DHFS-ID/DD REIMBURSEMENTS

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3464

Introduced 2/5/2026, by Sen. Graciela Guzmán

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.4

from Ch. 23, par. 5-5.4

Amends the Medical Assistance Article of the Illinois Public Aid
Code. Provides that for dates of service starting January 1, 2027,
reimbursement calculations and direct payments for services provided by
facilities licensed under the ID/DD Community Care Act are the
responsibility of the Department of Healthcare and Family Services.
Provides that appropriations for facilities licensed under the ID/DD
Community Care Act must be shifted from the Department of Human Services to
the Department of Healthcare and Family Services. Provides that nothing in
the amendatory Act shall prohibit the Department of Healthcare and Family
Services from paying more than the rates specified in the amendatory Act.
Provides that nothing in the amendatory Act shall affect certain reporting
requirements under the ID/DD Community Care Act.
LRB104 19667 KTG 33116 b

A BILL FOR

SB3464
LRB104 19667 KTG 33116 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 Illinois Public Aid Code is amended by
5
changing Section 5-5.4 as follows:

6

(305 ILCS 5/5-5.4)

(from Ch. 23, par. 5-5.4)
7

Sec. 5-5.4.
Standards of payment; Department of Healthcare
8
and Family Services.
The Department of Healthcare and Family
9
Services shall develop standards of payment of nursing
10
facility and ICF/DD services in facilities providing such
11
services under this Article which:
12

(1) Provide for the determination of a facility's payment
13
for nursing facility or ICF/DD services on a prospective
14
basis. The amount of the payment rate for all nursing
15
facilities certified by the Department of Public Health under
16
the ID/DD Community Care Act or the Nursing Home Care Act as
17
Intermediate Care for the Developmentally Disabled facilities,
18
Long Term Care for Under Age 22 facilities, Skilled Nursing
19
facilities, or Intermediate Care facilities under the medical
20
assistance program shall be prospectively established annually
21
on the basis of historical, financial, and statistical data
22
reflecting actual costs from prior years, which shall be
23
applied to the current rate year and updated for inflation,

SB3464
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1
except that the capital cost element for newly constructed
2
facilities shall be based upon projected budgets. The annually
3
established payment rate shall take effect on July 1 in 1984
4
and subsequent years. No rate increase and no update for
5
inflation shall be provided on or after July 1, 1994, unless
6
specifically provided for in this Section. The changes made by
7
Public Act 93-841 extending the duration of the prohibition
8
against a rate increase or update for inflation are effective
9
retroactive to July 1, 2004.
10

For facilities licensed by the Department of Public Health
11
under the Nursing Home Care Act as Intermediate Care for the
12
Developmentally Disabled facilities or Long Term Care for
13
Under Age 22 facilities, the rates taking effect on July 1,
14
1998 shall include an increase of 3%. For facilities licensed
15
by the Department of Public Health under the Nursing Home Care
16
Act as Skilled Nursing facilities or Intermediate Care
17
facilities, the rates taking effect on July 1, 1998 shall
18
include an increase of 3% plus $1.10 per resident-day, as
19
defined by the Department. For facilities licensed by the
20
Department of Public Health under the Nursing Home Care Act as
21
Intermediate Care Facilities for the Developmentally Disabled
22
or Long Term Care for Under Age 22 facilities, the rates taking
23
effect on January 1, 2006 shall include an increase of 3%. For
24
facilities licensed by the Department of Public Health under
25
the Nursing Home Care Act as Intermediate Care Facilities for
26
the Developmentally Disabled or Long Term Care for Under Age

