|
| | 09900SB2610ham001 | - 2 - | LRB099 19934 MJP 49036 a |
|
|
1 | | Section 10. Definitions. As used in this Act, unless the |
2 | | context requires otherwise:
|
3 | | "Applicable requirements of law" means State and federal |
4 | | statutes, rules, regulations, and guidance, as such may from |
5 | | time to time be amended or revised, governing the rights, |
6 | | protections, and services, including reimbursement for such |
7 | | services, afforded to individuals with developmental |
8 | | disabilities.
|
9 | | "Campus group home" means a residential facility meeting |
10 | | the requirements of Section 30 of this Act and operated as part |
11 | | of a continuum of care facility licensed under this Act.
|
12 | | "Continuum of care facility" means a legally incorporated |
13 | | entity that provides a comprehensive range of programs, |
14 | | services, and supports for adults with developmental |
15 | | disabilities, positioned at a central geographic campus |
16 | | facility, and including all of the following:
|
17 | | (1) community-integrated living arrangements provided |
18 | | within reasonable geographic proximity of the campus and in |
19 | | accordance with applicable requirements of law;
|
20 | | (2) employment opportunities, including both on-campus |
21 | | compensated work opportunities and off-campus supported |
22 | | employment opportunities provided in accordance with |
23 | | applicable requirements of law;
|
24 | | (3) developmental training programs and services |
25 | | provided in accordance with applicable requirements of |
26 | | law;
|
|
| | 09900SB2610ham001 | - 3 - | LRB099 19934 MJP 49036 a |
|
|
1 | | (4) on-campus community living facility opportunities |
2 | | provided on-campus and in accordance with applicable |
3 | | requirements of law;
|
4 | | (5) campus group home opportunities as authorized and |
5 | | defined in this Act and provided in accordance with |
6 | | applicable requirements of law; and
|
7 | | (6) medically complex for the developmentally disabled |
8 | | facility opportunities provided on-campus and in |
9 | | accordance with applicable requirements of law.
|
10 | | "Continuum of care license" means a license issued to a |
11 | | continuum of care facility in accordance with the terms of this |
12 | | Act.
|
13 | | "Continuum of care plan" means a formal, written plan |
14 | | meeting the requirements of Section 25 of this Act.
|
15 | | "Facility constituent elements" means the particular, |
16 | | discrete programs, services, and supports delineated in the |
17 | | definition of "continuum of care facility" and provided |
18 | | collectively by the facility.
|
19 | | Section 15. Powers and duties. The Secretary of Human |
20 | | Services, acting in consultation and coordination as necessary |
21 | | with the Director of Public Health and the Director of |
22 | | Healthcare and Family Services, shall, within 12 months after |
23 | | the effective date of this Act, establish a system of licensure |
24 | | for continuum of care facilities, in accordance with this Act, |
25 | | for the following purposes:
|
|
| | 09900SB2610ham001 | - 4 - | LRB099 19934 MJP 49036 a |
|
|
1 | | (1) protecting the welfare, safety, and rights of |
2 | | individuals with developmental disabilities;
|
3 | | (2) providing additional options for care and services |
4 | | for individuals with developmental disabilities; and
|
5 | | (3) providing a model of care that can transition |
6 | | individuals with developmental disabilities in a seamless |
7 | | and timely manner across the continuum of residential care |
8 | | settings and supportive services, training, education, and |
9 | | employment opportunities in a manner that maximizes |
10 | | beneficiary choice and satisfaction.
