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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4850

Introduced , by Rep. Gregg Johnson

SYNOPSIS AS INTRODUCED:

20 ILCS 1705/74
305 ILCS 5/5-5a.2 new

Amends the Mental Health and Developmental Disabilities
Administrative Act. Provides that beginning July 1, 2026, the Department
of Human Services shall reissue the original cost and wage survey for costs
associated with the administration of services to persons with
intellectual and developmental disabilities in community day services that
was contained in the Department's Guidehouse Rate Study. Provides that the
cost and wage survey shall be used to effectuate rate increases in
transportation funding for the administration of community day services to
persons with intellectual and developmental disabilities and may include
provider contact information, total costs of employee salaries and
benefits, staff turnover, and other information. Requires the Department
to adopt rules. Amends the Medical Assistance Article of the Illinois
Public Aid Code. Requires the Department of Healthcare and Family Services
to file an amendment to the Home and Community-Based Services Waiver
Program for Adults with Developmental Disabilities that removes the 5 hour
per day billing maximums at community day services. Provides that the
amendment shall not modify monthly and yearly billing maximums for
community day services. Provides that implementation is contingent on
federal approval. Effective July 1, 2026.
LRB104 19079 KTG 32524 b

A BILL FOR

HB4850
LRB104 19079 KTG 32524 b
1

AN ACT concerning public aid.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Mental Health and Developmental
5
Disabilities Administrative Act is amended by changing Section
6
74 as follows:

7

(20 ILCS 1705/74)
8

Sec. 74.
Rates and reimbursements.
9

(a) Within 30 days after July 6, 2017 (the effective date
10
of Public Act 100-23), the Department shall increase rates and
11
reimbursements to fund a minimum of a $0.75 per hour wage
12
increase for frontline personnel, including, but not limited
13
to, direct support professionals, aides, frontline
14
supervisors, qualified intellectual disabilities
15
professionals, nurses, and non-administrative support staff
16
working in community-based provider organizations serving
17
individuals with developmental disabilities. The Department
18
shall adopt rules, including emergency rules under subsection
19
(y) of Section 5-45 of the Illinois Administrative Procedure
20
Act, to implement the provisions of this Section.
21

(b) Rates and reimbursements. Within 30 days after June 4,
22
2018 (the effective date of Public Act 100-587), the
23
Department shall increase rates and reimbursements to fund a

HB4850
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LRB104 19079 KTG 32524 b
1
minimum of a $0.50 per hour wage increase for frontline
2
personnel, including, but not limited to, direct support
3
professionals, aides, frontline supervisors, qualified
4
intellectual disabilities professionals, nurses, and
5
non-administrative support staff working in community-based
6
provider organizations serving individuals with developmental
7
disabilities. The Department shall adopt rules, including
8
emergency rules under subsection (bb) of Section 5-45 of the
9
Illinois Administrative Procedure Act, to implement the
10
provisions of this Section.
11

(c) Rates and reimbursements. Within 30 days after June 5,
12
2019 (the effective date of Public Act 101-10), subject to
13
federal approval, the Department shall increase rates and
14
reimbursements in effect on June 30, 2019 for community-based
15
providers for persons with Developmental Disabilities by 3.5%
16
The Department shall adopt rules, including emergency rules
17
under subsection (jj) of Section 5-45 of the Illinois
18
Administrative Procedure Act, to implement the provisions of
19
this Section, including wage increases for direct care staff.
20

(d) For community-based providers serving persons with
21
intellectual/developmental disabilities, subject to federal
22
approval of any relevant Waiver Amendment, the rates taking
23
effect for services delivered on or after January 1, 2022,
24
shall include an increase in the rate methodology sufficient
25
to provide a $1.50 per hour wage increase for direct support
26
professionals in residential settings and sufficient to

HB4850
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LRB104 19079 KTG 32524 b
1
provide wages for all residential non-executive direct care
2
staff, excluding direct support professionals, at the federal
3
Department of Labor, Bureau of Labor Statistics' average wage
4
as defined in rule by the Department.
5

