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Table of Contents:

• FY 21 State Budget and Legislative Update
• Extension of Timely Filing Override for FSP Residential Providers
• HFS Seeking Community Input for IL Medicaid SUD Care
• Vote Yes For Fair Tax Organizational Sign-On
• Are You Interested in Serving as an Integrated Health Home?
• No Cost Insurance Program Analysis from The Horton Group
• Still Time to Submit a Proposal for the IARF/IABH Virtual Conference
• DPH Files Emergency Rules For COVID-19 Testing at SNF and ICF
• DDD Communication: Return to Residential Considerations
• ICF/DD Rate Increase Update
• IARF Webinar: WC-102 Communication & Restricted Duty
• Talking about COVID-19: Resources for People with I/DD Webinar

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FY 21 STATE BUDGET AND LEGISLATIVE UPDATE
The FY21 budget (SB 264) that passed the General Assembly Saturday night is a combination of GRF, OSF, increases in federal funding from CARES, and borrowing from the federal reserve patched together. Leader Harris said if not for the federal borrowing, the GA would’ve been forced to pass a budget that was 35% cut. Something he was not willing to do. Flat (similar level of spending to FY20) budget.
The major budget lines that fund community-based I/DD and BH services and supports were largely kept to the Governor’s FY21 request – meaning appropriations were included to adjust for minimum wage pressures, including the

• DHS-DDD $1.00/hr wage increase effective July 1, 2020; and
• $0.50/hr wage increase effective January 1, 2021.

Operational appropriation for FY 21 is $683 million, a 6% increase over FY 20 appropriations.
This includes funding for nearly 300 new caseworkers brought on in the spring of 2020 to process Medicaid eligibility applications, particularly considering a substantial Medicaid backlog. The Department also intends to bring on another 100 case workers specifically for LTC Medicaid eligibility.

BIMP (HB 357 p. 352)
IARF had worked through the last two days to ensure that BIMP language on the DDD increases was crystal clear in its intent – an increase in the wage rate components, but not a required direct pass through. The language IARF preferred was in the first BIMP amendment to HB 357, but at 11 PM another amendment was filed that contained other changes, and our changes were not incorporated into the new amendment, as they were in the first amendment. We have confirmed that the omission of our language was a drafting error, and not the result of exterior forces.
We have developed a strategy to engage DHS and key legislators to get more clarity as to the intent.

Telemedicine and Remote Supports and Services,
The Governor’s expansion of telehealth outlined in Executive Order 2020-09 will continue to be in place for the next several months during the public health emergency.  While legislation was not approved that permanently authorized the expansion of Telehealth in the I/DD setting during the brief legislative session last week, language was included that authorized the continued coverage of telehealth in the Medicaid program for up to 12 months past the public health emergency (with federal approval).  We will continue to work with the legislature on language heading into Veto Session to codify the expansion into law.

SB 1864, otherwise known as the Medicaid Omnibus bill, contains IARFs language that requires HFS and DHS to file a waiver for remote monitoring for CILAs. IARF members may recall that this was part of our original legislative agenda, and we are happy to say IARF was able to carry it through to the end.  This means that DHS-DDD and HFS have until next July (if not sooner) to adopt rules and a waiver amendment that would allow remote services and supports to be a reimbursable service in CILA under the waiver.

Unemployment Insurance and Worker’s Comp
As we indicated in a previous update, the General Assembly packed a lot into this legislation. Below are the major changes to Unemployment Insurance and Workers Comp Coverage:
Unemployment Insurance Changes (HB 2455):

• Waiver of the benefits charges to individual employers due to benefits paid and caused by COVID-19;
• Reimbursable employers are responsible for 50% of the benefits paid if the individual’s unemployment is directly or indirectly attributable to COVID-19;
• Clarifies that employers will not be charged for benefits paid due to the waiver of the 1 week waiting period;
• Waiver of the one week waiting period before benefits are paid;
• Regular benefits are extended by an additional 13 weeks;
• Expansion of benefits to non-instructional Workers;
• Allows the Director of IDES to provide for rules as allowed by federal law limiting the work search requirements;
• Guidance on “speed bumps.”

Worker’s Compensation changes (SB 471):

• Establishes a rebuttal presumption for COVID-19 Exposure and Contraction;
• Defines first responders and frontline workers;
• Guidance on COVID-19 diagnosis or positive test for presumption to apply;
• Establishes an employer’s burden of proof as in Johnston V IWCC Appellate Court Decision;
• Application of the Presumption of Date of Injury;
• Clarification of Claim Status if Presumption is Defeated;
• Insurance Experience Rating for Individual Employer Prohibited; and
• Temporary Total Benefit Certification and Employer Credits.

Both bills have passed both houses and are awaiting the Governor’s signature to become law.

