QUICK NOTES

  • The Division of Developmental Disabilities (DDD) recently posted 2 finalized Information Bulletins (both linked below). Please be on the lookout for another Information Bulletin regarding the January 1, 2023, rate increases next week.
  • The Self Direction Assistance (SDA) Guidelines (IDHS: Self Direction Assistance Guidelines UPDATED 12.28.22) have been reviewed and updated. This review is part of the ongoing initiative of the DDD to review and update all of our online manuals and policies.
  • The DDD will be hosting Rule 116 office hours for technical assistance for providers on January 19, 2023, at 3:00 p.m. The office hours are an opportunity for providers to collaborate with each other and ask the DDD for guidance on Rule 116 interpretation. Please use this link to register: Rule 116 Office Hours.

SODC TIER REPORT UPDATE

Please be aware that the State Operated Developmental Center (SODC) Tier Report will have a new name and a new look beginning January 2023. Moving forward, the newly renamed Transition Report will now differentiate between (1) individuals and families/guardians, as applicable, who are currently interested in and exploring community placement; and (2) individuals and families/guardians, as applicable, who are not currently interested in exploring placement. Please watch for these changes on the DHS website (current SODC Tier Report link).

IMPLEMENTATION OF JANUARY 1, 2023, RATE INCREASES

Provider agencies should expect the January 1, 2023, rate increases to show up on their ROCS after they submit January billing at the beginning of February 2023. This is normal for any rate change. Even though an agency will submit January billing with the “current” rates showing on ROCS, the billing system will process an agency’s January billing using the updated rates and the January MOBIUS Remittance Reports will show accurate reimbursements using the January rates. Please do not call DDD or DoIT staff about this change or whether an agency should submit January billing with the current rates showing in ROCS.

JANUARY 1, 2023, PROJECTED CILA RATES AND REVENUE

With the approval of the Waiver Amendment for the Adults with Developmental Disabilities Waiver and ahead of the January 1, 2023, effective date, DDD staff have completed the development of working models to begin calculating Community Integrated Living Arrangement (CILA) rates beginning January 1, 2023. Many providers have expressed an interest in receiving new CILA rate information as soon as possible for budget and planning purposes. In response to these requests, DDD staff have prepared CILA Rate Summary Sheets for each CILA agency. Those Summary Sheets were mailed to all CILA providers this week.

Please remember these are preliminary calculations based on current information. There are still several rate input factors which have to be merged and updated with current data. A change to any rate input factor will change the rate shown in the projections. The cover letter that accompanies the mailing explains in greater detail these input factors and what data remains to be updated. For most individuals, these projections underrepresent final funding calculations and will most likely not exactly match the CILA rates which will go into effect January 1, 2023. One of the data summaries shows each individual’s increase in wage funding as well as the increase of wage funding per funded staff hour. Overall, the calculations show that every CILA agency has more than enough additional wage funding to fully fund the required $0.50/hour wage direct passthrough to DSPs as well as the other $0.50 to be used flexibly for wages to DSPs and other front-line staff.

COVID PREMIUM TO END DECEMBER 31, 2022

As a reminder to CILA providers, the seven (7%) percent COVID premiums which have been added to CILA rates during the pandemic are ending effective December 31, 2022. The January 1, 2023, wage increase and other CILA rate methodology changes will be increasing rates well above the reductions from the end of COVID premiums. Statewide, CILA rates are going up between 12% to 17% with Chicago Metro rates, which qualify for the new Regionalization Factor, going up between 26% to 34%. In total, more than $190 million annually is being added to CILA funding beginning January 1, 2023.

REMINDER TO UPDATE INDIVIDUAL INCOME IN ROCS

As a reminder to all providers, each individual’s income must be updated at least annually. Unearned Income is required to be updated; Earned Income is not required to be reported and is not used by the DDD in any offsets calculated by the rate payment system. Failure to update income at least annually can result in individual payments for services being suspended. This stop payment edit is built into the payment system. January is the best time to update reported income with Social Security changes typically occurring effective January 1.

HEALTH RISK SCREENING TOOL (HRST) REMINDER

As a reminder, as of January 1, 2023, the DDD will use an individual’s electronic health care level (HCL) from the HRST as an input factor in calculating the individual’s staffing levels in CILA. This is being implemented as part of the recommendations from the Guidehouse Rate Study. To accomplish this, the DDD is planning to have a data merge with the web-based application which will update all HCLs to reflect what is in the web-based application. The HCL scores from HRST will affect the individual’s CILA reimbursement rate both positively and negatively. If the individual currently does not have an HCL score, the rate for 24-hour CILA will decrease.

Please work to ensure that the HCLs are accurate and up to date in the web-based application for all CILA residents. Please do NOT submit updated nursing packets or HCL scores via the ISC and Birdseye systems unless the individual has a change in their medical needs. If you need assistance with HRST please contact:  ilsupport@replacingrisk.com.

If a Community Day Services (CDS) provider uses the HRST for their CDS clients, the HRST must match the score that the residential provider has assigned. CDS providers are not reimbursed for the costs associated with using the HRST for the individuals who attend their CDS.

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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