Ligas Data Report as of 6/30/24 (Issued 8/19/24)

Ligas Data Report as of June 30, 2024

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 twenty first Ligas Data Report, containing data from Jan 1, 2024, through June 30, 2024. 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 Member Information FY19 FY20 FY21 FY22 FY23 FY24
1 Living at Home 15,215 15,969 16,360 16,812 17,893 19,106
2 ICF/DD after 6/15/11 313 322 323 339 425 478
3 ICF/DD on 6/15/11 with an Affirmative Statement to Move 1,351 1,343 1,335 1,334 1,333 1,331
3a -DD PAS 10 9 9 9 9 9 9
3b -DHS 1243/1238 952 947 941 940 940 939
3c -EFE Form 168 166 165 165 165 165
3d -OSG Request 202 201 200 200 199 198
3e -Other Guardian Request 20 20 20 20 20 20
4 # At End of the Fiscal Year 16,879 17,634 18,018 18,485 19,651 20,915

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 Additions in FY24
Individuals in ICFs/DD on 6/15/11 - - - - - -
Individuals in ICF/DDs after 6/15/11 70 15 17 22 93 62
Individuals in Community Settings 1,753 1,709 1,574 1,662 1,790 1,857
Total Additions 1,823 1,724 1,591 1,684 1,883 1,919
Removals Removals in FY19 Removals in FY20 Removals in FY21 Removals in FY22 Removals in FY23 Removals in FY24 
Individual Moved Out of State 104 75 97 100 89 76
Determined Clinically Ineligible 22 9 26 22 12 6
Determined Financially Ineligible 3 2 2 - 1 2
Withdrew-Reason Not Given 88 91 116 121 80 95
Individual Deceased 63 50 47 45 40 21
Objector - - - - - -
Other 627 518 662 725 340 256
Incorrect SSN (Duplicate Record) 4 1 6 15 7 21
Ineligible Setting 3 - - - -
Unable to Locate Individual 290 208 239 175 141 166
Stay in ICFDD 13 4 2 3 1 1
Submitted in Error - - - - - -
Move to ICFDD 36 11 10 11 6 11
Total Removals 1,253 969 1,207 1,217 717 655

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. Please note these figures do not include ICF/DD residents who entered an ICF/DD after June15, 2011, or who declined to transition under Ligas, and who are utilizing PUNS to transition to Community-Based Services.

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 FY24 Cumulative Total to Date
1 # of Class Members with Waiver Capacity Award Letters 31 0 1 4 0 1,472
2 *Total Class Members Who Have Moved to Waiver Services (per billing data) 32 0 0 4 0 1,472
2a Subtotal Who Received CILA Services 32 0 0 4 0 1,445
2b Subtotal Who Received HBS Services 0 0 0 0 0 *24
2c Subtotal Who Received CLF Services 0 0 0 0 0 3

 Notes:

  • The above data includes individuals who moved/are moving due to ICF/DD downsizing and closure agreements.
  • *The Cumulative Total to Date for 2b has incorrectly been reported as 4 on previous reports. This data has been reviewed and reported correctly as of this report.

Services for Class Members from the Waiting List

Thirteen 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. A set of tables is maintained on the Division's website that provides PUNs Selection Summary Information regarding the results of the selections.

- Ligas Benchmarks Total
1 # of Class Members Selected from the Waiting List (PUNS) 13,850
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 8,027
4 Total Class Members Who Have Received Waiver Services (as reported by the PAS agencies and providers) 7,962
5 Total Class Members Who Have Received Waiver Services (per billing data) 7,885
5a -Subtotal Who Received CILA Services (per billing data) 1,502
5b -Subtotal Who Received HBS Services (per billing data) 6,368
5c -Subtotal Who Received CLF Services (per billing data) 15