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1
22 facilities, the rates taking effect on January 1, 2009
2
shall include an increase sufficient to provide a $0.50 per
3
hour wage increase for non-executive staff. For facilities
4
licensed by the Department of Public Health under the ID/DD
5
Community Care Act as ID/DD Facilities the rates taking effect
6
within 30 days after July 6, 2017 (the effective date of Public
7
Act 100-23) shall include an increase sufficient to provide a
8
$0.75 per hour wage increase for non-executive staff. The
9
Department shall adopt rules, including emergency rules under
10
subsection (y) of Section 5-45 of the Illinois Administrative
11
Procedure Act, to implement the provisions of this paragraph.
12
For facilities licensed by the Department of Public Health
13
under the ID/DD Community Care Act as ID/DD Facilities and
14
under the MC/DD Act as MC/DD Facilities, the rates taking
15
effect within 30 days after June 5, 2019 (the effective date of
16
Public Act 101-10) shall include an increase sufficient to
17
provide a $0.50 per hour wage increase for non-executive
18
frontline personnel, including, but not limited to, direct
19
support persons, aides, frontline supervisors, qualified
20
intellectual disabilities professionals, nurses, and
21
non-administrative support staff. The Department shall adopt
22
rules, including emergency rules under subsection (bb) of
23
Section 5-45 of the Illinois Administrative Procedure Act, to
24
implement the provisions of this paragraph.
25

For facilities licensed by the Department of Public Health
26
under the Nursing Home Care Act as Intermediate Care for the

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LRB104 19667 KTG 33116 b
1
Developmentally Disabled facilities or Long Term Care for
2
Under Age 22 facilities, the rates taking effect on July 1,
3
1999 shall include an increase of 1.6% plus $3.00 per
4
resident-day, as defined by the Department. For facilities
5
licensed by the Department of Public Health under the Nursing
6
Home Care Act as Skilled Nursing facilities or Intermediate
7
Care facilities, the rates taking effect on July 1, 1999 shall
8
include an increase of 1.6% and, for services provided on or
9
after October 1, 1999, shall be increased by $4.00 per
10
resident-day, as defined by the Department.
11

For facilities licensed by the Department of Public Health
12
under the Nursing Home Care Act as Intermediate Care for the
13
Developmentally Disabled facilities or Long Term Care for
14
Under Age 22 facilities, the rates taking effect on July 1,
15
2000 shall include an increase of 2.5% per resident-day, as
16
defined by the Department. For facilities licensed by the
17
Department of Public Health under the Nursing Home Care Act as
18
Skilled Nursing facilities or Intermediate Care facilities,
19
the rates taking effect on July 1, 2000 shall include an
20
increase of 2.5% per resident-day, as defined by the
21
Department.
22

For facilities licensed by the Department of Public Health
23
under the Nursing Home Care Act as skilled nursing facilities
24
or intermediate care facilities, a new payment methodology
25
must be implemented for the nursing component of the rate
26
effective July 1, 2003. The Department of Public Aid (now

SB3464
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LRB104 19667 KTG 33116 b
1
Healthcare and Family Services) shall develop the new payment
2
methodology using the Minimum Data Set (MDS) as the instrument
3
to collect information concerning nursing home resident
4
condition necessary to compute the rate. The Department shall
5
develop the new payment methodology to meet the unique needs
6
of Illinois nursing home residents while remaining subject to
7
the appropriations provided by the General Assembly. A
8
transition period from the payment methodology in effect on
9
June 30, 2003 to the payment methodology in effect on July 1,
10
2003 shall be provided for a period not exceeding 3 years and
11
184 days after implementation of the new payment methodology
12
as follows:
13

