Illinois Department of Human Services
Information Bulletin
Division of Developmental Disabilities
DD.25.001
Purpose:
This Information Bulletin serves as a notice of rate changes pursuant to House Bill 4959/Public Act 103-0588.
Background:
In December 2020, the Illinois Department of Human Services (IDHS) Division of Developmental Disabilities (DDD) released the final report from Guidehouse Inc., Developmental Disability Services Rate Study (Rate Study). This Rate Study made recommendations to improve the intellectual and developmental disabilities (I/DD) system via updates to the system's rates, rate methodologies, and reimbursements. The Rate Study was the result of 2 years' worth of work completed by the Ligas Rates Oversight Committee and its 7 subcommittees made up of stakeholders across the I/DD system.
In February 2024, Governor Pritzker introduced his Fiscal Year 2025 (FY25) proposed budget to the Illinois General Assembly. The proposed budget included new funding for the DDD to implement several of the recommendations in the Rate Study. The appropriation bill passed by the Illinois General Assembly and signed into law by the Governor, appropriated funding above the Governor's introduced budget sufficient to implement additional Rate Study recommendations that will provide increases to the rates and reimbursements within the I/DD system as laid out below.
On December 19, 2024, Healthcare and Family Services (HFS) received approval of the amendments submitted for the Adults with Developmental Disabilities Waiver from Federal CMS.
Increase Overview:
Waiver Changes:
The implementation of the Rate Study recommendations in FY25 include rate and reimbursement increases (*Note: implementation guidance is below):
- Adult Community Integrated Living Arrangements (CILAs)
- $1.00 per hour wage increase in the rate methodology for Direct Support Professional (DSP) wages for CILA.
- Wage increases for other frontline staff wages to the federal Department of Labor's (DOL) Bureau of Labor Statistics (BLS) average wages for those positions included below:
- Increase mileage reimbursement to $0.67 per mile.
- Enhanced Residential Day Program:
- $1.00 per hour wage increase in the rate methodology for DSP wages.
- Wage increases for other frontline staff wages to the federal DOL BLS average wages.
- Community Day Services (CDS):
- $1.00 per hour wage increase in the rate methodology for DSP wages.
- Wage increases for other frontline staff wages to the federal DOL BLS average wages.
- Supported Employment Program (SEP):
- Wage increases for Job Coaches and other frontline staff for SEP Individual and SEP - Small Group to the federal DOL BLS average wages.
- SEP - Small Group received a 40% increase.
- Adult Day Services: Senior?
- Self-Direction Assistance
- Intermediate Care Facilities (ICF/IID), ICF/IID development training, and Medically Complex for the Developmentally Disabled (MC/DD) facilities:
- Effective January 1, 2025, subject to federal approval of the State Plan Amendment, the H.S.A. multipliers for facilities outside of the Chicago Metro Area will be no less than 1.00 and facilities within the Chicago Metro Area (Chicago, suburban Cook, and the collar counties (Lake, McHenry, Kane, DuPage, and Will), H.S.As 6, 7, 8, 9 (Will only) will have a multiplier of no less than 1.15.
- Effective January 1, 2025, subject to federal approval of the State Plan Amendment, $1.00 per hour wage increase to Aide wages for ICF/IID, ICF/IID developmental training programs, and MC/DD facilities. OTHER Rates/Rate Methodologies.
- State Operated Developmental Centers (SODC) CDS :
- $1.00 per hour wage increase in the rate methodology for DSP wages.
- Wage increases for other frontline staff wages to the federal DOL BLS average wages.
State Operated Developmental Centers (SODC) SEP:
-
- Wage increases for Job Coaches and other frontline staff for SEP Individual and SEP - Small Group to the federal DOL BLS average wages.
- SEP - Large Group received a 40% increase.
- Child Group Homes (17D):
- Effective July 1, 2024, implemented a 8.54% rate increase to align with a rate increase approved by the Department of Children and Family Services (DCFS).
Implementation Guidelines:
The federal Centers for Medicare and Medicaid Services (CMS) approval process for changes within the Adults with Developmental Disabilities Waiver requires the submission of a Waiver Amendment. The Adults with Developmental Disabilities Waiver has received federal CMS approval of its recent Waiver Amendment.
