| ||||
Public Act 102-0066 | ||||
| ||||
| ||||
AN ACT concerning health.
| ||||
Be it enacted by the People of the State of Illinois,
| ||||
represented in the General Assembly:
| ||||
Section 1. Short title. This Act may be cited as the | ||||
Housing is Recovery Pilot Program Act. | ||||
Section 3. Definitions. As used in this Act: | ||||
"Individual at high risk of unnecessary | ||||
institutionalization" means a person who has a serious mental | ||||
illness who is homeless (or will be homeless upon hospital | ||||
discharge or correctional facility release) and who has had: | ||||
(1) three or more psychiatric inpatient hospital | ||||
admissions within the most recent 12-month period; | ||||
(2) three or more stays in a State or county | ||||
correctional facility in the State of Illinois within the | ||||
most recent 12-month period; or | ||||
(3) a disability determination due to a serious mental | ||||
illness and has been incarcerated in a State or county | ||||
correctional facility in Illinois for the most recent 12 | ||||
consecutive months. | ||||
"Individual at high risk of overdose" means a person with | ||||
a substance use disorder who is homeless (or will be homeless | ||||
upon hospital discharge or correctional facility release) who | ||||
has had: |
(A) three or more hospital inpatient or inpatient | ||
detoxification admissions for a substance use disorder | ||
within the most recent 12-month period; | ||
(B) three or more stays in a State or county | ||
correctional facility in the State of Illinois within the | ||
most recent 12-month period; or | ||
(C) one or more drug overdoses in the last 12 months. | ||
"Engagement services" means home-based or community-based | ||
visits that assist the individual with maintaining his or her | ||
housing, and providing other wrap-around support, including | ||
linkage to mental health or substance use recovery support | ||
services. Such engagement services shall align with | ||
Medicaid-covered tenancy support services, and Medicaid | ||
community-based mental health and substance use treatment | ||
services, including case management, to ensure alignment with | ||
any existing or future Illinois Medicaid benefits, waivers or | ||
State plan amendments that include these services, and to | ||
maximize any potential federal Medicaid matching dollars that | ||
may be available to support engagement services. | ||
"Homeless" means the definition used by the U.S. | ||
Department of Health and Human Services, Health Resources and | ||
Services Administration in Section 330(h)(5)(A) of the Public | ||
Health Services Act (42 U.S.C. 254(b)). Under Section | ||
330(h)(5)(A), a homeless individual is an individual who lacks | ||
housing (without regard to whether the individual is a member | ||
of a family), including an individual whose primary residence |
during the night is a supervised public or private facility | ||
that provides temporary living accommodations, and an | ||
individual who is a resident in transitional housing. This | ||
includes individuals who are doubled up with other households. | ||
"Serious mental illness" means meeting both the diagnostic | ||
and functioning criteria consistent with the definition of | ||
Serious Mental Illness in the most current edition of the | ||
Illinois Department of Human Services/Division of Mental | ||
Health Community Mental Health Provider Manual. | ||
"Substance use disorder" as defined in Section 1-10 of the | ||
Substance Use Disorder Act. | ||
Section 5. Establishment of program. Subject to | ||
appropriation, the Housing is Recovery pilot program shall be | ||
established and administered by the Department of Human | ||
Services, Division of Mental Health. The purpose of the | ||
program is to prevent a person with a serious mental illness | ||
who is at high risk of unnecessary institutionalization, or a | ||
person with a substance use disorder who is at high risk of | ||
overdose, due to homelessness, a lack of access to recovery | ||
support services, and repeating cycles of hospitalizations or | ||
justice system involvement from being institutionalized or | ||
dying. This will be accomplished by enabling affordable | ||
housing through the use of a bridge rental subsidy combined | ||
with access to recovery support services or treatment. The | ||
triple aim of Housing is Recovery is: |
(1) preventing institutionalization and overdose | ||
deaths; | ||
(2) improving health outcomes and access to recovery | ||
support services; and | ||
(3) reducing State costs. | ||
Section 10. Eligibility. An individual meeting the | ||
requirements listed in this Section shall be eligible to | ||
receive a Housing is Recovery bridge rental subsidy for | ||
purposes of stabilizing his or her mental illness or substance | ||
use disorder. | ||
(1) An individual at high risk of unnecessary | ||
institutionalization who is 21 years of age or older, or | ||
