The Lead December 8, 2022 - LeadingAge Illinois

Housing:
LeadingAge Urges HUD to Improve RAD Financials, Process
Join the LeadingAge Illinois Regional HUD Member Monthly Meetings

Nursing Facilities Quality and Certified Nursing Assistant (CNA) Pay Scale Subsidy Payment Updates

The Illinois Department of Healthcare and Family Services (HFS) has issued an update to the Nursing Facilities Quality and Certified Nursing Assistant (CNA) Pay Scale Subsidy Payments.

First quarter (July 2022 through September 2022) Payments:

Payments for the Quality and the CNA Pay Scale Subsidy programs have been sent to Managed Care Organizations (MCOs) for payment to providers.

The Department of Healthcare and Family Services (HFS) anticipates MCOs taking up to three weeks to pay providers for the first round of payments.
In the August 5, 2022, provider notice, HFS requested provider payee information for use by MCOs to pay the Quality and CNA Pay Scale Subsidy payments. MCOs will not be able to pay their portion of the Quality and CNA Pay Scale Subsidy payments to any provider that has not submitted payee information to HFS. Please follow the instructions in the provider notice to submit outstanding payee information to the Department.

The Department is also generating payments for the Quality and CNA programs that will go directly to providers for the fee-for-service (FFS) portion. Payments are anticipated to be made by December 23, 2022

Second quarter (October 2022 through December 2022) Payments:

Payments for Quality and CNA Pay Scale Subsidies will be sent to MCOs prior to the end of December 2022.
The fee-for service portion will also be sent to the Comptroller for payment prior to the end of December 2022.
Fee-for-service and MCO payments for the CNA Pay Scale Subsidies are being held for a number of facilities until they fill out CNA experience levels and upload spreadsheets for the October 2022 – December 2022 quarter. Please note that these spreadsheets must be submitted prior to the beginning of each quarter.

Third quarter (January 2023 through March 2023) Payments:

Provider specific files will be loaded the week of December 5, 2022, to the LTC Exchange SharePoint site.

All providers participating in the CNA Pay Scale Subsidy program for the January 2023 – March 2023 quarter will be required to fill out the experience levels and upload the spreadsheets to the LTC Exchange SharePoint site.
Providers that participated in the previous quarter will not be required to sign an additional certification form.
Providers that are participating in the CNA Pay Scale Subsidy program for the first time in January 2023 will also be required to fill out and sign the CNA Pay Scale Enrollment Form for January 1, 2023 and upload it to the LTC Exchange SharePoint site. The form can be located at HFS Medicaid Reimbursement page for Long Term Care.
Payments for the third quarter will be sent to MCOs and the Comptroller for payment prior to the end of January 2023.

Nurse Staffing Agency Rules Proposed

The Illinois Department of Labor has proposed amendments to the Nurse Agency Licensing Act implementing Public Act 102-946, legislation LeadingAge Illinois and other associations worked to pass last session. The legislation was initiated to protect members from predatory price gouging.

It concerns staffing agencies that employ, refer, or assign nurses or certified nurse aides to health care facilities as temporary workers. Each nurse agency, upon applying for a license, must certify that it holds workers compensation and professional liability insurance and provide Department of Labor copies of its contracts with facilities. They must pay an application fee (increased from $250 to $1,000, plus a additional $250 per branch office) online and provide data on its shift fulfillment rate for the

previous three quarters. Agencies have new record keeping and reporting requirements also. The Department of Labor may initiate an investigation of a suspected violation with or without a complaint. The maximum (statutory) penalty for each violation moves from $1,000 to $10,000.

During the fall veto session recently, the Illinois Health and Hospital Association (IHA) has indicated they would like to amend this act to exempt agencies, specifically foreign nurse agencies, from the act as they are in dire need of nurses at hospitals statewide. The amendment was not called during the veto session and may come back up in the early January “lame duck” session.

Employees Eligible for Premium Pay Under ARPA Grants

A number of members have inquired about employees eligible for premium pay. We have reached out to the Illinois Department of Healthcare and Family Services (HFS) for clarification.

Page 25 of each of the agreements includes the definition of which types of employees would be eligible for the premium pay. To summarize it would be the following:

A permanent staff member, regardless of union affiliation, of a facility licensed by the Illinois Department of Public Health (IDPH) under the Nursing Home Care Act as a skilled nursing facility or intermediate care facility.
Engaged in “essential” work, which would include providing care or services to the residents/patients of the facility
Who meet one of the following two criteria (i.e. does not have to be both):
1. Is not exempt from the federal Fair Labor Standards Act overtime provisions (i.e. is an hourly employee), or
2. Whose total pay is below 150% of the average annual wage for all occupations in the worker’s county of residence, as defined by the Bureau of Labor Statistics Occupational Employment and Wage Statistics

For part 3.b. this information is publicly available at Occupational Employment and Wage Statistics Home Page (bls.gov). To get to the relevant data, you just need to filter column “PRIM_STATE” (Column D) to Illinois. The average salary is then found in column “A_MEAN”. From a federal compliance perspective, since Illinois is the recipient, the state wide average can be used which is $59,650. With this information, number three above can be reread to be:

Who meet one of the following two criteria (i.e. does not have to be both):
1. Is not exempt from the federal Fair Labor Standards Act overtime provisions (i.e. is an hourly employee), or
2. Whose total pay is below $89,475 (which is 150% of the average annual wage for all occupations in the State of Illinois, as defined by the Bureau of Labor Statistics Occupational Employment and Wage Statistics)

New HFS BLTC Manager of Policy and Rules

Kelsey Lock is the new Manager of Policy & Rules for the Bureau of Long Term Care at the Illinois Department of Healthcare and Family Services (HFS). Janene Brickey, who was previously in this role accepted a Deputy Administrator position with HFS overseeing Long Term Care and Mental Health. Kelsey has been with the Bureau for several years as the Regional Supervisor of the Lincoln Region.

LeadingAge Urges HUD to Improve RAD Financials, Process

In response to a request for comment by HUD, LeadingAge urged the agency to improve key parts of the Rental Assistance Demonstration (RAD) for PRAC properties. RAD is an important affordable housing preservation tool, and HUD is now expanding and improving the program for Section 202 properties serving older adults and for Section 811 properties serving people with disabilities. Several LeadingAge members have successfully participated in RAD, but many face challenges of financial feasibility. In the comments, LeadingAge urged HUD to adjust the initial rent-setting process for RAD-participating properties, take steps to provide access to better ongoing budget adjustments, improve Operating Pro Forma rules, and adjust internal HUD processes to better work with housing stakeholders. LeadingAge also recommended that HUD consider robust incentives to steer preserved properties toward energy efficiency and climate resilience, as well as design standards that better support independent aging. LeadingAge’s comments are available here.

Join the LeadingAge Illinois Regional HUD Member Monthly Meetings

Please join us for the Monthly HUD Member Regional Meeting from 12-1 p.m. CST every third Thursday.

The HUD Member Regional Meeting occurs every third Thursday and features updates from:

Linda Couch, Vice President of Housing Policy and Juliana Bilowich, Director, Housing Operations at LeadingAge National.
Gail Burks from HUD
LeadingAge affiliates in Illinois, Indiana, Michigan, Minnesota, Missouri, and Ohio.

You and your staff are encouraged to join these meetings. For more information, contact Jason Speaks, director of government relations.