Illinois General Assembly - Full Text of SB2610
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Full Text of SB2610  99th General Assembly




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1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Short title. This Act may be cited as the
5Continuum of Care Services for the Developmentally Disabled
7    Section 5. Purpose. The purpose of this Act is to authorize
8a new type of license for organizations providing services to
9individuals with developmental disabilities to be known as a
10continuum of care license; to define the requirements for a
11continuum of care facility to receive and maintain such a
12license; to establish a process for the development of an
13alternative budget-neutral reimbursement mechanism for such a
14facility; and to authorize a request to the federal government
15for a waiver pursuant to the federal Social Security Act.
16    Section 10. Definitions. As used in this Act, unless the
17context requires otherwise:
18    "Applicable requirements of law" means State and federal
19statutes, rules, regulations, and guidance, as such may from
20time to time be amended or revised, governing the rights,
21protections, and services, including reimbursement for such
22services, afforded to individuals with developmental



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2    "Campus group home" means a residential facility meeting
3the requirements of Section 30 of this Act and operated as part
4of a continuum of care facility licensed under this Act.
5    "Continuum of care facility" means a legally incorporated
6entity that provides a comprehensive range of programs,
7services, and supports for adults with developmental
8disabilities, positioned at a central geographic campus
9facility, and including all of the following:
10        (1) community-integrated living arrangements provided
11    within reasonable geographic proximity of the campus and in
12    accordance with applicable requirements of law;
13        (2) employment opportunities, including both on-campus
14    compensated work opportunities and off-campus supported
15    employment opportunities provided in accordance with
16    applicable requirements of law;
17        (3) developmental training programs and services
18    provided in accordance with applicable requirements of
19    law;
20        (4) on-campus community living facility opportunities
21    provided on-campus and in accordance with applicable
22    requirements of law;
23        (5) campus group home opportunities as authorized and
24    defined in this Act and provided in accordance with
25    applicable requirements of law; and
26        (6) medically complex for the developmentally disabled



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1    facility opportunities provided on-campus and in
2    accordance with applicable requirements of law.
3    "Continuum of care license" means a license issued to a
4continuum of care facility in accordance with the terms of this
6    "Continuum of care plan" means a formal, written plan
7meeting the requirements of Section 25 of this Act.
8    "Facility constituent elements" means the particular,
9discrete programs, services, and supports delineated in the
10definition of "continuum of care facility" and provided
11collectively by the facility.
12    Section 15. Powers and duties. The Secretary of Human
13Services, acting in consultation and coordination as necessary
14with the Director of Public Health and the Director of
15Healthcare and Family Services, shall, within 12 months after
16the effective date of this Act, establish a system of licensure
17for continuum of care facilities, in accordance with this Act,
18for the following purposes:
19        (1) protecting the welfare, safety, and rights of
20    individuals with developmental disabilities;
21        (2) providing additional options for care and services
22    for individuals with developmental disabilities; and
23        (3) providing a model of care that can transition
24    individuals with developmental disabilities in a seamless
25    and timely manner across the continuum of residential care



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1    settings and supportive services, training, education, and
2    employment opportunities in a manner that maximizes
3    beneficiary choice and satisfaction.
4    Section 20. Licensing standards. The Secretary of Human
5Services shall, within 12 months after the effective date of
6this Act, file rules establishing standards for licensing of
7continuum of care facilities under a single license. These
8rules shall ensure that an applicant for licensure:
9        (1) meets the definition of "continuum of care
10    facility" and provides all of the programs, services, and
11    supports required by that definition;
12        (2) develops, submits, and maintains adherence to a
13    continuum of care plan that meets the requirements of
14    Section 25 of this Act;
15        (3) meets the regulatory requirements set forth in
16    Section 30 of this Act;
17        (4) meets such requirements as the Secretary of Human
18    Services may determine appropriate for renewal of
19    licensure or for amendment of licensure to account for
20    changes in the composition of facility constituent
21    elements providing programs or services under the license;
22    and
23        (5) meets such other requirements as the Secretary of
24    Human Services may determine appropriate for the effective
25    implementation of this Act.