is aging out of guardianship under the Department of | ||
Children and Family Services, and who is eligible to | ||
enroll in, or is enrolled in, Medicaid for purposes of | ||
receiving mental health treatment pursuant to 89 Ill. Adm. | ||
Code 140. | ||
(2) An individual at high risk of overdose who is 21 | ||
years of age or older, or is aging out of guardianship | ||
under the Department of Children and Family Services, and | ||
who is eligible to enroll in, or is enrolled in, Medicaid | ||
for purposes of receiving substance use treatment. | ||
Section 15. Housing is Recovery bridge rental subsidy. A | ||
bridge rental subsidy received by an individual (the "subsidy |
holder") pursuant to this Act shall mirror the subsidies | ||
issued by the Department of Human Services, Division of Mental | ||
Health through the Moving On Program. The rental subsidy shall | ||
be for scattered-site rental units owned by a landlord or for | ||
rental units secured through a master lease. The rental | ||
subsidy shall assist the subsidy holder with monthly rental | ||
payments for rent that does not exceed the Fair Market Rent | ||
published annually for that year by the U.S. Department of | ||
Housing and Urban Development. The Department of Human | ||
Services, Division of Mental Health, shall have the discretion | ||
to allow a subsidy to apply to rent up to 120% of the Fair | ||
Market Rent if this is justified by the lack of available | ||
affordable housing in the local housing market. Community | ||
Mental Health Centers certified pursuant to 59 Ill. Adm. Code | ||
132 or supported housing service providers participating in | ||
this pilot program shall be responsible for assisting the | ||
subsidy holder with maintaining his or her housing that is | ||
supported by the bridge rental subsidy and either providing or | ||
coordinating engagement services with a mental health or | ||
substance use treatment provider. | ||
(1) The subsidy holder shall be responsible for | ||
contributing 30% of his or her income toward the cost of | ||
rent (zero income does not preclude participation). | ||
(2) The subsidy holder must agree to sign a lease with | ||
a landlord or a sublease agreement with the Community | ||
Mental Health Center or the housing services provider that |
has a master lease for the rental unit and agree to | ||
engagement services initiated by the supported housing | ||
provider, the Community Mental Health Center or contracted | ||
mental health or substance use treatment provider at least | ||
2 times a month, with at least one of those visits being a | ||
home visit. The engagement services shall be permitted in | ||
a home-based or community-based setting, and do not | ||
require a clinic visit. | ||
(3) A goal of this program is to encourage the subsidy | ||
holder to engage in mental health and substance use | ||
recovery support services or treatment when the individual | ||
is ready. However, this is a Housing First model that does | ||
not require abstinence from substance or alcohol use and | ||
does not require mental health or substance use treatment. | ||
(4) If a subsidy holder does not have an income due to | ||
a psychiatric disability, he or she shall be offered the | ||
opportunity for assistance with filing a "SOAR | ||
application" (Supplemental Security Income (SSI)/Social | ||
Security Disability Income (SSDI), Outreach, Access and | ||
Recovery application) by the Community Mental Health | ||
Center participating in the Housing is Recovery program | ||
that is providing his or her mental health support or | ||
treatment within 6 months of the initiation of mental | ||
health services. If the subsidy holder is only receiving | ||
housing support services, the housing services provider | ||
must partner with a Community Mental Health Center to do |
SOAR applications for individuals who elect to apply for a | ||
psychiatric disability. A subsidy holder is not required | ||
to apply for a disability determination. | ||
(5) The subsidy holder, if he or she is eligible, must | ||
apply for rental assistance or housing through the | ||
appropriate Public Housing Authority within 6 months of | ||
receiving a Housing is Recovery bridge rental subsidy or | ||
agree to apply when it is permissible to do so, and also be | ||
placed on the Illinois Housing Development Authority's | ||
Statewide Referral Network. | ||
Section 20. Identification and referral of eligible | ||
individuals prior to hospital discharge or correctional | ||
facility release for purposes of rapid housing post | ||
discharge/release and illness stability. The pilot program is | ||
intended to enable affordable housing to avoid | ||
institutionalization or overdose death by providing for | ||
connection to housing through a variety of settings, including | ||
in hospitals, county jails, prisons, homeless shelters and | ||
inpatient detoxification facilities and the referral process | ||