|
11 | | Section 20. Licensing standards. The Secretary of Human |
12 | | Services shall, within 12 months after the effective date of |
13 | | this Act, file rules establishing standards for licensing of |
14 | | continuum of care facilities under a single license. These |
15 | | rules shall ensure that an applicant for licensure:
|
16 | | (1) meets the definition of "continuum of care |
17 | | facility" and provides all of the programs, services, and |
18 | | supports required by that definition;
|
19 | | (2) develops, submits, and maintains adherence to a |
20 | | continuum of care plan that meets the requirements of |
21 | | Section 25 of this Act;
|
22 | | (3) meets the regulatory requirements set forth in |
23 | | Section 30 of this Act;
|
24 | | (4) meets such requirements as the Secretary of Human |
25 | | Services may determine appropriate for renewal of |
|
| | 09900SB2610ham001 | - 5 - | LRB099 19934 MJP 49036 a |
|
|
1 | | licensure or for amendment of licensure to account for |
2 | | changes in the composition of facility constituent |
3 | | elements providing programs or services under the license; |
4 | | and
|
5 | | (5) meets such other requirements as the Secretary of |
6 | | Human Services may determine appropriate for the effective |
7 | | implementation of this Act.
|
8 | | Section 25. Continuum of care plan. An applicant for a |
9 | | continuum of care license shall submit to the Secretary of |
10 | | Human Services, in such form and manner as the Secretary of |
11 | | Human Services shall require, a continuum of care plan that |
12 | | demonstrates how the applicant will:
|
13 | | (1) undertake a comprehensive approach to facilitating |
14 | | the movement of individuals to the most appropriate site |
15 | | and level of care and services provided based on that |
16 | | individual's preference and needs;
|
17 | | (2) provide for the seamless integrated transition of |
18 | | individuals between and among the required care settings |
19 | | and services in a manner that addresses the individual's |
20 | | location on the spectrum of disability and progression |
21 | | along the age spectrum;
|
22 | | (3) maximize employment and training opportunities |
23 | | consistent with the individual's preferences and |
24 | | capabilities; |
25 | | (4) provide programs, services, and supports geared to |
|
| | 09900SB2610ham001 | - 6 - | LRB099 19934 MJP 49036 a |
|
|
1 | | addressing the demand for services for a growing population |
2 | | of aging individuals and individuals who need the services |
3 | | offered by a medically complex for the developmentally |
4 | | disabled facility;
and |
5 | | (5) demonstrate a commitment to providing informed, |
6 | | free, and meaningful choice regarding the type of community |
7 | | in which the individual prefers to live and the type of |
8 | | employment opportunities or developmental training the |
9 | | individual prefers to receive; beneficiary engagement; |
10 | | annual care planning and ongoing treatment focused on the |
11 | | needs and preferences of the individual and adherence to |
12 | | other applicable requirements of law relevant to |
13 | | protecting the rights and welfare of individuals with |
14 | | developmental disabilities; and |
15 | | (6) use an evidence-based assessment tool, approved by |
16 | | the Department of Human Services and the Department of |
17 | | Healthcare and Family Services, to periodically reassess |
18 | | and confirm that individuals receiving more intense or |
19 | | restrictive services continue to require, or to choose if |
20 | | applicable, that level of support and services. |
21 | | Section 30. Applicable requirements. The Secretary of |
22 | | Human Services, acting as appropriate through or in |
23 | | coordination with the Director of Public Health, shall in |
24 | | licensing a continuum of care facility ensure the following:
|
25 | | (1) community-integrated living arrangements provided |
|
| | 09900SB2610ham001 | - 7 - | LRB099 19934 MJP 49036 a |
|
|
1 | | by such licensee meet all otherwise applicable |
2 | | requirements of law pertaining to such arrangements, |
3 | | including those set forth in the Community-Integrated |
4 | | Living Arrangements Licensure and Certification Act, |
5 | | except that a continuum of care facility may, consistent |
6 | | with all applicable requirements of law, prioritize the |
7 | | movement of individuals into or out of |
8 | | community-integrated living arrangements from or into |
9 | | other residential facility constituent elements;
|
10 | | (2) on-campus and off-campus employment opportunities |
11 | | provided by the licensee meet all otherwise applicable |
12 | | requirements of law pertaining to such opportunities;
|
13 | | (3) developmental training programs and services |
14 | | provided by the licensee meet all otherwise applicable |
15 | | requirements of law pertaining to such programs and |
16 | | services;
|
17 | | (4) community living facility opportunities provided |
18 | | by the licensee meet all otherwise applicable requirements |
19 | | of law pertaining to such opportunities;
|
20 | | (5) campus group homes provided by the licensee meet |
21 | | all otherwise applicable requirements of law pertaining to |
22 | | an ID/DD facility under the ID/DD Community Care Act;
|
23 | | (6) medically complex for the developmentally disabled |
24 | | facility opportunities provided by the licensee meet all |
25 | | otherwise applicable requirements of law pertaining to |
26 | | such opportunities;
and |
|
| | 09900SB2610ham001 | - 8 - | LRB099 19934 MJP 49036 a |
|
|
1 | | (7) the applicant complies with such other |
2 | | requirements as the Secretary of Human Services may |
3 | | consider necessary and appropriate to carry out the |
4 | | purposes of this Act and other applicable requirements of |
5 | | law. |
6 | | A continuum of care license may be issued to a continuum of |
7 | | care facility upon the adoption of the rules provided for in |
8 | | Section 20 of this Act.
