HB3380 95TH GENERAL ASSEMBLY

LRB095 08723 DRJ 28906 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB3380

Introduced 2/26/2007, by Rep. Lisa M. Dugan

SYNOPSIS AS INTRODUCED:

405 ILCS 30/4

from Ch. 91 1/2, par. 904

Amends the Community Services Act. Provides that if a new governmental mandate effective on or after July 1, 2007 (i) is imposed upon a private service provider, corporation, local government entity, or voluntary association providing services to persons with mental illness, persons with a developmental disability, or persons with an alcohol or drug dependency living in the community and (ii) has or will have a material adverse financial impact on the private service provider or other entity, the Department of Human Services shall negotiate a contract amendment with the private service provider or other entity to increase the maximum obligation amount or unit price to offset the material adverse financial impact of the new governmental mandate, provided that the private service provider or other entity furnishes substantial evidence to the Department of such material adverse financial impact along with a request to renegotiate based on a new governmental mandate. Provides for an appeal process. Effective July 1, 2007.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning health.

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

Section 5. The Community Services Act is amended by changing Section 4 as follows:

(405 ILCS 30/4) (from Ch. 91 1/2, par. 904)

Sec. 4. Financing for Community Services.

(a) The Department of Human Services is authorized to provide financial assistance to eligible private service providers, corporations, local government entities or voluntary associations for the provision of services to persons with mental illness, persons with a developmental disability and alcohol and drug dependent persons living in the community for the purpose of achieving the goals of this Act.

The Department shall utilize the following funding mechanisms for community services:

(1) Purchase of Care Contracts: services purchased on a predetermined fee per unit of service basis from private providers or governmental entities. Fee per service rates are set by an established formula which covers some portion of personnel, supplies, and other allowable costs, and which makes some allowance for geographic variations in costs as well as for additional program components.

(2) Grants: sums of money which the Department grants to private providers or governmental entities pursuant to the grant recipient's agreement to provide certain services, as defined by departmental grant guidelines, to an approximate number of service recipients. Grant levels are set through consideration of personnel, supply and other allowable costs, as well as other funds available to the program.

(3) Other Funding Arrangements: funding mechanisms may be established on a pilot basis in order to examine the feasibility of alternative financing arrangements for the provision of community services.

The Department shall strive to establish and maintain an equitable system of payment which encourages providers to improve their clients' capabilities for independence and reduces their reliance on community or State-operated services. In accepting Department funds, providers shall recognize their responsibility to be accountable to the Department and the State for the delivery of services which are consistent with the philosophies and goals of this Act and the rules and regulations promulgated under it.

(b) If a new governmental mandate effective on or after July 1, 2007 (i) is imposed upon a private service provider, corporation, local government entity, or voluntary association providing services to persons with mental illness, persons with a developmental disability, or persons with an alcohol or drug dependency living in the community and (ii) has or will have a material adverse financial impact on the private service provider, corporation, local government entity, or voluntary association, the Department shall negotiate a contract amendment with the private service provider, corporation, local government entity, or voluntary association to increase the maximum obligation amount or unit price to offset the material adverse financial impact of the new governmental mandate, provided that the private service provider, corporation, local government entity, or voluntary association furnishes substantial evidence to the Department of such material adverse financial impact along with a request to renegotiate based on a new governmental mandate.

Any private service provider, corporation, local government entity, or voluntary association aggrieved by a decision of the Department denying or failing to negotiate a contract amendment to remedy a material adverse impact of a new governmental mandate pursuant to this subsection may appeal such decision by requesting an administrative hearing before an administrative law judge. A private service provider, corporation, local government entity, or voluntary association's request for a contract amendment shall, for purposes of appeal, be deemed to have been denied if a determination is not received from the Department within 30 days after the Department's receipt of the request. A private service provider, corporation, local government entity, or voluntary association may appeal an adverse final administrative decision of the Department pursuant to the Administrative Review Law.

For the purposes of this subsection:

"New governmental mandate" means a statutory requirement, administrative rule, regulation, assessment, executive order, judicial order, or other governmental requirement that (i) was not in effect when a contract was originally entered into by the Department and a private service provider, corporation, local government entity, or voluntary association and (ii) directly or indirectly imposes an obligation upon the private service provider, corporation, local government entity, or voluntary association to take any action or to refrain from taking any action in order to fulfill its contractual duties.

"Material adverse financial impact" means: (1) an increase in the reasonable costs to the private service provider, corporation, local government entity, or voluntary association in performing a contract with the Department of the lesser of (i) 3% percent of the maximum obligation amount or unit price of the contract or (ii) $5,000 in the aggregate as a result of all such mandates in effect during the contract year; or (2) an action that affects the core purpose and primary intent of the contract.

(Source: P.A. 88-380; 89-507, eff. 7-1-97.)

Section 99. Effective date. This Act takes effect July 1, 2007.