DDD COMMUNICATION | December 19, 2024

HAPPY HOLIDAYS FROM DDD!

Dear DDD Community,

I am honored to send a message of wholesome appreciation for the year that we have had together. As I reflect on 2024, I am thrilled by the efforts to expand services, grow opportunities for engagement of individuals with lived expertise and their families, and increase the quality of the services offered across the system. Your efforts to provide substantial services and supports to the individuals so they can live lives of their choosing never ceases to amaze me. Each and every individual receiving services, family of individuals served, ISC, trade and advocacy association, provider agency, DDD staff, and stakeholder is so incredibly appreciated.

Here are just a few of our accomplishments and milestone moments from 2024:

Continued implementation of the Guidehouse Rate Study recommendations focused on those individuals living in Community Integrated Living Arrangement (CILA) including:
1. The successful roll out of the new Guidehouse rate methodology July 1, 2024.
2. Updated Inventory for Client & Agency Planning (ICAP) and Health Risk Screening Tool (HRST) assessments, some of which were more than 10 years old, for all people in CILA July 1, 2024.
3. Annualization of the FY24 $2.50/hour DSP wage increase (waiver and Intermediate Care Facility (ICF)), regionalization of Community Day Services (CDS)
4. $1/hour wage increase included in the FY25 approved budget (effective 1/1/25 or upon federal Center for Medicaid & Medicare Services (CMS) approval)
State Operated Development Center (SODC) Transformation continued including:
1. Significant movement on the Camera Project (SODCs have added over 300 cameras, and nearly 400 in process)
2. Completion of 11 grand round trainings, with 100% representation of clinical teams.
3. Completed identification and hiring of Safety Officers at the SODCs
4. Partnerships with Southern Illinois University, Equip for Equality and the Illinois League of Advocates for the Developmentally Disabled (ILADD) among other stakeholders
5. Transition of over 50% of identified Choate residents to least restrictive or desired environments.
6. The Reintegration Funding Program was developed and announced which offers $50,000 reintegration funding over two years to ensure the support for transition of individuals in Home and Community Based Services (HCBS) services in the community. Funding begins January 1, 2025.
$5 million to providers to fund de-escalation training for frontline staff and provider trainers was rolled out in November 2024, offering $16,500 per CILA and CDS provider to increase capacity to support individuals with higher behavioral needs in the community.
IDHS Division of Rehabilitation Services (DRS) and DDD in partnership with many community advocates and the Illinois Council on Developmental Disabilities to encourage the passage of the Dignity in Pay (HB 793) legislation in November, moving Illinois towards elimination of subminimum wage in five years. Included in this effort is:
1. An increase in the small group supported employment rate of 40% on the wage rate (effective January 1, 2025, or upon approval by CMS).
2. An increase in the Personal Needs Allowance for individuals living in CILA beginning January 1, 2025, from $60 to $100 monthly.
3. Development of a notice of funding opportunity of $2 million for providers who currently hold a 14(c) subminimum wage certificate to expand their business model to provide alternatives to subminimum wage. This following the completion of an initial two-year grant This following the completion of an initial two-year grant that offered direct funding, training and technical assistance for organizations to transition to program models which support Competitive Integrated Employment.
The Stabilization Home program
1. Provided services to 79 individuals in crisis
2. Accepted 55 new admissions
3. Transitioned 94% of individuals served back into the community including successfully diverting 13 individuals who wanted to remain in the community but did not have a home and would have otherwise entered an SODC
Support Services Team (SST)
1. Referrals were increased to 9% this calendar year resulting in a total of 609 new individuals served.
2. A total of 1340 individuals were supported this year
3. 10,277 people attended the 24 bi-monthly workshops that provide education on behavior and mental health related topics
Nearly $12 million has been approved and/or vouchered for Community Day Ser providers to boost their recruitment and retention efforts for direct care and non-administrative staff.
The Housing Navigator program saw successes too.
1. There were 158 individuals referred to the program
2. 112 individuals were entered into the Statewide Referral Network (SRN) or other community-based affordable/public housing
3. and 26 individuals moved into their own home
59 ILCS 120 (Rule 120), which oversees all Division of Developmental Disability (DDD) HCBS waivers, was finalized after 20 years. The last update was in 1998. This was a huge endeavor which included stakeholder meetings, feedback and responses from many different advocacy and provider organizations, and discussions with Joint Committee on Administrative Rule (JCAR). A huge thanks to the DD Regulatory Advisory Board members for their efforts in seeing this Rule updated. It followed the massive update of Rule 115, the CILA rule, in FY23.

