HB 2788

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Full Text of HB2788
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	HB2788 - 104th General Assembly
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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB2788
Introduced 2/6/2025, by Rep. Laura Faver Dias
SYNOPSIS AS INTRODUCED:
5 ILCS 100/5-45.65 new
20 ILCS 1705/74
305 ILCS 5/5-5.4	  from Ch. 23, par. 5-5.4
Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.
LRB104 10112 KTG 20184 b
A BILL FOR
		HB2788		LRB104 10112 KTG 20184 b
1    AN ACT concerning State government.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.65 as follows:
6    (5 ILCS 100/5-45.65 new)
7    Sec. 5-45.65. Emergency rulemaking; wage increase for 
8direct support personnel. To provide for the expeditious and 
9timely implementation of subsection (h) of Section 74 of the 
10Mental Health and Developmental Disabilities Administrative 
11Act, emergency rules implementing the changes may be adopted 
12in accordance with Section 5-45 by the Department of Human 
13Services. The adoption of emergency rules authorized by 
14Section 5-45 and this Section is deemed to be necessary for the 
15public interest, safety, and welfare.
16    This Section is repealed one year after the effective date 
17of this amendatory Act of the 104th General Assembly.
18    Section 5. The Mental Health and Developmental
19Disabilities Administrative Act is amended by changing Section
2074 as follows:
21    (20 ILCS 1705/74)
		HB2788	- 2 -	LRB104 10112 KTG 20184 b
1    Sec. 74. Rates and reimbursements.
2    (a) Within 30 days after July 6, 2017 (the effective date
3of Public Act 100-23), the Department shall increase rates and
4reimbursements to fund a minimum of a $0.75 per hour wage
5increase for front-line personnel, including, but not limited
6to, direct support professionals, aides, front-line
7supervisors, qualified intellectual disabilities
8professionals, nurses, and non-administrative support staff
9working in community-based provider organizations serving
10individuals with developmental disabilities. The Department
11shall adopt rules, including emergency rules under subsection
12(y) of Section 5-45 of the Illinois Administrative Procedure
13Act, to implement the provisions of this Section.
14    (b) Rates and reimbursements. Within 30 days after June 4,
152018 (the effective date of Public Act 100-587), the
16Department shall increase rates and reimbursements to fund a
17minimum of a $0.50 per hour wage increase for front-line
18personnel, including, but not limited to, direct support
19professionals, aides, front-line supervisors, qualified
20intellectual disabilities professionals, nurses, and
21non-administrative support staff working in community-based
22provider organizations serving individuals with developmental
23disabilities. The Department shall adopt rules, including
24emergency rules under subsection (bb) of Section 5-45 of the
25Illinois Administrative Procedure Act, to implement the
26provisions of this Section.
		HB2788	- 3 -	LRB104 10112 KTG 20184 b
1    (c) Rates and reimbursements. Within 30 days after June 5,
22019 (the effective date of Public Act 101-10), subject to
3federal approval, the Department shall increase rates and
4reimbursements in effect on June 30, 2019 for community-based
5providers for persons with Developmental Disabilities by 3.5%
6The Department shall adopt rules, including emergency rules
7under subsection (jj) of Section 5-45 of the Illinois
8Administrative Procedure Act, to implement the provisions of
9this Section, including wage increases for direct care staff.
10    (d) For community-based providers serving persons with
11intellectual/developmental disabilities, subject to federal
12approval of any relevant Waiver Amendment, the rates taking
13effect for services delivered on or after January 1, 2022,
14shall include an increase in the rate methodology sufficient
15to provide a $1.50 per hour wage increase for direct support
16professionals in residential settings and sufficient to
17provide wages for all residential non-executive direct care
18staff, excluding direct support professionals, at the federal
19Department of Labor, Bureau of Labor Statistics' average wage
20as defined in rule by the Department.
21    The establishment of and any changes to the rate
22methodologies for community-based services provided to persons
23with intellectual/developmental disabilities are subject to
24federal approval of any relevant Waiver Amendment and shall be
25defined in rule by the Department. The Department shall adopt
26rules, including emergency rules as authorized by Section 5-45
		HB2788	- 4 -	LRB104 10112 KTG 20184 b
1of the Illinois Administrative Procedure Act, to implement the
2provisions of this subsection (d).
3    (e) For community-based providers serving persons with
4intellectual/developmental disabilities, subject to federal
5approval of any relevant Waiver Amendment, the rates taking
6effect for services delivered on or after January 1, 2023,
7shall include an increase in the rate methodology sufficient
8to provide a $1.00 per hour wage increase for all direct
9support professionals and all other frontline personnel who
10are not subject to the Bureau of Labor Statistics' average
11wage increases, who work in residential and community day
12services settings, with at least $0.50 of those funds to be
13provided as a direct increase to base wages, with the
14remaining $0.50 to be used flexibly for base wage increases.
