Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Public Act 100-1065


 

Public Act 1065 100TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 100-1065
 
HB5868 EnrolledLRB100 21705 KTG 39208 b

    AN ACT concerning health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 1. Legislative findings and purpose. Medical
clinics, emergency rooms, and hospitals across the country are
overwhelmed by the opioid crisis and have been adversely
affected by costs and increasing rates of recidivism due to an
increase in the need for additional comprehensive
community-based continuum of care services for persons with
opioid and other substance use disorders. According to the
Centers for Disease Control and Prevention, there has been a
600% increase in the incidence of opioid use disorders since
1999, creating an increased need for treatment and other
recovery support services. Most persons with substance use
disorders also face co-existing social and economic challenges
including poverty, job insecurity, and a lack of safe and sober
living environments. The current health care system is often
too expensive, fragmented, and disjointed to sufficiently
address the needs of persons with substance use disorders.
Consequently, we are at a pivotal time in history when
insurance companies are having to become more innovative in
their approaches to contain costs and improve the outcomes of
those persons with substance use disorders. Hospitals are also
contemplating new and innovative ways to reduce their costs and
rates of recidivism, improve the outcomes of those persons with
substance use disorders, and monitor these persons with a
greater level of care in order to achieve the highest level of
multiple performance outcomes at a time when performance
metrics matter more than ever. The State of Illinois has the
opportunity to lead the nation by supporting and amplifying the
most comprehensive and vertically integrated approach to
recovery that can effectively address the root causes of
substance use disorders, while stabilizing other co-existing
social, economic, and housing conditions that can impair a
person's long-term recovery. In addition to helping persons
achieve physical recovery from a substance use disorder, it is
also important to help them find new meaning in their personal
lives by rebuilding and strengthening their family
relationships, community ties, and spiritual development.
Recovery housing can facilitate this holistic approach to
recovery and help persons replace their need for substances
with more meaningful elements of life. Therefore, it is the
purpose of this Act to provide Illinois citizens with greater
access to a more robust and holistic continuum of behavioral
health care services and supports by providing health care
coverage for recovery housing for persons with substance use
disorders.
 
    Section 5. The Illinois Insurance Code is amended by adding
Section 356z.29 as follows:
 
    (215 ILCS 5/356z.29 new)
    Sec. 356z.29. Recovery housing for persons with substance
use disorders.
    (a) Definitions. As used in this Section:
    "Substance use disorder" and "case management" have the
meanings ascribed to those terms in Section 1-10 of the
Substance Use Disorder Act.
    "Hospital" means a facility licensed by the Department of
Public Health under the Hospital Licensing Act.
    "Federally qualified health center" means a facility as
defined in Section 1905(l)(2)(B) of the federal Social Security
Act.
    "Recovery housing" means a residential extended care
treatment facility or a recovery home as defined and licensed
in 77 Illinois Administrative Code, Part 2060, by the Illinois
Department of Human Services, Division of Substance Use
Prevention and Recovery.
    (b) A group or individual policy of accident and health
insurance or managed care plan amended, delivered, issued, or
renewed on or after the effective date of this amendatory Act
of the 100th General Assembly may provide coverage for
residential extended care services and supports for persons
recovery housing for persons with substance use disorders who
are at risk of a relapse following discharge from a health care
clinic, federally qualified health center, hospital withdrawal
management program or any other licensed withdrawal management
program, or hospital emergency department so long as all of the
following conditions are met:
        (1) A health care clinic, federally qualified health
    center, hospital withdrawal management program or any
    other licensed withdrawal management program, or hospital
    emergency department has conducted an individualized
    assessment, using criteria established by the American
    Society of Addiction Medicine, of the person's condition
    prior to discharge and has identified the person as being
    at risk of a relapse and in need of supportive services,
    including employment and training and case management, to
    maintain long-term recovery. A determination of whether a
    person is in need of supportive services shall also be
    based on whether the person has a history of poverty, job
    insecurity, and lack of a safe and sober living
    environment.
        (2) The recovery housing is administered by a
    community-based agency that is licensed by or under
    contract with the Department of Human Services, Division of
    Substance Use Prevention and Recovery.
        (3) The recovery housing is administered by a
    community-based agency as described in paragraph (2) upon
    the referral of a health care clinic, federally qualified
    health center, hospital withdrawal management program or
    any other licensed withdrawal management program, or
    hospital emergency department.
    (c) Based on the individualized needs assessment, any
coverage provided in accordance with this Section may include,
but not be limited to, the following:
        (1) Substance use disorder treatment services that are
    in accordance with licensure standards promulgated by the
    Department of Human Services, Division of Substance Use
    Prevention and Recovery.
        (2) Transitional housing services, including food or
    meal plans.
        (3) Individualized case management and referral
    services, including case management and social services
    for the families of persons who are seeking treatment for a
    substance use disorder.
        (4) Job training or placement services.
    (d) The insurer may rate each community-based agency that
is licensed by or under contract with the Department of Human
Services, Division of Substance Use Prevention and Recovery to
provide recovery housing based on an evaluation of each
agency's ability to:
        (1) reduce health care costs;
        (2) reduce recidivism rates for persons suffering from
    a substance use disorder;
        (3) improve outcomes;
        (4) track persons with substance use disorders; and
        (5) improve the quality of life of persons with
    substance use disorders through the utilization of
    sustainable recovery, education, employment, and housing
    services.
    The insurer may publish the results of the ratings on its
official website and shall, on an annual basis, update the
posted results.
    (e) The Department of Insurance may adopt any rules
necessary to implement the provisions of this Section in
accordance with the Illinois Administrative Procedure Act and
all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.

Effective Date: 1/1/2019