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 6/30/2024

Most recent CILA log, all persons currently in CILA

Type of CILA 1 2 3 4 5 6 7 8 Total
24HR 46 58 599 1,976 1022 1,882 807 3,386 9,776
Host Family 41 187 29 2 0 0 0 0 259
Intermittent* 608 138 47 53 15 23 5 47 936
Total 695 383 675 2,031 1,037 1,905 812 3,433 10,971

Ligas Placements into CILA (from either an ICF/DD or from the PUNS list) as of 6/30/2024

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 12 142 558 219 334 103 833 2,207
Host Family 2 23 0 0 0 0 0 0 25
Intermittent * 151 20 9 10 3 6 2 3 204
Total 159 55 151 568 222 340 105 836 2,436

Crisis Placements in CILA as of 6/30/24

Updates the last 6-month report with Crisis approvals from 1/1/2024 to 6/30/2024.

Type of CILA 1 2 3 4 5 6 7 8 Total
24HR 0 3 4 24 4 12 2 25 74
Host Family 1 2 3 4 5 6 0 8 29
Intermittent * 7 13 140 548 215 318 96 861 2,198
Total 8 18 147 576 224 336 98 894 2,301

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.

- - FY19 FY20 FY21 FY22 FY23 FY24 Cumulative Total to Date
1 Total # of Crisis Requests Received 304 293 251 190 202 186 4,097
2 Total # of Class Members Approved 280 283 249 188 201 186 3,857
2a -# of Class Members Approved for CILA 194 165 164 132 100 108 2,420
2b -# of Class Members Approved for HBS 86 118 85 56 101 78 1,432
3 Total # of Class Members Who Received Services 277 283 249 186 201 184 3,839
3a -# of Class Members Who Received CILA Services 193 165 164 132 100 108 2,409
3b -# of Class Members Who Received HBS Services 84 118 85 54 101 *76 1,425
4 Total # of Class Members Denied Crisis Approvals 24 10 2 2 1 0 240

 Notes:

  • The Total # of Crisis Request Received (1) reflects Class Members in crisis and for whom a packet was submitted for DDD Waiver services. This number does not include people who temporarily go into an ICF/DD or SODC but still want crisis services- this data is reported separately. SODC report is done on a monthly basis and interim ICF/DD placement report is done on a quarterly basis.
  • *In FY24 (7/1/23-12/31/23) two Class Members were approved for AHBS (2b) but did not begin services (3b). One Class Member chose to remain in a Mental Health facility and is receiving therapy and learning coping skills while the facility is adjusting his medications. The other Class Member remains at home with the family and was deciding between AHBS, CILA and a provider.
  • The Total # of Class members Who Received Services (#3) was incorrectly reported as 83 on the previous report; this should've been 85. This has been corrected on this report, along with the Cumulative Total to Date.


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.

- Closure/Downsizing Agreements FY19 FY20 FY21 FY22 FY23 FY24 Cumulative Total to Date
1 # of Agreements Initiated 9 5 0 2 2 4 87
2 Total # Licensed Capacity 127 164 0 115 31 61 1,701
3 Total # of People to Move 91 127 0 83 28 44 1,372
3a -Moved to CILAs 75 88 0 1 0 14 1,220
3b -Moved to HBS 0 2 0 0 0 0 3
3c -Transferred to other ICFs/DD 11 29 0 13 0 0 74
3d -Other 5 8 0 3 0 2 57
3e -Move Pending 0 0 0 24 28 16 80

 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.

- - FY20 FT21 FY22 FY23 FY24 Cumulative Total
1 Total Class Members Appeals (Rows 2,3,4,5 = Row 1) 32 25 31 25 19 568
1a Crisis Appeals 3 1 2 1 1 186
1b Eligibility Appeals 29 24 29 24 18 382
2 Subtotal Appeals Upheld 7 7 4 4 3 172
3 Subtotal Appeals Denied 18 9 21 10 11 327
4 Subtotal Appeals Pending 1 2 6 11 5 11
5 Subtotal Appeals Withdrawn/Closed 6 3 0 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 included 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 letters

PUNS Selection Date Number of Selection Letters Sent Contact Made
8/12/19 1,251 1,234
7/12/20 1,561 1,548
7/12/21 1,596 1,563
7/11/22 1,272 1,221
7/18/23 1,342 1,255

Total number of individuals who entered services from any PUNS selection.

