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| | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB4801 Introduced 2/6/2024, by Rep. Robyn Gabel SYNOPSIS AS INTRODUCED: | | | Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to maintain the rate add-on implemented on January 1, 2023 for the provision of 2 meals per day at no less than $6.15 per day as stated in the supportive living program home and community-based service waiver approved by the federal Centers for Medicare and Medicaid Services. |
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| | A BILL FOR |
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1 | | AN ACT concerning public aid. |
2 | | Be it enacted by the People of the State of Illinois, |
3 | | represented in the General Assembly: |
4 | | Section 5. The Illinois Public Aid Code is amended by |
5 | | changing Section 5-5.01a as follows: |
6 | | (305 ILCS 5/5-5.01a) |
7 | | Sec. 5-5.01a. Supportive living facilities program. |
8 | | (a) The Department shall establish and provide oversight |
9 | | for a program of supportive living facilities that seek to |
10 | | promote resident independence, dignity, respect, and |
11 | | well-being in the most cost-effective manner. |
12 | | A supportive living facility is (i) a free-standing |
13 | | facility or (ii) a distinct physical and operational entity |
14 | | within a mixed-use building that meets the criteria |
15 | | established in subsection (d). A supportive living facility |
16 | | integrates housing with health, personal care, and supportive |
17 | | services and is a designated setting that offers residents |
18 | | their own separate, private, and distinct living units. |
19 | | Sites for the operation of the program shall be selected |
20 | | by the Department based upon criteria that may include the |
21 | | need for services in a geographic area, the availability of |
22 | | funding, and the site's ability to meet the standards. |
23 | | (b) Beginning July 1, 2014, subject to federal approval, |
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1 | | the Medicaid rates for supportive living facilities shall be |
2 | | equal to the supportive living facility Medicaid rate |
3 | | effective on June 30, 2014 increased by 8.85%. Once the |
4 | | assessment imposed at Article V-G of this Code is determined |
5 | | to be a permissible tax under Title XIX of the Social Security |
6 | | Act, the Department shall increase the Medicaid rates for |
7 | | supportive living facilities effective on July 1, 2014 by |
8 | | 9.09%. The Department shall apply this increase retroactively |
9 | | to coincide with the imposition of the assessment in Article |
10 | | V-G of this Code in accordance with the approval for federal |
11 | | financial participation by the Centers for Medicare and |
12 | | Medicaid Services. |
13 | | The Medicaid rates for supportive living facilities |
14 | | effective on July 1, 2017 must be equal to the rates in effect |
15 | | for supportive living facilities on June 30, 2017 increased by |
16 | | 2.8%. |
17 | | The Medicaid rates for supportive living facilities |
18 | | effective on July 1, 2018 must be equal to the rates in effect |
19 | | for supportive living facilities on June 30, 2018. |
20 | | Subject to federal approval, the Medicaid rates for |
21 | | supportive living services on and after July 1, 2019 must be at |
22 | | least 54.3% of the average total nursing facility services per |
23 | | diem for the geographic areas defined by the Department while |
24 | | maintaining the rate differential for dementia care and must |
25 | | be updated whenever the total nursing facility service per |
26 | | diems are updated. Beginning July 1, 2022, upon the |
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1 | | implementation of the Patient Driven Payment Model, Medicaid |
2 | | rates for supportive living services must be at least 54.3% of |
3 | | the average total nursing services per diem rate for the |
4 | | geographic areas. For purposes of this provision, the average |
5 | | total nursing services per diem rate shall include all add-ons |
6 | | for nursing facilities for the geographic area provided for in |
7 | | Section 5-5.2. The rate differential for dementia care must be |
8 | | maintained in these rates and the rates shall be updated |
9 | | whenever nursing facility per diem rates are updated. |
10 | | Subject to federal approval, beginning January 1, 2024, |
11 | | the dementia care rate for supportive living services must be |
12 | | no less than the non-dementia care supportive living services |
13 | | rate multiplied by 1.5. |
14 | | (c) The Department may adopt rules to implement this |
15 | | Section. Rules that establish or modify the services, |
16 | | standards, and conditions for participation in the program |
