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1 | | (A) three or more hospital inpatient or inpatient |
2 | | detoxification admissions for a substance use disorder |
3 | | within the most recent 12-month period; |
4 | | (B) three or more stays in a State or county |
5 | | correctional facility in the State of Illinois within the |
6 | | most recent 12-month period; or |
7 | | (C) one or more drug overdoses in the last 12 months. |
8 | | "Engagement services" means home-based or community-based |
9 | | visits that assist the individual with maintaining his or her |
10 | | housing, and providing other wrap-around support, including |
11 | | linkage to mental health or substance use recovery support |
12 | | services. Such engagement services shall align with |
13 | | Medicaid-covered tenancy support services, and Medicaid |
14 | | community-based mental health and substance use treatment |
15 | | services, including case management, to ensure alignment with |
16 | | any existing or future Illinois Medicaid benefits, waivers or |
17 | | State plan amendments that include these services, and to |
18 | | maximize any potential federal Medicaid matching dollars that |
19 | | may be available to support engagement services. |
20 | | "Homeless" means the definition used by the U.S. |
21 | | Department of Health and Human Services, Health Resources and |
22 | | Services Administration in Section 330(h)(5)(A) of the Public |
23 | | Health Services Act (42 U.S.C. 254(b)). Under Section |
24 | | 330(h)(5)(A), a homeless individual is an individual who lacks |
25 | | housing (without regard to whether the individual is a member |
26 | | of a family), including an individual whose primary residence |
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1 | | during the night is a supervised public or private facility |
2 | | that provides temporary living accommodations, and an |
3 | | individual who is a resident in transitional housing. This |
4 | | includes individuals who are doubled up with other households. |
5 | | "Serious mental illness" means meeting both the diagnostic |
6 | | and functioning criteria consistent with the definition of |
7 | | Serious Mental Illness in the most current edition of the |
8 | | Illinois Department of Human Services/Division of Mental |
9 | | Health Community Mental Health Provider Manual. |
10 | | "Substance use disorder" as defined in Section 1-10 of the |
11 | | Substance Use Disorder Act. |
12 | | Section 5. Establishment of program. Subject to |
13 | | appropriation, the Housing is Recovery pilot program shall be |
14 | | established and administered by the Department of Human |
15 | | Services, Division of Mental Health. The purpose of the |
16 | | program is to prevent a person with a serious mental illness |
17 | | who is at high risk of unnecessary institutionalization, or a |
18 | | person with a substance use disorder who is at high risk of |
19 | | overdose, due to homelessness, a lack of access to recovery |
20 | | support services, and repeating cycles of hospitalizations or |
21 | | justice system involvement from being institutionalized or |
22 | | dying. This will be accomplished by enabling affordable |
23 | | housing through the use of a bridge rental subsidy combined |
24 | | with access to recovery support services or treatment. The |
25 | | triple aim of Housing is Recovery is: |
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1 | | (1) preventing institutionalization and overdose |
2 | | deaths; |
3 | | (2) improving health outcomes and access to recovery |
4 | | support services; and |
5 | | (3) reducing State costs. |
6 | | Section 10. Eligibility. An individual meeting the |
7 | | requirements listed in this Section shall be eligible to |
8 | | receive a Housing is Recovery bridge rental subsidy for |
9 | | purposes of stabilizing his or her mental illness or substance |
10 | | use disorder. |
11 | | (1) An individual at high risk of unnecessary |
12 | | institutionalization who is 21 years of age or older, or |
13 | | is aging out of guardianship under the Department of |
14 | | Children and Family Services, and who is eligible to |
15 | | enroll in, or is enrolled in, Medicaid for purposes of |
16 | | receiving mental health treatment pursuant to 89 Ill. Adm. |
17 | | Code 140. |
18 | | (2) An individual at high risk of overdose who is 21 |
19 | | years of age or older, or is aging out of guardianship |
20 | | under the Department of Children and Family Services, and |
21 | | who is eligible to enroll in, or is enrolled in, Medicaid |
22 | | for purposes of receiving substance use treatment. |
23 | | Section 15. Housing is Recovery bridge rental subsidy. A |
24 | | bridge rental subsidy received by an individual (the "subsidy |
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1 | | holder") pursuant to this Act shall mirror the subsidies |
2 | | issued by the Department of Human Services, Division of Mental |
3 | | Health through the Moving On Program. The rental subsidy shall |
4 | | be for scattered-site rental units owned by a landlord or for |
5 | | rental units secured through a master lease. The rental |