Election Omnibus Bill
IARF had been pursuing, prior to the COIVD outbreak, a law that would have changed the definition of “disabled voter” to correspond with the ADA definition of “disabled,” changed the dissemination of materials from 60 days to 75 days prior to the election, and make an automatic vote by mail program for those “disabled voters.”  Since this bill is going to pertain only to the 2020 election, our language was not included, but IARF has been given assurance that this initiative will have a chance to be addressed in the next election bill that comes through the General Assembly.  However, the 75-day dissemination of materials was included for the 2020 election, so IARF is proud to have put that recommendation forward. The bill, SB 1863, has passed both houses and is awaiting the Governor’s signature to become law. (Contact: IARF Staff)

EXTENSION OF TIMELY FILING OVERRIDE FOR FSP RESIDENTIAL PROVIDERS
HFS has issued a notice to inform providers that the Department of Healthcare and Family Services is updating billing policy for providers of Family Support Program (FSP) Residential Treatment Services.  You can find the complete notice here.  (Contact Dan Frey)
 
HFS SEEKING COMMUNITY INPUT FOR IL MEDICAID SUD CARE
The Illinois Department of Healthcare and Family Services (HFS) is seeking community input regarding how to improve substance use disorder care for Medicaid beneficiaries.  You can click here for more information.
 
Your input is critical. Organizations and individuals can schedule online interviews or submit written feedback. Interviews will take place June 1st through June 29th, 2020. Please send at least 3 available days/times for a 30-60 minute interview to the following with Subject Line: SUD Input.

▫ Southern Illinois, South Central Illinois and Central Illinois - Angie Bailey, Southern Illinois Healthcare: angie.bailey@sih.net

▫ Northern Illinois or State-Wide Agencies or Organizations - Christie Edwards, Cook County Health: credwards@cookcountyhhs.org

Letters will be accepted until 5pm on June 29th.

* This activity is funded by the Centers for Medicare and Medicaid Services (CMS) through Sec. 1003 of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. (Contact Dan Frey)

VOTE YES FOR FAIR TAX ORGANIZATIONAL SIGN-ON
As you all know, IARF last December unanimously passed a resolution to support the Illinois Fair Tax initiative.  As a part of that initiative, IARF has been participating in the Vote Yes for Fair Tax and Vote Yes for Fairness committees.
 
Vote Yes for Fair Tax has requested that organizations who support the passage of the Fair Tax constitutional amendment in November sign on to formally list their support.  You can do so by clicking here.    IARF has signed on as a supportive organization as well and will be hosting a webinar on June 10^th for those who are interested in learning more about Vote Yes for Fair Tax; click here to register. (Contact Dan Frey)
 
ARE YOU INTERESTED IN SERVING AS AN INTEGRATED HEALTH HOME?
With the launch of the Integrated Health Home (IHH) now pushed back to January 1, 2021, there are ways to begin the process of becoming an IHH ahead of more specific information or criteria becoming available.  If you are interested in serving as an IHH, please let the Illinois Association of Medicaid Health Plans (IAMHP) know and they will send that information on to the Medicaid health plans.
 
Complete the IHH Submission Form and IAMHP will send at least a weekly report to the plans with your information. (Contact Dan Frey)
 
NO COST INSURANCE PROGRAM ANALYSIS FROM THE HORTON GROUP
Have the experts at The Horton Group review your insurance program (benefits, liability, workers comp, etc.) at no cost.  Given the added compliance and regulation caused by COVID-19 and the increasingly tight bottom line, we hope to provide insight and cost savings to IARF members.  Key areas of opportunity on the medical benefits include:

• Leveraging carriers that are aggressive for new business opportunities
• Utilizing technology to communicate with a changed workforce
• Perfecting FMLA and leave management
• Conducting a full compliance review to ensure you are up-to-date with the latest regulations

Now, more than ever, it is imperative for Illinois human service agencies to take an active role in their property and casualty insurance renewals. Carriers are imposing new limits on abuse and molestation coverages, umbrellas are being limited, and the workers compensation market is becoming more conservative. Horton’s Human Service Team positions our clients to yield the best results from the insurance marketplace. Our team brings risk management expertise as well as carrier and coverage specialization to mitigate risk, reduce workload, and lower costs for the following classes of business…

• Developmental Disability Agencies
• Alcohol and Substance Abuse Rehabilitation
• Residential/ CILA Providers
• Hospice/ Palliative Care
• Respite Providers
• Day Program Providers, and more

Utilizing our strategic insurance carrier network, the Horton Human Service Team can assist with the following lines of coverage:

• Workers Compensation
• Directors & Officers
• Property & General Liability
• Employment Practices Liability
• Abuse & Molestation
• Cyber Liability
• Umbrella and Excess Liability
• Special Event Liability, and more

