HB1950 EngrossedLRB102 12590 KTG 17928 b

1    AN ACT concerning public aid.
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
5Medicaid Technical Assistance Act.
6    Section 3. Findings. The General Assembly finds as
8        (1) This Act seeks to remedy a fraction of a much
9    larger broken system by addressing access to health care,
10    managed care organization reform, mental and substance
11    abuse treatment services, and services to address the
12    social determinants of health.
13        (2) Illinois transitioned Medicaid services to managed
14    care with the goals of achieving better health outcomes
15    for the Medicaid population and reducing the per capita
16    costs of health care.
17        (3) Illinois benefits when people have support
18    constructing the sturdy foundation of health and
19    well-being that we all need to reach our potential.
20    Medicaid managed care can be a vital tool in ensuring that
21    people have the full range of supports that form this
22    foundation, including services from community providers
23    that address behavioral health needs, as well as related



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1    services that help people access food, housing, and
2    employment.
3        (4) However, there are barriers that prevent Illinois
4    from fully realizing the benefits of Medicaid managed
5    care. The 2 devastating years of the State budget impasse
6    resulted in 2 years of lost opportunity for community
7    providers to invest in the people, systems, and technology
8    that are necessary for them to participate in Medicaid
9    managed care. A recent survey by the Illinois
10    Collaboration on Youth of more than 130 community
11    providers revealed that the majority do not have contracts
12    with managed care organizations, and most do not have
13    adequate billing and technology infrastructure sufficient
14    for Medicaid billing now or in the future. The survey also
15    revealed that community-based providers primarily serving
16    people of color are the least prepared to participate in
17    Medicaid managed care.
18        (5) The disparity in readiness between providers
19    primarily serving people of color and those who serve a
20    more mixed or white clientele is especially urgent because
21    62% of Illinois' Medicaid recipients are people of color.
22    Racial disparities in behavioral health care result in
23    significant human and financial costs to both the
24    individual and to the State.
25        (6) The COVID-19 pandemic has further exacerbated the
26    health disparities experienced by communities of color.



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1    COVID-19 has increased both the Medicaid-eligible
2    population in Illinois, and increased the demand for
3    behavioral health services, as Illinois residents grapple
4    with trauma, death, job loss, depression, suicide,
5    addiction, and exposure to violence. In addition, COVID-19
6    threatens the stability and viability of community-based
7    providers, further straining the healthcare safety net for
8    people who depend on Medicaid for these essential
9    services.
10        (7) Lack of support for a diversity of providers
11    reduces choice for Medicaid recipients and may incentivize
12    managed care organizations to focus on a narrow selection
13    of community partners. Having some choice in which
14    providers people see for these essential services and
15    having access to providers who understand their community,
16    culture, and language has been demonstrated to reduce
17    disparities in health outcomes and improve health and
18    well-being across the lifespan.
19        (8) The Medicaid managed care system lacks consistent,
20    statewide support for community providers, creating
21    inefficiency and duplication. Providers need targeted
22    trainings focused on their levels of readiness, learning
23    collaboratives to provide group-level support for those
24    experiencing similar challenges, and a mechanism to
25    identify problems that need systemic solutions. Illinois
26    could receive up to 70% in Medicaid matching funds from



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1    the federal government to supplement the costs of
2    operating a Medicaid Technical Assistance Center.
3        (9) When community-based healthcare providers are able
4    to contract with managed care organizations to deliver
5    Medicaid services, people can access the care they need,
6    in their communities, from providers they trust.
7    Section 5. Definitions. As used in this Act:
8    "Behavioral health providers" means mental health and
9substance use disorder providers.
10    "Department" means the Department of Healthcare and Family
12    "Health care providers" means organizations who provide
13physical, mental, substance use disorder, or social
14determinant of health services.
15    "Health equity" means providing care that does not vary in
16quality because of personal characteristics such as gender,
17ethnicity, geographic location, and socioeconomic status.
18    "Network adequacy" means a Medicaid beneficiaries' ability
19to access all necessary provider types within time and
20distance standards as defined in the Managed Care Organization
21model contract.
22    "Service deserts" means geographic areas of the State with
23no or limited Medicaid providers that accept Medicaid.
24    "Social determinants of health" means any conditions that
25impact an individual's health, including, but not limited to,