15In addition, the rates taking effect for services delivered on
16or after January 1, 2023 shall include an increase sufficient
17to provide wages for all residential non-executive direct care
18staff, excluding direct support professionals, at the federal
19Department of Labor, Bureau of Labor Statistics' average wage
20as defined in rule by the Department.
21    The establishment of and any changes to the rate
22methodologies for community-based services provided to persons
23with intellectual/developmental disabilities are subject to
24federal approval of any relevant Waiver Amendment and shall be
25defined in rule by the Department. The Department shall adopt
26rules, including emergency rules as authorized by Section 5-45
		HB2788	- 5 -	LRB104 10112 KTG 20184 b
1of the Illinois Administrative Procedure Act, to implement the
2provisions of this subsection.
3    (f) For community-based providers serving persons with
4intellectual/developmental disabilities, subject to federal
5approval of any relevant Waiver Amendment, the rates taking
6effect for services delivered on or after January 1, 2024
7shall include an increase in the rate methodology sufficient
8to provide a $2.50 per hour wage increase for all direct
9support professionals and all other frontline personnel who
10are not subject to the Bureau of Labor Statistics' average
11wage increases and who work in residential and community day
12services settings. At least $1.25 of the per hour wage
13increase shall be provided as a direct increase to base wages,
14and the remaining $1.25 of the per hour wage increase shall be
15used flexibly for base wage increases. In addition, the rates
16taking effect for services delivered on or after January 1,
172024 shall include an increase sufficient to provide wages for
18all residential non-executive direct care staff, excluding
19direct support professionals, at the federal Department of
20Labor, Bureau of Labor Statistics' average wage as defined in
21rule by the Department.
22    The establishment of and any changes to the rate
23methodologies for community-based services provided to persons
24with intellectual/developmental disabilities are subject to
25federal approval of any relevant Waiver Amendment and shall be
26defined in rule by the Department. The Department shall adopt
		HB2788	- 6 -	LRB104 10112 KTG 20184 b
1rules, including emergency rules as authorized by Section 5-45
2of the Illinois Administrative Procedure Act, to implement the
3provisions of this subsection.
4    (g) For community-based providers serving persons with
5intellectual or developmental disabilities, subject to federal
6approval of any relevant Waiver Amendment, the rates taking
7effect for services delivered on or after January 1, 2025
8shall include an increase in the rate methodology sufficient
9to provide a $1 per hour wage rate increase for all direct
10support personnel and all other frontline personnel who are
11not subject to the Bureau of Labor Statistics' average wage
12increases and who work in residential and community day
13services settings, with at least $0.75 of those funds to be
14provided as a direct increase to base wages and the remaining
15$0.25 to be used flexibly for base wage increases. These
16increases shall not be used by community-based providers for
17operational or administrative expenses. In addition, the rates
18taking effect for services delivered on or after January 1,
192025 shall include an increase sufficient to provide wages for
20all residential non-executive direct care staff, excluding
21direct support personnel, at the federal Department of Labor,
22Bureau of Labor Statistics' average wage as defined by rule by
23the Department. For services delivered on or after January 1,
242025, the rates shall include adjustments to
25employment-related expenses as defined by rule by the
26Department.
		HB2788	- 7 -	LRB104 10112 KTG 20184 b
1    The establishment of and any changes to the rate
2methodologies for community-based services provided to persons
3with intellectual or developmental disabilities are subject to
4federal approval of any relevant Waiver Amendment and shall be
5defined in rule by the Department. The Department shall adopt
6rules, including emergency rules as authorized by Section 5-45
7of the Illinois Administrative Procedure Act, to implement the
8provisions of this subsection.
9    (h) For community-based providers serving persons with 
10intellectual or developmental disabilities, by no later than 
11January 1, 2026, the Department of Healthcare and Family 
12Services, in collaboration with the Department of Human 
13Services, shall file an amendment to the Home and 
14Community-Based Services Waiver Program for Adults with 
15Developmental Disabilities authorized under Section 1915(c) of 
16the Social Security Act that shall include an increase in the 
17rate methodology sufficient to provide for a wage rate of 150% 
18of the statewide, regional, or local minimum wage for services 
19delivered on or after January 1, 2026, for all direct support 
20personnel and all other frontline personnel who are not 
21subject to the Bureau of Labor Statistics' average wage 
22increases and who work in residential and community day 
23services settings. The amendment shall also include an 
24increase in the rate methodology sufficient to provide wage 
25increases for all residential non-executive direct care staff, 
26excluding direct support personnel, at the federal Department 
		HB2788	- 8 -	LRB104 10112 KTG 20184 b
1of Labor, Bureau of Labor Statistics' average wage as defined 
2by rule by the Department of Human Services for services 
3delivered on or after January 1, 2026. For services delivered 
4on or after January 1, 2026, the rates shall include 
5adjustments to employment-related expenses as defined by rule 
6by the Department of Human Services. The Department of Human 
7Services shall adopt rules, including emergency rules as 
8authorized by Section 5-45 of the Illinois Administrative 
9Procedure Act, to implement the provisions of this subsection.
