Illinois General Assembly - Full Text of SB2610
Illinois General Assembly

Previous General Assemblies

Full Text of SB2610  99th General Assembly


Rep. Jim Durkin

Filed: 5/24/2016





09900SB2610ham001LRB099 19934 MJP 49036 a


2    AMENDMENT NO. ______. Amend Senate Bill 2610 by replacing
3everything after the enacting clause with the following:
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.



09900SB2610ham001- 2 -LRB099 19934 MJP 49036 a

1    Section 10. Definitions. As used in this Act, unless the
2context requires otherwise:
3    "Applicable requirements of law" means State and federal
4statutes, rules, regulations, and guidance, as such may from
5time to time be amended or revised, governing the rights,
6protections, and services, including reimbursement for such
7services, afforded to individuals with developmental
9    "Campus group home" means a residential facility meeting
10the requirements of Section 30 of this Act and operated as part
11of a continuum of care facility licensed under this Act.
12    "Continuum of care facility" means a legally incorporated
13entity that provides a comprehensive range of programs,
14services, and supports for adults with developmental
15disabilities, positioned at a central geographic campus
16facility, 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
11continuum of care facility in accordance with the terms of this
13    "Continuum of care plan" means a formal, written plan
14meeting the requirements of Section 25 of this Act.
15    "Facility constituent elements" means the particular,
16discrete programs, services, and supports delineated in the
17definition of "continuum of care facility" and provided
18collectively by the facility.
19    Section 15. Powers and duties. The Secretary of Human
20Services, acting in consultation and coordination as necessary
21with the Director of Public Health and the Director of
22Healthcare and Family Services, shall, within 12 months after
23the effective date of this Act, establish a system of licensure
24for continuum of care facilities, in accordance with this Act,
25for 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
12Services shall, within 12 months after the effective date of
13this Act, file rules establishing standards for licensing of
14continuum of care facilities under a single license. These
15rules 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
9continuum of care license shall submit to the Secretary of
10Human Services, in such form and manner as the Secretary of
11Human Services shall require, a continuum of care plan that
12demonstrates 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
22Human Services, acting as appropriate through or in
23coordination with the Director of Public Health, shall in
24licensing 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
7care facility upon the adoption of the rules provided for in
8Section 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
11this Act and to maintain eligibility for reimbursement for
12services under applicable State and federal programs,
13including Title XIX of the federal Social Security Act,
14facility constituent elements of an entity licensed as a
15continuum of care facility may be considered to be licensed
16pursuant to the otherwise applicable requirements of law as set
17forth in Section 30 of this Act.
18    (b) In the event that a continuum of care facility ceases
19to retain licensure as a continuum of care facility, facility
20constituent elements that meet all otherwise applicable
21requirements of law with respect to such element as set forth
22in Section 30 of this Act shall be deemed to be licensed
23pursuant to such requirements.
24    (c) Residents of campus group homes and
25community-integrated living arrangements that are facility



09900SB2610ham001- 9 -LRB099 19934 MJP 49036 a

1constituent elements shall continue to be beneficiaries of and
2have the rights and protections provided to residents of ID/DD
3facilities and community-integrated living arrangements,
4respectively, under the consent decree entered by the United
5States District Court for the Northern District of Illinois in
6the 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,
8members of the class in Ligas residing in ID/DD facilities on
9June 15, 2011 may move to community-integrated living
10arrangements as they chose to do so; members of the class in
11Ligas admitted to ID/DD facilities after June 15, 2011 must
12enroll on the Prioritization of Urgency of Need for Services
13waiting list and be selected for community-integrated living
14arrangements services prior to moving.
15    (d) A continuum of care licensee shall be permitted to add
16new facility constituent elements under its license provided
17that it demonstrates a need for the new facility constituent
18elements and that the facility constituent elements meet all
19applicable requirements of law.
20    Section 40. Reimbursement rules. The Secretary of Human
21Services and the Director of Healthcare and Family Services
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
18Services Law of the Civil Administrative Code of Illinois is
19amended by adding Section 2205-13 as follows:
20    (20 ILCS 2205/2205-13 new)
21    Sec. 2205-13. Authorization to secure a federal waiver
22pursuant to the federal Social Security Act or a State plan
24    (a) The Director of Healthcare and Family Services, in



09900SB2610ham001- 12 -LRB099 19934 MJP 49036 a

1collaboration and coordination with the Secretary of Human
2Services, shall develop and submit to the United States
3Department of Health and Human Services, Centers for Medicare
4and Medicaid Services, Center for Medicaid and State
5Operations, a request for a waiver pursuant to the federal
6Social Security Act or a State plan amendment consistent with
7the purpose of subsection (b) of this Section and requirements
8of subsection (c) of this Section.
9    (b) The purpose of the waiver or a State plan amendment
10authorized by subsection (a) of this Section is to obtain
11approval for the use of funds under Title XIX of the federal
12Social Security Act to provide for an alternative model of
13licensure, reimbursement, and quality assurance for services
14to individuals with developmental disabilities consistent with
15the Continuum of Care Services for the Developmentally Disabled
17    (c) A waiver or a State plan amendment requested pursuant
18to this authorization must involve the licensure of a continuum
19of care facility pursuant to and consistent with all
20requirements of the Continuum of Care Services for the
21Developmentally Disabled Act and a proposal for a reimbursement
22methodology developed under paragraph (2) of Section 40 of the
23Continuum of Care Services for the Developmentally Disabled