6 | | subsidy shall assist the subsidy holder with monthly rental |
7 | | payments for rent that does not exceed the Fair Market Rent |
8 | | published annually for that year by the U.S. Department of |
9 | | Housing and Urban Development. The Department of Human |
10 | | Services, Division of Mental Health, shall have the discretion |
11 | | to allow a subsidy to apply to rent up to 120% of the Fair |
12 | | Market Rent if this is justified by the lack of available |
13 | | affordable housing in the local housing market. Community |
14 | | Mental Health Centers certified pursuant to 59 Ill. Adm. Code |
15 | | 132 or supported housing service providers participating in |
16 | | this pilot program shall be responsible for assisting the |
17 | | subsidy holder with maintaining his or her housing that is |
18 | | supported by the bridge rental subsidy and either providing or |
19 | | coordinating engagement services with a mental health or |
20 | | substance use treatment provider. |
21 | | (1) The subsidy holder shall be responsible for |
22 | | contributing 30% of his or her income toward the cost of |
23 | | rent (zero income does not preclude participation). |
24 | | (2) The subsidy holder must agree to sign a lease with |
25 | | a landlord or a sublease agreement with the Community |
26 | | Mental Health Center or the housing services provider that |
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1 | | has a master lease for the rental unit and agree to |
2 | | engagement services initiated by the supported housing |
3 | | provider, the Community Mental Health Center or contracted |
4 | | mental health or substance use treatment provider at least |
5 | | 2 times a month, with at least one of those visits being a |
6 | | home visit. The engagement services shall be permitted in |
7 | | a home-based or community-based setting, and do not |
8 | | require a clinic visit. |
9 | | (3) A goal of this program is to encourage the subsidy |
10 | | holder to engage in mental health and substance use |
11 | | recovery support services or treatment when the individual |
12 | | is ready. However, this is a Housing First model that does |
13 | | not require abstinence from substance or alcohol use and |
14 | | does not require mental health or substance use treatment. |
15 | | (4) If a subsidy holder does not have an income due to |
16 | | a psychiatric disability, he or she shall be offered the |
17 | | opportunity for assistance with filing a "SOAR |
18 | | application" (Supplemental Security Income (SSI)/Social |
19 | | Security Disability Income (SSDI), Outreach, Access and |
20 | | Recovery application) by the Community Mental Health |
21 | | Center participating in the Housing is Recovery program |
22 | | that is providing his or her mental health support or |
23 | | treatment within 6 months of the initiation of mental |
24 | | health services. If the subsidy holder is only receiving |
25 | | housing support services, the housing services provider |
26 | | must partner with a Community Mental Health Center to do |
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1 | | SOAR applications for individuals who elect to apply for a |
2 | | psychiatric disability. A subsidy holder is not required |
3 | | to apply for a disability determination. |
4 | | (5) The subsidy holder, if he or she is eligible, must |
5 | | apply for rental assistance or housing through the |
6 | | appropriate Public Housing Authority within 6 months of |
7 | | receiving a Housing is Recovery bridge rental subsidy or |
8 | | agree to apply when it is permissible to do so, and also be |
9 | | placed on the Illinois Housing Development Authority's |
10 | | Statewide Referral Network. |
11 | | Section 20. Identification and referral of eligible |
12 | | individuals prior to hospital discharge or correctional |
13 | | facility release for purposes of rapid housing post |
14 | | discharge/release and illness stability. The pilot program is |
15 | | intended to enable affordable housing to avoid |
16 | | institutionalization or overdose death by providing for |
17 | | connection to housing through a variety of settings, including |
18 | | in hospitals, county jails, prisons, homeless shelters and |
19 | | inpatient detoxification facilities and the referral process |
20 | | established must take this into account. Within 2 months of |
21 | | the effective date of this Act, the Department of Human |
22 | | Services, Division of Mental Health, in partnership with the |
23 | | Department of Healthcare and Family Services and the |
24 | | Department of Human Services, Division of Substance Use |
25 | | Prevention and Recovery (SUPR), the Department of Corrections, |
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1 | | and with meaningful stakeholder input through a working group |
2 | | of Community Mental Health Centers, homeless service |
3 | | providers, substance use treatment providers, hospitals with |
4 | | inpatient psychiatric units or detoxification units, |
5 | | representatives from county jails, persons with lived |
6 | | experience, and family support organizations, shall develop a |
7 | | process for identifying and referring eligible individuals for |