The establishment of and any changes to the rate
6
methodologies for community-based services provided to persons
7
with intellectual/developmental disabilities are subject to
8
federal approval of any relevant Waiver Amendment and shall be
9
defined in rule by the Department. The Department shall adopt
10
rules, including emergency rules as authorized by Section 5-45
11
of the Illinois Administrative Procedure Act, to implement the
12
provisions of this subsection (d).
13

(e) For community-based providers serving persons with
14
intellectual/developmental disabilities, subject to federal
15
approval of any relevant Waiver Amendment, the rates taking
16
effect for services delivered on or after January 1, 2023,
17
shall include an increase in the rate methodology sufficient
18
to provide a $1.00 per hour wage increase for all direct
19
support professionals and all other frontline personnel who
20
are not subject to the Bureau of Labor Statistics' average
21
wage increases, who work in residential and community day
22
services settings, with at least $0.50 of those funds to be
23
provided as a direct increase to base wages, with the
24
remaining $0.50 to be used flexibly for base wage increases.
25
In addition, the rates taking effect for services delivered on
26
or after January 1, 2023 shall include an increase sufficient

HB4850
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LRB104 19079 KTG 32524 b
1
to provide wages for all residential non-executive direct care
2
staff, excluding direct support professionals, at the federal
3
Department of Labor, Bureau of Labor Statistics' average wage
4
as defined in rule by the Department.
5

The establishment of and any changes to the rate
6
methodologies for community-based services provided to persons
7
with intellectual/developmental disabilities are subject to
8
federal approval of any relevant Waiver Amendment and shall be
9
defined in rule by the Department. The Department shall adopt
10
rules, including emergency rules as authorized by Section 5-45
11
of the Illinois Administrative Procedure Act, to implement the
12
provisions of this subsection.
13

(f) For community-based providers serving persons with
14
intellectual/developmental disabilities, subject to federal
15
approval of any relevant Waiver Amendment, the rates taking
16
effect for services delivered on or after January 1, 2024
17
shall include an increase in the rate methodology sufficient
18
to provide a $2.50 per hour wage increase for all direct
19
support professionals and all other frontline personnel who
20
are not subject to the Bureau of Labor Statistics' average
21
wage increases and who work in residential and community day
22
services settings. At least $1.25 of the per hour wage
23
increase shall be provided as a direct increase to base wages,
24
and the remaining $1.25 of the per hour wage increase shall be
25
used flexibly for base wage increases. In addition, the rates
26
taking effect for services delivered on or after January 1,

HB4850
- 5 -
LRB104 19079 KTG 32524 b
1
2024 shall include an increase sufficient to provide wages for
2
all residential non-executive direct care staff, excluding
3
direct support professionals, at the federal Department of
4
Labor, Bureau of Labor Statistics' average wage as defined in
5
rule by the Department.
6

The establishment of and any changes to the rate
7
methodologies for community-based services provided to persons
8
with intellectual/developmental disabilities are subject to
9
federal approval of any relevant Waiver Amendment and shall be
10
defined in rule by the Department. The Department shall adopt
11
rules, including emergency rules as authorized by Section 5-45
12
of the Illinois Administrative Procedure Act, to implement the
13
provisions of this subsection.
14

(g) For community-based providers serving persons with
15
intellectual or developmental disabilities, subject to federal
16
approval of any relevant Waiver Amendment, the rates taking
17
effect for services delivered on or after January 1, 2025
18
shall include an increase in the rate methodology sufficient
19
to provide a $1 per hour wage rate increase for all direct
20
support personnel and all other frontline personnel who are
21
not subject to the Bureau of Labor Statistics' average wage
22
increases and who work in residential and community day
23
services settings, with at least $0.75 of those funds to be
24
provided as a direct increase to base wages and the remaining
25
$0.25 to be used flexibly for base wage increases. These
26
increases shall not be used by community-based providers for