established must take this into account. Within 2 months of | ||
the effective date of this Act, the Department of Human | ||
Services, Division of Mental Health, in partnership with the | ||
Department of Healthcare and Family Services and the | ||
Department of Human Services, Division of Substance Use | ||
Prevention and Recovery (SUPR), the Department of Corrections, |
and with meaningful stakeholder input through a working group | ||
of Community Mental Health Centers, homeless service | ||
providers, substance use treatment providers, hospitals with | ||
inpatient psychiatric units or detoxification units, | ||
representatives from county jails, persons with lived | ||
experience, and family support organizations, shall develop a | ||
process for identifying and referring eligible individuals for | ||
the Housing is Recovery program prior to hospital discharge or | ||
correctional system release, or other appropriate place for | ||
referral, including homeless shelters. The process developed | ||
shall aim to enable rapid access to housing | ||
post-discharge/release to avoid unnecessary | ||
institutionalization or a return to homelessness or unstable | ||
housing. The working group shall meet at least monthly prior | ||
to development of an administrative rule or policy established | ||
to carry out the intent of this Act. The Department of Human | ||
Services, Division of Mental Health, shall explore ways to | ||
collaborate with the U.S. Department of Housing and Urban | ||
Development's Coordinated Entry System and other ways for | ||
electronic referral. The Department of Human Services, | ||
Division of Mental Health, and the Department of Healthcare | ||
and Family Services shall collaborate to ensure that the | ||
referral process aligns with any existing or future Medicaid | ||
waivers or State plan amendments for tenancy support services. | ||
Section 25. Participating Community Mental Health Centers |
and housing service provider responsibilities for locating and | ||
transitioning the individual into housing, assisting in | ||
retaining housing, and the provision of engagement and | ||
recovery support services. The Department of Human Services, | ||
Division of Mental Health, shall select interested Community | ||
Mental Health Centers that are certified pursuant to 59 Ill. | ||
Adm. Code 132 and interested housing service providers for | ||
participation in the Housing is Recovery program. | ||
(1) For purposes of incentivizing continuity of care, | ||
the same participating Community Mental Health Center may | ||
be responsible for providing both the housing support and | ||
the mental health or substance use engagement, recovery | ||
support services and treatment to a subsidy holder. If a | ||
housing support services provider does not also provide | ||
the mental health or substance use treatment services the | ||
individual engages in, there must be strong coordination | ||
of care between the housing services provider and the | ||
treatment provider. | ||
(2) The provider must demonstrate that the rental | ||
units secured through this program pass minimum quality | ||
inspection standards. | ||
(3) Community Mental Health Centers providing housing | ||
support through this program shall be responsible for any | ||
SOAR applications for a subsidy holder that has a | ||
psychiatric disability who does not have SSI or SSDI if | ||
the subsidy holder chooses to apply for disability. A |
housing services provider delivering the housing support | ||
services through this program must contract with a | ||
Community Mental Health Center to provide assistance with | ||
SOAR applications to subsidy holders electing to apply for | ||
SSI or SSDI within 6 months of the subsidy holder | ||
receiving the subsidy. | ||
(4) Service providers shall be permitted to engage in | ||
master leasing to secure apartments for those who are hard | ||
to house due to criminal backgrounds, history of substance | ||
use and stigma. | ||
Section 30. Securing rental housing units for purposes of | ||
immediate temporary housing following hospital discharge or | ||
release from a correctional facility while a long-term rental | ||
unit is secured. Up to 20% of the available annual | ||
appropriation for the Housing is Recovery program shall be | ||
available to Community Mental Health Centers or the housing | ||
services provider for purposes of securing critical time | ||
intervention rental units to house an eligible individual | ||
immediately following discharge from a hospitalization or | ||
release from a correctional facility because locating an | ||
apartment unit for a longer-term one-year lease and the | ||
related move-in can take up to 3 months. Such temporary units | ||
may be used for immediate temporary housing, not to exceed 90 | ||
days for purposes of preventing the individual from reentering | ||
homelessness or unstable housing, or avoiding unnecessary |