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1access to healthy food, safety, education, and housing
3    "Stakeholders" means, but are not limited to, health care
4providers, advocacy organizations, managed care organizations,
5Medicaid beneficiaries, and State and city partners.
6    Section 10. Medicaid Technical Assistance Center. The
7Department of Healthcare and Family Services shall establish a
8Medicaid Technical Assistance Center. The Medicaid Technical
9Assistance Center shall operate as a cross-system educational
10resource to strengthen the business infrastructure of health
11care provider organizations in Illinois to ultimately increase
12the capacity, access, health equity, and quality of Illinois'
13Medicaid managed care program, HealthChoice Illinois, and
14YouthCare, the Medicaid managed care program for children and
15youth who receive Medicaid health services through the
16Department of Children and Family Services. The Medicaid
17Technical Assistance Center shall be established within the
18Department's Office of Medicaid Innovation.
19    Section 15. Collaboration. The Medicaid Technical
20Assistance Center shall collaborate with public and private
21partners throughout the State to identify, establish, and
22maintain best practices necessary for health providers to
23ensure their capacity to participate in HealthChoice Illinois
24or YouthCare. The Medicaid Technical Assistance Center shall



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1administer the following:
2        (1) Outreach and engagement: The Medicaid Technical
3    Assistance Center shall undertake efforts to identify and
4    engage community-based providers offering behavioral
5    health services or services addressing the social
6    determinants of health, especially those predominantly
7    serving communities of color or those operating within or
8    near service deserts, for the purpose of offering training
9    and technical assistance to them through the Medicaid
10    Technical Assistance Center. Outreach and engagement
11    services may be subcontracted.
12        (2) Trainings: The Medicaid Technical Assistance
13    Center shall create and administer ongoing trainings for
14    health care providers. Trainings may be subcontracted. The
15    Medicaid Technical Assistance Center shall provide
16    in-person and web-based trainings. In-person training
17    shall be conducted throughout the State. All trainings
18    must be free of charge. The Medicaid Technical Assistance
19    Center shall administer post-training surveys and
20    incorporate feedback. Training content and delivery must
21    be reflective of Illinois providers' varying levels of
22    readiness, resources, and client populations.
23        (3) Web-based resources: The Medicaid Technical
24    Assistance Center shall maintain an independent, easy to
25    navigate, and up-to-date website that includes, but is not
26    limited to: recorded training archives, a training



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1    calendar, provider resources and tools, up-to-date
2    explanations of Department and managed care organization
3    guidance, a running database of frequently asked questions
4    and contact information for key staff members of the
5    Department, managed care organizations, and the Medicaid
6    Technical Assistance Center.
7        (4) Learning collaboratives: The Medicaid Technical
8    Assistance Center shall host regional learning
9    collaboratives that will supplement the Medicaid Technical
10    Assistance Center training curriculum to bring together
11    groups of stakeholders to share issues and best practices,
12    and to escalate issues. Leadership of the Department and
13    managed care organizations shall attend learning
14    collaboratives on a quarterly basis.
15        (5) Network adequacy reports: The Medicaid Technical
16    Assistance Center shall publicly release a report on
17    Medicaid provider network adequacy within the first 3
18    years of implementation and annually thereafter. The
19    reports shall identify provider service deserts and health
20    care disparities by race and ethnicity.
21        (6) Equitable delivery system: The Medicaid Technical
22    Assistance Center is committed to the principle that all
23    Medicaid recipients have accessible and equitable physical
24    and mental healthcare services. All providers served
25    through the Medicaid Technical Assistance Center shall
26    deliver services notwithstanding the patient's race,



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1    color, gender, gender identity, age, ancestry, marital
2    status, military status, religion, national origin,
3    disability status, sexual orientation, order of protection
4    status, as defined under Section 1-103 of the Illinois
5    Human Rights Act, or immigration status.
6    Section 20. Federal financial participation. The
7Department of Healthcare and Family Services, to the extent
8allowable under federal law, shall maximize federal financial
9participation for any moneys appropriated to the Department
10for the Medicaid Technical Assistance Center. Any federal
11financial participation funds obtained in accordance with this
12Section shall be used for the further development and
13expansion of the Medicaid Technical Assistance Center. All
14federal financial participation funds obtained under this
15subsection shall be deposited into the Medicaid Technical
16Assistance Center Fund created under Section 25.
17    Section 25. Medicaid Technical Assistance Center Fund. The
18Medicaid Technical Assistance Center Fund is created as a
19special fund in the State treasury. The Fund shall consist of
20any moneys appropriated to the Department of Healthcare and
21Family Services for the purposes of this Act and any federal
22financial participation funds obtained as provided under
23Section 20. Moneys in the Fund shall be used for carrying out
24the purposes of this Act and for no other purpose. All interest



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1earned on the moneys in the Fund shall be deposited into the
3    Section 90. The State Finance Act is amended by adding
4Section 5.935 as follows:
5    (30 ILCS 105/5.935 new)
6    Sec. 5.935. The Medicaid Technical Assistance Center Fund.
7    Section 99. Effective date. This Act takes effect upon
8becoming law.