Full Text of SB2610 99th General Assembly
SB2610eng 99TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 1. Short title. This Act may be cited as the | 5 | | Continuum of Care Services for the Developmentally Disabled | 6 | | Act. | 7 | | Section 5. Purpose. The purpose of this Act is to authorize | 8 | | a new type of license for organizations providing services to | 9 | | individuals with developmental disabilities to be known as a | 10 | | continuum of care license; to define the requirements for a | 11 | | continuum of care facility to receive and maintain such a | 12 | | license; to establish a process for the development of an | 13 | | alternative budget-neutral reimbursement mechanism for such a | 14 | | facility; and to authorize a request to the federal government | 15 | | for a waiver pursuant to Section 1115 of the federal Social | 16 | | Security Act.
| 17 | | Section 10. Definitions. As used in this Act, unless the | 18 | | context requires otherwise:
| 19 | | "Applicable requirements of law" means State and federal | 20 | | statutes, rules, regulations, and guidance, as such may from | 21 | | time to time be amended or revised, governing the rights, | 22 | | protections, and services, including reimbursement for such |
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| 1 | | services, afforded to individuals with developmental | 2 | | disabilities.
| 3 | | "Campus group home" means a residential facility meeting | 4 | | the requirements of Section 30 of this Act and operated as part | 5 | | of a continuum of care facility licensed under this Act.
| 6 | | "Continuum of care facility" means a legally incorporated | 7 | | entity that provides a comprehensive range of programs, | 8 | | services, and supports for adults with developmental | 9 | | disabilities, positioned at a central geographic campus | 10 | | facility, and including all of the following:
| 11 | | (1) community-integrated living arrangements provided | 12 | | within reasonable geographic proximity of the campus and in | 13 | | accordance with applicable requirements of law;
| 14 | | (2) employment opportunities, including both on-campus | 15 | | compensated work opportunities and off-campus supported | 16 | | employment opportunities provided in accordance with | 17 | | applicable requirements of law;
| 18 | | (3) developmental training programs and services | 19 | | provided in accordance with applicable requirements of | 20 | | law;
| 21 | | (4) on-campus community living facility opportunities | 22 | | provided on-campus and in accordance with applicable | 23 | | requirements of law;
| 24 | | (5) campus group home opportunities as authorized and | 25 | | defined in this Act and provided in accordance with | 26 | | applicable requirements of law; and
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| 1 | | (6) medically complex for the developmentally disabled | 2 | | facility opportunities provided on-campus and in | 3 | | accordance with applicable requirements of law.
| 4 | | "Continuum of care license" means a license issued to a | 5 | | continuum of care facility in accordance with the terms of this | 6 | | Act.
| 7 | | "Continuum of care plan" means a formal, written plan | 8 | | meeting the requirements of Section 25 of this Act.
| 9 | | "Facility constituent elements" means the particular, | 10 | | discrete programs, services, and supports delineated in the | 11 | | definition of "continuum of care facility" and provided | 12 | | collectively by the facility.
| 13 | | Section 15. Powers and duties. The Director of Human | 14 | | Services, acting in consultation and coordination as necessary | 15 | | with the Director of Public Health and the Director of | 16 | | Healthcare and Family Services, shall establish a system of | 17 | | licensure for continuum of care facilities, in accordance with | 18 | | this Act, for 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 Director of Human | 5 | | Services shall adopt rules establishing standards for | 6 | | licensing of continuum of care facilities under a single | 7 | | license. These rules shall ensure that an applicant for | 8 | | 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 Director 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 Director 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 | 2 | | continuum of care license shall submit to the Director of Human | 3 | | Services, in such form and manner as the Director of Human | 4 | | Services shall require, a continuum of care plan that | 5 | | demonstrates 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.
| 8 | | Section 30. Applicable requirements. The Director of Human | 9 | | Services, acting as appropriate through or in coordination with | 10 | | the Director of Public Health, shall in licensing a continuum | 11 | | of care facility ensure the following:
| 12 | | (1) community-integrated living arrangements provided | 13 | | by such licensee meet all otherwise applicable | 14 | | requirements of law pertaining to such arrangements, | 15 | | including those set forth in the Community-Integrated | 16 | | Living Arrangements Licensure and Certification Act, | 17 | | except that a continuum of care facility may prioritize the | 18 | | movement of individuals into or out of | 19 | | community-integrated living arrangements from or into | 20 | | other residential facility constituent elements;
| 21 | | (2) on-campus and off-campus employment opportunities | 22 | | provided by the licensee meet all otherwise applicable | 23 | | requirements of law pertaining to such opportunities;
| 24 | | (3) developmental training programs and services | 25 | | provided by the licensee meet all otherwise applicable |
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| 1 | | requirements of law pertaining to such programs and | 2 | | services;
| 3 | | (4) community living facility opportunities provided | 4 | | by the licensee meet all otherwise applicable requirements | 5 | | of law pertaining to such opportunities;
| 6 | | (5) campus group homes provided by the licensee meet | 7 | | all otherwise applicable requirements of law pertaining to | 8 | | an ID/DD facility under the ID/DD Community Care Act;
| 9 | | (6) medically complex for the developmentally disabled | 10 | | facility opportunities provided by the licensee meet all | 11 | | otherwise applicable requirements of law pertaining to | 12 | | such opportunities;
and | 13 | | (7) the applicant complies with such other | 14 | | requirements as the Director of Human Services may consider | 15 | | necessary and appropriate to carry out the purposes of this | 16 | | Act and other applicable requirements of law.
| 17 | | Section 35. Existing and future programs and services.
| 18 | | (a) To the extent necessary to carry out the purposes of | 19 | | this Act and to maintain eligibility for reimbursement for | 20 | | services under applicable State and federal programs, | 21 | | including Title XIX of the federal Social Security Act, | 22 | | facility constituent elements of an entity licensed as a | 23 | | continuum of care facility may be considered to be licensed | 24 | | pursuant to the otherwise applicable requirements of law as set | 25 | | forth in Section 30 of this Act.
