Illinois General Assembly - Full Text of HB6304
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Full Text of HB6304  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 Section 1115 of the federal Social
16Security Act.
17    Section 10. Definitions. As used in this Act, unless the
18context requires otherwise:
19    "Applicable requirements of law" means State and federal
20statutes, rules, regulations, and guidance, as such may from
21time-to-time be amended or revised, governing the rights,
22protections, and services, including reimbursement for such



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1services, afforded to individuals with developmental
3    "Campus group home" means a residential facility meeting
4the requirements of Section 30 of this Act and operated as part
5of a continuum of care facility licensed under this Act.
6    "Continuum of care facility" means a legally incorporated
7entity that provides a comprehensive range of programs,
8services, and supports for adults with developmental
9disabilities, positioned at a central geographic campus
10facility, 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    sheltered employment and off-campus supported employment
16    opportunities provided in accordance with applicable
17    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
5continuum of care facility in accordance with the terms of this
7    "Continuum of care plan" means a formal, written plan
8meeting the requirements of Section 25 of this Act.
9    "Facility constituent elements" means the particular,
10discrete programs, services, and supports delineated in the
11definition of "continuum of care facility" and provided
12collectively by the facility.
13    Section 15. Powers and duties. The Director of Human
14Services, acting in consultation and coordination as necessary
15with the Director of Public Health and the Director of
16Healthcare and Family Services, shall establish a system of
17licensure for continuum of care facilities, in accordance with
18this 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
5Services shall adopt rules establishing standards for
6licensing of continuum of care facilities under a single
7license. These rules shall ensure that an applicant for
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
2continuum of care license shall submit to the Director of Human
3Services, in such form and manner as the Director of Human
4Services 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 and medically complex individuals with
21    developmental disabilities; and
22        (5) demonstrate a commitment to providing informed,
23    free, and meaningful choice regarding the type of community
24    in which the individual prefers to live and the type of
25    employment opportunities or developmental training the



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1    individual prefers to receive; beneficiary engagement;
2    annual care planning and ongoing treatment focused on the
3    needs and preferences of the individual and adherence to
4    other applicable requirements of law relevant to
5    protecting the rights and welfare of individuals with
6    developmental disabilities.
7    Section 30. Applicable requirements. The Director of Human
8Services, acting as appropriate through or in coordination with
9the Director of Public Health, shall in licensing a continuum
10of care facility ensure the following:
11        (1) community-integrated living arrangements provided
12    by such licensee meet all otherwise applicable
13    requirements of law pertaining to such arrangements,
14    including those set forth in the Community-Integrated
15    Living Arrangements Licensure and Certification Act,
16    except that a continuum of care facility may prioritize the
17    movement of individuals into or out of
18    community-integrated living arrangements from or into
19    other residential facility constituent elements;
20        (2) on-campus and off-campus employment opportunities
21    provided by the licensee meet all otherwise applicable
22    requirements of law pertaining to such opportunities;
23        (3) developmental training programs and services
24    provided by the licensee meet all otherwise applicable
25    requirements of law pertaining to such programs and



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1    services;
2        (4) community living facility opportunities provided
3    by the licensee meet all otherwise applicable requirements
4    of law pertaining to such opportunities;
5        (4) campus group homes provided by the licensee meet
6    all otherwise applicable requirements of law pertaining to
7    an ID/DD facility under the ID/DD Community Care Act;
8        (5) medically complex for the developmentally disabled
9    facility opportunities provided by the licensee meet all
10    otherwise applicable requirements of law pertaining to
11    such opportunities; and
12        (6) the applicant complies with such other
13    requirements as the Director of Human Services may consider
14    necessary and appropriate to carry out the purposes of this
15    Act and other applicable requirements of law.
16    Section 35. Existing and future programs and services.
17    (a) To the extent necessary to carry out the purposes of
18this Act and to maintain eligibility for reimbursement for
19services under applicable State and federal programs,
20including Title XIX of the federal Social Security Act,
21facility constituent elements of an entity licensed as a
22continuum of care facility may be considered to be licensed
23pursuant to the otherwise applicable requirements of law as set
24forth in Section 30 of this Act.
25    (b) In the event that a continuum of care facility ceases



