SB3756 102ND GENERAL ASSEMBLY

LRB102 24079 KTG 33300 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB3756

Introduced 1/21/2022, by Sen. Rachelle Crowe

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.7

from Ch. 23, par. 5-5.7

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that from funds appropriated, directly or indirectly, from moneys received by the State from the Coronavirus State Fiscal Recovery Fund for Fiscal Years 2021 and 2022, the Department of Healthcare and Family Services shall continue to expend such funds only for purposes permitted by Section 9901 of the American Rescue Plan Act of 2021 (ARPA) and related federal guidance. Provides that such expenditures may include, but are not limited to: payments to providers for costs incurred due to the COVID-19 public health emergency; unreimbursed costs for testing and treatment of uninsured Illinois residents; and expenditures permitted in order to address (i) disparities in public health outcomes, (ii) nursing and other essential health care workforce investments, (iii) the exacerbation of pre-existing disparities, and (iv) the promotion of healthy childhood environments. Requires the Department to continue to make payments to long-term care service providers and facilities, for purposes related to financial support for the long-term care industry and front line workers, but only as permitted by Section 9901 of the American Rescue Plan Act of 2021. Requires nursing facilities to spend 60% of funds received as a direct pass-through to front line workers on pandemic bonus pay to employees and on temporary benefits, such as day care or other related benefits. Permits nursing facilities to spend the remaining 40% of the distributions on other financial support for their workers provided on or after December 1, 2021, or on other ARPA permitted purposes including, but not limited to: (i) the payment of education expenses to enhance direct care staff recruitment; (ii) enhanced and expanded training for nursing facility staff; and on other specified purposes. Requires providers to sign award agreements and to submit proposed monthly budgets for the use of funds prior to the release of funds. Provides that the Department shall have the authority to audit and potentially recoup funds not utilized as outlined and attested. Requires the Department to redistribute to providers any remaining, returned, or recouped funds by June 30, 2022. Effective immediately.

A BILL FOR

AN ACT concerning public aid.

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

Section 5. The Illinois Public Aid Code is amended by changing Section 5-5.7 as follows:

(305 ILCS 5/5-5.7) (from Ch. 23, par. 5-5.7)

Sec. 5-5.7. Cost reports - audits.

(a) The Department of Healthcare and Family Services shall work with the Department of Public Health to use cost report information currently being collected under provisions of the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, and the MC/DD Act. The Department of Healthcare and Family Services may, in conjunction with the Department of Public Health, develop in accordance with generally accepted accounting principles a uniform chart of accounts which each facility providing services under the medical assistance program shall adopt, after a reasonable period.

Facilities licensed under the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act of 2013, the ID/DD Community Care Act, or the MC/DD Act and providers of adult developmental training services certified by the Department of Human Services pursuant to Section 15.2 of the Mental Health and Developmental Disabilities Administrative Act which provide services to clients eligible for medical assistance under this Article are responsible for submitting the required annual cost report to the Department of Healthcare and Family Services.

The Department of Healthcare and Family Services shall audit the financial and statistical records of each provider participating in the medical assistance program as a nursing facility, a specialized mental health rehabilitation facility, or an ICF/DD over a 3 year period, beginning with the close of the first cost reporting year. Following the end of this 3-year term, audits of the financial and statistical records will be performed each year in at least 20% of the facilities participating in the medical assistance program with at least 10% being selected on a random sample basis, and the remainder selected on the basis of exceptional profiles. All audits shall be conducted in accordance with generally accepted auditing standards.

The Department of Healthcare and Family Services shall establish prospective payment rates for categories or levels of services within each licensure class, in order to more appropriately recognize the individual needs of patients in nursing facilities.

The Department of Healthcare and Family Services shall provide, during the process of establishing the payment rate for nursing facility, specialized mental health rehabilitation facility, or ICF/DD services, or when a substantial change in rates is proposed, an opportunity for public review and comment on the proposed rates prior to their becoming effective.

(b) Pandemic related payments for long-term care service providers and facilities.