|
9 | | Section 35. Existing and future programs and services.
|
10 | | (a) To the extent necessary to carry out the purposes of |
11 | | this Act and to maintain eligibility for reimbursement for |
12 | | services under applicable State and federal programs, |
13 | | including Title XIX of the federal Social Security Act, |
14 | | facility constituent elements of an entity licensed as a |
15 | | continuum of care facility may be considered to be licensed |
16 | | pursuant to the otherwise applicable requirements of law as set |
17 | | forth in Section 30 of this Act.
|
18 | | (b) In the event that a continuum of care facility ceases |
19 | | to retain licensure as a continuum of care facility, facility |
20 | | constituent elements that meet all otherwise applicable |
21 | | requirements of law with respect to such element as set forth |
22 | | in Section 30 of this Act shall be deemed to be licensed |
23 | | pursuant to such requirements.
|
24 | | (c) Residents of campus group homes and |
25 | | community-integrated living arrangements that are facility |
|
| | 09900SB2610ham001 | - 9 - | LRB099 19934 MJP 49036 a |
|
|
1 | | constituent elements shall continue to be beneficiaries of and |
2 | | have the rights and protections provided to residents of ID/DD |
3 | | facilities and community-integrated living arrangements, |
4 | | respectively, under the consent decree entered by the United |
5 | | States District Court for the Northern District of Illinois in |
6 | | the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15, 2011 |
7 | | (Ligas).
While the consent decree in Ligas remains in effect, |
8 | | members of the class in Ligas residing in ID/DD facilities on |
9 | | June 15, 2011 may move to community-integrated living |
10 | | arrangements as they chose to do so; members of the class in |
11 | | Ligas admitted to ID/DD facilities after June 15, 2011 must |
12 | | enroll on the Prioritization of Urgency of Need for Services |
13 | | waiting list and be selected for community-integrated living |
14 | | arrangements services prior to moving. |
15 | | (d) A continuum of care licensee shall be permitted to add |
16 | | new facility constituent elements under its license provided |
17 | | that it demonstrates a need for the new facility constituent |
18 | | elements and that the facility constituent elements meet all |
19 | | applicable requirements of law.