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1to retain licensure as a continuum of care facility, facility
2constituent elements that meet all otherwise applicable
3requirements of law with respect to such element as set forth
4in Section 30 of this Act shall be deemed to be licensed.
5    (c) Residents of campus group homes and
6community-integrated living arrangements that are facility
7constituent elements shall continue to be beneficiaries of and
8have the rights and protections provided to residents of ID/DD
9facilities and community-integrated living arrangements,
10respectively, under the consent decree entered by the United
11States District Court for the Northern District of Illinois in
12the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15,
14    (d) A continuum of care licensee shall be permitted to add
15new facility constituent elements under its license provided
16that it demonstrates a need for the new facility constituent
17elements and that the facility constituent elements meet all
18applicable requirements of law.
19    Section 40. Reimbursement rules. The Director of Human
20Services and the Director of Healthcare and Family Services
22        (1) ensure that reimbursement utilizing federal and
23    State resources for services provided to eligible
24    beneficiaries through a continuum of care facility
25    comports with the following requirements:



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1            (A) such services shall be reimbursed in a
2        budget-neutral manner such that reimbursement for
3        services provided by the facility constituent elements
4        of a continuum of care licensee shall be neither
5        greater nor lesser than the reimbursement received for
6        such services provided by that facility constituent
7        element prior to the licensing of the continuum of care
8        facility, adjusted to take into account any subsequent
9        changes in reimbursement for such similar services,
10        or, if the facility constituent element is a new
11        facility reimbursement for the services provided by
12        the new facility shall be no less than the
13        reimbursement received for such services by a
14        comparable facility constituent element of that
15        continuum of care facility; and
16            (B) for purposes of reimbursement under Title XIX
17        of the federal Social Security Act, a continuum of care
18        licensee shall enter into a single provider agreement
19        with the Director of Healthcare and Family Services;
20        changes that may occur from time to time in the
21        facility constituent elements under the continuum of
22        care license shall be addressed as may be required by
23        applicable requirements of law through amendments to
24        the provider agreement; the Director of Healthcare and
25        Family Services shall make all reasonable efforts to
26        ensure that all facility constituent elements that are



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1        approved parts of a continuum of care license remain
2        qualified for reimbursement under relevant State and
3        federal programs including Title XIX of the federal
4        Social Security Act; and
5        (2) in cooperation with interested stakeholders,
6    develop an alternative payment methodology for a continuum
7    of care facility involving the utilization of an annualized
8    global payment amount or other mechanism.
9    Section 45. The Department of Healthcare and Family
10Services Law of the Civil Administrative Code of Illinois is
11amended by adding Section 2205-13 as follows:
12    (20 ILCS 2205/2205-13 new)
13    Sec. 2205-13. Authorization to secure a federal waiver
14pursuant to Section 1115 of the federal Social Security Act.
15    (a) The Director of Healthcare and Family Services, in
16collaboration and coordination with the Director of Human
17Services, shall develop and submit to the United States
18Department of Health and Human Services, Centers for Medicare
19and Medicaid Services, Center for Medicaid and State
20Operations, a request for a waiver pursuant to Section 1115 of
21the federal Social Security Act consistent with the purpose of
22subsection (b) of this Section and requirements of subsection
23(c) of this Section.
24    (b) The purpose of the waiver authorized by subsection (a)



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1of this Section is to obtain approval for the use of funds
2under Title XIX of the federal Social Security Act to provide
3for an alternative model of licensure, reimbursement, and
4quality assurance for services to individuals with
5developmental disabilities consistent with the Continuum of
6Care Services for the Developmentally Disabled Act.
7    (c) A waiver requested pursuant to this authorization must
8involve the licensure of a continuum of care facility pursuant
9to and consistent with all requirements of the Continuum of
10Care Services for the Developmentally Disabled Act and a
11proposal for a reimbursement methodology developed under
12paragraph (2) of Section 40 of the Continuum of Care Services
13for the Developmentally Disabled Act.