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1    Section 25. Continuum of care plan. An applicant for a
2continuum of care license shall submit to the Secretary of
3Human Services, in such form and manner as the Secretary of
4Human Services shall require, a continuum of care plan that
5demonstrates how the applicant will:
6        (1) undertake a comprehensive approach to facilitating
7    the movement of individuals to the most appropriate site
8    and level of care and services provided based on that
9    individual's preference and needs;
10        (2) provide for the seamless integrated transition of
11    individuals between and among the required care settings
12    and services in a manner that addresses the individual's
13    location on the spectrum of disability and progression
14    along the age spectrum;
15        (3) maximize employment and training opportunities
16    consistent with the individual's preferences and
17    capabilities;
18        (4) provide programs, services, and supports geared to
19    addressing the demand for services for a growing population
20    of aging individuals and individuals who need the services
21    offered by a medically complex for the developmentally
22    disabled facility; and
23        (5) demonstrate a commitment to providing informed,
24    free, and meaningful choice regarding the type of community
25    in which the individual prefers to live and the type of



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1    employment opportunities or developmental training the
2    individual prefers to receive; beneficiary engagement;
3    annual care planning and ongoing treatment focused on the
4    needs and preferences of the individual and adherence to
5    other applicable requirements of law relevant to
6    protecting the rights and welfare of individuals with
7    developmental disabilities; and
8        (6) use an evidence-based assessment tool, approved by
9    the Department of Human Services and the Department of
10    Healthcare and Family Services, to periodically reassess
11    and confirm that individuals receiving more intense or
12    restrictive services continue to require, or to choose if
13    applicable, that level of support and services.
14    Section 30. Applicable requirements. The Secretary of
15Human Services, acting as appropriate through or in
16coordination with the Director of Public Health, shall in
17licensing a continuum of care facility ensure the following:
18        (1) community-integrated living arrangements provided
19    by such licensee meet all otherwise applicable
20    requirements of law pertaining to such arrangements,
21    including those set forth in the Community-Integrated
22    Living Arrangements Licensure and Certification Act,
23    except that a continuum of care facility may, consistent
24    with all applicable requirements of law, prioritize the
25    movement of individuals into or out of



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1    community-integrated living arrangements from or into
2    other residential facility constituent elements;
3        (2) on-campus and off-campus employment opportunities
4    provided by the licensee meet all otherwise applicable
5    requirements of law pertaining to such opportunities;
6        (3) developmental training programs and services
7    provided by the licensee meet all otherwise applicable
8    requirements of law pertaining to such programs and
9    services;
10        (4) community living facility opportunities provided
11    by the licensee meet all otherwise applicable requirements
12    of law pertaining to such opportunities;
13        (5) campus group homes provided by the licensee meet
14    all otherwise applicable requirements of law pertaining to
15    an ID/DD facility under the ID/DD Community Care Act;
16        (6) medically complex for the developmentally disabled
17    facility opportunities provided by the licensee meet all
18    otherwise applicable requirements of law pertaining to
19    such opportunities; and
20        (7) the applicant complies with such other
21    requirements as the Secretary of Human Services may
22    consider necessary and appropriate to carry out the
23    purposes of this Act and other applicable requirements of
24    law.
25    A continuum of care license may be issued to a continuum of
26care facility upon the adoption of the rules provided for in



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1Section 20 of this Act.
2    Section 35. Existing and future programs and services.
3    (a) To the extent necessary to carry out the purposes of
4this Act and to maintain eligibility for reimbursement for
5services under applicable State and federal programs,
6including Title XIX of the federal Social Security Act,
7facility constituent elements of an entity licensed as a
8continuum of care facility may be considered to be licensed
9pursuant to the otherwise applicable requirements of law as set
10forth in Section 30 of this Act.
11    (b) In the event that a continuum of care facility ceases
12to retain licensure as a continuum of care facility, facility
13constituent elements that meet all otherwise applicable
14requirements of law with respect to such element as set forth
15in Section 30 of this Act shall be deemed to be licensed
16pursuant to such requirements.
17    (c) Residents of campus group homes and
18community-integrated living arrangements that are facility
19constituent elements shall continue to be beneficiaries of and
20have the rights and protections provided to residents of ID/DD
21facilities and community-integrated living arrangements,
22respectively, under the consent decree entered by the United
23States District Court for the Northern District of Illinois in
24the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15, 2011
25(Ligas). While the consent decree in Ligas remains in effect,