The federal CMS approval process for rate changes for ICF/IID, ICF/IID developmental training facilities, and Medically Complex for the Developmentally Disabled (MC/DD) facilities is done via State Plan Amendment (SPA), which is a different process than a waiver amendment. The Department of Healthcare and Family Services (HFS) is awaiting SPA approval from federal CMS. The ICF/IID, ICF/IID developmental training facilities and MC/DD facility increases are anticipated to be effective January 1, 2025, pending federal CMS approval.
Waiver Funded Services:
Pursuant to House Bill 4959/Public Act 103-0588 and with federal CMS' approval of the Waiver Amendment in December 2024 to implement rate increases, providers of community-based services and supports to individuals with I/DD shall increase wages as follows:
- Effective January 1, 2025, for DSPs, by $1.00 per hour, with at least $0.75 of those funds to be provided for a $0.75/hour direct increase to all DSP wages, with the remaining 25% ($0.25/hour) to be used flexibly for wage increases for DSPs and other frontline staff not covered by the federal DOL BLS average wage increases.
- As it relates to the wage language that comes directly from Public Act 103-0008, please note:
- "Base wages" refers to the current wage you are paying each DSP or ICF Aide across your organization; and
- The phrase "flexibly for base wage increases" refers to other options for providing increases, examples include wage increases targeted to specific DSPs or ICF Aides based on longevity, new employees, certain CILAs or ICFs, etc.
- Effective January 1, 2024, non-executive direct care staff, excluding DSPs, will be adjusted to the federal DOL BLS mean hourly wage based on the same or similar occupation title.
- Effective January 1, 2024, a fifteen percent (15%) Regionalization Factor is being implemented for CDS, Enhanced Residential, and Supported Employment Programs in Chicago, suburban Cook County, and the collar counties (list provided previously and again below). While DDD is not prescribing how the Regionalization Factor is to be implemented, DDD strongly encourages all providers receiving the Regionalization Factor to utilize the additional funding towards direct care staff wages.
- The Regionalization Factor will not impact an agency operating wholly outside of Chicago, suburban Cook, and the collar counties (Lake, McHenry, Kane, DuPage, and Will). For any agency operating CDS, Enhanced Residential, and Supported Employment Programs both within and outside the Chicago, suburban Cook County, and collar counties region, the 15% Regionalization Factor will only be received on the Chicago, suburban Cook County, and collar counties part of that agency's CILA (as was implemented effective January 1, 2023), CDS, Enhanced Residential and Supported Employment operations. As such, it will be up to each agency based on the percentage of their operations that qualify for the Regionalization Factor to determine the implementation of the additional revenue for staff wages or other operational needs. These are issues that impacted agencies will have to consider, evaluate, and make determinations on to ensure the continuation of quality services and supports within their organization moving forward.
- Any increases provided to DSP wages between July 1, 2024, and December 31, 2024, that a provider has voluntarily provided or been required to provide based on local minimum wage requirements will be inclusive towards the required DSP wage increase.
- Pursuant to House Bill 4647/Public Act 102-0944, DDD created a process whereby CILA provider agencies are required to certify they are passing the wage increases on to their direct care staff as mandated by DDD. DDD will issue guidance with the wage attestation forms in the Spring. DDD has the discretion to require other Waiver-funded programs/providers receiving the DSP wage increases to complete the wage attestation forms.
ICF Services:
Notwithstanding the provisions set forth in Section 153.100, facilities licensed by the Department of Public Health under the ID/DD Community Care Act (210 ILCS 47) or MC/DD Act (210 ILCS 46) will receive an increase to their facility rate upon receipt of federal approval of the SPA:
- Effective January 1, 2025, subject to federal approval of the State Plan Amendment, facilities will receive an increase to their reimbursement rates sufficient to provide a $1.00 per hour wage increase for ICF Aides, with at least 75% ($0.75/hour) of those funds to be provided for a $0.75/hour direct increase to all ICF Aide wages, with the remaining 25% ($0.25/hour) to be used flexibly for wage increases to ICF Aides and other frontline staff not covered by the federal DOL BLS average wage increases.
- Effective January 1, 2025, subject to federal approval of the SPA, facilities will receive an increase to their reimbursement rates sufficient to provide wage increases for non-executive direct care staff, excluding ICF Aides, to the federal DOL BLS average hourly wage based on the same or similar occupation title.
- Effective January 1, 2025, subject to federal approval of the State Plan Amendment, the H.S.A. multipliers for facilities outside of the Chicago Metro Area will be no less than 1.00 and facilities within the Chicago Metro Area (Chicago, suburban Cook, and the collar counties (Lake, McHenry, Kane, DuPage, and Will), H.S.As 6, 7, 8, 9 (Will only) will have a multiplier of no less than 1.15.
