HB 699 — PUBLIC AID-TECH

HB0699 EngrossedEnrolled LRB093 05498 MKM 05589 b AN ACT in relation to public aid.

The Illinois Public Aid Code is amended by changing Section 10-15-5.4 as follows:

(305 ILCS 5/10-1)5/5-5.4) (from Ch.

10-1)5-5.4) Sec.

10-1.5-5.4.

DeclarationStandards of PublicPayment Policy - PersonsDepartment Eligible for Child Support Enforcement Services - Fees for Non-Applicants and Non-Recipients.) It is the intent of tPublic ___Aid. _____o______________ ---- Code that the financial aid and social welfare services herein provided supplement rather than supplant the primary and continuing obligation of the family unit for self-support to the fullest extent permitted by the resources available to it.

ThisThe primaryDepartment andof continuingPublic obligationAid appliesshall whetherdevelop thestandards family unit of parentspayment and children or of husbandskilled nursing and wifeintermediate remainscare intactservices and resides in afacilities commonproviding householdsuch orservices whetherunder thethis unitArticle haswhich: been broken by absence of one or more members of the unit.

The(1) obligationProvide offor the familydetermination unitof is particularly applicable when a memberfacility’s ispayment infor necessitousskilled circumstancesnursing and lacksintermediate thecare meansservices ofon a livelihoodprospective compatiblebasis. with health and well-being.

ItThe isamount of the purposepayment rate for all nursing facilities certified by the Department of thisPublic ArticleHealth tounder providethe forNursing locatingHome anCare absentAct parentas orIntermediate spouse,Care for determiningthe hisDevelopmentally financialDisabled circumstances,facilities, andLong Term Care for enforcingUnder hisAge legal22 obligationfacilities, Skilled Nursing facilities, or Intermediate Care facilities under the medical assistance program shall be prospectively established annually on the basis of support,historical, iffinancial, heand isstatistical abledata reflecting actual costs from prior years, which shall be applied to furnishthe support,current inrate wholeyear orand inupdated part.for inflation, except that the capital cost element for newly constructed facilities shall be based upon projected budgets.

The Illinoisannually Departmentestablished ofpayment Publicrate Aid shall givetake priorityeffect toon establishing,July enforcing1 andin collecting1984 the current support obligation, and thensubsequent toyears. past due support owed to the family unit, except with respect to collections effected through the intercept programs provided for in this Article.

HB0699No Engrossedrate -2-increase LRB093and 05498no MKMupdate 05589for binflation Theshall childbe support enforcement services provided hereunderon shallor beafter furnishedJuly dependents1, of1994 anand absentbefore parentJuly or1, spouse2005, whounless arespecifically applicantsprovided for orin recipients of financial aid under this Code.Section.

ItThe ischanges not,made however,by athis conditionamendatory Act of eligibilitythe for93rd financialGeneral aidAssembly thatextending therethe beduration noof responsiblethe relativesprohibition whoagainst a rate increase or update for inflation are reasonablyeffective ableretroactive to provideJuly support.1, 2004.

Nor,For exceptfacilities aslicensed providedby inthe SectionsDepartment 4-1.7of andPublic 10-8,Health shallHB0699 Enrolled - 2 - LRB093 05498 MKM 05589 b under the existenceNursing ofHome suchCare relativesAct oras theirIntermediate paymentCare offor supportthe contributionsDevelopmentally disqualifyDisabled afacilities needyor personLong Term Care for financialUnder aid.Age 22 facilities, the rates taking effect on July 1, 1998 shall include an increase of 3%.

ByFor acceptingfacilities financiallicensed aidby underthe thisDepartment Code, a spouse or a parent or other person having custody of aPublic childHealth shallunder be deemed to have made assignment to the IllinoisNursing DepartmentHome forCare aidAct underas ArticlesSkilled III,Nursing IV,facilities V and VII or toIntermediate aCare localfacilities, governmentalthe unitrates fortaking aideffect underon ArticleJuly VI1, of1998 anyshall andinclude allan rights,increase title,of and3% interestplus in$1.10 anyper supportresident-day, obligationas updefined toby the amountDepartment. of financial aid provided.

TheFor rightsfacilities tolicensed supportby assigned to the Illinois Department of Public AidHealth orunder localthe governmentalNursing unitHome shallCare constituteAct anas obligationIntermediate owedCare for the StateDevelopmentally Disabled facilities or localLong governmentalTerm unitCare byfor theUnder personAge who22 isfacilities, responsiblethe forrates providingtaking theeffect support,on andJuly 1, 1999 shall beinclude collectiblean underincrease allof applicable1.6% processes.plus $3.00 per resident-day, as defined by the Department.

TheFor Illinoisfacilities licensed by the Department of Public AidHealth shallunder alsothe furnishNursing theHome childCare supportAct enforcementas servicesSkilled establishedNursing underfacilities thisor ArticleIntermediate inCare behalffacilities, ofthe personsrates whotaking areeffect noton applicantsJuly for1, or1999 recipientsshall include an increase of financial1.6% aidand, underfor thisservices Codeprovided inon accordanceor withafter theOctober requirements1, of1999, Titleshall IV,be Partincreased Dby of$4.00 theper Socialresident-day, Securityas Act.defined by the Department.