10(Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
11102-830, eff. 1-1-23; 103-8, eff. 6-7-23; 103-154, eff.
126-30-23; 103-588, eff. 6-5-24.)
13    Section 10. The Illinois Public Aid Code is amended by
14changing Section 5-5.4 as follows:
15    (305 ILCS 5/5-5.4)  (from Ch. 23, par. 5-5.4)
16    Sec. 5-5.4. Standards of payment; Department of Healthcare
17and Family Services. The Department of Healthcare and Family
18Services shall develop standards of payment of nursing
19facility and ICF/DD services in facilities providing such
20services under this Article which:
21    (1) Provide for the determination of a facility's payment
22for nursing facility or ICF/DD services on a prospective
23basis. The amount of the payment rate for all nursing
24facilities certified by the Department of Public Health under
		HB2788	- 9 -	LRB104 10112 KTG 20184 b
1the ID/DD Community Care Act or the Nursing Home Care Act as
2Intermediate Care for the Developmentally Disabled facilities,
3Long Term Care for Under Age 22 facilities, Skilled Nursing
4facilities, or Intermediate Care facilities under the medical
5assistance program shall be prospectively established annually
6on the basis of historical, financial, and statistical data
7reflecting actual costs from prior years, which shall be
8applied to the current rate year and updated for inflation,
9except that the capital cost element for newly constructed
10facilities shall be based upon projected budgets. The annually
11established payment rate shall take effect on July 1 in 1984
12and subsequent years. No rate increase and no update for
13inflation shall be provided on or after July 1, 1994, unless
14specifically provided for in this Section. The changes made by
15Public Act 93-841 extending the duration of the prohibition
16against a rate increase or update for inflation are effective
17retroactive to July 1, 2004.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as Intermediate Care for the
20Developmentally Disabled facilities or Long Term Care for
21Under Age 22 facilities, the rates taking effect on July 1,
221998 shall include an increase of 3%. For facilities licensed
23by the Department of Public Health under the Nursing Home Care
24Act as Skilled Nursing facilities or Intermediate Care
25facilities, the rates taking effect on July 1, 1998 shall
26include an increase of 3% plus $1.10 per resident-day, as
		HB2788	- 10 -	LRB104 10112 KTG 20184 b
1defined by the Department. For facilities licensed by the
2Department of Public Health under the Nursing Home Care Act as
3Intermediate Care Facilities for the Developmentally Disabled
4or Long Term Care for Under Age 22 facilities, the rates taking
5effect on January 1, 2006 shall include an increase of 3%. For
6facilities licensed by the Department of Public Health under
7the Nursing Home Care Act as Intermediate Care Facilities for
8the Developmentally Disabled or Long Term Care for Under Age
922 facilities, the rates taking effect on January 1, 2009
10shall include an increase sufficient to provide a $0.50 per
11hour wage increase for non-executive staff. For facilities
12licensed by the Department of Public Health under the ID/DD
13Community Care Act as ID/DD Facilities the rates taking effect
14within 30 days after July 6, 2017 (the effective date of Public
15Act 100-23) shall include an increase sufficient to provide a
16$0.75 per hour wage increase for non-executive staff. The
17Department shall adopt rules, including emergency rules under
18subsection (y) of Section 5-45 of the Illinois Administrative
19Procedure Act, to implement the provisions of this paragraph.
20For facilities licensed by the Department of Public Health
21under the ID/DD Community Care Act as ID/DD Facilities and
22under the MC/DD Act as MC/DD Facilities, the rates taking
23effect within 30 days after June 5, 2019 (the effective date of
24Public Act 101-10) shall include an increase sufficient to
25provide a $0.50 per hour wage increase for non-executive
26front-line personnel, including, but not limited to, direct
		HB2788	- 11 -	LRB104 10112 KTG 20184 b
1support persons, aides, front-line supervisors, qualified
2intellectual disabilities professionals, nurses, and
3non-administrative support staff. The Department shall adopt
4rules, including emergency rules under subsection (bb) of
5Section 5-45 of the Illinois Administrative Procedure Act, to
6implement the provisions of this paragraph.
7    For facilities licensed by the Department of Public Health
8under the Nursing Home Care Act as Intermediate Care for the
9Developmentally Disabled facilities or Long Term Care for
10Under Age 22 facilities, the rates taking effect on July 1,
111999 shall include an increase of 1.6% plus $3.00 per
12resident-day, as defined by the Department. For facilities
13licensed by the Department of Public Health under the Nursing
14Home Care Act as Skilled Nursing facilities or Intermediate
15Care facilities, the rates taking effect on July 1, 1999 shall
16include an increase of 1.6% and, for services provided on or
17after October 1, 1999, shall be increased by $4.00 per
18resident-day, as defined by the Department.
