State of Illinois
92nd General Assembly
Legislation

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92_HB0845

 
                                               LRB9206238TAtm

 1        AN  ACT  concerning  mental  health   and   developmental
 2    disabilities.

 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:

 5        Section   5.  The   Mental   Health   and   Developmental
 6    Disabilities  Administrative  Act  is  amended  by   changing
 7    Section 54 as follows:

 8        (20 ILCS 1705/54) (from Ch. 91 1/2, par. 100-54)
 9        Sec.  54. Establishment of rates for purchase of services
10    and accreditation costs.
11        (a) It is  the  purpose  of  this  Section  to  establish
12    procedures    for    the    development,   calculation,   and
13    communication of rates promulgated by the Department for  the
14    purchase   of  services  for  persons  with  a  developmental
15    disability, and persons with mental illness; to  require  the
16    promulgation  of  rules  which specify the treatment of costs
17    for purposes of establishing rates for various purchase  care
18    program  categories;  to  require  that  rates  be equitable,
19    understandable,  and  established  through  an  open,  public
20    process; and to require the  delineation  of  where  purchase
21    care,  grant-in-aid,  and  other  payment mechanisms are most
22    appropriately utilized.  The Department's rate-setting policy
23    should  stimulate  the   development   of   cost   effective,
24    clinically   appropriate,  community-based  residential,  and
25    other support services for recipients according to an  annual
26    statement of purchase care goals and objectives.
27        (b)  The   Department   shall   establish  rates  in  all
28    instances where services are purchased by the Department  for
29    a  specific  recipient  from  a  specific  community  service
30    provider  for which the Department has the responsibility for
31    establishing payment  rates.   When  determining  rates,  the
 
                            -2-                LRB9206238TAtm
 1    Department  shall  take into consideration differences in the
 2    costs of doing business among the various geographic  regions
 3    of   the  State  and  shall  set  rates  that  reflect  those
 4    differences.   The  Department  may,  for   various   program
 5    categories, adopt rates that are set by other State agencies.
 6        (c)  The Department shall perform the following duties:
 7             (1)  Develop rate-setting methodologies for purchase
 8        care program categories.
 9             (2)  Promulgate   rules  and  regulations  governing
10        rate-setting, treatment of costs, treatment of occupancy,
11        and payment and contracting processes for purchase care.
12             (3)  Collect cost and performance  information  from
13        care providers.  The Department may stipulate forms, unit
14        of   service   definitions,   reporting   procedures  and
15        reporting intervals.
16             (4)  Calculate purchase of care reimbursement  rates
17        for  specific  providers  based  on  the promulgated rate
18        methodology for that program category.
19             (5)  Negotiate  and  implement  purchase   of   care
20        contracts with specific providers.
21             (6)  Develop  an  annual  statement of purchase care
22        goals and objectives detailing maximum units  of  service
23        by  program  category to be purchased.  The plan for each
24        fiscal year shall be completed by May 1 of  the  previous
25        fiscal year.
26             (7)  Conduct  an annual review and prepare an annual
27        report of rates and units of service purchased, comparing
28        the  annual  purchase  of  care  statement  with   actual
29        services  purchased,  and  the  actual  cost of providing
30        those services.  The report shall be  made  available  by
31        May 1.
32             (8)  Establish and promulgate a process and criteria
33        for appealing rates.
34             (9)  Develop  and  promulgate standards and criteria
 
                            -3-                LRB9206238TAtm
 1        by which provider performance shall be evaluated.
 2             (10)  Set rates based on published methodologies and
 3        subject to the availability of funds appropriated by  the
 4        General Assembly.
 5             (11)  Establish  and  promulgate  a policy regarding
 6        applicability of income offsets in  rate  calculation  or
 7        payment processes.
 8             (12)  Develop  criteria  for  selection  of  payment
 9        mechanisms to be employed in funding community services.
10        (d)  The    Department   may   investigate   and   employ
11    alternative   rate   setting   approaches   and   engage   in
12    demonstration projects.  These approaches  must  be  publicly
13    articulated  by  the  Department, identifying the purpose and
14    scope of  the  alternative  approach  and  evaluation  to  be
15    conducted.
16        (e)  (Blank).
17        (f)  In  addition  to its other duties under the Section,
18    the Department must establish procedures and rates  to  repay
19    community   service   providers   for  the  providers'  costs
20    associated with maintaining their national accreditation.
21    (Source:  P.A.  89-58,  eff.  1-1-96;  89-507,  eff.  7-1-97;
22    90-423, eff. 8-15-97.)

23        Section 99.  Effective date.  This Act takes effect  upon
24    becoming law.

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