TheFor Departmentfacilities maylicensed establishby athe scheduleDepartment of reasonablePublic fees,Health tounder bethe paidNursing Home Care Act as Intermediate Care for the servicesDevelopmentally providedDisabled andfacilities mayor deductLong aTerm collectionCare fee,for notUnder toAge exceed22 10%facilities, the rates taking effect on July 1, 2000 shall include an increase of the2.5% amountper collected,resident-day, fromas suchdefined collection.by the Department.

TheFor Illinoisfacilities licensed by the Department of Public AidHealth shallunder cause to be published and distributed publications reasonably calculated to inform the publicNursing thatHome individualsCare whoAct areas notSkilled recipientsNursing offacilities or applicantsIntermediate forCare publicfacilities, aidthe underrates thistaking Codeeffect areon eligibleJuly for1, the2000 childshall supportinclude HB0699an Engrossedincrease -3-of LRB0932.5% 05498per MKMresident-day, 05589as bdefined enforcementby servicesthe underDepartment. this Article X.

SuchFor publicationsfacilities shalllicensed setby forththe anDepartment explanation,of inPublic plainHealth language,under that the childNursing supportHome enforcementCare servicesAct programas isskilled independentnursing offacilities anyor publicintermediate aidcare programfacilities, undera thenew Codepayment andmethodology thatmust thebe receivingimplemented offor childthe supportnursing enforcementcomponent servicesof in no way implies that the personrate receivingeffective suchJuly services1, is2003. receiving public aid.

The Department of Public Aid shall develop the HB0699 Enrolled - 3 - LRB093 05498 MKM 05589 b new payment methodology using the Minimum Data Set (MDS) as the instrument to collect information concerning nursing home resident condition necessary to compute the rate.

The Department of Public Aid shall develop the new payment methodology to meet the unique needs of Illinois nursing home residents while remaining subject to the appropriations provided by the General Assembly.

A transition period from the payment methodology in effect on June 30, 2003 to the payment methodology in effect on July 1, 2003 shall be provided for a period not exceeding 2 years after implementation of the new payment methodology as follows:

(A) For a facility that would receive a lower nursing component rate per patient day under the new system than the facility received effective on the date immediately preceding the date that the Department implements the new payment methodology, the nursing component rate per patient day for the facility shall be held at the level in effect on the date immediately preceding the date that the Department implements the new payment methodology until a higher nursing component rate of reimbursement is achieved by that facility.

(B) For a facility that would receive a higher nursing component rate per patient day under the payment methodology in effect on July 1, 2003 than the facility received effective on the date immediately preceding the date that the Department implements the new payment methodology, the nursing component rate per patient day for the facility shall be adjusted.

(C) Notwithstanding paragraphs (A) and (B), the nursing component rate per patient day for the facility shall be adjusted subject to appropriations provided by the General Assembly.

For facilities licensed by the Department of Public Health under the Nursing Home Care Act as Intermediate Care for the Developmentally Disabled facilities or Long Term Care for Under Age 22 facilities, the rates taking effect on March 1, 2001 HB0699 Enrolled - 4 - LRB093 05498 MKM 05589 b shall include a statewide increase of 7.85%, as defined by the Department.

For facilities licensed by the Department of Public Health under the Nursing Home Care Act as Intermediate Care for the Developmentally Disabled facilities or Long Term Care for Under Age 22 facilities, the rates taking effect on April 1, 2002 shall include a statewide increase of 2.0%, as defined by the Department.

This increase terminates on July 1, 2002;

beginning July 1, 2002 these rates are reduced to the level of the rates in effect on March 31, 2002, as defined by the Department.

For facilities licensed by the Department of Public Health under the Nursing Home Care Act as skilled nursing facilities or intermediate care facilities, the rates taking effect on July 1, 2001 shall be computed using the most recent cost reports on file with the Department of Public Aid no later than April 1, 2000, updated for inflation to January 1, 2001.

For rates effective July 1, 2001 only, rates shall be the greater of the rate computed for July 1, 2001 or the rate effective on June 30, 2001.

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

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

These rates shall take effect only upon approval and implementation of the payment methodologies required under HB0699 Enrolled - 5 - LRB093 05498 MKM 05589 b Section 5A-12.

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

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

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

These costs shall be passed through to the facility without caps or limitations, except for adjustments required under normal auditing procedures.

Rates established effective each July 1 shall govern payment for services rendered throughout that fiscal year, except that rates established on July 1, 1996 shall be increased by 6.8% for services provided on or after January 1, 1997.

Such rates will be based upon the rates calculated for the year beginning July 1, 1990, and for subsequent years thereafter until June 30, 2001 shall be based on the facility cost reports for the facility fiscal year ending at any point in time during the previous calendar year, updated to the midpoint of the rate year.