103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4801

 

Introduced 2/6/2024, by Rep. Robyn Gabel

 

SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-5.01a

    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

 

HB4801LRB103 38207 KTG 68341 b

1    AN ACT concerning public aid.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Public Aid Code is amended by
5changing 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
9for a program of supportive living facilities that seek to
10promote resident independence, dignity, respect, and
11well-being in the most cost-effective manner.
12    A supportive living facility is (i) a free-standing
13facility or (ii) a distinct physical and operational entity
14within a mixed-use building that meets the criteria
15established in subsection (d). A supportive living facility
16integrates housing with health, personal care, and supportive
17services and is a designated setting that offers residents
18their own separate, private, and distinct living units.
19    Sites for the operation of the program shall be selected
20by the Department based upon criteria that may include the
21need for services in a geographic area, the availability of
22funding, and the site's ability to meet the standards.
23    (b) Beginning July 1, 2014, subject to federal approval,

 

 

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1the Medicaid rates for supportive living facilities shall be
2equal to the supportive living facility Medicaid rate
3effective on June 30, 2014 increased by 8.85%. Once the
4assessment imposed at Article V-G of this Code is determined
5to be a permissible tax under Title XIX of the Social Security
6Act, the Department shall increase the Medicaid rates for
7supportive living facilities effective on July 1, 2014 by
89.09%. The Department shall apply this increase retroactively
9to coincide with the imposition of the assessment in Article
10V-G of this Code in accordance with the approval for federal
11financial participation by the Centers for Medicare and
12Medicaid Services.
13    The Medicaid rates for supportive living facilities
14effective on July 1, 2017 must be equal to the rates in effect
15for supportive living facilities on June 30, 2017 increased by
162.8%.
17    The Medicaid rates for supportive living facilities
18effective on July 1, 2018 must be equal to the rates in effect
19for supportive living facilities on June 30, 2018.
20    Subject to federal approval, the Medicaid rates for
21supportive living services on and after July 1, 2019 must be at
22least 54.3% of the average total nursing facility services per
23diem for the geographic areas defined by the Department while
24maintaining the rate differential for dementia care and must
25be updated whenever the total nursing facility service per
26diems are updated. Beginning July 1, 2022, upon the

 

 

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1implementation of the Patient Driven Payment Model, Medicaid
2rates for supportive living services must be at least 54.3% of
3the average total nursing services per diem rate for the
4geographic areas. For purposes of this provision, the average
5total nursing services per diem rate shall include all add-ons
6for nursing facilities for the geographic area provided for in
7Section 5-5.2. The rate differential for dementia care must be
8maintained in these rates and the rates shall be updated
9whenever nursing facility per diem rates are updated.
10    Subject to federal approval, beginning January 1, 2024,
11the dementia care rate for supportive living services must be
12no less than the non-dementia care supportive living services
13rate multiplied by 1.5.
14    (c) The Department may adopt rules to implement this
15Section. Rules that establish or modify the services,
16standards, and conditions for participation in the program
17shall be adopted by the Department in consultation with the
18Department on Aging, the Department of Rehabilitation
19Services, and the Department of Mental Health and
20Developmental Disabilities (or their successor agencies).
21    (d) Subject to federal approval by the Centers for
22Medicare and Medicaid Services, the Department shall accept
23for consideration of certification under the program any
24application for a site or building where distinct parts of the
25site or building are designated for purposes other than the
26provision 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
17selected as supportive living facilities and are in good
18standing with the Department's rules are exempt from the
19provisions of the Nursing Home Care Act and the Illinois
20Health 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
23assistance percentage for supportive living services for a
2412-month period from April 1, 2021 through March 31, 2022.
25Subject to federal approval, including the approval of any
26necessary waiver amendments or other federally required

 

 

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1documents or assurances, for a 12-month period the Department
2must pay a supplemental $26 per diem rate to all supportive
3living facilities with the additional federal financial
4participation funds that result from the enhanced federal
5medical assistance percentage from April 1, 2021 through March
631, 2022. The Department may issue parameters around how the
7supplemental payment should be spent, including quality
8improvement activities. The Department may alter the form,
9methods, or timeframes concerning the supplemental per diem
10rate to comply with any subsequent changes to federal law,
11changes made by guidance issued by the federal Centers for
12Medicare and Medicaid Services, or other changes necessary to
13receive the enhanced federal medical assistance percentage.
14    (g) All applications for the expansion of supportive
15living dementia care settings involving sites not approved by
16the Department on January 1, 2024 (the effective date of
17Public Act 103-102) this amendatory Act of the 103rd General
18Assembly may allow new elderly non-dementia units in addition
19to new dementia care units. The Department may approve such
20applications only if the application has: (1) no more than one
21non-dementia care unit for each dementia care unit and (2) the
22site is not located within 4 miles of an existing supportive
23living program site in Cook County (including the City of
24Chicago), not located within 12 miles of an existing
25supportive living program site in DuPage County, Kane County,
26Lake County, McHenry County, or Will County, or not located

 

 

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1within 25 miles of an existing supportive living program site
2in any other county.
3    (h) As stated in the supportive living program home and
4community-based service waiver approved by the federal Centers
5for Medicare and Medicaid Services, the Department must
6maintain the rate add-on implemented on January 1, 2023 for
7the 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;
9103-102, Article 20, Section 20-5, eff. 1-1-24; 103-102,
10Article 100, Section 100-5, eff. 1-1-24; revised 12-15-23.)