(A) For a facility that would receive a lower nursing
14

component rate per patient day under the new system than
15

the facility received effective on the date immediately
16

preceding the date that the Department implements the new
17

payment methodology, the nursing component rate per
18

patient day for the facility shall be held at the level in
19

effect on the date immediately preceding the date that the
20

Department implements the new payment methodology until a
21

higher nursing component rate of reimbursement is achieved
22

by that facility.
23

(B) For a facility that would receive a higher nursing
24

component rate per patient day under the payment
25

methodology in effect on July 1, 2003 than the facility
26

received effective on the date immediately preceding the

SB3464
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LRB104 19667 KTG 33116 b
1

date that the Department implements the new payment
2

methodology, the nursing component rate per patient day
3

for the facility shall be adjusted.
4

(C) Notwithstanding paragraphs (A) and (B), the
5

nursing component rate per patient day for the facility
6

shall be adjusted subject to appropriations provided by
7

the General Assembly.
8

For facilities licensed by the Department of Public Health
9
under the Nursing Home Care Act as Intermediate Care for the
10
Developmentally Disabled facilities or Long Term Care for
11
Under Age 22 facilities, the rates taking effect on March 1,
12
2001 shall include a statewide increase of 7.85%, as defined
13
by the Department.
14

Notwithstanding any other provision of this Section, for
15
facilities licensed by the Department of Public Health under
16
the Nursing Home Care Act as skilled nursing facilities or
17
intermediate care facilities, except facilities participating
18
in the Department's demonstration program pursuant to the
19
provisions of Title 77, Part 300, Subpart T of the Illinois
20
Administrative Code, the numerator of the ratio used by the
21
Department of Healthcare and Family Services to compute the
22
rate payable under this Section using the Minimum Data Set
23
(MDS) methodology shall incorporate the following annual
24
amounts as the additional funds appropriated to the Department
25
specifically to pay for rates based on the MDS nursing
26
component methodology in excess of the funding in effect on

SB3464
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LRB104 19667 KTG 33116 b
1
December 31, 2006:
2

(i) For rates taking effect January 1, 2007,
3

$60,000,000.
4

(ii) For rates taking effect January 1, 2008,
5

$110,000,000.
6

(iii) For rates taking effect January 1, 2009,
7

$194,000,000.
8

(iv) For rates taking effect April 1, 2011, or the
9

first day of the month that begins at least 45 days after
10

February 16, 2011 (the effective date of Public Act
11

96-1530), $416,500,000 or an amount as may be necessary to
12

complete the transition to the MDS methodology for the
13

nursing component of the rate. Increased payments under
14

this item (iv) are not due and payable, however, until (i)
15

the methodologies described in this paragraph are approved
16

by the federal government in an appropriate State Plan
17

amendment and (ii) the assessment imposed by Section 5B-2
18

of this Code is determined to be a permissible tax under
19

Title XIX of the Social Security Act.
20

Notwithstanding any other provision of this Section, for
21
facilities licensed by the Department of Public Health under
22
the Nursing Home Care Act as skilled nursing facilities or
23
intermediate care facilities, the support component of the
24
rates taking effect on January 1, 2008 shall be computed using
25
the most recent cost reports on file with the Department of
26
Healthcare and Family Services no later than April 1, 2005,

SB3464
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LRB104 19667 KTG 33116 b
1
updated for inflation to January 1, 2006.
2

For facilities licensed by the Department of Public Health
3
under the Nursing Home Care Act as Intermediate Care for the
4
Developmentally Disabled facilities or Long Term Care for
5
Under Age 22 facilities, the rates taking effect on April 1,
6
2002 shall include a statewide increase of 2.0%, as defined by
7
the Department. This increase terminates on July 1, 2002;
8
beginning July 1, 2002 these rates are reduced to the level of
9
the rates in effect on March 31, 2002, as defined by the
10
Department.
11

For facilities licensed by the Department of Public Health
12
under the Nursing Home Care Act as skilled nursing facilities
13
or intermediate care facilities, the rates taking effect on
14
July 1, 2001 shall be computed using the most recent cost
15
reports on file with the Department of Public Aid no later than
16
April 1, 2000, updated for inflation to January 1, 2001. For
17
rates effective July 1, 2001 only, rates shall be the greater
18
of the rate computed for July 1, 2001 or the rate effective on
19
June 30, 2001.
20

Notwithstanding any other provision of this Section, for
21
facilities licensed by the Department of Public Health under
22
the Nursing Home Care Act as skilled nursing facilities or
23
intermediate care facilities, the Illinois Department shall
24
determine by rule the rates taking effect on July 1, 2002,
25
which shall be 5.9% less than the rates in effect on June 30,
26
2002.