- FY20 FY21 FY22 FY23 FY24
# of Individuals 602 708 806 759 732

Adults on PUNS Seeking Services as of 6/30/24.

Time Waiting while Seeking Services as of June 30, 2024 Persons Est. FY for Services
Over 60 months 362 FY25
59.99 months to 48 months 1,132 FY25
47.99 months to 36 months 1,154 FY25FY26
35.99 months to 24 months 1,379 *FY26/FY27
23.99 months to 12 months 1,608 *FY27/FY28
11.99 months and less 1,735 *FY28/FY29
Total 7,320

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 FY21 FY22 FY23 FY24
Adult HBS to Intermittent CILA 5 2 1 2 7 11
Adult HBS to Family CILA 2 4 6 *0 *0 *0
Adult HBS to Host Family CILA 0 0 1 0 0 0
Adult HBS to 24-Hour CILA 27 56 67 55 66 122
HBS to CILA Denials 0 0 0 0 0 0
HBS to CILA Appeals 0 0 0 0 0 0

Note: *As of January 1, 2022, Family CILA (displayed on previous reports) has been rolled into Intermittent CILA.


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 6/30/24.

ISC Services Initiated Level II Complete/ Eligibility Confirmed Contact Made Stay ICF/DD Deceased Grand Total
CAU - B 1 6 24 4 2 37
CISA - I 0 1 0 1 0 2
CSO - C 1 0 0 0 0 1
PSC - J 3 0 0 0 0 3
PSC - K 0 2 0 0 0 2
SAI - D 0 1 0 2 0 3
Service - A 0 2 0 5 0 7
SICCS - L 0 0 0 1 0 1
Grand Total 5 12 24 13 2 56

Of the 56 individuals above, 42 are under the guardianship of the Office of State Guardian. Below is the status of the 42 as of 6/30/24.

ISC Services Initiated Level II Complete/ Eligibility Confirmed Contact Made STAY ICF/DD Deceased Grand Total
CAU 0 1 23 4 2 30
CSO 1 0 0 0 0 1
PSC-J 2 0 0 0 0 2
SAI 0 1 0 0 0 1
SERVICE-A 0 2 0 5 0 7
SICCS 0 0 0 1 0 1
Grand Total 3 4 23 10 2 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

Status FY23 FY24
Referred 242 187
Enrolled 237 *297
Applied to Non-SRN Housing 10 19
Enrolled in SRN 175 265 (Actively enrolled)
Ineligible for SRN 22 56
Housed 31 82 (To date)
Outreach Contacts to Housing Owners 90+ 178

 Note:

  • Data should be seen as a "snapshot" as opposed to actual reporting (which is not uniform yet). Some people housed might still be considered enrolled so the Navigator can maintain contact. The number of people who fall in the "Ineligible for SRN" is decreasing due to better income screening ahead of time.
  • *At the peak of the year there were 329 enrolled. Over the past 6 months, 86 people decided not to move forward with Navigation after either being screened or were enrolled and requested to un-enroll.


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. As of 1/1/24, DDD SEP services and supports are available to residents of Illinois State Operated Developmental Centers (SODC) as well.

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.

FY24 New/Initial Authorizations

Type of Request Submitted Approved
Individual 81 69
Group 59 52
Both 0 0
Total 140 121

Annual Revalidation. Annual Revalidation of all DDD SEP Awards was completed by the end of FY24. All individuals previously authorized for DDD SEP were eligible.