8 | | the Housing is Recovery program prior to hospital discharge or |
9 | | correctional system release, or other appropriate place for |
10 | | referral, including homeless shelters. The process developed |
11 | | shall aim to enable rapid access to housing |
12 | | post-discharge/release to avoid unnecessary |
13 | | institutionalization or a return to homelessness or unstable |
14 | | housing. The working group shall meet at least monthly prior |
15 | | to development of an administrative rule or policy established |
16 | | to carry out the intent of this Act. The Department of Human |
17 | | Services, Division of Mental Health, shall explore ways to |
18 | | collaborate with the U.S. Department of Housing and Urban |
19 | | Development's Coordinated Entry System and other ways for |
20 | | electronic referral. The Department of Human Services, |
21 | | Division of Mental Health, and the Department of Healthcare |
22 | | and Family Services shall collaborate to ensure that the |
23 | | referral process aligns with any existing or future Medicaid |
24 | | waivers or State plan amendments for tenancy support services. |
25 | | Section 25. Participating Community Mental Health Centers |
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1 | | and housing service provider responsibilities for locating and |
2 | | transitioning the individual into housing, assisting in |
3 | | retaining housing, and the provision of engagement and |
4 | | recovery support services. The Department of Human Services, |
5 | | Division of Mental Health, shall select interested Community |
6 | | Mental Health Centers that are certified pursuant to 59 Ill. |
7 | | Adm. Code 132 and interested housing service providers for |
8 | | participation in the Housing is Recovery program. |
9 | | (1) For purposes of incentivizing continuity of care, |
10 | | the same participating Community Mental Health Center may |
11 | | be responsible for providing both the housing support and |
12 | | the mental health or substance use engagement, recovery |
13 | | support services and treatment to a subsidy holder. If a |
14 | | housing support services provider does not also provide |
15 | | the mental health or substance use treatment services the |
16 | | individual engages in, there must be strong coordination |
17 | | of care between the housing services provider and the |
18 | | treatment provider. |
19 | | (2) The provider must demonstrate that the rental |
20 | | units secured through this program pass minimum quality |
21 | | inspection standards. |
22 | | (3) Community Mental Health Centers providing housing |
23 | | support through this program shall be responsible for any |
24 | | SOAR applications for a subsidy holder that has a |
25 | | psychiatric disability who does not have SSI or SSDI if |
26 | | the subsidy holder chooses to apply for disability. A |
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1 | | housing services provider delivering the housing support |
2 | | services through this program must contract with a |
3 | | Community Mental Health Center to provide assistance with |
4 | | SOAR applications to subsidy holders electing to apply for |
5 | | SSI or SSDI within 6 months of the subsidy holder |
6 | | receiving the subsidy. |
7 | | (4) Service providers shall be permitted to engage in |
8 | | master leasing to secure apartments for those who are hard |
9 | | to house due to criminal backgrounds, history of substance |
10 | | use and stigma. |
11 | | Section 30. Securing rental housing units for purposes of |
12 | | immediate temporary housing following hospital discharge or |
13 | | release from a correctional facility while a long-term rental |
14 | | unit is secured. Up to 20% of the available annual |
15 | | appropriation for the Housing is Recovery program shall be |
16 | | available to Community Mental Health Centers or the housing |
17 | | services provider for purposes of securing critical time |
18 | | intervention rental units to house an eligible individual |
19 | | immediately following discharge from a hospitalization or |
20 | | release from a correctional facility because locating an |
21 | | apartment unit for a longer-term one-year lease and the |
22 | | related move-in can take up to 3 months. Such temporary units |
23 | | may be used for immediate temporary housing, not to exceed 90 |
24 | | days for purposes of preventing the individual from reentering |
25 | | homelessness or unstable housing, or avoiding unnecessary |
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1 | | institutionalization. The Department of Human Services, |
2 | | Division of Mental Health, shall allow providers to certify |
3 | | that such rental units meet minimum housing quality standards |
4 | | and ensure a process by which community providers are able to |
5 | | secure vacant rental units for the purpose of immediate |
6 | | short-term housing post-hospital discharge or correctional |
7 | | system release while a longer term housing rental unit is |
8 | | secured. |
9 | | Section 35. Basic move-in expenses. The Housing is |
10 | | Recovery program shall include reasonable payment for the |
