Illinois General Assembly - Full Text of Public Act 099-0892
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Public Act 099-0892


 

Public Act 0892 99TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 099-0892
 
SB2610 EnrolledLRB099 19934 MJP 44333 b

    AN ACT concerning regulation.
 
    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
Continuum of Care Services for the Developmentally Disabled
Act.
 
    Section 5. Purpose. The purpose of this Act is to authorize
a new type of license for organizations providing services to
individuals with developmental disabilities to be known as a
continuum of care license; to define the requirements for a
continuum of care facility to receive and maintain such a
license; to establish a process for the development of an
alternative budget-neutral reimbursement mechanism for such a
facility; and to authorize a request to the federal government
for a waiver pursuant to the federal Social Security Act.
 
    Section 10. Definitions. As used in this Act, unless the
context requires otherwise:
    "Applicable requirements of law" means State and federal
statutes, rules, regulations, and guidance, as such may from
time to time be amended or revised, governing the rights,
protections, and services, including reimbursement for such
services, afforded to individuals with developmental
disabilities.
    "Campus group home" means a residential facility meeting
the requirements of Section 30 of this Act and operated as part
of a continuum of care facility licensed under this Act.
    "Continuum of care facility" means a legally incorporated
entity that provides a comprehensive range of programs,
services, and supports for adults with developmental
disabilities, positioned at a central geographic campus
facility, and including all of the following:
        (1) community-integrated living arrangements provided
    within reasonable geographic proximity of the campus and in
    accordance with applicable requirements of law;
        (2) employment opportunities, including both on-campus
    compensated work opportunities and off-campus supported
    employment opportunities provided in accordance with
    applicable requirements of law;
        (3) developmental training programs and services
    provided in accordance with applicable requirements of
    law;
        (4) on-campus community living facility opportunities
    provided on-campus and in accordance with applicable
    requirements of law;
        (5) campus group home opportunities as authorized and
    defined in this Act and provided in accordance with
    applicable requirements of law; and
        (6) medically complex for the developmentally disabled
    facility opportunities provided on-campus and in
    accordance with applicable requirements of law.
    "Continuum of care license" means a license issued to a
continuum of care facility in accordance with the terms of this
Act.
    "Continuum of care plan" means a formal, written plan
meeting the requirements of Section 25 of this Act.
    "Facility constituent elements" means the particular,
discrete programs, services, and supports delineated in the
definition of "continuum of care facility" and provided
collectively by the facility.
 
    Section 15. Powers and duties. The Secretary of Human
Services, acting in consultation and coordination as necessary
with the Director of Public Health and the Director of
Healthcare and Family Services, shall, within 12 months after
the effective date of this Act, establish a system of licensure
for continuum of care facilities, in accordance with this Act,
for the following purposes:
        (1) protecting the welfare, safety, and rights of
    individuals with developmental disabilities;
        (2) providing additional options for care and services
    for individuals with developmental disabilities; and
        (3) providing a model of care that can transition
    individuals with developmental disabilities in a seamless
    and timely manner across the continuum of residential care
    settings and supportive services, training, education, and
    employment opportunities in a manner that maximizes
    beneficiary choice and satisfaction.
 
    Section 20. Licensing standards. The Secretary of Human
Services shall, within 12 months after the effective date of
this Act, file rules establishing standards for licensing of
continuum of care facilities under a single license. These
rules shall ensure that an applicant for licensure:
        (1) meets the definition of "continuum of care
    facility" and provides all of the programs, services, and
    supports required by that definition;
        (2) develops, submits, and maintains adherence to a
    continuum of care plan that meets the requirements of
    Section 25 of this Act;
        (3) meets the regulatory requirements set forth in
    Section 30 of this Act;
        (4) meets such requirements as the Secretary of Human
    Services may determine appropriate for renewal of
    licensure or for amendment of licensure to account for
    changes in the composition of facility constituent
    elements providing programs or services under the license;
    and
        (5) meets such other requirements as the Secretary of
    Human Services may determine appropriate for the effective
    implementation of this Act.
 