- Pursuant to House Bill 4647/Public Act 102-0944, DDD created a process whereby ICF/IID provider agencies are required to certify they are passing the wage increases on to their direct care staff as mandated by DDD. DDD will issue guidance with the wage attestation forms in the Spring. DDD has the discretion to require other ICF/IID programs/providers, including MC/DD facilities, receiving the DSP wage increases to complete the wage attestation forms.
Rate Calculations:
The programs impacted by the above rate and reimbursement changes are depicted on the recently released DDD Rate table effective January 1, 2025 (as well as in the below tables).
DDD will recalculate rates (utilizing 01/01/2025 rates) for all individuals in those applicable programs who use individual rates and all facilities for those programs that use provider rates.
ICF/IID and MC/DD rates are adjusted as a percentage. Because they are regionalized rates, they are not able to be reflected in the table below. Additionally, they are not adjusted by Health Service Area (HSA). The increases to ICF/IID developmental training program rates for January 1, 2025, will be implemented by HFS as soon as federal approval is received.
Rate Table - Waiver & SODC (Effective 01/01/2025)
| Bill Code |
Program Name |
Statewide Hourly Rate |
Chicago Metro Hourly Rate |
| 31U |
Community Day Services (On-Site) |
$17.75 |
$20.16 |
| 31C |
Community Day Services (Off-Site) |
$20.17 |
$23.14 |
| 32G |
SODC Supported Employment - Small Group (1:3) |
$21.62 |
$24.82 |
| 33G |
Supported Employment - Small Group (1:3) |
$21.62 |
$24.82 |
| 34G |
SODC Supported Employment - Large Group (1:6) |
$8.40 |
$9.62 |
| 34U |
SODC Supported Employment - Individual |
$49.00 |
$56.31 |
| 36G |
Supported Employment - Large Group (1:6) |
$8.40 |
$9.62 |
| 36U |
Supported Employment - Individual |
$49.00 |
$56.31 |
| 35U |
Adult Day Services |
$21.82 |
$21.82 |
| 37U |
Enhanced Residential Habilitation |
$22.20 |
$25.45 |
| 38U |
SODC Community Day Services (On-Site) |
$17.75 |
$20.16 |
| 38C |
SODC Community Day Services (Off-Site) |
$20.17 |
$23.14 |
| 17D |
Children's Group Home |
Varies |
Varies |
| 60D |
Community Integrated Living Arrangement (CILA) - Individual Rate Model |
Varies |
Varies |
| 60D |
CILA Host Family Stipend - High |
$120.00 |
$138.00 |
| 60D |
CILA Host Family Stipend - Mod |
$110.00 |
$126.50 |
| 60D |
CILA Host Family Stipend - Low |
$100.00 |
$115.00 |
| 60D |
CILA Host Family Mileage - Per Diem |
$6.68 |
$6.68 |
| 61H |
Community Integrated Living Arrangement (CILA) |
$59.09 |
$67.37 |
|
- Intermittent Hourly Supports 1:1 |
|
|
| 62H |
Community Integrated Living Arrangement (CILA) |
$29.54 |
$33.68 |
|
- Intermittent Hourly Supports 1:2 |
|
|
| 63H |
Community Integrated Living Arrangement (CILA) |
$19.70 |
$22.46 |
|
- Intermittent Hourly Supports 1:3 |
|
|
| Behavior Intervention and Treatment: |
| 56U - L1 |
Level 1 - Licensed Professional - Statewide Rate |
$99.11 |
$99.11 |
| 56U - L2 |
Level 2 - Other Credentials or No Level Specified |
$78.07 |
$78.07 |
| 57U |
Individual Counseling |
$50.41 |
$50.41 |
| 57G |
Group Counseling |
$16.80 |
$16.80 |
| 58U |
Individual Therapy |
$69.71 |
$69.71 |
| 58G |
Group Therapy |
$23.24 |
$23.24 |
| 51A-L |
ISSA |
$54.59 |
$54.59 |
| 55A |
HBS Self Directed Assistance |
$54.59 |
$54.59 |
| 52P |
Physical Therapy |
$111.00 |
$111.00 |
| 52O |
Occupational Therapy |
$111.00 |