19    For facilities licensed by the Department of Public Health
20under the Nursing Home Care Act as Intermediate Care for the
21Developmentally Disabled facilities or Long Term Care for
22Under Age 22 facilities, the rates taking effect on July 1,
232000 shall include an increase of 2.5% per resident-day, as
24defined by the Department. For facilities licensed by the
25Department of Public Health under the Nursing Home Care Act as
26Skilled Nursing facilities or Intermediate Care facilities,
		HB2788	- 12 -	LRB104 10112 KTG 20184 b
1the rates taking effect on July 1, 2000 shall include an
2increase of 2.5% per resident-day, as defined by the
3Department.
4    For facilities licensed by the Department of Public Health
5under the Nursing Home Care Act as skilled nursing facilities
6or intermediate care facilities, a new payment methodology
7must be implemented for the nursing component of the rate
8effective July 1, 2003. The Department of Public Aid (now
9Healthcare and Family Services) shall develop the new payment
10methodology using the Minimum Data Set (MDS) as the instrument
11to collect information concerning nursing home resident
12condition necessary to compute the rate. The Department shall
13develop the new payment methodology to meet the unique needs
14of Illinois nursing home residents while remaining subject to
15the appropriations provided by the General Assembly. A
16transition period from the payment methodology in effect on
17June 30, 2003 to the payment methodology in effect on July 1,
182003 shall be provided for a period not exceeding 3 years and
19184 days after implementation of the new payment methodology
20as follows:
21        (A) For a facility that would receive a lower nursing
22    component rate per patient day under the new system than
23    the facility received effective on the date immediately
24    preceding the date that the Department implements the new
25    payment methodology, the nursing component rate per
26    patient day for the facility shall be held at the level in
		HB2788	- 13 -	LRB104 10112 KTG 20184 b
1    effect on the date immediately preceding the date that the
2    Department implements the new payment methodology until a
3    higher nursing component rate of reimbursement is achieved
4    by that facility.
5        (B) For a facility that would receive a higher nursing
6    component rate per patient day under the payment
7    methodology in effect on July 1, 2003 than the facility
8    received effective on the date immediately preceding the
9    date that the Department implements the new payment
10    methodology, the nursing component rate per patient day
11    for the facility shall be adjusted.
12        (C) Notwithstanding paragraphs (A) and (B), the
13    nursing component rate per patient day for the facility
14    shall be adjusted subject to appropriations provided by
15    the General Assembly.
16    For facilities licensed by the Department of Public Health
17under the Nursing Home Care Act as Intermediate Care for the
18Developmentally Disabled facilities or Long Term Care for
19Under Age 22 facilities, the rates taking effect on March 1,
202001 shall include a statewide increase of 7.85%, as defined
21by the Department.
22    Notwithstanding any other provision of this Section, for
23facilities licensed by the Department of Public Health under
24the Nursing Home Care Act as skilled nursing facilities or
25intermediate care facilities, except facilities participating
26in the Department's demonstration program pursuant to the
		HB2788	- 14 -	LRB104 10112 KTG 20184 b
1provisions of Title 77, Part 300, Subpart T of the Illinois
2Administrative Code, the numerator of the ratio used by the
3Department of Healthcare and Family Services to compute the
4rate payable under this Section using the Minimum Data Set
5(MDS) methodology shall incorporate the following annual
6amounts as the additional funds appropriated to the Department
7specifically to pay for rates based on the MDS nursing
8component methodology in excess of the funding in effect on
9December 31, 2006:
10        (i) For rates taking effect January 1, 2007,
11    $60,000,000.
12        (ii) For rates taking effect January 1, 2008,
13    $110,000,000.
14        (iii) For rates taking effect January 1, 2009,
15    $194,000,000.
16        (iv) For rates taking effect April 1, 2011, or the
17    first day of the month that begins at least 45 days after
18    February 16, 2011 (the effective date of Public Act
19    96-1530), $416,500,000 or an amount as may be necessary to
20    complete the transition to the MDS methodology for the
21    nursing component of the rate. Increased payments under
22    this item (iv) are not due and payable, however, until (i)
23    the methodologies described in this paragraph are approved
24    by the federal government in an appropriate State Plan
25    amendment and (ii) the assessment imposed by Section 5B-2
26    of this Code is determined to be a permissible tax under
		HB2788	- 15 -	LRB104 10112 KTG 20184 b
1    Title XIX of the Social Security Act.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, the support component of the
6rates taking effect on January 1, 2008 shall be computed using
7the most recent cost reports on file with the Department of
8Healthcare and Family Services no later than April 1, 2005,
9updated for inflation to January 1, 2006.