SB3464
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LRB104 19667 KTG 33116 b
1

Notwithstanding any other provision of this Section, for
2
facilities licensed by the Department of Public Health under
3
the Nursing Home Care Act as skilled nursing facilities or
4
intermediate care facilities, if the payment methodologies
5
required under Section 5A-12 and the waiver granted under 42
6
CFR 433.68 are approved by the United States Centers for
7
Medicare and Medicaid Services, the rates taking effect on
8
July 1, 2004 shall be 3.0% greater than the rates in effect on
9
June 30, 2004. These rates shall take effect only upon
10
approval and implementation of the payment methodologies
11
required under Section 5A-12.
12

Notwithstanding any other provisions of this Section, for
13
facilities licensed by the Department of Public Health under
14
the Nursing Home Care Act as skilled nursing facilities or
15
intermediate care facilities, the rates taking effect on
16
January 1, 2005 shall be 3% more than the rates in effect on
17
December 31, 2004.
18

Notwithstanding any other provision of this Section, for
19
facilities licensed by the Department of Public Health under
20
the Nursing Home Care Act as skilled nursing facilities or
21
intermediate care facilities, effective January 1, 2009, the
22
per diem support component of the rates effective on January
23
1, 2008, computed using the most recent cost reports on file
24
with the Department of Healthcare and Family Services no later
25
than April 1, 2005, updated for inflation to January 1, 2006,
26
shall be increased to the amount that would have been derived

SB3464
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LRB104 19667 KTG 33116 b
1
using standard Department of Healthcare and Family Services
2
methods, procedures, and inflators.
3

Notwithstanding any other provisions of this Section, for
4
facilities licensed by the Department of Public Health under
5
the Nursing Home Care Act as intermediate care facilities that
6
are federally defined as Institutions for Mental Disease, or
7
facilities licensed by the Department of Public Health under
8
the Specialized Mental Health Rehabilitation Act of 2013, a
9
socio-development component rate equal to 6.6% of the
10
facility's nursing component rate as of January 1, 2006 shall
11
be established and paid effective July 1, 2006. The
12
socio-development component of the rate shall be increased by
13
a factor of 2.53 on the first day of the month that begins at
14
least 45 days after January 11, 2008 (the effective date of
15
Public Act 95-707). As of August 1, 2008, the
16
socio-development component rate shall be equal to 6.6% of the
17
facility's nursing component rate as of January 1, 2006,
18
multiplied by a factor of 3.53. For services provided on or
19
after April 1, 2011, or the first day of the month that begins
20
at least 45 days after February 16, 2011 (the effective date of
21
Public Act 96-1530), whichever is later, the Illinois
22
Department may by rule adjust these socio-development
23
component rates, and may use different adjustment
24
methodologies for those facilities participating, and those
25
not participating, in the Illinois Department's demonstration
26
program pursuant to the provisions of Title 77, Part 300,

SB3464
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LRB104 19667 KTG 33116 b
1
Subpart T of the Illinois Administrative Code, but in no case
2
may such rates be diminished below those in effect on August 1,
3
2008.
4

For facilities licensed by the Department of Public Health
5
under the Nursing Home Care Act as Intermediate Care for the
6
Developmentally Disabled facilities or as long-term care
7
facilities for residents under 22 years of age, the rates
8
taking effect on July 1, 2003 shall include a statewide
9
increase of 4%, as defined by the Department.
10