(1) Expenditures. From funds appropriated, directly or indirectly, from moneys received by the State from the Coronavirus State Fiscal Recovery Fund for Fiscal Years 2021 and 2022, the Department shall continue to expend such funds only for purposes permitted by Section 9901 of the American Rescue Plan Act of 2021 (ARPA) and related federal guidance. Such expenditures may include, but are not limited to: payments to providers for costs incurred due to the COVID-19 public health emergency; unreimbursed costs for testing and treatment of uninsured Illinois residents; the costs of COVID-19 mitigation and prevention; medical expenses related to aftercare or extended care for COVID-19 patients with longer term symptoms and effects; the costs of behavioral health care; the costs of public health and safety staff; and expenditures permitted in order to address (i) disparities in public health outcomes, (ii) nursing and other essential health care workforce investments, (iii) the exacerbation of pre-existing disparities, and (iv) the promotion of healthy childhood environments.

The Department shall continue to make payments to long term-care service providers and facilities, for purposes related to financial support for the long-term care industry and front line workers, but only as permitted by Section 9901 of the American Rescue Plan Act of 2021 and related federal guidance, including, but not limited to, the following: $225,000,000, where at least $135,000,000 (60%) of the funds shall be passed directly to front-line workers, and $90,000,000 (40%) for COVID-19 related provider expenses allowable by the American Rescue Plan Act of 2021 and related federal guidance.

The $225,000,000 appropriation shall be distributed in one lump sum payment to long-term care service providers within 30 days after the effective date of this amendatory Act of the 102nd General Assembly. ARPA fund recipients shall have one year after receiving the lump sum distribution from the Department to expend those ARPA funds.

The Department shall utilize the same methodology for determining each long-term care service provider's payment as used to distribute the $75,000,000 appropriation for the first quarter of Fiscal Year 2022, which utilized the staffing data based on nursing hours from the federal Payroll Based Journal for the second quarter of Fiscal Year 2021. The per nursing hour allocation for the 3 quarter-lump sum distribution, or $225,000,000, shall be $13.29 per nursing hour or 3 times the allocation for the first quarter of Fiscal Year 2022, or $4.43.

(2) Nursing facilities.

(A) Nursing facilities are required to spend 60% of funds received as a direct pass-through to front line workers on the following pandemic-related uses:

(i) pandemic bonus pay to employees on or after December 1, 2021 (hazard, hero, premium pay and premium wages, or other temporary wage increases); and

(ii) temporary benefits, such as day care or other related benefits, provided December 1, 2021 or later.

(B) Nursing facilities may spend the remaining 40% of the distributions on either the uses listed in subparagraph (A) or on other financial support for their workers provided on or after December 1, 2021, or on other purposes permitted by Section 9901 of the American Rescue Plan Act of 2021 and related federal guidance, including, but not limited to, the following expenditures made on or after December 1, 2021:

(i) the payment of education expenses to enhance direct care staff recruitment;

(ii) enhanced and expanded training for nursing facility staff to better achieve patient outcomes, such as training on infection control, proper personal protective equipment, best practices in quality of care, and culturally competent patient communications;

(iii) additional forms of pandemic-related financial support for the nursing facility workforce (to be specified by the provider);

(iv) costs incurred due to the COVID-19 public health emergency;

(v) unreimbursed costs for testing and treatment of COVID-19;

(vi) costs incurred due to COVID-19 mitigation and prevention;

(vii) medical expenses related to aftercare or extended care for COVID-19 patients with longer term symptoms and effects;

(viii) vaccine bonuses;

(ix) signing bonuses for new hires;

(x) the cost of temporary nursing agencies; or

(xi) the cost of personal protective equipment.

(3) Award agreements. Providers shall sign award agreements and shall submit proposed monthly budgets for the use of funds prior to the release of funds. The Department shall have the authority to audit and potentially recoup funds not utilized as outlined and attested. The Department shall redistribute to providers any remaining, returned, or recouped funds by June 30, 2022.

(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)

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