(a) It is the purpose of this Section to establish procedures for the development, calculation, and communication of rates promulgated by the Department for the purchase of services for persons with a developmental disability, and persons with mental illness; to require the promulgation of rules which specify the treatment of costs for purposes of establishing rates for various purchase care program categories; to require that rates be equitable, understandable, and established through an open, public process; and to require the delineation of where purchase care, grant-in-aid, and other payment mechanisms are most appropriately utilized. The Department’s rate-setting policy should stimulate the development of cost effective, clinically appropriate, community-based residential, and other support services for recipients according to an annual statement of purchase care goals and objectives.
     (b) The Department shall establish rates in all instances where services are purchased by the Department for a specific recipient from a specific community service provider for which the Department has the responsibility for establishing payment rates. When determining rates, the Department shall take into consideration differences in the costs of doing business among the various geographic regions of the State and shall set rates that reflect those differences. The Department may, for various program categories, adopt rates that are set by other State agencies.

Terms Used In Illinois Compiled Statutes 20 ILCS 1705/54

  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14

     (c) The Department shall perform the following duties:
        (1) Develop rate-setting methodologies for purchase
    
care program categories.
        (2) Promulgate rules and regulations governing
    
rate-setting, treatment of costs, treatment of occupancy, and payment and contracting processes for purchase care.
        (3) Collect cost and performance information from
    
care providers. The Department may stipulate forms, unit of service definitions, reporting procedures and reporting intervals.
        (4) Calculate purchase of care reimbursement rates
    
for specific providers based on the promulgated rate methodology for that program category.
        (5) Negotiate and implement purchase of care
    
contracts with specific providers.
        (6) Develop an annual statement of purchase care
    
goals and objectives detailing maximum units of service by program category to be purchased. The plan for each fiscal year shall be completed by May 1 of the previous fiscal year.
        (7) Conduct an annual review and prepare an annual
    
report of rates and units of service purchased, comparing the annual purchase of care statement with actual services purchased, and the actual cost of providing those services. The report shall be made available by May 1.
        (8) Establish and promulgate a process and criteria
    
for appealing rates.
        (9) Develop and promulgate standards and criteria by
    
which provider performance shall be evaluated.
        (10) Set rates based on published methodologies and
    
subject to the availability of funds appropriated by the General Assembly.
        (11) Establish and promulgate a policy regarding
    
applicability of income offsets in rate calculation or payment processes.
        (12) Develop criteria for selection of payment
    
mechanisms to be employed in funding community services.
    (d) The Department may investigate and employ alternative rate setting approaches and engage in demonstration projects. These approaches must be publicly articulated by the Department, identifying the purpose and scope of the alternative approach and evaluation to be conducted.
     (e) (Blank).
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