HB0503 96TH GENERAL ASSEMBLY

LRB096 05782 DRJ 15857 b

96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB0503

Introduced 2/4/2009, by Rep. Marlow H. Colvin

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.5b new

Amends the Illinois Public Aid Code. Provides that under the medical assistance program, beginning January 1, 2009, the Department of Healthcare and Family Services may reimburse a skilled nursing facility, intermediate care facility, or institution for mental diseases providing long-term care services, based upon patient days reported in the facility's most recent cost report, for spending incurred to provide health care benefits to its employees serving the vulnerable populations residing in the facility, in order to attract and retain a qualified and healthy workforce. Provides that subject to available appropriations, the reimbursement shall be made according to certain criteria. Provides that the reimbursement is subject to audit by the Department and shall be reduced or eliminated in the case of any facility that does not honor its commitment to increase spending to improve the health of its employees or that decreases such spending. Effective July 1, 2009.

FISCAL NOTE ACT MAY APPLY

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 adding Section 5-5.5b as follows:

(305 ILCS 5/5-5.5b new)

Sec. 5-5.5b. Long-term care facilities; healthy employees initiative.

(a) Beginning January 1, 2009, the Department of Healthcare and Family Services may reimburse an individual skilled nursing facility, intermediate care facility, or Class I Institution for Mental Diseases providing long-term care services, based upon patient days reported in the facility's most recent cost report, for spending incurred to provide health care benefits to its employees serving the vulnerable populations residing in the facility, in order to attract and retain a qualified and healthy workforce. Subject to available appropriations, this reimbursement shall be made according to the following criteria:

(1) The Department shall reimburse the facility to compensate for spending on health care for its eligible employees. Eligible employees include employees engaged in direct care work and covered by a recognized health care benefits package.

(2) In order to qualify for reimbursement under this Section, a facility must provide to the Department, before January 1 of each year, documentation of a written, legally binding commitment to increase spending for the purpose of providing health care benefits to its eligible employees during the next year. The commitment must be binding as to both existing and future staff. The commitment must include a method of enforcing the commitment that is available to the employees or their representative and is expeditious, uses a neutral decision-maker, and is economical for the employees. The Department must also receive documentation of the facility's provision of written notice of the commitment and the availability of the enforcement mechanism to the employees or their representative.

(3) Reimbursement shall be based on the amount of increased spending incurred for health care by the facility that exceeds the spending reported in the cost report currently used by the Department. Reimbursement shall be calculated as follows: the per diem equivalent of the quarterly difference between the cost to provide health care benefits for covered eligible employees as identified in the legally binding commitment and the previous period cost of health care as reported in the cost report currently used by the Department, subject to the limitations identified in paragraph (2).

(4) Any facility is eligible to receive reimbursement under this Section. A facility's eligibility to receive reimbursement shall continue as long as the facility maintains eligibility under paragraph (2) and the reimbursement program continues to exist.

(b) Reimbursement under this Section is subject to audit by the Department and shall be reduced or eliminated in the case of any facility that does not honor its commitment to increase spending to improve the health of its employees or that decreases such spending.

(c) Nothing in this Section shall be construed to interfere with reimbursements to facilities based on the Minimum Data Set (MDS) funding methodology.

(d) As used in this Section, "Class I Institution for Mental Diseases" has the meaning ascribed to that term in the Social Security Act and 89 Ill. Admin. Code 145.30.

Section 99. Effective date. This Act takes effect July 1, 2009.