For facilities licensed by the Department of Public Health
11
under the Nursing Home Care Act as Intermediate Care for the
12
Developmentally Disabled facilities or Long Term Care for
13
Under Age 22 facilities, the rates taking effect on the first
14
day of the month that begins at least 45 days after January 11,
15
2008 (the effective date of Public Act 95-707) shall include a
16
statewide increase of 2.5%, as defined by the Department.
17

Notwithstanding any other provision of this Section, for
18
facilities licensed by the Department of Public Health under
19
the Nursing Home Care Act as skilled nursing facilities or
20
intermediate care facilities, effective January 1, 2005,
21
facility rates shall be increased by the difference between
22
(i) a facility's per diem property, liability, and malpractice
23
insurance costs as reported in the cost report filed with the
24
Department of Public Aid and used to establish rates effective
25
July 1, 2001 and (ii) those same costs as reported in the
26
facility's 2002 cost report. These costs shall be passed

SB3464
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LRB104 19667 KTG 33116 b
1
through to the facility without caps or limitations, except
2
for adjustments required under normal auditing procedures.
3

Rates established effective each July 1 shall govern
4
payment for services rendered throughout that fiscal year,
5
except that rates established on July 1, 1996 shall be
6
increased by 6.8% for services provided on or after January 1,
7
1997. Such rates will be based upon the rates calculated for
8
the year beginning July 1, 1990, and for subsequent years
9
thereafter until June 30, 2001 shall be based on the facility
10
cost reports for the facility fiscal year ending at any point
11
in time during the previous calendar year, updated to the
12
midpoint of the rate year. The cost report shall be on file
13
with the Department no later than April 1 of the current rate
14
year. Should the cost report not be on file by April 1, the
15
Department shall base the rate on the latest cost report filed
16
by each skilled care facility and intermediate care facility,
17
updated to the midpoint of the current rate year. In
18
determining rates for services rendered on and after July 1,
19
1985, fixed time shall not be computed at less than zero. The
20
Department shall not make any alterations of regulations which
21
would reduce any component of the Medicaid rate to a level
22
below what that component would have been utilizing in the
23
rate effective on July 1, 1984.
24

(2) Shall take into account the actual costs incurred by
25
facilities in providing services for recipients of skilled
26
nursing and intermediate care services under the medical

SB3464
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LRB104 19667 KTG 33116 b
1
assistance program.
2

(3) Shall take into account the medical and psycho-social
3
characteristics and needs of the patients.
4

(4) Shall take into account the actual costs incurred by
5
facilities in meeting licensing and certification standards
6
imposed and prescribed by the State of Illinois, any of its
7
political subdivisions or municipalities and by the U.S.
8
Department of Health and Human Services pursuant to Title XIX
9
of the Social Security Act.
10

The Department of Healthcare and Family Services shall
11
develop precise standards for payments to reimburse nursing
12
facilities for any utilization of appropriate rehabilitative
13
personnel for the provision of rehabilitative services which
14
is authorized by federal regulations, including reimbursement
15
for services provided by qualified therapists or qualified
16
assistants, and which is in accordance with accepted
17
professional practices. Reimbursement also may be made for
18
utilization of other supportive personnel under appropriate
19
supervision.
20

The Department shall develop enhanced payments to offset
21
the additional costs incurred by a facility serving
22
exceptional need residents and shall allocate at least
23
$4,000,000 of the funds collected from the assessment
24
established by Section 5B-2 of this Code for such payments.
25
For the purpose of this Section, "exceptional needs" means,
26
but need not be limited to, ventilator care and traumatic

SB3464
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LRB104 19667 KTG 33116 b
1
brain injury care. The enhanced payments for exceptional need
2
residents under this paragraph are not due and payable,
3
however, until (i) the methodologies described in this
4
paragraph are approved by the federal government in an
5
appropriate State Plan amendment and (ii) the assessment
6
imposed by Section 5B-2 of this Code is determined to be a
7
permissible tax under Title XIX of the Social Security Act.
8