HB4850
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LRB104 19079 KTG 32524 b
1
operational or administrative expenses. In addition, the rates
2
taking effect for services delivered on or after January 1,
3
2025 shall include an increase sufficient to provide wages for
4
all residential non-executive direct care staff, excluding
5
direct support personnel, at the federal Department of Labor,
6
Bureau of Labor Statistics' average wage as defined by rule by
7
the Department. For services delivered on or after January 1,
8
2025, the rates shall include adjustments to
9
employment-related expenses as defined by rule by the
10
Department.
11

The establishment of and any changes to the rate
12
methodologies for community-based services provided to persons
13
with intellectual or developmental disabilities are subject to
14
federal approval of any relevant Waiver Amendment and shall be
15
defined in rule by the Department. The Department shall adopt
16
rules, including emergency rules as authorized by Section 5-45
17
of the Illinois Administrative Procedure Act, to implement the
18
provisions of this subsection.
19

(h) For community-based providers serving persons with
20
intellectual or developmental disabilities, subject to federal
21
approval of any relevant Waiver Amendment, the rates taking
22
effect for services delivered on or after January 1, 2026
23
shall include an increase in the rate methodology sufficient
24
to provide a $0.80 per hour wage increase for all direct
25
support personnel and all other frontline personnel who are
26
not subject to the Bureau of Labor Statistics' average wage

HB4850
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LRB104 19079 KTG 32524 b
1
increases and who work in residential and community day
2
services settings, with at least $0.60 of the per hour wage
3
increase to be provided as a direct increase to base wages, and
4
the remaining $0.20 of the per hour wage increase to be used
5
flexibly for base wage increases. These increases shall not be
6
used by community-based providers for operational or
7
administrative expenses. In addition, the rates taking effect
8
for services delivered on or after January 1, 2026 shall
9
include an increase sufficient to provide wages for all
10
residential non-executive direct care staff, excluding direct
11
support personnel, at the federal Department of Labor, Bureau
12
of Labor Statistics' average wage as defined in rule by the
13
Department.
14

The establishment of and any changes to the rate
15
methodologies for community-based services provided to persons
16
with intellectual or developmental disabilities are subject to
17
federal approval of any relevant Waiver Amendment and shall be
18
defined in rule by the Department. The Department shall adopt
19
rules, including emergency rules as authorized by Section 5-45
20
of the Illinois Administrative Procedure Act, to implement the
21
provisions of this subsection.
22

(i) Beginning July 1, 2026, the Department shall reissue
23
the original cost and wage survey for costs associated with
24
the administration of services to persons with intellectual
25
and developmental disabilities in community day services that
26
was contained in the Department's Guidehouse Rate Study. The

HB4850
- 8 -
LRB104 19079 KTG 32524 b
1
cost and wage survey shall be used to effectuate rate
2
increases in transportation funding for the administration of
3
community day services to persons with intellectual and
4
developmental disabilities and may include the following
5
items:

6

(1) Provider contact information.
7

(2) Total costs of employee salaries and benefits.
8

(3) Category of services provided by agencies.
9

(4) Salary and wage information for staff.
10

(5) Benefits for staff.
11

(6) Staff turnover.
12

(7) Day services costs.
13

(8) Supported employment costs.
14

(9) Costs related to the provision of transportation.
15

The Department shall adopt rules to implement this
16
subsection.

17
(Source: P.A. 103-8, eff. 6-7-23; 103-154, eff. 6-30-23;
18
103-588, eff. 6-5-24; 104-2, eff. 6-16-25.)

19

Section 10.
The Illinois Public Aid Code is amended by
20
adding Section 5-5a.2 as follows:

21

(305 ILCS 5/5-5a.2 new)
22

Sec. 5-5a.2.
Community day services billing; adults with
23
intellectual and developmental disabilities.
The Department
24
shall file an amendment to the Home and Community-Based

HB4850
- 9 -
LRB104 19079 KTG 32524 b
1
Services Waiver Program for Adults with Developmental
2
Disabilities authorized under Section 1915(c) of the Social
3
Security Act that removes the 5 hour per day billing maximums
4
for community day services. The amendment shall not modify
5
monthly and yearly billing maximums for community day
6
services. Implementation of this Section is contingent on
7
federal approval.

8

Section 99.
Effective date.
This Act takes effect July 1,
9
2026.

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