10    For facilities licensed by the Department of Public Health
11under the Nursing Home Care Act as Intermediate Care for the
12Developmentally Disabled facilities or Long Term Care for
13Under Age 22 facilities, the rates taking effect on April 1,
142002 shall include a statewide increase of 2.0%, as defined by
15the Department. This increase terminates on July 1, 2002;
16beginning July 1, 2002 these rates are reduced to the level of
17the rates in effect on March 31, 2002, as defined by the
18Department.
19    For facilities licensed by the Department of Public Health
20under the Nursing Home Care Act as skilled nursing facilities
21or intermediate care facilities, the rates taking effect on
22July 1, 2001 shall be computed using the most recent cost
23reports on file with the Department of Public Aid no later than
24April 1, 2000, updated for inflation to January 1, 2001. For
25rates effective July 1, 2001 only, rates shall be the greater
26of the rate computed for July 1, 2001 or the rate effective on
		HB2788	- 16 -	LRB104 10112 KTG 20184 b
1June 30, 2001.
2    Notwithstanding any other provision of this Section, for
3facilities licensed by the Department of Public Health under
4the Nursing Home Care Act as skilled nursing facilities or
5intermediate care facilities, the Illinois Department shall
6determine by rule the rates taking effect on July 1, 2002,
7which shall be 5.9% less than the rates in effect on June 30,
82002.
9    Notwithstanding any other provision of this Section, for
10facilities licensed by the Department of Public Health under
11the Nursing Home Care Act as skilled nursing facilities or
12intermediate care facilities, if the payment methodologies
13required under Section 5A-12 and the waiver granted under 42
14CFR 433.68 are approved by the United States Centers for
15Medicare and Medicaid Services, the rates taking effect on
16July 1, 2004 shall be 3.0% greater than the rates in effect on
17June 30, 2004. These rates shall take effect only upon
18approval and implementation of the payment methodologies
19required under Section 5A-12.
20    Notwithstanding any other provisions of this Section, for
21facilities licensed by the Department of Public Health under
22the Nursing Home Care Act as skilled nursing facilities or
23intermediate care facilities, the rates taking effect on
24January 1, 2005 shall be 3% more than the rates in effect on
25December 31, 2004.
26    Notwithstanding any other provision of this Section, for
		HB2788	- 17 -	LRB104 10112 KTG 20184 b
1facilities licensed by the Department of Public Health under
2the Nursing Home Care Act as skilled nursing facilities or
3intermediate care facilities, effective January 1, 2009, the
4per diem support component of the rates effective on January
51, 2008, computed using the most recent cost reports on file
6with the Department of Healthcare and Family Services no later
7than April 1, 2005, updated for inflation to January 1, 2006,
8shall be increased to the amount that would have been derived
9using standard Department of Healthcare and Family Services
10methods, procedures, and inflators.
11    Notwithstanding any other provisions of this Section, for
12facilities licensed by the Department of Public Health under
13the Nursing Home Care Act as intermediate care facilities that
14are federally defined as Institutions for Mental Disease, or
15facilities licensed by the Department of Public Health under
16the Specialized Mental Health Rehabilitation Act of 2013, a
17socio-development component rate equal to 6.6% of the
18facility's nursing component rate as of January 1, 2006 shall
19be established and paid effective July 1, 2006. The
20socio-development component of the rate shall be increased by
21a factor of 2.53 on the first day of the month that begins at
22least 45 days after January 11, 2008 (the effective date of
23Public Act 95-707). As of August 1, 2008, the
24socio-development component rate shall be equal to 6.6% of the
25facility's nursing component rate as of January 1, 2006,
26multiplied by a factor of 3.53. For services provided on or
		HB2788	- 18 -	LRB104 10112 KTG 20184 b
1after April 1, 2011, or the first day of the month that begins
2at least 45 days after February 16, 2011 (the effective date of
3Public Act 96-1530), whichever is later, the Illinois
4Department may by rule adjust these socio-development
5component rates, and may use different adjustment
6methodologies for those facilities participating, and those
7not participating, in the Illinois Department's demonstration
8program pursuant to the provisions of Title 77, Part 300,
9Subpart T of the Illinois Administrative Code, but in no case
10may such rates be diminished below those in effect on August 1,
112008.
12    For facilities licensed by the Department of Public Health
13under the Nursing Home Care Act as Intermediate Care for the
14Developmentally Disabled facilities or as long-term care
15facilities for residents under 22 years of age, the rates
16taking effect on July 1, 2003 shall include a statewide
17increase of 4%, as defined by the Department.