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| 1 | | (b) In the event that a continuum of care facility ceases | 2 | | to retain licensure as a continuum of care facility, facility | 3 | | constituent elements that meet all otherwise applicable | 4 | | requirements of law with respect to such element as set forth | 5 | | in Section 30 of this Act shall be deemed to be licensed | 6 | | pursuant to such requirements.
| 7 | | (c) Residents of campus group homes and | 8 | | community-integrated living arrangements that are facility | 9 | | constituent elements shall continue to be beneficiaries of and | 10 | | have the rights and protections provided to residents of ID/DD | 11 | | facilities and community-integrated living arrangements, | 12 | | respectively, under the consent decree entered by the United | 13 | | States District Court for the Northern District of Illinois in | 14 | | the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15, | 15 | | 2011.
| 16 | | (d) A continuum of care licensee shall be permitted to add | 17 | | new facility constituent elements under its license provided | 18 | | that it demonstrates a need for the new facility constituent | 19 | | elements and that the facility constituent elements meet all | 20 | | applicable requirements of law.
| 21 | | Section 40. Reimbursement rules. The Director of Human | 22 | | Services and the Director of Healthcare and Family Services | 23 | | shall:
| 24 | | (1) ensure that reimbursement utilizing federal and | 25 | | State resources for services provided to eligible |
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| 1 | | beneficiaries through a continuum of care facility | 2 | | comports with the following requirements:
| 3 | | (A) such services shall be reimbursed in a | 4 | | budget-neutral manner such that reimbursement for | 5 | | services provided by the facility constituent elements | 6 | | of a continuum of care licensee shall be neither | 7 | | greater nor lesser than the reimbursement received for | 8 | | such services provided by that facility constituent | 9 | | element prior to the licensing of the continuum of care | 10 | | facility, adjusted to take into account any subsequent | 11 | | changes in reimbursement for such similar services, | 12 | | or, if the facility constituent element is a new | 13 | | facility reimbursement for the services provided by | 14 | | the new facility shall be no less than the | 15 | | reimbursement received for such services by a | 16 | | comparable facility constituent element of that | 17 | | continuum of care facility; and
| 18 | | (B) for purposes of reimbursement under Title XIX | 19 | | of the federal Social Security Act, a continuum of care | 20 | | licensee shall enter into a single provider agreement | 21 | | with the Director of Healthcare and Family Services; | 22 | | changes that may occur from time to time in the | 23 | | facility constituent elements under the continuum of | 24 | | care license shall be addressed as may be required by | 25 | | applicable requirements of law through amendments to | 26 | | the provider agreement; the Director of Healthcare and |
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| 1 | | Family Services shall make all reasonable efforts to | 2 | | ensure that all facility constituent elements that are | 3 | | approved parts of a continuum of care license remain | 4 | | qualified for reimbursement under relevant State and | 5 | | federal programs including Title XIX of the federal | 6 | | Social Security Act; and
| 7 | | (2) in cooperation with interested stakeholders, | 8 | | develop an alternative payment methodology for a continuum | 9 | | of care facility involving the utilization of an annualized | 10 | | global payment amount or other mechanism.
| 11 | | Section 45. The Department of Healthcare and Family | 12 | | Services Law of the
Civil Administrative Code of Illinois is | 13 | | amended by adding Section 2205-13 as follows: | 14 | | (20 ILCS 2205/2205-13 new) | 15 | | Sec. 2205-13. Authorization to secure a federal waiver | 16 | | pursuant to Section 1115 of the federal Social Security Act. | 17 | | (a) The Director of Healthcare and Family Services, in | 18 | | collaboration and coordination with the Director of Human | 19 | | Services, shall develop and submit to the United States | 20 | | Department of Health and Human Services, Centers for Medicare | 21 | | and Medicaid Services, Center for Medicaid and State | 22 | | Operations, a request for a waiver pursuant to Section 1115 of | 23 | | the federal Social Security Act consistent with the purpose of | 24 | | subsection (b) of this Section and requirements of subsection |
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| 1 | | (c) of this Section. | 2 | | (b) The purpose of the waiver authorized by subsection (a) | 3 | | of this Section is to obtain approval for the use of funds | 4 | | under Title XIX of the federal Social Security Act to provide | 5 | | for an alternative model of licensure, reimbursement, and | 6 | | quality assurance for services to individuals with | 7 | | developmental disabilities consistent with the Continuum of | 8 | | Care Services for the Developmentally Disabled Act. | 9 | | (c) A waiver requested pursuant to this authorization must | 10 | | involve the licensure of a continuum of care facility pursuant | 11 | | to and consistent with all requirements of the Continuum of | 12 | | Care Services for the Developmentally Disabled Act and a | 13 | | proposal for a reimbursement methodology developed under | 14 | | paragraph (2) of Section 40 of the Continuum of Care Services | 15 | | for the Developmentally Disabled Act.
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