Type of Request Submitted Approved
Individual 241 229
Group 97 95
Both 4 4
Total 342 328

Notes:

  • The rationale for denial of New/Initial Authorizations includes ineligibility, lapsed timeframes, and missing or erroneous information/forms. Individuals can reapply if eligibility criteria are met.
  • The rationale for denial of Revalidations includes DDD SEP Group Location is Provider Controlled, Owned or Operated; Improper Request (missing data or not currently authorized).

Revalidation Data

Data Set FY23 FY24
Average Age of DDD SEP Recipient 47 47
Average Hourly Wage $14.18 $14.75
Average Hours Worked per Month 54 53
Average Percentage of Hours of Work Supported by DDD SEP 56% 56%
DDD SEP Recipients with Multiple Jobs 29 41
Average Annualized Pre-tax Earnings $9,260.78 $9,557.64

FY24 Revalidation Request by Independent Service Coordination (ISC) Agency (received request in FY23 for services in FY24).

ISC Agency Number of Request Received Percentage of Total Request
Central Illinois Service Access 38 11%
Champaign County Regional Planning Commission 39 10%
Community Alternatives Unlimited 103 30%
Community Service Options 23 7%
Prairieland Service Coordination Inc 74 22%
Service Inc 66 19%
Southern Illinois Case Coordination Services 17 5%
Suburban Access 19 6%
No ISC Oversight 2 6%
Unknown 5 1%


Ligas Estimated Cost

Projection updated 6/30/24

- FY2019 FY2020 FY2021 FY2022 FY2023 FY2024 Est FY2025 Proj
PUNS Placements $121,038,545 $142,231,381 $170,000,148 $206,240,421 $276,437,992 $342,831,145 $402,044,285
to CILA $47,121,873 $56,626,115 $69,208,652 $88,707,153 $123,208,718 $159,469,094 $182,452,122
to HBSS $73,916,673 $85,605,266 $100,791,496 $117,533,268 $153,229,274 $183,362,051 $219,592,163
Transitions from ICF/DD's $93,917,401 $101,492,568 $110,747,730 $129,225,034 $166,279,832 $202,549,582 $218,376,183
to CILA $93,239,974 $100,812,701 $110,057,804 $128,544,614 $165,512,195 $201,737,330 $217,490,751
to HBSS $677,427 $679,867 $689,927 $680,419 $767,637 $812,252 $885,432
ISSA $6,233,433 $7,209,232 $8,593,704 $9,696,159 $15,076,333 $16,679,259 $18,865,091
Other Costs $3,262,850 $4,074,545 $4,326,775 $4,967,085 $5,402,950 $6,063,650 $6,599,050
Court Monitor $213,250 $243,135 $256,500 $284,850 $284,850 $305,850 $305,850
HBSS Fiscal Agent $2,677,000 $3,084,300 $3,574,100 $4,208,700 $4,868,100 $5,507,800 $6,043,200
Family Advocate Initiative $250,000 $250,000 $250,000 $250,000 $250,000 $250,000 $250,000
Ligas Compliance Monitoring $101,203 $149,941 $0 $0 $0 $0 $0
Ligas Training $21,397 $25,000 $0 $0 $0 $0 $0
DD Scorecards $43,920 $0 $0 $0 $0 $0
Rate Study $278,250 $246,175 $6,078 $0 $0 $0
Person Centered Planning $0 $0 $217,457 $0 $0 $0
Total $224,452,229 $255,007,726 $293,668,357 $350,128,699 $463,197,107 $568,123,636 $645,884,609
End of year Persons in Service: FY2019 FY2020 FY2021 FY2022 FY2023 FY2024 Est FY2025 Proj
PUNS Placements
PUNS to CILA 841 947 1,072 1,162 1,243 1,315 1,410
PUNS to HBSS 3,140 3,631 4,260 4,985 5,717 6,397 6,933
Subtotal 3,981 4,578 5,332 6,147 6,960 7,712 8,343
Transitions from ICF/DD's
ICFDD to CILA 1,601 1,621 1,627 1,628 1,631 1,631 1,631
ICFDD to HBSS 27 27 27 27 27 27 27
Subtotal 1,628 1,648 1,654 1,655 1,658 1,658 1,658
Total (all receive ISSA) 5,609 6,226 6,986 7,802 8,618 9,370 10,001
ICF/DD Bed Reduction FY2019 FY2020 FY2021 FY2022 FY2023 FY2024 Est FY2025 Proj
Beds Closed in FY 99 56 71 46 66 39 18
Cumulative Beds Closed 1,159 1,215 1,286 1,332 1,398 1,437 1,455