18    For facilities licensed by the Department of Public Health
19under the Nursing Home Care Act as Intermediate Care for the
20Developmentally Disabled facilities or Long Term Care for
21Under Age 22 facilities, the rates taking effect on the first
22day of the month that begins at least 45 days after January 11,
232008 (the effective date of Public Act 95-707) shall include a
24statewide increase of 2.5%, as defined by the Department.
25    Notwithstanding any other provision of this Section, for
26facilities licensed by the Department of Public Health under
		HB2788	- 19 -	LRB104 10112 KTG 20184 b
1the Nursing Home Care Act as skilled nursing facilities or
2intermediate care facilities, effective January 1, 2005,
3facility rates shall be increased by the difference between
4(i) a facility's per diem property, liability, and malpractice
5insurance costs as reported in the cost report filed with the
6Department of Public Aid and used to establish rates effective
7July 1, 2001 and (ii) those same costs as reported in the
8facility's 2002 cost report. These costs shall be passed
9through to the facility without caps or limitations, except
10for adjustments required under normal auditing procedures.
11    Rates established effective each July 1 shall govern
12payment for services rendered throughout that fiscal year,
13except that rates established on July 1, 1996 shall be
14increased by 6.8% for services provided on or after January 1,
151997. Such rates will be based upon the rates calculated for
16the year beginning July 1, 1990, and for subsequent years
17thereafter until June 30, 2001 shall be based on the facility
18cost reports for the facility fiscal year ending at any point
19in time during the previous calendar year, updated to the
20midpoint of the rate year. The cost report shall be on file
21with the Department no later than April 1 of the current rate
22year. Should the cost report not be on file by April 1, the
23Department shall base the rate on the latest cost report filed
24by each skilled care facility and intermediate care facility,
25updated to the midpoint of the current rate year. In
26determining rates for services rendered on and after July 1,
		HB2788	- 20 -	LRB104 10112 KTG 20184 b
11985, fixed time shall not be computed at less than zero. The
2Department shall not make any alterations of regulations which
3would reduce any component of the Medicaid rate to a level
4below what that component would have been utilizing in the
5rate effective on July 1, 1984.
6    (2) Shall take into account the actual costs incurred by
7facilities in providing services for recipients of skilled
8nursing and intermediate care services under the medical
9assistance program.
10    (3) Shall take into account the medical and psycho-social
11characteristics and needs of the patients.
12    (4) Shall take into account the actual costs incurred by
13facilities in meeting licensing and certification standards
14imposed and prescribed by the State of Illinois, any of its
15political subdivisions or municipalities and by the U.S.
16Department of Health and Human Services pursuant to Title XIX
17of the Social Security Act.
18    The Department of Healthcare and Family Services shall
19develop precise standards for payments to reimburse nursing
20facilities for any utilization of appropriate rehabilitative
21personnel for the provision of rehabilitative services which
22is authorized by federal regulations, including reimbursement
23for services provided by qualified therapists or qualified
24assistants, and which is in accordance with accepted
25professional practices. Reimbursement also may be made for
26utilization of other supportive personnel under appropriate
		HB2788	- 21 -	LRB104 10112 KTG 20184 b
1supervision.
2    The Department shall develop enhanced payments to offset
3the additional costs incurred by a facility serving
4exceptional need residents and shall allocate at least
5$4,000,000 of the funds collected from the assessment
6established by Section 5B-2 of this Code for such payments.
7For the purpose of this Section, "exceptional needs" means,
8but need not be limited to, ventilator care and traumatic
9brain injury care. The enhanced payments for exceptional need
10residents under this paragraph are not due and payable,
11however, until (i) the methodologies described in this
12paragraph are approved by the federal government in an
13appropriate State Plan amendment and (ii) the assessment
14imposed by Section 5B-2 of this Code is determined to be a
15permissible tax under Title XIX of the Social Security Act.
16    Beginning January 1, 2014 the methodologies for
17reimbursement of nursing facility services as provided under
18this Section 5-5.4 shall no longer be applicable for services
19provided on or after January 1, 2014.
20    No payment increase under this Section for the MDS
21methodology, exceptional care residents, or the
22socio-development component rate established by Public Act
2396-1530 of the 96th General Assembly and funded by the
24assessment imposed under Section 5B-2 of this Code shall be
25due and payable until after the Department notifies the
26long-term care providers, in writing, that the payment
		HB2788	- 22 -	LRB104 10112 KTG 20184 b
1methodologies to long-term care providers required under this
2Section have been approved by the Centers for Medicare and
3Medicaid Services of the U.S. Department of Health and Human
4Services and the waivers under 42 CFR 433.68 for the
5assessment imposed by this Section, if necessary, have been
6granted by the Centers for Medicare and Medicaid Services of
7the U.S. Department of Health and Human Services. Upon
8notification to the Department of approval of the payment
9methodologies required under this Section and the waivers
10granted under 42 CFR 433.68, all increased payments otherwise
11due under this Section prior to the date of notification shall
12be due and payable within 90 days of the date federal approval
13is received.