17 | | shall be adopted by the Department in consultation with the |
18 | | Department on Aging, the Department of Rehabilitation |
19 | | Services, and the Department of Mental Health and |
20 | | Developmental Disabilities (or their successor agencies). |
21 | | (d) Subject to federal approval by the Centers for |
22 | | Medicare and Medicaid Services, the Department shall accept |
23 | | for consideration of certification under the program any |
24 | | application for a site or building where distinct parts of the |
25 | | site or building are designated for purposes other than the |
26 | | provision of supportive living services, but only if: |
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1 | | (1) those distinct parts of the site or building are |
2 | | not designated for the purpose of providing assisted |
3 | | living services as required under the Assisted Living and |
4 | | Shared Housing Act; |
5 | | (2) those distinct parts of the site or building are |
6 | | completely separate from the part of the building used for |
7 | | the provision of supportive living program services, |
8 | | including separate entrances; |
9 | | (3) those distinct parts of the site or building do |
10 | | not share any common spaces with the part of the building |
11 | | used for the provision of supportive living program |
12 | | services; and |
13 | | (4) those distinct parts of the site or building do |
14 | | not share staffing with the part of the building used for |
15 | | the provision of supportive living program services. |
16 | | (e) Facilities or distinct parts of facilities which are |
17 | | selected as supportive living facilities and are in good |
18 | | standing with the Department's rules are exempt from the |
19 | | provisions of the Nursing Home Care Act and the Illinois |
20 | | Health Facilities Planning Act. |
21 | | (f) Section 9817 of the American Rescue Plan Act of 2021 |
22 | | (Public Law 117-2) authorizes a 10% enhanced federal medical |
23 | | assistance percentage for supportive living services for a |
24 | | 12-month period from April 1, 2021 through March 31, 2022. |
25 | | Subject to federal approval, including the approval of any |
26 | | necessary waiver amendments or other federally required |
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1 | | documents or assurances, for a 12-month period the Department |
2 | | must pay a supplemental $26 per diem rate to all supportive |
3 | | living facilities with the additional federal financial |
4 | | participation funds that result from the enhanced federal |
5 | | medical assistance percentage from April 1, 2021 through March |
6 | | 31, 2022. The Department may issue parameters around how the |
7 | | supplemental payment should be spent, including quality |
8 | | improvement activities. The Department may alter the form, |
9 | | methods, or timeframes concerning the supplemental per diem |
10 | | rate to comply with any subsequent changes to federal law, |
11 | | changes made by guidance issued by the federal Centers for |
12 | | Medicare and Medicaid Services, or other changes necessary to |
13 | | receive the enhanced federal medical assistance percentage. |
14 | | (g) All applications for the expansion of supportive |
15 | | living dementia care settings involving sites not approved by |
16 | | the Department on January 1, 2024 ( the effective date of |
17 | | Public Act 103-102) this amendatory Act of the 103rd General |
18 | | Assembly may allow new elderly non-dementia units in addition |
19 | | to new dementia care units. The Department may approve such |
20 | | applications only if the application has: (1) no more than one |
21 | | non-dementia care unit for each dementia care unit and (2) the |
22 | | site is not located within 4 miles of an existing supportive |
23 | | living program site in Cook County (including the City of |
24 | | Chicago), not located within 12 miles of an existing |
25 | | supportive living program site in DuPage County, Kane County, |
26 | | Lake County, McHenry County, or Will County, or not located |
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1 | | within 25 miles of an existing supportive living program site |
2 | | in any other county. |
3 | | (h) As stated in the supportive living program home and |
4 | | community-based service waiver approved by the federal Centers |
5 | | for Medicare and Medicaid Services, the Department must |
6 | | maintain the rate add-on implemented on January 1, 2023 for |
7 | | the provision of 2 meals per day at no less than $6.15 per day. |
8 | | (Source: P.A. 102-43, eff. 7-6-21; 102-699, eff. 4-19-22; |
9 | | 103-102, Article 20, Section 20-5, eff. 1-1-24; 103-102, |
10 | | Article 100, Section 100-5, eff. 1-1-24; revised 12-15-23.) |