The first step in taking an active role in your renewal is ensuring that your agency has appropriate coverages and losses are being mitigated. If you are interested in having The Horton group review your insurance programs at no cost, contact Liz Letke at Elizabeth.Letke@thehortongroup.com today! (Contact: Maggie Henley)

STILL TIME TO SUBMIT A PROPOSAL FOR THE IARF/IABH VIRTUAL CONFERENCE
Proposals for presentations at the 2020 IARF and IABH Virtual Conference are still being accepted. The Conference will host a range of professionals and paraprofessionals providing prevention, treatment and recovery services for adults and children with intellectual/developmental disabilities, mental health and substance use disorders. Proposals related to all aspects of human service including management, policy, human resources and more are welcomed. Click here to view the full call for proposals.
 
If you would like to submit a proposal, please click here to access the submission form. Proposals must be submitted by no later than June 5^th. (Contact: Maggie Henley)
 
DPH FILES EMERGENCY RULES FOR COVID-19 TESTING AT SNF AND ICF
Effective May 28, 2020, DPH has filed Emergency Rules that requires long term care facilities (SNF and ICF) to add testing for infectious diseases to the facility’s infection control policies and procedures. IARF noted that the rules only apply to SNF and ICF as CILA, MC/DD, and the Child Care Acts are not specifically mentioned.

Facilities must comply with infection control recommendations provided by the Department or their local health department and must test residents and staff when they have either an outbreak in the facility or when the chain of transmission is high and the Department directs them to conduct testing.  Test results must be reported to the Department. (Contact: Luis Andrade)
 
DDD COMMUNICATION: RETURN TO RESIDENTIAL CONSIDERATIONS
IDHS-DDD released a new provider communication, expressing a desire to reopen services and supports cautiously -- with safety and everyone’s quality of life in mind.  The Division believes one of the first steps includes individuals who are residing outside of their residential setting beginning the process of returning to their CILA or ICF-DD services.  The Division recommends a return once they plan to remain there long-term and offered discussion points for families and providers to consider when planning the transition.    (Contact: Beth Owens)
 
ICF/DD RATE INCREASE UPDATE
The Division of Developmental Disabilities announced this week that legislation to approve an increase to wages to $13.00 per hour for direct care staff in Intermediate Care Facilities (ICF/DD) passed through both the House and the Senate.  This is required for State Plan Amendments (SPA) due to ICF/DD rates being set in statute.  After legislation is passed, the State is required to publish a public notice and allow for public comments for 30 days. HFS is set to publish the public notice for this increase as soon as this week.  The effective date for the rate increase cannot precede the passage of the legislation and beginning of the public notice period. Due to the unforeseen delays with the legislative approval and the requirements for SPAs, the soonest the State can ask for the $13 increase to be effective is June 1, 2020. Once the SPA is approved, HFS and IDHS have indicated they will move with all haste to ensure a smooth implementation for providers.  A memo from Director Stark on this can be found HERE. (Contact: Beth Owens)
 
IARF WEBINAR: WC-102 COMMUNICATION & RESTRICTED DUTY
On June 30^th IARF will host our second webinar in the Workers’ Compensation Webinar Series with Lori Beers. In course 102, we will dig a bit deeper into working with modified duty restrictions. This section will include how to facilitate communication between you, the employee, and the doctor, regarding modified duty work. We’ll discuss how to track and monitor modified duty, to ensure employee safety and compliance.  Lastly, we’ll go over the rules regarding time away from work for injury related medical treatment.
 
 At the end of this course, attendees will:

• Understand the rules for communicating with the doctor and injured employee with regards to work restrictions.
• Understand how to track and monitor work restrictions.
• Understand how to handle time away from work for injury related medical treatment.

Click here to learn more and register today. This webinar is free for IARF members and member login is required for registration. If you have any questions, please contact mhenley@iarf.org. (Contact: Maggie Henley)

TALKING ABOUT COVID-19: RESOURCES FOR PEOPLE WITH I/DD WEBINAR
This webinar is part of COVID-19 Webinar Series presented by the HealthMatters Program (https://www.healthmattersprogram.org), Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago through continued partnership with Project SEARCH (https://www.projectsearch.us) funded by the Ohio Developmental Disabilities Council, Grant # 17CH03FA20 and Aspire (https://aspirechicago.com). Kathy Service, National Task Group on Intellectual Disabilities and Dementia Practices will present on strategies, resources, and tips to support people with I/DD to understand what’s going on with COVID-19, why do we need to take precautions, and how will protections help us. Additionally, the presentation will discuss how to advocate for legal rights and reasonable accommodations.  You can register for the free webinar HERE. (Contact: Beth Owens)