Beginning January 1, 2014 the methodologies for
9
reimbursement of nursing facility services as provided under
10
this Section 5-5.4 shall no longer be applicable for services
11
provided on or after January 1, 2014.
12

No payment increase under this Section for the MDS
13
methodology, exceptional care residents, or the
14
socio-development component rate established by Public Act
15
96-1530 of the 96th General Assembly and funded by the
16
assessment imposed under Section 5B-2 of this Code shall be
17
due and payable until after the Department notifies the
18
long-term care providers, in writing, that the payment
19
methodologies to long-term care providers required under this
20
Section have been approved by the Centers for Medicare and
21
Medicaid Services of the U.S. Department of Health and Human
22
Services and the waivers under 42 CFR 433.68 for the
23
assessment imposed by this Section, if necessary, have been
24
granted by the Centers for Medicare and Medicaid Services of
25
the U.S. Department of Health and Human Services. Upon
26
notification to the Department of approval of the payment

SB3464
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LRB104 19667 KTG 33116 b
1
methodologies required under this Section and the waivers
2
granted under 42 CFR 433.68, all increased payments otherwise
3
due under this Section prior to the date of notification shall
4
be due and payable within 90 days of the date federal approval
5
is received.
6

On and after July 1, 2012, the Department shall reduce any
7
rate of reimbursement for services or other payments or alter
8
any methodologies authorized by this Code to reduce any rate
9
of reimbursement for services or other payments in accordance
10
with Section 5-5e.
11

For facilities licensed by the Department of Public Health
12
under the ID/DD Community Care Act as ID/DD Facilities and
13
under the MC/DD Act as MC/DD Facilities, subject to federal
14
approval, the rates taking effect for services delivered on or
15
after August 1, 2019 shall be increased by 3.5% over the rates
16
in effect on June 30, 2019. The Department shall adopt rules,
17
including emergency rules under subsection (ii) of Section
18
5-45 of the Illinois Administrative Procedure Act, to
19
implement the provisions of this Section, including wage
20
increases for direct care staff.
21

For facilities licensed by the Department of Public Health
22
under the ID/DD Community Care Act as ID/DD Facilities and
23
under the MC/DD Act as MC/DD Facilities, subject to federal
24
approval, the rates taking effect on the latter of the
25
approval date of the State Plan Amendment for these facilities
26
or the Waiver Amendment for the home and community-based

SB3464
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LRB104 19667 KTG 33116 b
1
services settings shall include an increase sufficient to
2
provide a $0.26 per hour wage increase to the base wage for
3
non-executive staff. The Department shall adopt rules,
4
including emergency rules as authorized by Section 5-45 of the
5
Illinois Administrative Procedure Act, to implement the
6
provisions of this Section, including wage increases for
7
direct care staff.
8

For facilities licensed by the Department of Public Health
9
under the ID/DD Community Care Act as ID/DD Facilities and
10
under the MC/DD Act as MC/DD Facilities, subject to federal
11
approval of the State Plan Amendment and the Waiver Amendment
12
for the home and community-based services settings, the rates
13
taking effect for the services delivered on or after July 1,
14
2020 shall include an increase sufficient to provide a $1.00
15
per hour wage increase for non-executive staff. For services
16
delivered on or after January 1, 2021, subject to federal
17
approval of the State Plan Amendment and the Waiver Amendment
18
for the home and community-based services settings, shall
19
include an increase sufficient to provide a $0.50 per hour
20
increase for non-executive staff. The Department shall adopt
21
rules, including emergency rules as authorized by Section 5-45
22
of the Illinois Administrative Procedure Act, to implement the
23
provisions of this Section, including wage increases for
24
direct care staff.
25

For facilities licensed by the Department of Public Health
26
under the ID/DD Community Care Act as ID/DD Facilities and