14    On and after July 1, 2012, the Department shall reduce any
15rate of reimbursement for services or other payments or alter
16any methodologies authorized by this Code to reduce any rate
17of reimbursement for services or other payments in accordance
18with Section 5-5e.
19    For facilities licensed by the Department of Public Health
20under the ID/DD Community Care Act as ID/DD Facilities and
21under the MC/DD Act as MC/DD Facilities, subject to federal
22approval, the rates taking effect for services delivered on or
23after August 1, 2019 shall be increased by 3.5% over the rates
24in effect on June 30, 2019. The Department shall adopt rules,
25including emergency rules under subsection (ii) of Section
265-45 of the Illinois Administrative Procedure Act, to
		HB2788	- 23 -	LRB104 10112 KTG 20184 b
1implement the provisions of this Section, including wage
2increases for direct care staff.
3    For facilities licensed by the Department of Public Health
4under the ID/DD Community Care Act as ID/DD Facilities and
5under the MC/DD Act as MC/DD Facilities, subject to federal
6approval, the rates taking effect on the latter of the
7approval date of the State Plan Amendment for these facilities
8or the Waiver Amendment for the home and community-based
9services settings shall include an increase sufficient to
10provide a $0.26 per hour wage increase to the base wage for
11non-executive staff. The Department shall adopt rules,
12including emergency rules as authorized by Section 5-45 of the
13Illinois Administrative Procedure Act, to implement the
14provisions of this Section, including wage increases for
15direct care staff.
16    For facilities licensed by the Department of Public Health
17under the ID/DD Community Care Act as ID/DD Facilities and
18under the MC/DD Act as MC/DD Facilities, subject to federal
19approval of the State Plan Amendment and the Waiver Amendment
20for the home and community-based services settings, the rates
21taking effect for the services delivered on or after July 1,
222020 shall include an increase sufficient to provide a $1.00
23per hour wage increase for non-executive staff. For services
24delivered on or after January 1, 2021, subject to federal
25approval of the State Plan Amendment and the Waiver Amendment
26for the home and community-based services settings, shall
		HB2788	- 24 -	LRB104 10112 KTG 20184 b
1include an increase sufficient to provide a $0.50 per hour
2increase for non-executive staff. The Department shall adopt
3rules, including emergency rules as authorized by Section 5-45
4of the Illinois Administrative Procedure Act, to implement the
5provisions of this Section, including wage increases for
6direct care staff.
7    For facilities licensed by the Department of Public Health
8under the ID/DD Community Care Act as ID/DD Facilities and
9under the MC/DD Act as MC/DD Facilities, subject to federal
10approval of the State Plan Amendment, the rates taking effect
11for the residential services delivered on or after July 1,
122021, shall include an increase sufficient to provide a $0.50
13per hour increase for aides in the rate methodology. For
14facilities licensed by the Department of Public Health under
15the ID/DD Community Care Act as ID/DD Facilities and under the
16MC/DD Act as MC/DD Facilities, subject to federal approval of
17the State Plan Amendment, the rates taking effect for the
18residential services delivered on or after January 1, 2022
19shall include an increase sufficient to provide a $1.00 per
20hour increase for aides in the rate methodology. In addition,
21for residential services delivered on or after January 1, 2022
22such rates shall include an increase sufficient to provide
23wages for all residential non-executive direct care staff,
24excluding aides, at the federal Department of Labor, Bureau of
25Labor Statistics' average wage as defined in rule by the
26Department. The Department shall adopt rules, including
		HB2788	- 25 -	LRB104 10112 KTG 20184 b
1emergency rules as authorized by Section 5-45 of the Illinois
2Administrative Procedure Act, to implement the provisions of
3this Section.
4    For facilities licensed by the Department of Public Health
5under the ID/DD Community Care Act as ID/DD facilities and
6under the MC/DD Act as MC/DD facilities, subject to federal
7approval of the State Plan Amendment, the rates taking effect
8for services delivered on or after January 1, 2023, shall
9include a $1.00 per hour wage increase for all direct support
10personnel and all other frontline personnel who are not
11subject to the Bureau of Labor Statistics' average wage
12increases, who work in residential and community day services
13settings, with at least $0.50 of those funds to be provided as
14a direct increase to all aide base wages, with the remaining
15$0.50 to be used flexibly for base wage increases to the rate
16methodology for aides. In addition, for residential services
17delivered on or after January 1, 2023 the rates shall include
18an increase sufficient to provide wages for all residential
19non-executive direct care staff, excluding aides, at the
20federal Department of Labor, Bureau of Labor Statistics'
21average wage as determined by the Department. Also, for
22services delivered on or after January 1, 2023, the rates will
23include adjustments to employment-related expenses as defined
24in rule by the Department. The Department shall adopt rules,
25including emergency rules as authorized by Section 5-45 of the
26Illinois Administrative Procedure Act, to implement the
		HB2788	- 26 -	LRB104 10112 KTG 20184 b
1provisions of this Section.
