2 Total # Licensed Capacity 127 164 0 115 31 1,640
3 Total # of People to Move 91 127 0 83 28 1,328
3a -Moved to CILAs 75 88 0 1 0 1,206
3b -Moved to HBS 0 2 0 0 0 3
3c -Transferred to other ICFs/DD 11 29 0 13 0 74
3d -Other 5 8 0 3 0 55
3e -Move Pending 0 0 0 24 28 52

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 Cumulative Total to Date
1 Total Class Members Appeals (Rows 2,3,4,5 = Row 1) 32 25 31 25 549
1a Crisis Appeals 3 1 2 1 185
1b Eligibility Appeals 29 24 29 24 364
2 Subtotal Appeals Upheld 7 7 4 4 163
3 Subtotal Appeals Denied 18 9 20 10 309
4 Subtotal Appeals Pending 1 2 7 11 19
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 1,272 1,221

Total number of individuals who entered services from any PUNS selection

Individuals who entered services from any PUNS selection FY20 FY21 FY22 FY23
# of Individuals 602 708 764 759

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 42 FY24
59.99 months to 48 months 353 FY24/FY25
47.99 months to 36 months 1,210 FY25/FY26
35.99 months to 24 months 1,360 FY26/FY27
23.99 months to 12 months 1,499 FY27/FY28
11.99 months and less 1,756 FY28/FY29
Total 6,220

 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
Adult HBS to Intermittent CILA 5 2 1 2 7
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 66
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 06/30/23.

ISC Services Initiated Level II Complete/ Eligibility Confirmed Contact Made Stay ICF/DD Grand Total
CAU (Area B) 1 7 25 4 37
CISA (Area I) 0 1 0 1 2
CSO (Area C) 1 0 0 0 1
Prairieland (Area J) 2 1 0 0 3
Prairieland (Area K) 1 1 0 0 2
SAI (Area D) 0 1 0 2 3
Service (Area A) 0 2 1 4 7
SICCS (Area L) 0 0 0 1 1
Grand Total 5 13 26 12 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) 1 0 0 0 1
Prairieland (Area J) 2 0 0 0 2
SAI (Area D) 0 1 0 0 1
Service (Area A) 0 2 1 4 7
SICCS (Area L) 0 0 0 1 1
Grand Total 3 5 25 9 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.

Housing Related Efforts: Housing Navigator Pilot

In efforts to assist individuals with developmental disabilities in finding affordable housing options, the Division of Developmental Disabilities in partnership with the Illinois Council on Developmental Disabilities is overseeing a Housing Navigator project. The Independent Service Coordination Agency Housing Navigator position was created to cultivate and pursue community-based, independent housing options for people with DD who are already in the waiver and those newly selected from the PUNS list. The key activities of the ISC Housing Navigator are to cultivate landlord and affordable housing relationships across various communities and to identify housing stock. In addition, the Housing Navigator will work with individuals with DD and their families to maintain a localized list of people interested in independent supportive housing as an option to ultimately make the match between independent housing options and people with DD.

Housing Navigator Summary

- FY23 (as of 4/30/23)
Referred 217+
Enrolled 194+
Applied to Non-SRN Housing 40+
Enrolled in SRN 167+
Ineligible for SRN 38+
Housed 26+
Outreach Contacts to Housing Owners 90+

* Notes: Data should be seen as a "snapshot" as opposed to actual reporting (which is not uniform yet). Please note May and June data has not yet been reported.

Supported Employment Program

DDD has implemented, and will continue to directly monitor, an efficient and clear process for Medicaid Waiver funded individuals, including Class Members, to request and revalidate DDD Supported Employment Program (SEP) funding. This process involves persons receiving services and supports, the Independent Service Coordination entity and DDD. All requests are directly reviewed by the DDD Supported Employment Administrator.

DDD SEP Administration:

  • Allows individuals to obtain and sustain long term employment supports once DRS funding has been successfully exhausted (DDD SEP Individual) or when DRS successful outcome is not necessary (DDD SEP Group); and
  • Ensures alignment with the Medicaid Waiver and the HCBS Settings Rule; and
  • Maximizes likelihood of appropriate implementation of supports to all eligible individuals.

Annual Revalidation of all DDD SEP Awards was completed by the end of FY23. All individuals currently authorized for DDD SEP were eligible.

Type of Request Revalidation Requests Submitted Revalidation Requests Approved
Individual 253 236
Group 146 108
Both 4 4
Total 403 348

Notes: Approval Percentage for FY23 is 86%, which is higher than FY22 Revalidation (83%). The rationale for denial of Revalidations: 1) DDD SEP Group Location is Provider Controlled, Owned or Operated; 2) Improper Request (missing data or not currently authorized).