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LRB104 19667 KTG 33116 b
1
under the MC/DD Act as MC/DD Facilities, subject to federal
2
approval of the State Plan Amendment, the rates taking effect
3
for the residential services delivered on or after July 1,
4
2021, shall include an increase sufficient to provide a $0.50
5
per hour increase for aides in the rate methodology. For
6
facilities licensed by the Department of Public Health under
7
the ID/DD Community Care Act as ID/DD Facilities and under the
8
MC/DD Act as MC/DD Facilities, subject to federal approval of
9
the State Plan Amendment, the rates taking effect for the
10
residential services delivered on or after January 1, 2022
11
shall include an increase sufficient to provide a $1.00 per
12
hour increase for aides in the rate methodology. In addition,
13
for residential services delivered on or after January 1, 2022
14
such rates shall include an increase sufficient to provide
15
wages for all residential non-executive direct care staff,
16
excluding aides, at the federal Department of Labor, Bureau of
17
Labor Statistics' average wage as defined in rule by the
18
Department. The Department shall adopt rules, including
19
emergency rules as authorized by Section 5-45 of the Illinois
20
Administrative Procedure Act, to implement the provisions of
21
this Section.
22

For facilities licensed by the Department of Public Health
23
under the ID/DD Community Care Act as ID/DD facilities and
24
under the MC/DD Act as MC/DD facilities, subject to federal
25
approval of the State Plan Amendment, the rates taking effect
26
for services delivered on or after January 1, 2023, shall

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LRB104 19667 KTG 33116 b
1
include a $1.00 per hour wage increase for all direct support
2
personnel and all other frontline personnel who are not
3
subject to the Bureau of Labor Statistics' average wage
4
increases, who work in residential and community day services
5
settings, with at least $0.50 of those funds to be provided as
6
a direct increase to all aide base wages, with the remaining
7
$0.50 to be used flexibly for base wage increases to the rate
8
methodology for aides. In addition, for residential services
9
delivered on or after January 1, 2023 the rates shall include
10
an increase sufficient to provide wages for all residential
11
non-executive direct care staff, excluding aides, at the
12
federal Department of Labor, Bureau of Labor Statistics'
13
average wage as determined by the Department. Also, for
14
services delivered on or after January 1, 2023, the rates will
15
include adjustments to employment-related expenses as defined
16
in rule by the Department. The Department shall adopt rules,
17
including emergency rules as authorized by Section 5-45 of the
18
Illinois Administrative Procedure Act, to implement the
19
provisions of this Section.
20

For facilities licensed by the Department of Public Health
21
under the ID/DD Community Care Act as ID/DD facilities and
22
under the MC/DD Act as MC/DD facilities, subject to federal
23
approval of the State Plan Amendment, the rates taking effect
24
for services delivered on or after January 1, 2024 shall
25
include a $2.50 per hour wage increase for all direct support
26
personnel and all other frontline personnel who are not

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LRB104 19667 KTG 33116 b
1
subject to the Bureau of Labor Statistics' average wage
2
increases and who work in residential and community day
3
services settings. At least $1.25 of the per hour wage
4
increase shall be provided as a direct increase to all aide
5
base wages, and the remaining $1.25 of the per hour wage
6
increase shall be used flexibly for base wage increases to the
7
rate methodology for aides. In addition, for residential
8
services delivered on or after January 1, 2024, the rates
9
shall include an increase sufficient to provide wages for all
10
residential non-executive direct care staff, excluding aides,
11
at the federal Department of Labor, Bureau of Labor
12
Statistics' average wage as determined by the Department.
13
Also, for services delivered on or after January 1, 2024, the
14
rates will include adjustments to employment-related expenses
15
as defined in rule by the Department. The Department shall
16
adopt rules, including emergency rules as authorized by
17
Section 5-45 of the Illinois Administrative Procedure Act, to
18
implement the provisions of this Section.
19

