Dear Stakeholders:

The Division of Developmental Disabilities (DDD) is thrilled to announce that today, Thursday, December 15, 2022, the federal Centers for Medicare and Medicaid Services (CMS) approved the Waiver Amendment for the Adults with Developmental Disabilities Waiver, effective January 1, 2023. As a reminder, the Waiver Amendment makes several updates including the implementation of the next set of priorities from the Guidehouse Rate Study related to Home and Community-Based Services. The updates include:

  • Increases to Direct Support Professional (DSP), Qualified Intellectual Disability Professional (QIDP), Supervisor, Job Coach, Dietician and Registered Nurse (RN) wages in Community-Integrated Living Arrangement (CILA) and Community Day Services (CDS) rates:
    • $1.00/hour DSP wage increase;
    • Increases to the U.S. Department of Labor Bureau of Labor Statistics average wages for all other direct care staff listed above;
  • Implements 15% regionality for CILA wage rates in Chicago, suburban Cook and the collar counties (Lake, McHenry, Kane, DuPage, and Will);
  • Implements the CILA rate calculator:
    • Adds the Health Risk Screening Tool with the ICAP for determining an individual’s staffing hours in 24-hour shift staff CILA settings;
    • Implements the Guidehouse staff ratios in 24-hour shift staff CILA settings;
    • Adds the Program Support funding component to 24-hour shift staff CILA settings;
    • Increases Host Family CILA stipends;
    • Adjusts base nursing, medication administration oversight and nursing treatment hours based on the individual’s Health Care Level in all 24-hour shift staff CILA settings;
    • Changes all nurse hours to be funded using the RN Wage Rate;
    • Changes the administration allowance from a fixed amount to a percentage of the program support costs in 24-hour shift staff CILA settings (Host Family and I-CILA were changed last year); and
    • Updates the rates/percentages for transportation, employee-related expenses (ERE), program support, occupancy and administration; and
  • Revises the Restraint and Restrictive Intervention sections.

The DDD has sent previous communications related to these updates/changes:

DDD staff are currently working on the final testing of the updated CILA Rate Calculator for the January 1, 2023, rates and reimbursements. The DDD knows many providers have asked for updated rate and reimbursement information as they develop their budgets for calendar year 2023. The DDD anticipates being able to provide estimated rate summaries within the next couple of weeks to each CILA agency. The DDD appreciates your continued patience as the DDD finalizes all the programming and testing. Final rates with updated rate sheets are still set to be distributed in early- to mid-February 2023.

Additionally, the DDD will be publishing an Information Bulletin (Information Bulletins webpage) to communicate how these changes are to be implemented, beyond what was communicated in the above-linked wage guidance communication.

As a reminder, the Department of Healthcare and Family Services (HFS) has submitted the State Plan Amendment for the increases to the Intermediate Care Facility (ICF) system. The DDD will communicate with stakeholders as that process moves forward. Finally, the DDD anticipates the Waiver Amendment for the Children’s Residential Waiver will be approved very soon.

Thank you!

Sarah Myerscough-Mueller
Interim Director, Division of Developmental Disabilities
Illinois Department of Human Services

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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