DHS Q&A

Here are written answers from Illinois Department of Human Services spokespersons Patrick Laughlin and Marisa Kollias in response to questions from Illinois Times regarding the case of Amber Williams and Community Integrated Living Arrangement homes, or CILAs:

Can you or someone else at DHS speak with me about this case and who oversees and fines CILAs for bad care?

The Department of Human Services’ Division of Developmental Disabilities (DDD) oversees and funds the provision of services and supports in Community Integrated Living Arrangements (CILAs). CILAs are home and community-based services (HCBS), waiver-funded facilities that serve between one and eight individuals with intellectual and developmental disabilities. The Illinois Department of Human Services (IDHS) Bureau of Accreditation, Licensure, and Certification (BALC) licenses all CILA sites.  

How many people live in CILAs throughout Illinois?

As of FY22 year end, 9,787 individuals resided in CILA settings that are staffed 24/7. Approximately 1,300 individuals lived in other CILA settings (Host Family and Intermittent). All Broadstep CILA services are 24/7 staffed settings.

How many people live in the Springfield Broadstep CILA?

In Sangamon County, Broadstep serves 36 individuals. The individual Broadstep CILA that you are inquiring about (for Amber Williams) houses four individuals.

How many people live in Broadstep CILAs throughout Illinois? 

As of the end of fiscal 2022, 154 individuals lived in CILAs operated by Broadstep in Illinois.

How much does the state pay annually for the care of people in CILAs and in Broadstep CILAs in particular?

The cost of serving an individual in a CILA is determined by the individual needs of that person. As of FY22 year end, the average topline rate for 24-hour CILA settings was $90,728. That number reflects some temporary adjustments that remained in place due to the public health emergency, but does not include statewide wage increases that went into place as of Jan. 1, 2023.     

The total amount billed by Broadstep for residential services in FY22 was $9,752,467.  

The total amount, statewide, for 24/7 residential services in FY22 was $945,721,446.

What has the state done to safeguard care and humane treatment of clients in CILAs? 

The State conducts several reviews of sites that are funded by our HCBS waivers and safeguards individuals through the same:   

The State contracts with eight Independent Service Coordination (ISC) agencies in 12 regions of the State. The ISC agencies are responsible for meeting with each waiver-funded individual. Effective July 1, 2022, the number of required meetings, annually, was increased from two to four. Three of the four are required to be in-person.   

DDD’s Bureau of Quality Management (BQM) conducts face-to-face interviews with a (statistically significant) selected sample number of waiver-funded individuals on an annual basis to determine whether the individuals’ needs are being met. BQM also conducts both planned and unplanned focus reviews at sites and with individuals throughout the State.   

DDD conducts annual reviews of all CILAs sites under Rule 116 (59 IAC 116 – Administration of Medication in Community Settings). These reviews are conducted by nurses employed by DDD.   

The Illinois Department of Human Services’ Bureau of Accreditation, Licensure and Certification (BALC) conducts surveys of providers focused on the CILA or Community Day Service site. These surveys occur every two years for CILAs and one year for Community Day Services (CDS) sites. Satisfactory scores are required to maintain licensure and good standing.

Additionally, DDD has additional avenues to help individuals and places requirements on CILA and CDS providers.

Those include:

All CILA residence homes are required to post information on how to report abuse and neglect, as well as contact information for the Office of Inspector General, Office of Guardian, and Equip for Equality, the designated Protection & Advocacy agency for Illinois. 

IDHS’s Office of Inspector General maintains a phone number (800-368-1463) for individuals and general members of the public to submit complaints. Complaints also can be filed online at https://bit.ly/CILAcomplaints.

The Office of Inspector General investigates allegations of abuse and neglect at CILAs and CDS sites. If OIG makes a substantiated finding of physical abuse, sexual abuse, financial exploitation or egregious neglect against a CILA or CDS employee, that employee could be placed on the Health Care Worker Registry – a Registry maintained by the Illinois Department of Public Health – resulting in their indefinite ban from the health care industry in Illinois.  

This article appears in Spring Home & Garden 2023.