|
(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.
|