Revalidation Data

- FY23
Average Age of DDD SEP Recipient 47
Average Hourly Wage $14.18
Average Hours Worked per Month 54
Average Percentage of Hours of Work Supported by DDD SEP 56%
DDD SEP Recipients with Multiple Jobs 29
Average Annualized Pre-tax Earnings $9,260.78

FY23 Revalidation Request by Independent Service Coordination (ISC) Agency

ISC Agency Number of Request Received Percentage of Total Request
Central Illinois Service Access 34 8%
Champaign County Regional Planning Commission 39 10%
Community Alternatives Unlimited 113 28%
Community Service Options 53 12%
Prairieland Service Coordination Inc 57 14%
Service Inc 60 15%
Southern Illinois Case Coordination Services 11 3%
Suburban Access 28 7%
No ISC Oversight 3 1%
Unknown 5 1%

Ligas Estimated Cost

Projection updated June 2023

Ligas Activities FY2019 FY2020 FY2021 FY2022 FY2023 Est. FY2024 Proj.
PUNS Placements $120,979,448 $142,169,132 $170,266,255 $206,235,879 $273,621,575 $332,252,567
to CILA $47,062,776 $56,563,866 $69,140,993 $88,414,039 $120,564,755 $156,580,185
to HBSS $73,916,673 $85,605,266 $101,125,262 $111,532,162 $153,056,820 $175,672,381
Transitions from ICF/DD's $93,917,401 $101,492,568 $110,749,919 $129,070,490 $162,780,811 $197,457,217
to CILA $93,239,974 $100,812,701 $110,057,804 $128,422,862 $162,013,174 $196,665,246
to HBSS $677,427 $679,867 $692,115 $647,628 $767,637 $791,971
ISSA $6,232,266 $7,208,020 $8,592,405 $9,688,319 $15,065,302 $16,505,889
Other Costs $3,262,850 $4,074,546 $4,326,775 $4,963,785 $5,398,550 $5,951,650
Court Monitor $213,250 $243,135 $256,500 $284,850 $284,850 $284,850
HBSS Fiscal Agent $2,677,000 $3,084,300 $3,574,100 $4,205,400 $4,863,700 $5,416,800
Family Advocate Initiative $250,000 $250,000 $250,000 $250,000 $250,000 $250,000
Ligas Compliance Monitoring $101,203 $149,941 $0 $0 $0 $0
Ligas Training $21,397 $25,000 $0 $0 $0 $0
DD Scorecards $0 $43,920 $0 $0 $0 $0
Rate Study $0 $278,250 $246,175 $6,078 $0 $0
Person Centered Planning $0 $0 $0 $217,457 $0 $0
Total $224,391,965 $254,944,266 $293,935,354 $350,123,740 $456,866,237 $552,167,324
End of year Persons in Service: FY2019 FY2020 FY2021 FY2022 FY2023 Est. FY2024 Proj.
PUNS Placements
PUNS to CILA 841 947 1,072 1,162 1,243 1,338
PUNS to HBSS 3,140 3,631 4,260 4,984 5,700 6,236
Subtotal 3,981 4,578 5,332 6,146 6,943 7,574
Transitions from ICF/DD's
ICFDD to CILA 1,601 1,621 1,627 1,628 1,631 1,631
ICFDD to HBSS 27 27 27 27 27 27
Subtotal 1,628 1,648 1,654 1,655 1,658 1,658
Total (all receive ISSA) 5,609 6,226 6,986 7,801 8,601 9,232
ICF/DD Bed Reduction FY2019 FY2020 FY2021 FY2022 FY2023 Est. FY2024 Proj.
Beds Closed in FY 44 16 5 - - -
Cumulative Beds Closed 941 957 962 962 962 962

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 is described below:

Overall spending for the DDLTC System FY2020 FY2021 FY2022 FY2023 Est. FY2024 Proj.
Cost in Millions *$287.2 $279.00 $289.30 $310.20 $337.80
$ Change from Prior Yr. ($8.20) $10.30 $20.90 $27.60
Average Persons 3,837 3,588 3,444 3,321 3,321
Persons Change from Prior Yr. -249 -104 -123 0

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 "Accepted Claims" is described below:

Adult Waiver Claims Accepted FY2020 FY2021 FY2022 FY2023 Est. FY2024 Proj.
Adult Waiver Claims (millions) $852.30 $911.20 $1,006.90 $1,228.20 $1,486.12
$ Change from Prior Yr. $58.90 $95.70 $221.30 $257.92
Unduplicated Persons 21,862 22,358 22,728 23,128 23,428
Persons Change from Prior Yr. 496 370 400 300

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. FY2024 Proj.
DD CILA Services Billings (millions) $784.30 $845.60 $935.80 $1,089.80 $1,285.96
$ Change from Prior Yr. $61.30 $90.20 $154.00 $196.16
Authorized CILA persons 11,352 11,277 11,134 11,006 11,094
Persons Change from Prior Yr. -75 -143 -128 88

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.