institutionalization. The Department of Human Services, | ||
Division of Mental Health, shall allow providers to certify | ||
that such rental units meet minimum housing quality standards | ||
and ensure a process by which community providers are able to | ||
secure vacant rental units for the purpose of immediate | ||
short-term housing post-hospital discharge or correctional | ||
system release while a longer term housing rental unit is | ||
secured. | ||
Section 35. Basic move-in expenses. The Housing is | ||
Recovery program shall include reasonable payment for the | ||
basic move-in expenses of the subsidy holder, including, but | ||
not limited to, payment of a security deposit and other | ||
move-in fees or expenses, and basic household supplies and | ||
furnishings. | ||
Section 40. Subsidy administration. The bridge rental | ||
subsidy administration (such as payment of rent to the | ||
landlord and other administration expenses) and quality | ||
inspection of the rental units may be done by community-based | ||
organizations with experience and expertise in housing subsidy | ||
administration and by Community Mental Health Centers that the | ||
Department of Human Services, Division of Mental Health, | ||
determines have the administrative infrastructure for subsidy | ||
administration. Such organizations shall manage and administer | ||
all aspects of the subsidy (such as payment of rent, quality |
inspections) on behalf of the subsidy holder. | ||
Section 45. Landlord education and stigma reduction plan | ||
and materials. The Department of Human Services, Division of | ||
Mental Health, with meaningful input from stakeholders, shall | ||
develop a plan for educating prospective landlords that may | ||
lease to individuals receiving a bridge rental subsidy through | ||
the Housing is Recovery program. This educational plan shall | ||
include written materials that indicate that individuals with | ||
psychiatric disabilities and substance use disorders often | ||
have criminal justice involvement due to their previously | ||
untreated mental health or substance use condition and periods | ||
of homelessness. Implementation of this plan shall be rolled | ||
out in conjunction with the implementation of the Housing is | ||
Recovery program. | ||
Section 50. State agency coordination. The Department of | ||
Human Services, Division of Mental Health, shall partner with | ||
SUPR to ensure coordination of the services required pursuant | ||
to this Act and all substance use recovery support services | ||
and treatment for which SUPR has oversight. The Department of | ||
Human Services, Division of Mental Health, shall also work | ||
with the Department of Healthcare and Family Services to | ||
maximize all recovery support services and treatment that are | ||
or can be covered by Medicaid. |
Section 55. Provider and State agency education on the | ||
pilot program. The Department of Human Services, Division of | ||
Mental Health shall put together written materials on the | ||
Housing is Recovery program and eligibility criteria for | ||
purposes of educating participating providers, county jails, | ||
the Department of Corrections, hospitals and other relevant | ||
stakeholders on the program. The Department of Human Services, | ||
Division of Mental Health, shall engage in an ongoing | ||
education effort to ensure that all stakeholders are aware of | ||
the program and how to screen for eligibility and referral. | ||
Section 60. Reimbursement for subsidy administration, | ||
housing support and engagement services and other program | ||
costs. The Department of Human Services, Division of Mental | ||
Health shall develop a reimbursement approach for community | ||
providers doing subsidy administration that covers all costs | ||
of subsidy administration, quality inspection and other | ||
services. The Department of Human Services, Division of Mental | ||
Health shall also develop a reimbursement approach that covers | ||
all costs incurred by Community Mental Health Centers and | ||
housing services providers for identifying and securing rental | ||
units for subsidy holders, including all travel related to | ||
finding and locating an apartment and move-in of the subsidy | ||
holder, quality inspections for temporary housing units, | ||
completing and submitting SOAR applications, the costs | ||
associated with obtaining necessary documents associated with |
obtaining a lease for the subsidy holder (such as obtaining a | ||
State ID); for engagement services not covered by Medicaid; | ||
and for any other reasonable and necessary costs associated | ||
with the program outlined in this Act. Reimbursement shall | ||
also include all costs associated with collecting and tracking | ||
data for purposes of program evaluation and improvement. At | ||
the discretion of the Department of Human Services, Division | ||
of Mental Health, up to 5% of the annual appropriation may be | ||