11 | | basic move-in expenses of the subsidy holder, including, but |
12 | | not limited to, payment of a security deposit and other |
13 | | move-in fees or expenses, and basic household supplies and |
14 | | furnishings. |
15 | | Section 40. Subsidy administration. The bridge rental |
16 | | subsidy administration (such as payment of rent to the |
17 | | landlord and other administration expenses) and quality |
18 | | inspection of the rental units may be done by community-based |
19 | | organizations with experience and expertise in housing subsidy |
20 | | administration and by Community Mental Health Centers that the |
21 | | Department of Human Services, Division of Mental Health, |
22 | | determines have the administrative infrastructure for subsidy |
23 | | administration. Such organizations shall manage and administer |
24 | | all aspects of the subsidy (such as payment of rent, quality |
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1 | | inspections) on behalf of the subsidy holder. |
2 | | Section 45. Landlord education and stigma reduction plan |
3 | | and materials. The Department of Human Services, Division of |
4 | | Mental Health, with meaningful input from stakeholders, shall |
5 | | develop a plan for educating prospective landlords that may |
6 | | lease to individuals receiving a bridge rental subsidy through |
7 | | the Housing is Recovery program. This educational plan shall |
8 | | include written materials that indicate that individuals with |
9 | | psychiatric disabilities and substance use disorders often |
10 | | have criminal justice involvement due to their previously |
11 | | untreated mental health or substance use condition and periods |
12 | | of homelessness. Implementation of this plan shall be rolled |
13 | | out in conjunction with the implementation of the Housing is |
14 | | Recovery program. |
15 | | Section 50. State agency coordination. The Department of |
16 | | Human Services, Division of Mental Health, shall partner with |
17 | | SUPR to ensure coordination of the services required pursuant |
18 | | to this Act and all substance use recovery support services |
19 | | and treatment for which SUPR has oversight. The Department of |
20 | | Human Services, Division of Mental Health, shall also work |
21 | | with the Department of Healthcare and Family Services to |
22 | | maximize all recovery support services and treatment that are |
23 | | or can be covered by Medicaid. |
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1 | | Section 55. Provider and State agency education on the |
2 | | pilot program. The Department of Human Services, Division of |
3 | | Mental Health shall put together written materials on the |
4 | | Housing is Recovery program and eligibility criteria for |
5 | | purposes of educating participating providers, county jails, |
6 | | the Department of Corrections, hospitals and other relevant |
7 | | stakeholders on the program. The Department of Human Services, |
8 | | Division of Mental Health, shall engage in an ongoing |
9 | | education effort to ensure that all stakeholders are aware of |
10 | | the program and how to screen for eligibility and referral. |
11 | | Section 60. Reimbursement for subsidy administration, |
12 | | housing support and engagement services and other program |
13 | | costs. The Department of Human Services, Division of Mental |
14 | | Health shall develop a reimbursement approach for community |
15 | | providers doing subsidy administration that covers all costs |
16 | | of subsidy administration, quality inspection and other |
17 | | services. The Department of Human Services, Division of Mental |
18 | | Health shall also develop a reimbursement approach that covers |
19 | | all costs incurred by Community Mental Health Centers and |
20 | | housing services providers for identifying and securing rental |
21 | | units for subsidy holders, including all travel related to |
22 | | finding and locating an apartment and move-in of the subsidy |
23 | | holder, quality inspections for temporary housing units, |
24 | | completing and submitting SOAR applications, the costs |
25 | | associated with obtaining necessary documents associated with |
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1 | | obtaining a lease for the subsidy holder (such as obtaining a |
2 | | State ID); for engagement services not covered by Medicaid; |
3 | | and for any other reasonable and necessary costs associated |
4 | | with the program outlined in this Act. Reimbursement shall |
5 | | also include all costs associated with collecting and tracking |
6 | | data for purposes of program evaluation and improvement. At |
7 | | the discretion of the Department of Human Services, Division |
8 | | of Mental Health, up to 5% of the annual appropriation may be |
9 | | applied to growing mental health or substance use treatment or |
10 | | recovery support capacity if a participating provider in the |
11 | | Housing is Recovery program demonstrates an inability to take |
12 | | eligible individuals due to such capacity limitations. |
13 | | Section 65. Subsidy termination. The subsidy holder shall |