    Section 25. Continuum of care plan. An applicant for a
continuum of care license shall submit to the Secretary of
Human Services, in such form and manner as the Secretary of
Human Services shall require, a continuum of care plan that
demonstrates how the applicant will:
        (1) undertake a comprehensive approach to facilitating
    the movement of individuals to the most appropriate site
    and level of care and services provided based on that
    individual's preference and needs;
        (2) provide for the seamless integrated transition of
    individuals between and among the required care settings
    and services in a manner that addresses the individual's
    location on the spectrum of disability and progression
    along the age spectrum;
        (3) maximize employment and training opportunities
    consistent with the individual's preferences and
    capabilities;
        (4) provide programs, services, and supports geared to
    addressing the demand for services for a growing population
    of aging individuals and individuals who need the services
    offered by a medically complex for the developmentally
    disabled facility; and
        (5) demonstrate a commitment to providing informed,
    free, and meaningful choice regarding the type of community
    in which the individual prefers to live and the type of
    employment opportunities or developmental training the
    individual prefers to receive; beneficiary engagement;
    annual care planning and ongoing treatment focused on the
    needs and preferences of the individual and adherence to
    other applicable requirements of law relevant to
    protecting the rights and welfare of individuals with
    developmental disabilities; and
        (6) use an evidence-based assessment tool, approved by
    the Department of Human Services and the Department of
    Healthcare and Family Services, to periodically reassess
    and confirm that individuals receiving more intense or
    restrictive services continue to require, or to choose if
    applicable, that level of support and services.
 
    Section 30. Applicable requirements. The Secretary of
Human Services, acting as appropriate through or in
coordination with the Director of Public Health, shall in
licensing a continuum of care facility ensure the following:
        (1) community-integrated living arrangements provided
    by such licensee meet all otherwise applicable
    requirements of law pertaining to such arrangements,
    including those set forth in the Community-Integrated
    Living Arrangements Licensure and Certification Act,
    except that a continuum of care facility may, consistent
    with all applicable requirements of law, prioritize the
    movement of individuals into or out of
    community-integrated living arrangements from or into
    other residential facility constituent elements;
        (2) on-campus and off-campus employment opportunities
    provided by the licensee meet all otherwise applicable
    requirements of law pertaining to such opportunities;
        (3) developmental training programs and services
    provided by the licensee meet all otherwise applicable
    requirements of law pertaining to such programs and
    services;
        (4) community living facility opportunities provided
    by the licensee meet all otherwise applicable requirements
    of law pertaining to such opportunities;
        (5) campus group homes provided by the licensee meet
    all otherwise applicable requirements of law pertaining to
    an ID/DD facility under the ID/DD Community Care Act;
        (6) medically complex for the developmentally disabled
    facility opportunities provided by the licensee meet all
    otherwise applicable requirements of law pertaining to
    such opportunities; and
        (7) the applicant complies with such other
    requirements as the Secretary of Human Services may
    consider necessary and appropriate to carry out the
    purposes of this Act and other applicable requirements of
    law.
    A continuum of care license may be issued to a continuum of
care facility upon the adoption of the rules provided for in
Section 20 of this Act.
 
    Section 35. Existing and future programs and services.
    (a) To the extent necessary to carry out the purposes of
this Act and to maintain eligibility for reimbursement for
services under applicable State and federal programs,
including Title XIX of the federal Social Security Act,
facility constituent elements of an entity licensed as a
continuum of care facility may be considered to be licensed
pursuant to the otherwise applicable requirements of law as set
forth in Section 30 of this Act.
    (b) In the event that a continuum of care facility ceases
to retain licensure as a continuum of care facility, facility
constituent elements that meet all otherwise applicable
requirements of law with respect to such element as set forth
in Section 30 of this Act shall be deemed to be licensed
pursuant to such requirements.
    (c) Residents of campus group homes and
community-integrated living arrangements that are facility
constituent elements shall continue to be beneficiaries of and
have the rights and protections provided to residents of ID/DD
facilities and community-integrated living arrangements,
respectively, under the consent decree entered by the United
States District Court for the Northern District of Illinois in
the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15, 2011
(Ligas). While the consent decree in Ligas remains in effect,
members of the class in Ligas residing in ID/DD facilities on
June 15, 2011 may move to community-integrated living
arrangements as they choose to do so; members of the class in
Ligas admitted to ID/DD facilities after June 15, 2011 must
enroll on the Prioritization of Urgency of Need for Services
waiting list and be selected for community-integrated living
arrangements services prior to moving.
    (d) A continuum of care licensee shall be permitted to add
new facility constituent elements under its license provided
that it demonstrates a need for the new facility constituent
elements and that the facility constituent elements meet all
applicable requirements of law.
 