applied to growing mental health or substance use treatment or | ||
recovery support capacity if a participating provider in the | ||
Housing is Recovery program demonstrates an inability to take | ||
eligible individuals due to such capacity limitations. | ||
Section 65. Subsidy termination. The subsidy holder shall | ||
continue to hold the subsidy until he or she receives a housing | ||
voucher or rental subsidy through a Public Housing Authority | ||
unless: | ||
(1) The individual has a stay in a nursing home, | ||
Institution for Mental Disease (IMD) or specialized mental | ||
health rehabilitation facility (SMHRF) exceeding 6 | ||
consecutive months. During a stay in nursing home, IMD or | ||
SMHRF of less than 6 months, the program will continue to | ||
pay the subsidized portion of the rent in order to | ||
maintain the housing unit for the subsidy holder upon | ||
discharge. | ||
(2) The individual has a stay in a correctional |
facility exceeding 6 consecutive months. During a | ||
correctional facility stay of less than 6 months, the | ||
program will continue to pay the subsidized portion of the | ||
rent in order to maintain the housing unit for the subsidy | ||
holder. | ||
(3) A subsidy does not terminate if the subsidy holder | ||
is required to move multiple times due to landlord | ||
eviction or does not engage in treatment, as the target | ||
population for this pilot program is expected to have | ||
multiple barriers to remaining housed. | ||
Section 70. Developing public-private partnerships to | ||
expand affordable housing options for those with serious | ||
mental illnesses. The Department of Human Services, Division | ||
of Mental Health shall work with the Department of Healthcare | ||
and Family Services, Medicaid managed care organizations and | ||
hospitals across the State to develop public-private | ||
partnerships to incentivize private funding from hospitals and | ||
managed care organizations to match State dollars invested in | ||
the Housing is Recovery program for purposes of preventing | ||
repeated preventable hospitalizations, overdose deaths and | ||
unnecessary institutionalization. | ||
Section 75. Data collection and program evaluation. | ||
(a) For purposes of evaluating the effectiveness of the | ||
Housing is Recovery program and for making improvements to the |
program, the Department of Human Services, Division of Mental | ||
Health shall contract with an independent outside research | ||
organization with expertise in housing services for | ||
individuals with serious mental illnesses and substance use | ||
disorders to evaluate the program's effectiveness on enabling | ||
housing stability, reducing hospitalizations and justice | ||
system involvement, encouraging engagement in mental health | ||
and substance use treatment, fostering employment engagement, | ||
and reducing institutionalization and overdose deaths. Such | ||
evaluation shall commence after 4 years of implementation of | ||
the program and shall be submitted to the General Assembly by | ||
the end of the fifth year of implementation. For purposes of | ||
assisting with this evaluation, the working group established | ||
pursuant to Section 20 shall also make recommendations to the | ||
Department of Human Services, Division of Mental Health, | ||
regarding what data must be tracked by providers and the | ||
Department of Human Services, Division of Mental Health, to | ||
evaluate the program and to make future changes to the program | ||
to ensure its effectiveness in meeting the triple aim stated | ||
in Section 5. | ||
(b) Beginning after the first 12 months of implementation | ||
and on an annual basis, the Department of Human Services, | ||
Division of Mental Health, shall track and make public the | ||
following information: (1) the number of individuals receiving | ||
subsidies in reporting period (12-month average); (2) | ||
participant demographics including age, race, gender identity, |
and primary language; (3) the average duration of time | ||
individuals are enrolled in the program (by months); (4) the | ||
number of individuals removed from the program and reasons for | ||
removal; (5) the number of grievances filed by participants | ||
and a summary of grievance type; and (6) program referral | ||
sources. Reports shall be generated on an annual basis and | ||
publicly posted on the Department of Human Services website. | ||
Section 80. Act subject to appropriation. This Act is | ||
subject to appropriation. The appropriation shall be divided | ||
equally between bridge subsidies issued to individuals who are | ||
at high risk of unnecessary institutionalization and those who | ||
are at high risk of overdose. | ||
Section 85. Rulemaking authority. Any administrative rules | ||
necessary to implement this Act shall be filed within 12 | ||
months following the effective date of this Act.
| ||
Section 99. Effective date. This Act takes effect upon | ||
becoming law.
|