14 | | continue to hold the subsidy until he or she receives a housing |
15 | | voucher or rental subsidy through a Public Housing Authority |
16 | | unless: |
17 | | (1) The individual has a stay in a nursing home, |
18 | | Institution for Mental Disease (IMD) or specialized mental |
19 | | health rehabilitation facility (SMHRF) exceeding 6 |
20 | | consecutive months. During a stay in nursing home, IMD or |
21 | | SMHRF of less than 6 months, the program will continue to |
22 | | pay the subsidized portion of the rent in order to |
23 | | maintain the housing unit for the subsidy holder upon |
24 | | discharge. |
25 | | (2) The individual has a stay in a correctional |
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1 | | facility exceeding 6 consecutive months. During a |
2 | | correctional facility stay of less than 6 months, the |
3 | | program will continue to pay the subsidized portion of the |
4 | | rent in order to maintain the housing unit for the subsidy |
5 | | holder. |
6 | | (3) A subsidy does not terminate if the subsidy holder |
7 | | is required to move multiple times due to landlord |
8 | | eviction or does not engage in treatment, as the target |
9 | | population for this pilot program is expected to have |
10 | | multiple barriers to remaining housed. |
11 | | Section 70. Developing public-private partnerships to |
12 | | expand affordable housing options for those with serious |
13 | | mental illnesses. The Department of Human Services, Division |
14 | | of Mental Health shall work with the Department of Healthcare |
15 | | and Family Services, Medicaid managed care organizations and |
16 | | hospitals across the State to develop public-private |
17 | | partnerships to incentivize private funding from hospitals and |
18 | | managed care organizations to match State dollars invested in |
19 | | the Housing is Recovery program for purposes of preventing |
20 | | repeated preventable hospitalizations, overdose deaths and |
21 | | unnecessary institutionalization. |
22 | | Section 75. Data collection and program evaluation. |
23 | | (a) For purposes of evaluating the effectiveness of the |
24 | | Housing is Recovery program and for making improvements to the |
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1 | | program, the Department of Human Services, Division of Mental |
2 | | Health shall contract with an independent outside research |
3 | | organization with expertise in housing services for |
4 | | individuals with serious mental illnesses and substance use |
5 | | disorders to evaluate the program's effectiveness on enabling |
6 | | housing stability, reducing hospitalizations and justice |
7 | | system involvement, encouraging engagement in mental health |
8 | | and substance use treatment, fostering employment engagement, |
9 | | and reducing institutionalization and overdose deaths. Such |
10 | | evaluation shall commence after 4 years of implementation of |
11 | | the program and shall be submitted to the General Assembly by |
12 | | the end of the fifth year of implementation. For purposes of |
13 | | assisting with this evaluation, the working group established |
14 | | pursuant to Section 20 shall also make recommendations to the |
15 | | Department of Human Services, Division of Mental Health, |
16 | | regarding what data must be tracked by providers and the |
17 | | Department of Human Services, Division of Mental Health, to |
18 | | evaluate the program and to make future changes to the program |
19 | | to ensure its effectiveness in meeting the triple aim stated |
20 | | in Section 5. |
21 | | (b) Beginning after the first 12 months of implementation |
22 | | and on an annual basis, the Department of Human Services, |
23 | | Division of Mental Health, shall track and make public the |
24 | | following information: (1) the number of individuals receiving |
25 | | subsidies in reporting period (12-month average); (2) |
26 | | participant demographics including age, race, gender identity, |
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1 | | and primary language; (3) the average duration of time |
2 | | individuals are enrolled in the program (by months); (4) the |
3 | | number of individuals removed from the program and reasons for |
4 | | removal; (5) the number of grievances filed by participants |
5 | | and a summary of grievance type; and (6) program referral |
6 | | sources. Reports shall be generated on an annual basis and |
7 | | publicly posted on the Department of Human Services website. |
8 | | Section 80. Act subject to appropriation. This Act is |
9 | | subject to appropriation. The appropriation shall be divided |
10 | | equally between bridge subsidies issued to individuals who are |
11 | | at high risk of unnecessary institutionalization and those who |
12 | | are at high risk of overdose. |
13 | | Section 85. Rulemaking authority. Any administrative rules |
14 | | necessary to implement this Act shall be filed within 12 |
15 | | months following the effective date of this Act.
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16 | | Section 99. Effective date. This Act takes effect upon |
17 | | becoming law.
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