Notes:

  • The estimated amounts are anticipated spending based on approved appropriations for the current fiscal year. The projected amounts are anticipated spending not yet appropriated.
  • ICFDD Bed Reduction is based on client discharge date (i.e. Fiscal Year) for ICFDD facilities with downsizing agreements. Revised July, 2024.

Additional Budget Related Information

DD Long Term Care Service System Cost

Overall spending for the DDLTC System is described below:

- FY20 FY21 FY22 FY2023 FY2024 Est. FY2025 Proj.
Cost in Millions *$287.2 $279.00 $289.50 $308.20 $342.60 $368.30
$ Change from Prior Yr. ($8.20) $10.50 $18.70 $34.40 $25.70
Average Persons 3,837 3,588 3,446 3,332 3,257 3,316
Persons Change from Prior Yr. -249 -142 -114 -75 59

Source: Est. Liability per HFS Reports DHS Budget Office.

Note: *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:

- FY2020 FY2021 FY2022 FY2023 FY2024 Est. FY2025 Proj.
Adult Waiver Claims (millions) $852.30 $911.20 $1,033.00 $1,262.00 $1,428.40 $1,539.20
$ Change from Prior Yr. $58.90 $121.80 $229.00 $166.40 $110.80
Unduplicated Persons 21,862 22,358 22,740 23,210 23,674 24,148
Persons Change from Prior Yr. 496 382 470 464 474

Notes:

  • 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 (Cl Type C) is described below:

- FY2020 FY2021 FY2022 FY2023 FY2024 Est. FY2025 Proj.
DD CILA Services Billings (mil) $784.30 $845.60 $934.60 $1,079.30 $1,288.40 $1,400.70
$ Change from Prior Yr. $61.30 $89.00 $144.70 $209.10 $112.30
Authorized CILA persons 11,352 11,277 11,134 11,006 10,990 11,072
Persons Change from Prior Yr. -75 -143 -128 -16 82



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.

In 2023, the Illinois Department of Human Services (IDHS) and the Division of Developmental Disabilities (DDD) engaged in ongoing and further analysis related to the CILA Rate Calculator, including collaboration with rate consultant, Guidehouse, Inc. and the Ligas Rates Oversight Committee to ensure that the implementation of all components of the CILA Rate Calculator are accurate and reflective of the most appropriate level of care needed for each individual who receives CILA services. The FY25 budget includes funding to ensure that there is not a decrease in DSP hours based on the agreed upon 28.6 million hours, adding an DSP hours adjustment factor to the rate in FY25. IDHS and DDD has communicated weekly to stakeholders through DDD Communications and anticipates holding office hours and other education for providers on the rate calculator including the adjustment factor. IDHS-DDD will provide ongoing updates regarding the work with Guidehouse.

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 fourth homes in 2023, bringing the current total capacity to 32 to beds. Additionally, in 2024, out of a recognized need for increased female supports, a second female home was dedicated to the program, allowing female supports to be provided by each respective agency.

The DDD is working on formalizing internal and external documents which include, but are not limited, the following: originating provider manual and stabilization home provider manual. DDD is working in conjunction with the procurement office to establish a process of applying to be a long-term stabilization home provider, potentially increase the number of short-term stabilization home providers, and a transitional home provider.

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.

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.