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DDD CILA- Related Information Bulletins: Community- Integrated Living Arrangement (CILA) Individual Rate Determination Model. CILA User Guide, Cost Center Definitions, and Allowance Levels. CILA Start- Up Guidelines. CILA Forms Table of Contents. Introduction. The History of CILA Rate Setting. Program Code: 50D: Max Allowed: 25 hours per fiscal year, unless a written extension request is submitted and approved: Units: Hours and minutes rounded to the nearest 15 minutes: Billable Time: Participating in service plan. Help in finding attorneys, therapists, educational consultants, psychologists, diagnosticians, health care providers, tutors, coaches, and advocates for children with learning disabilities and special education needs. The Philosophy of CILA Rate Setting: Model for Individual Need. The CILA Rate Model has been in use for seven years and each time this . Once again, we must report that very significant changes have taken place since the last update of this book. 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User Guide publication and incorporates the information distributed in various follow- up memoranda to the field. Policy and methodological changes, new or revised documentation requirements, and adjustments to the rate setting criteria used by Department staff in reviewing and running individual rates that have been adopted are included in this edition of the User Guide. The User Guide contains numerous tables that show the cost center- specific reimbursement rates used in the Model. Unless otherwise specified, these cost center reimbursement rate values are effective as of January 1, 2. They incorporate all legislatively- appropriated cost- of- living- increases, special appropriations, and other allowance level adjustments made by the Department, including the $1. Wage/Fringe Enhancement for Direct Service Persons, QMRPs, Supervisors, and . Please begin using these revised forms immediately. Finally, there have been many successes and challenges associated with the day- to- day administration of the CILA Individualized Rate Model. The Model rate setting process that began in July, 1. CILA Rates Unit staff now mail out and make rate adjustments for over 4. Individual Rate Reviews each month. In addition, community agencies send in hundreds of unscheduled changes per month that adjust individual rates for things like client address changes, changes to individual nursing requirements, and new client income information. In the Department's opinion, the CILA rate setting process has vastly improved the method by which the State of Illinois reimburses community agencies for providing residential supports. Clearly, there are still many areas where the Department, community provider agencies, and Pre- Admission Screening (PAS) agencies can improve their performance within the administration of the rate setting process. Over the years, working together, we have made many improvements and we will continue to do so. This re- visitation of the CILA Individual Rate Determination Model User Guide represents another benchmark in timing for communicating our efforts along these lines. We remain committed to improving the Model's methodology and to making the administrative part of the rate setting and rate review processes as efficient and as routine as possible. Any questions on the content of this User Guide, or on the policies expressed within, should be directed to the CILA Rates Unit, Bureau of Community Reimbursement, 4. North Fourth Street, Springfield, Illinois 6. The History of CILA Rate Setting. Community- Integrated Living Arrangements (CILAs) provide flexible supports to persons with developmental disabilities in the person's own home or other community settings where eight or fewer individuals live together. CILA supports were first funded by the Department of Mental Health and Developmental Disabilities (DMHDD) in Fiscal Year 1. At that time, rates were set at a . The Cost- Over- Standard methodology set rates that were generally higher than the standard $3. Department. A 1. 99. Health Care Financing Authority (HCFA) audit, now CMS, (referred to as a 1. Illinois' method of funding CILA supports to be deficient in that the Waiver Claiming Rate did not separate room and board costs from program costs on an individualized basis, that one total rate was applied to all persons receiving 2. Hour or Intermittent services, and that rates were being set based on a provider's financial needs rather than the individual's service needs. Almost concurrently with the HCFA findings, the Department's Advisory Council for Unified Services/Supports to Illinois Citizens with Developmental Disabilities, in their strategic planning document, Strategic Planning for Services and Supports in Illinois (September 1. Members from the Department's Advisory Council, with staff from DMHDD and the Department of Public Aid (DPA), convened to develop a methodology that would set rates based on a specific individual's needs and the conditions in which the CILA supports were being provided. In July, 1. 99. 4, the CILA Individual Rate Model was implemented. Since that time, all rates for new CILA placements have been determined using the new rate- setting methodology. As of this writing, (January 2. Model- determined individual rates have been approved with annualized total funding of nearly $2. On July 1, 1. 99. Department of Mental Health and Developmental Disabilities was incorporated into the new Department of Human Services and the administration and oversight of the CILA Individual Rate Determination Model moved under the new Department. HCFA, now CMS, returned to Illinois to review the State's waiver programs in 1. CILA program. Beginning in July, 1. CILA, were required to have a . This information is now used to establish the reimbursement for all nursing services in the CILA rate for an individual. NSPs must be updated annually and the information must be corroborated by a Registered Nurse. Also in July, 1. 99. Department's budget included a $1. This change meant that the providers of these supports would now bill the Department for reimbursement after delivering the day or therapy services to the individual. Other, less significant methodological changes have been adopted and became effective in January, 2. These changes were distributed to all provider agencies of CILA services and other interested parties in a February 2. Associate Director Melissa Wright. The changes explained in that memorandum are included within this User Guide. Most recently, Governor George Ryan and the Illinois General Assembly included in the Department's Fiscal Year 2. Wage/Fringe Benefit Enhancement. This time, however, the $1. Direct Service Persons, other front- line staff, QMRPs, Supervisors, and . This Wage/Fringe Benefit Enhancement increased individual CILA rates by a Statewide average of 8. The CILA Individual Rate Determination Model was first implemented in July 1. The Model's evolution over the past seven years has been due, in part, to the federal government's involvement because of its commitment to assist the State in funding CILA services and, in part, as a result of the continued efforts of DHS staff, community agency providers, PAS agencies, and other interested parties. Undoubtedly, as has been proven over the years, more changes to the rate setting and administrative processes of the CILA services system and the CILA Individual Rate Model may be expected in the future. The Statewide Advisory Council on Developmental Disabilities, comprised of community agency representatives, family members, and consumers from each . Reimbursement is founded on the principle of reasonable, predicted costs to support a person with developmental disabilities as determined by the Model, rather than the estimated costs that will be incurred as determined by a specific community agency or other entity. Using fixed cost center reimbursement rates based on system- wide provider cost report data where possible, and proxy values for expenses such as housing and transportation where necessary or appropriate, rates are produced for individuals that are the same across all providers given identical individual needs and conditions in which supports are provided. Effective November, 2. Illinois . Prior to this time, individual CILA rates included reimbursement for only one day program type, e. Developmental Training, Supported Employment. This change increased the personal choice of day program activities in which CILA recipients could choose to participate and widen the number of community agencies from which services could be provided. Since the reimbursement for these therapies was included in the total rate paid to the residential provider, it was often assumed that the residential provider agency would control which licensed therapist was going to provide the support. Now, each CILA recipient is authorized for a fixed number of hours of Behavior Intervention Services, Individual and/or Group Therapy, and Individual and/or Group Counseling. Physical Therapy, Occupational Therapy, and Speech Therapy services are authorized for a flat 5. State of Illinois' single Medicaid agency, the Department of Public Aid, is received. 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