|
20 | | Section 40. Reimbursement rules. The Secretary of Human |
21 | | Services and the Director of Healthcare and Family Services |
22 | | shall:
|
23 | | (1) ensure that reimbursement utilizing federal and |
24 | | State resources for services provided to eligible |
25 | | beneficiaries through a continuum of care facility |
|
| | 09900SB2610ham001 | - 10 - | LRB099 19934 MJP 49036 a |
|
|
1 | | comports with the following requirements:
|
2 | | (A) such services shall be reimbursed in a |
3 | | budget-neutral manner such that reimbursement for |
4 | | services provided by the facility constituent elements |
5 | | of a continuum of care licensee shall be neither |
6 | | greater nor lesser than the reimbursement received for |
7 | | such services provided by that facility constituent |
8 | | element prior to the licensing of the continuum of care |
9 | | facility, adjusted to take into account any subsequent |
10 | | changes in reimbursement for such similar services, |
11 | | or, if the facility constituent element is a new |
12 | | facility reimbursement for the services provided by |
13 | | the new facility shall be no less than the |
14 | | reimbursement received for such services by a |
15 | | comparable facility constituent element of that |
16 | | continuum of care facility; and
|
17 | | (B) a continuum of care licensee shall enter into a |
18 | | single provider agreement with the Director of |
19 | | Healthcare and Family Services or the Secretary of |
20 | | Human Services; changes that may occur from time to |
21 | | time in the facility constituent elements under the |
22 | | continuum of care license shall be addressed as may be |
23 | | required by applicable requirements of law through |
24 | | amendments to the provider agreement; the Director of |
25 | | Healthcare and Family Services shall make all |
26 | | reasonable efforts to ensure that all facility |
|
| | 09900SB2610ham001 | - 11 - | LRB099 19934 MJP 49036 a |
|
|
1 | | constituent elements that are approved parts of a |
2 | | continuum of care license remain qualified for |
3 | | reimbursement under relevant State and federal |
4 | | programs including Title XIX of the federal Social |
5 | | Security Act; and
|
6 | | (2) in cooperation with interested stakeholders, |
7 | | develop an alternative payment methodology for a continuum |
8 | | of care facility; the initial methodology shall produce |
9 | | payments that are budget neutral as compared to the |
10 | | services provided by the licensee prior to the |
11 | | implementation of the continuum of care license; the |
12 | | effectiveness of the methodology and corresponding rate |
13 | | levels shall be evaluated 18 months following the |
14 | | implementation of the methodology and every 12 months |
15 | | thereafter and shall be adjusted as necessary, subject to |
16 | | appropriation. |
17 | | Section 45. The Department of Healthcare and Family |
18 | | Services Law of the
Civil Administrative Code of Illinois is |
19 | | amended by adding Section 2205-13 as follows: |
20 | | (20 ILCS 2205/2205-13 new) |
21 | | Sec. 2205-13. Authorization to secure a federal waiver |
22 | | pursuant to the federal Social Security Act or a State plan |
23 | | amendment. |
24 | | (a) The Director of Healthcare and Family Services, in |
|
| | 09900SB2610ham001 | - 12 - | LRB099 19934 MJP 49036 a |
|
|
1 | | collaboration and coordination with the Secretary of Human |
2 | | Services, shall develop and submit to the United States |
3 | | Department of Health and Human Services, Centers for Medicare |
4 | | and Medicaid Services, Center for Medicaid and State |
5 | | Operations, a request for a waiver pursuant to the federal |
6 | | Social Security Act or a State plan amendment consistent with |
7 | | the purpose of subsection (b) of this Section and requirements |
8 | | of subsection (c) of this Section. |
9 | | (b) The purpose of the waiver or a State plan amendment |
10 | | authorized by subsection (a) of this Section is to obtain |
11 | | approval for the use of funds under Title XIX of the federal |
12 | | Social Security Act to provide for an alternative model of |
13 | | licensure, reimbursement, and quality assurance for services |
14 | | to individuals with developmental disabilities consistent with |
15 | | the Continuum of Care Services for the Developmentally Disabled |
16 | | Act. |
17 | | (c) A waiver or a State plan amendment requested pursuant |
18 | | to this authorization must involve the licensure of a continuum |
19 | | of care facility pursuant to and consistent with all |
20 | | requirements of the Continuum of Care Services for the |
21 | | Developmentally Disabled Act and a proposal for a reimbursement |
22 | | methodology developed under paragraph (2) of Section 40 of the |
23 | | Continuum of Care Services for the Developmentally Disabled |
24 | | Act. ".
|