2    For facilities licensed by the Department of Public Health
3under the ID/DD Community Care Act as ID/DD facilities and
4under the MC/DD Act as MC/DD facilities, subject to federal
5approval of the State Plan Amendment, the rates taking effect
6for services delivered on or after January 1, 2024 shall
7include a $2.50 per hour wage increase for all direct support
8personnel and all other frontline personnel who are not
9subject to the Bureau of Labor Statistics' average wage
10increases and who work in residential and community day
11services settings. At least $1.25 of the per hour wage
12increase shall be provided as a direct increase to all aide
13base wages, and the remaining $1.25 of the per hour wage
14increase shall be used flexibly for base wage increases to the
15rate methodology for aides. In addition, for residential
16services delivered on or after January 1, 2024, the rates
17shall include an increase sufficient to provide wages for all
18residential non-executive direct care staff, excluding aides,
19at the federal Department of Labor, Bureau of Labor
20Statistics' average wage as determined by the Department.
21Also, for services delivered on or after January 1, 2024, the
22rates will include adjustments to employment-related expenses
23as defined in rule by the Department. The Department shall
24adopt rules, including emergency rules as authorized by
25Section 5-45 of the Illinois Administrative Procedure Act, to
26implement the provisions of this Section.
		HB2788	- 27 -	LRB104 10112 KTG 20184 b
1    For facilities licensed by the Department of Public Health
2under the ID/DD Community Care Act as ID/DD facilities and
3under the MC/DD Act as MC/DD facilities, subject to federal
4approval of a State Plan Amendment, the rates taking effect
5for services delivered on or after January 1, 2025 shall
6include a $1.00 per hour wage increase for all direct support
7personnel and all other frontline personnel who are not
8subject to the Bureau of Labor Statistics' average wage
9increases and who work in residential and community day
10services settings, with at least $0.75 of those funds to be
11provided as a direct increase to all aide base wages and the
12remaining $0.25 to be used flexibly for base wage increases to
13the rate methodology for aides. These increases shall not be
14used by facilities for operational and administrative
15expenses. In addition, for residential services delivered on
16or after January 1, 2025, the rates shall include an increase
17sufficient to provide wages for all residential non-executive
18direct care staff, excluding aides, at the federal Department
19of Labor, Bureau of Labor Statistics' average wage as
20determined by the Department. Also, for services delivered on
21or after January 1, 2025, the rates will include adjustments
22to employment-related expenses as defined in rule by the
23Department. The Department shall adopt rules, including
24emergency rules as authorized by Section 5-45 of the Illinois
25Administrative Procedure Act, to implement the provisions of
26this Section.
		HB2788	- 28 -	LRB104 10112 KTG 20184 b
1    Notwithstanding any other provision of this Section to the
2contrary, any regional wage adjuster for facilities located
3outside of the counties of Cook, DuPage, Kane, Lake, McHenry,
4and Will shall be no lower than 1.00, and any regional wage
5adjuster for facilities located within the counties of Cook,
6DuPage, Kane, Lake, McHenry, and Will shall be no lower than
71.15.
8    For facilities licensed by the Department of Public Health 
9under the ID/DD Community Care Act as ID/DD facilities and 
10under the MC/DD Act as MC/DD facilities, no later than January 
111, 2026, the Department of Healthcare and Family Services must 
12submit a Title XIX State Plan amendment to the federal Centers 
13for Medicare and Medicaid Services that shall include an 
14increase in the rate methodology sufficient to provide for a 
15wage rate of 150% of the statewide, regional, or local minimum 
16wage for services delivered on or after January 1, 2026, for 
17all direct support personnel and all other frontline personnel 
18who are not subject to the Bureau of Labor Statistics' average 
19wage increases and who work in residential and community day 
20services settings. The State Plan amendment shall also include 
21an increase in the rate methodology sufficient to provide wage 
22increases for all residential non-executive direct care staff, 
23excluding direct support personnel, at the federal Department 
24of Labor, Bureau of Labor Statistics' average wage as defined 
25by rule by the Department for services delivered on or after 
26January 1, 2026. For services delivered on or after January 1, 
		HB2788	- 29 -	LRB104 10112 KTG 20184 b
12026, the rates shall include adjustments to 
2employment-related expenses as defined by rule by the 
3Department.
4(Source: P.A. 102-16, eff. 6-17-21; 102-699, eff. 4-19-22;
5103-8, eff. 6-7-23; 103-588, eff. 7-1-24.)
6    Section 99. Effective date. This Act takes effect upon
7becoming law.