For facilities licensed by the Department of Public Health
20
under the ID/DD Community Care Act as ID/DD facilities and
21
under the MC/DD Act as MC/DD facilities, subject to federal
22
approval of a State Plan Amendment, the rates taking effect
23
for services delivered on or after January 1, 2025 shall
24
include a $1.00 per hour wage increase for all direct support
25
personnel and all other frontline personnel who are not
26
subject to the Bureau of Labor Statistics' average wage

SB3464
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LRB104 19667 KTG 33116 b
1
increases and who work in residential and community day
2
services settings, with at least $0.75 of those funds to be
3
provided as a direct increase to all aide base wages and the
4
remaining $0.25 to be used flexibly for base wage increases to
5
the rate methodology for aides. These increases shall not be
6
used by facilities for operational and administrative
7
expenses. In addition, for residential services delivered on
8
or after January 1, 2025, the rates shall include an increase
9
sufficient to provide wages for all residential non-executive
10
direct care staff, excluding aides, at the federal Department
11
of Labor, Bureau of Labor Statistics' average wage as
12
determined by the Department. Also, for services delivered on
13
or after January 1, 2025, the rates will include adjustments
14
to employment-related expenses as defined in rule by the
15
Department. The Department shall adopt rules, including
16
emergency rules as authorized by Section 5-45 of the Illinois
17
Administrative Procedure Act, to implement the provisions of
18
this Section.
19

For facilities licensed by the Department of Public Health
20
under the ID/DD Community Care Act as ID/DD facilities and
21
under the MC/DD Act as MC/DD facilities, subject to federal
22
approval of a State Plan Amendment, the rates taking effect
23
for services delivered on or after January 1, 2026 shall
24
include a $0.80 per hour wage increase for all direct support
25
personnel and all other frontline personnel who are not
26
subject to the Bureau of Labor Statistics' average wage

SB3464
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LRB104 19667 KTG 33116 b
1
increases and who work in residential and community day
2
services settings, with at least $0.60 of those funds to be
3
provided as a direct increase to all aide base wages and the
4
remaining $0.20 to be used flexibly for base wage increases to
5
the rate methodology for aides. These increases shall not be
6
used by facilities for operational and administrative
7
expenses. In addition, for residential services delivered on
8
or after January 1, 2026, the rates shall include an increase
9
sufficient to provide wages for all residential non-executive
10
direct care staff, excluding aides, at the federal Department
11
of Labor, Bureau of Labor Statistics' average wage as
12
determined by the Department. Also, for services delivered on
13
or after January 1, 2026, the rates will include adjustments
14
to employment-related expenses as defined in rule by the
15
Department. The Department shall adopt rules, including
16
emergency rules as authorized by Section 5-45 of the Illinois
17
Administrative Procedure Act, to implement the provisions of
18
this Section.
19

Notwithstanding any other provision of this Section to the
20
contrary, any regional wage adjuster for facilities located
21
outside of the counties of Cook, DuPage, Kane, Lake, McHenry,
22
and Will shall be no lower than 1.00, and any regional wage
23
adjuster for facilities located within the counties of Cook,
24
DuPage, Kane, Lake, McHenry, and Will shall be no lower than
25
1.15.
26

(5) For dates of service starting January 1, 2027,

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LRB104 19667 KTG 33116 b
1
reimbursement calculations and direct payments for services
2
provided by facilities licensed under the ID/DD Community Care
3
Act are the responsibility of the Department of Healthcare and
4
Family Services. Appropriations for facilities licensed under
5
the ID/DD Community Care Act must be shifted from the
6
Department of Human Services to the Department of Healthcare
7
and Family Services. Nothing in this Section shall prohibit
8
the Department of Healthcare and Family Services from paying
9
more than the rates specified in this Section. Nothing in this
10
Section shall affect the requirements of Section 3-213 of the
11
ID/DD Community Care Act.

12
(Source: P.A. 103-8, eff. 6-7-23; 103-588, eff. 7-1-24; 104-2,
13
eff. 6-16-25.)

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