HB0074ham001 101ST GENERAL ASSEMBLY

Rep. Aaron M. Ortiz

Filed: 4/9/2019

10100HB0074ham001 LRB101 02959 KTG 59512 a

AMENDMENT TO HOUSE BILL 74

AMENDMENT NO. ______. Amend House Bill 74 by replacing everything after the enacting clause with the following:

"Section 5. The Illinois Public Aid Code is amended by adding Section 11-5.5 as follows:

(305 ILCS 5/11-5.5 new)

Sec. 11-5.5. Expedited long-term care eligibility determinations for persons with intellectual or developmental disabilities.

(a) The Department of Healthcare and Family Services shall follow and implement the requirements and processes described under Section 11-5.4 when making long-term care eligibility determinations for persons with intellectual or developmental disabilities.

(b) Subject to federal approval, the Department of Healthcare and Family Services must implement an ex parte renewal process for Medicaid-eligible individuals with an intellectual or developmental disability. As used in this Section, "renewal" has the same meaning as "redetermination" in State policies, administrative rule, and federal Medicaid law. The ex parte renewal process must be fully operational on or before January 1, 2020.

(1) An individual is eligible for the ex parte renewal process if the individual:

(A) has an intellectual or developmental disability;

(B) has been determined Medicaid eligible;

(C) receives services:

(i) under the State's Home and Community-Based Services Waiver Program for adults with developmental disabilities;

(ii) under the State's Residential Waiver for Children and Young Adults with Developmental Disabilities;

(iii) under the State's Support Waiver for Children and Young Adults with Developmental Disabilities; or

(iv) at a facility licensed by the ID/DD Community Care Act; and

(D) has received no transfer of assets or resources during the federally prescribed look-back period as specified by federal law, unless those resources are deposited into an individual's Achieving a Better Life Experience (ABLE) account and meet all requirements thereof.

(2) The Department of Human Services must adopt policies and procedures to improve communication between local Family Community Resource Center personnel, the Division of Developmental Disabilities pilot hub personnel, applicants and their families or guardians, and the provider organizations and independent service coordination agencies serving and supporting the applicants. Such policies and procedures must at a minimum permit applicants and their representatives and the facilities in which the applicants reside to speak directly to an individual trained to take telephone inquiries and provide appropriate responses.

(3) The Department of Human Services must use the standards and distribution requirements described in Section 11-5.4 and in Section 11-6 for notification of missing supporting documents and information during the renewal and appeal process.

(4) The Department of Human Services and the Department of Healthcare and Family Services' Office of the Inspector General shall follow the processes under Section 11-5.4 concerning the allowance of additional time for the submission of information and documents needed for a review of resources.

(5) Reporting requirements for the Department of Human Services, the Department of Healthcare and Family Services, and the Auditor General shall follow those requirements under Section 11-5.4.

(6) The Department of Human Services and Department of Healthcare and Family Services shall adopt any rules necessary to administer and enforce any provision of this Section.

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