Your individual daily contributions have been vital to our collective success. We could not do this without you. May your holiday season be filled with joy,

Tonya Piephoff - Director, IDHS Division of Developmental Disabilities

IRA L. COLLINS; CONDOLENCES

The Division wishes to honor the memory of the late Ira L. Collins. He served the community of people with disabilities since 1956 in multiple states. Ira worked with IDHS Department of Mental Health and Developmental Disabilities (DMHDD) from 1970-retirement in State Operated Development Centers and as a Deputy Director of DMHDD. Ira played a large role in the Special Olympics and other community functions. Memorial, obituary, and service information is here: Ira L Collins Obituary - Visitation & Funeral Information

WAIVER AMENDMENT APPROVED

DDD has been notified that the Centers for Medicare and Medicaid Services (CMS) has approved the Adults with Developmental Disabilities Wavier Amendment. This amendment includes the FY25 wage increases, the establishment of a new Specialty Telehealth and Assessment Team (STAT) service, and the increase in small group supported employment rates. Look for upcoming information bulletins for more information on the implementation of these changes.

DIGITAL SIGNATURES

In order to be compliant with Rule 115, the DDD will only accept electronic signatures that are compliant with Rule 115.320(h). For example, nursing assessments in a Microsoft Word document with a typed signature will not be accepted. The Nurse Trainer must use a wet signature, or an electronic signature inserted with a compliant electronic system similar to DocuSign. Similarly, the Notice of Deficiency document that provides the level and compliance score for a provider during a Bureau of Licensure and Accreditation Survey (BALC) would also require a wet signature or an electronic signature that is compliant with Rule 115.

LEGISLATIVE CHANGES

There are a number of legislative changes that will be taking place in the new year. DDD will continue to share clarifications and information bulletins in January.

Medication Administration (SB 0860): Illinois General Assembly- Bill Status for SB0860

This legislation will make changes to the current Medication Administration Rule 116 in the following ways:

As a result of this legislation, DDD is excited to announce that the competency-based training and assessment (CBTA) process for Rule 116 will be streamlined. There is a change in how to complete the initial CBTA for an authorized direct support professional (ADSP) as well as subsequent CBTAs for new individuals served and medication changes. Once an ADSP is authorized, subsequent CBTAs for new individuals served, or new medications, will no longer be automatically required. An information bulletin will be released in the new year.
It allows insulin pumps to be used within the CILA setting and changes.
1. Individuals will be required to be independent with their insulin pump.
2. Providers will be required to have policies and procedures for assessing for independence with insulin pumps in place prior to the use of an insulin pump. Information bulletin to follow.
Non-insulin injectable treatments (via pre-filled pen or auto-injectors) used for metabolic glycemic disorders (GLP-1 receptor agonists) will be allowed to be given by ADSPs after training. Information bulletin to follow in the new year.

A DRAFT information bulletin (IB) has been posted regarding insulin pump usage. The DRAFT IB can be accessed here: IDHS: DRAFT - Insulin Pump Management in CILA Waiver Settings. This DRAFT IB is available for comments through January 2, 2025.

To view all Draft IBs, you may do so here: IDHS: DDD Draft Information Bulletins

Dignity in Pay (HB 793): Illinois General Assembly - Bill Status for HB0793

During veto session, Dignity in Pay, HB 793, successfully passed and outlined the process to end the funding of subminimum wage in Illinois over a five-year period. Included in this legislation is the following:

An increase in the small group supported employment rate of 40% on the wage rate (effective January 1, 2025, or upon approval by CMS).
An increase in the Personal Needs Allowance for individuals living in CILA beginning January 1, 2025, from $60 to $100 monthly.

The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.

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