$111.00 |
| 52S |
Speech Therapy |
$111.00 |
$111.00 |
| 52T |
Specialty Telehealth and Assessment Service (STAT) Estimated Beginning April 1, 2025 |
$60.00 |
$60.00 |
| 53S |
Temporary Intensive Staffing - SODC CDS |
$26.63 |
$30.62 |
| 53D |
Temporary Intensive Staffing - Day (CDS only) |
$26.63 |
$30.62 |
| 53R |
Temporary Intensive Staffing - Residential (60D only) |
$26.63 |
$30.62 |
Staffing Hourly Wage Table (CILA & Day Programs)
| Position Statewide |
Wage Rates Statewide/Chicago Metro (without ERE Fringe) |
Employer Required Expenses(ERE) (Fringe) Percentages |
| DSP Residential - Awake, |
$20.50/$23.58 |
29.90% |
| Asleep & Substitute |
|
|
| Supervisor - Residential |
$22.93/$26.37 |
29.00% |
| QIDP - Residential |
$26.14/$30.06 |
28.10% |
| RN - Residential |
$39.65/$45.60 |
24.90% |
| Dietician - Residential |
$30.75/$35.36 |
26.00% |
| DSP - Community Day Services (CDS) |
$20.50/$23.58 |
29.90% |
| Supported Employment - Job Coach |
$22.08/$25.39 |
29.00% |
| Supervisor - CDS |
$22.93/$26.37 |
29.00% |
| QIDP - CDS |
$26.14/$30.06 |
28.10% |
Staffing Hourly Rate Table (ICF/IID Without ERE (Fringe), Effective 1/1/2025)
| - |
- |
AIDE |
Nurse |
QIDP |
| - |
DFL |
$20.50 |
$33.40 |
$26.14 |
| HSA 1 |
1.0357162 |
$20.96 |
$34.59 |
$27.07 |
| HSA 2 |
1.0000000 |
$20.50 |
$33.40 |
$26.14 |
| HSA 3 |
1.0000000 |
$20.50 |
$33.40 |
$26.14 |
| HSA 4 |
1.0000000 |
$20.50 |
$33.40 |
$26.14 |
| HSA 5 |
1.0000000 |
$20.50 |
$33.40 |
$26.14 |
| HSA 6 |
1.2014172 |
$23.07 |
$40.13 |
$31.41 |
| HSA 7 |
1.2014172 |
$23.07 |
$40.13 |
$31.41 |
| HSA 8 |
1.2014172 |
$23.07 |
$40.13 |
$31.41 |
| HSA 9 Will |
1.1500000 |
$22.41 |
$38.41 |
$30.06 |
| HAS 9 Kankakee |
1.1169271 |
$22.41 |
$37.31 |
$29.20 |
| HSA 10 |
1.0357162 |
$20.96 |
$34.59 |
$27.07 |
| HSA 11 |
1.0000000 |
$20.50 |
$33.40 |
$26.14 |
Table Notes:
As a reminder, the following programs are NOT included in the rate adjustments specific to the Rate Study recommendations. Some of the programs listed did receive increases beginning January 1, 2025, as stated in this Bulletin as well as listed in the tables above:
- 17D Child Group Home
- 19D Child Care Institution
- 35U Adult Day Services
- 51A-L ISSA
- 55A Self Direction Assistance
- 55D Personal Support Worker (rates set by individual consumer)
- 67D CLF - Waiver
- 67E CLF - Non-Waiver
- 87D Respite
- 89D Respite
- 880 Grant Group Respite
- 50D Grant ISSA
- 500 Grant ISC
- 780 Grant PAS
- 781 Grant Bogard
Home-Based Services/Purchase of Services:
Standard statewide rates used within the Home-Based Services and Support (HBS) Program, e.g., rates for CDS and SEP, will be impacted by this increase. As was noted in the Final Information Bulletin DD.24.015, IDHS: HBS Rates Increase 2025, the monthly allocation for HBS will also be increasing effective January 1, 2025 by 2.5% due to the Social Security Administration's rate increase to the Supplemental Security Income individual benefit.
Please refer to the above-linked Information Bulletin for information on the SSI increase as well as the above-linked DDD Rate Table to complete HBS service authorizations effective January 1, 2025.
Effective Date:
The waiver rate changes outlined in this IB are effective January 1, 2025. For ICF Aides and other front-line staff in ICF/IID, ICF/IID developmental training facilities, and MC/DD facilities, those rate changes are effective January 1, 2025, subject to federal SPA approval.
