210 ILCS 135/13.3: Community-integrated living arrangement per diem reimbursement.

(Text of Section before amendment by P.A. 104-470)

As used in this Section, "medical absence" means a situation in which a resident is temporarily absent from a community-integrated living arrangement to receive medical treatment or for other reasons that have been recommended by third-party medical personnel, including, but not limited to, hospitalizations, placements in short-term stabilization homes or State-operated facilities, stays in nursing facilities, rehabilitation in long-term care facilities, or other absences for legitimate medical reasons.

Beginning January 1, 2025, the Department's Division of Developmental Disabilities shall provide 100% of the per diem reimbursement to a 24-hour community-integrated living arrangement provider for up to 20 days for any resident requiring a medical absence. During the medical absence, the provider shall hold the bed for the resident. After the medical absence, the resident shall return to the community-integrated living arrangement when the resident is medically able to return in order for the provider to receive the full per diem reimbursement for the absent days. The per diem reimbursement shall be in addition to the existing occupancy factor policy set by the Division of Developmental Disabilities.

(Text of Section after amendment by P.A. 104-470)

Community-integrated living arrangement per diem reimbursement. As used in this Section, "medical absence" means a situation in which a resident is temporarily absent from a community-integrated living arrangement to receive medical treatment or for other reasons that have been recommended by third-party medical personnel, including, but not limited to, hospitalizations, placements in short-term stabilization homes or State-operated facilities, stays in nursing facilities, rehabilitation in long-term care facilities, or other absences for legitimate medical reasons.

Beginning January 1, 2025, the Department's Division of Developmental Disabilities shall provide 100% of the per diem reimbursement to a 24-hour community-integrated living arrangement provider for up to 20 days for any resident requiring a medical absence. During the medical absence, the provider shall hold the bed for the resident. After the medical absence, the resident shall return to the community-integrated living arrangement when the resident is medically able to return in order for the provider to receive the full per diem reimbursement for the absent days. However, if it is determined by a treating physician that the resident is unable to return to the community-integrated living arrangement, or if the resident dies during the medical absence, the provider shall receive 100% of the per diem reimbursement for up to 20 medical absence days. The per diem reimbursement shall be in addition to the existing occupancy factor policy set by the Division of Developmental Disabilities. Any Department policy or rulemaking issued to implement this Section shall provide that for medical absences a resident's termination date is the date the resident either passes away or the date it is determined by a treating physician that the resident is unable to return to the community-integrated living arrangement.