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1members of the class in Ligas residing in ID/DD facilities on
2June 15, 2011 may move to community-integrated living
3arrangements as they choose to do so; members of the class in
4Ligas admitted to ID/DD facilities after June 15, 2011 must
5enroll on the Prioritization of Urgency of Need for Services
6waiting list and be selected for community-integrated living
7arrangements services prior to moving.
8    (d) A continuum of care licensee shall be permitted to add
9new facility constituent elements under its license provided
10that it demonstrates a need for the new facility constituent
11elements and that the facility constituent elements meet all
12applicable requirements of law.
13    Section 40. Reimbursement rules. The Secretary of Human
14Services and the Director of Healthcare and Family Services
16        (1) ensure that reimbursement utilizing federal and
17    State resources for services provided to eligible
18    beneficiaries through a continuum of care facility
19    comports with the following requirements:
20            (A) such services shall be reimbursed in a
21        budget-neutral manner such that reimbursement for
22        services provided by the facility constituent elements
23        of a continuum of care licensee shall be neither
24        greater nor lesser than the reimbursement received for
25        such services provided by that facility constituent



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1        element prior to the licensing of the continuum of care
2        facility, adjusted to take into account any subsequent
3        changes in reimbursement for such similar services,
4        or, if the facility constituent element is a new
5        facility reimbursement for the services provided by
6        the new facility shall be no less than the
7        reimbursement received for such services by a
8        comparable facility constituent element of that
9        continuum of care facility; and
10            (B) a continuum of care licensee shall enter into a
11        single provider agreement with the Director of
12        Healthcare and Family Services or the Secretary of
13        Human Services; changes that may occur from time to
14        time in the facility constituent elements under the
15        continuum of care license shall be addressed as may be
16        required by applicable requirements of law through
17        amendments to the provider agreement; the Director of
18        Healthcare and Family Services shall make all
19        reasonable efforts to ensure that all facility
20        constituent elements that are approved parts of a
21        continuum of care license remain qualified for
22        reimbursement under relevant State and federal
23        programs including Title XIX of the federal Social
24        Security Act; and
25        (2) in cooperation with interested stakeholders,
26    develop an alternative payment methodology for a continuum



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1    of care facility; the initial methodology shall produce
2    payments that are budget neutral as compared to the
3    services provided by the licensee prior to the
4    implementation of the continuum of care license; the
5    effectiveness of the methodology and corresponding rate
6    levels shall be evaluated 18 months following the
7    implementation of the methodology and every 12 months
8    thereafter and shall be adjusted as necessary, subject to
9    appropriation.
10    Section 45. The Department of Healthcare and Family
11Services Law of the Civil Administrative Code of Illinois is
12amended by adding Section 2205-13 as follows:
13    (20 ILCS 2205/2205-13 new)
14    Sec. 2205-13. Authorization to secure a federal waiver
15pursuant to the federal Social Security Act or a State plan
17    (a) The Director of Healthcare and Family Services, in
18collaboration and coordination with the Secretary of Human
19Services, shall develop and submit to the United States
20Department of Health and Human Services, Centers for Medicare
21and Medicaid Services, Center for Medicaid and State
22Operations, a request for a waiver pursuant to the federal
23Social Security Act or a State plan amendment consistent with
24the purpose of subsection (b) of this Section and requirements



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1of subsection (c) of this Section.
2    (b) The purpose of the waiver or a State plan amendment
3authorized by subsection (a) of this Section is to obtain
4approval for the use of funds under Title XIX of the federal
5Social Security Act to provide for an alternative model of
6licensure, reimbursement, and quality assurance for services
7to individuals with developmental disabilities consistent with
8the Continuum of Care Services for the Developmentally Disabled
10    (c) A waiver or a State plan amendment requested pursuant
11to this authorization must involve the licensure of a continuum
12of care facility pursuant to and consistent with all
13requirements of the Continuum of Care Services for the
14Developmentally Disabled Act and a proposal for a reimbursement
15methodology developed under paragraph (2) of Section 40 of the
16Continuum of Care Services for the Developmentally Disabled