    Section 40. Reimbursement rules. The Secretary of Human
Services and the Director of Healthcare and Family Services
shall:
        (1) ensure that reimbursement utilizing federal and
    State resources for services provided to eligible
    beneficiaries through a continuum of care facility
    comports with the following requirements:
            (A) such services shall be reimbursed in a
        budget-neutral manner such that reimbursement for
        services provided by the facility constituent elements
        of a continuum of care licensee shall be neither
        greater nor lesser than the reimbursement received for
        such services provided by that facility constituent
        element prior to the licensing of the continuum of care
        facility, adjusted to take into account any subsequent
        changes in reimbursement for such similar services,
        or, if the facility constituent element is a new
        facility reimbursement for the services provided by
        the new facility shall be no less than the
        reimbursement received for such services by a
        comparable facility constituent element of that
        continuum of care facility; and
            (B) a continuum of care licensee shall enter into a
        single provider agreement with the Director of
        Healthcare and Family Services or the Secretary of
        Human Services; changes that may occur from time to
        time in the facility constituent elements under the
        continuum of care license shall be addressed as may be
        required by applicable requirements of law through
        amendments to the provider agreement; the Director of
        Healthcare and Family Services shall make all
        reasonable efforts to ensure that all facility
        constituent elements that are approved parts of a
        continuum of care license remain qualified for
        reimbursement under relevant State and federal
        programs including Title XIX of the federal Social
        Security Act; and
        (2) in cooperation with interested stakeholders,
    develop an alternative payment methodology for a continuum
    of care facility; the initial methodology shall produce
    payments that are budget neutral as compared to the
    services provided by the licensee prior to the
    implementation of the continuum of care license; the
    effectiveness of the methodology and corresponding rate
    levels shall be evaluated 18 months following the
    implementation of the methodology and every 12 months
    thereafter and shall be adjusted as necessary, subject to
    appropriation.
 
    Section 45. The Department of Healthcare and Family
Services Law of the Civil Administrative Code of Illinois is
amended by adding Section 2205-13 as follows:
 
    (20 ILCS 2205/2205-13 new)
    Sec. 2205-13. Authorization to secure a federal waiver
pursuant to the federal Social Security Act or a State plan
amendment.
    (a) The Director of Healthcare and Family Services, in
collaboration and coordination with the Secretary of Human
Services, shall develop and submit to the United States
Department of Health and Human Services, Centers for Medicare
and Medicaid Services, Center for Medicaid and State
Operations, a request for a waiver pursuant to the federal
Social Security Act or a State plan amendment consistent with
the purpose of subsection (b) of this Section and requirements
of subsection (c) of this Section.
    (b) The purpose of the waiver or a State plan amendment
authorized by subsection (a) of this Section is to obtain
approval for the use of funds under Title XIX of the federal
Social Security Act to provide for an alternative model of
licensure, reimbursement, and quality assurance for services
to individuals with developmental disabilities consistent with
the Continuum of Care Services for the Developmentally Disabled
Act.
    (c) A waiver or a State plan amendment requested pursuant
to this authorization must involve the licensure of a continuum
of care facility pursuant to and consistent with all
requirements of the Continuum of Care Services for the
Developmentally Disabled Act and a proposal for a reimbursement
methodology developed under paragraph (2) of Section 40 of the
Continuum of Care Services for the Developmentally Disabled
Act.

Effective Date: 1/1/2017