SB1664 Engrossed LRB095 09053 DRJ 29244 b

1     AN ACT concerning health.
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4     Section 5. The Community Services Act is amended by
5 changing Sections 1, 2, 3, and 4 as follows:
6     (405 ILCS 30/1)  (from Ch. 91 1/2, par. 901)
7     Sec. 1. Purpose. It is declared to be the policy and intent
8 of the Illinois General Assembly that the Department of Human
9 Services assume leadership in facilitating the establishment
10 of comprehensive and coordinated arrays of private and public
11 services for persons with mental illness, persons with a
12 developmental disability, and alcohol and drug dependent
13 citizens residing in communities throughout the state. The
14 Department shall work in partnership with local government
15 entities, direct service providers, voluntary associations and
16 communities to create a system that is sensitive to the needs
17 of local communities and which complements existing family and
18 other natural supports, social institutions and programs.
19     The goals of the service system shall include but not be
20 limited to the following: to strengthen the person with a
21 disability's disabled individual's independence, self-esteem
22 and ability to participate in and contribute to community life;
23 to insure continuity of care for persons with a disability



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1 clients; to enable persons with a disability disabled persons
2 to access needed services, commensurate with their individual
3 wishes and needs, regardless of where they reside in the state;
4 to prevent unnecessary institutionalization and the
5 dislocation of individuals from their home communities; to
6 provide a range of services so that persons can receive these
7 services in settings which do not unnecessarily restrict their
8 liberty; and to encourage persons with a disability clients to
9 move among settings as their needs change.
10     The system shall include provision of services in the areas
11 of prevention, client assessment and diagnosis, case
12 coordination, crisis and emergency care, treatment and
13 habilitation and support services, and community residential
14 alternatives, including Intermediate Care Facilities for the
15 Developmentally Disabled and Long Term Care for Under Age 22
16 facilities, to institutional settings. The General Assembly
17 recognizes that community programs are a core and essential an
18 integral part of the larger service system, which includes
19 state-operated facilities for persons who cannot receive
20 appropriate services in the community. Whereas the community is
21 providing more of the services and supports formerly provided
22 by the State, such a shift should be acknowledged by the State
23 as a clear priority with funding that values community services
24 and supports for persons who choose to live and work in those
25 settings.
26     Towards achievement of these ends, the Department of Human



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1 Services, working in coordination with other State agencies,
2 shall assume responsibilities pursuant to this Act, which
3 includes activities in the areas of planning, quality
4 assurance, program evaluation, community education, and the
5 provision of financial and technical assistance to local
6 provider agencies.
7 (Source: P.A. 88-380; 89-507, eff. 7-1-97.)
8     (405 ILCS 30/2)  (from Ch. 91 1/2, par. 902)
9     Sec. 2. Community Services System. Services should be
10 planned, developed, delivered and evaluated as part of a
11 comprehensive and coordinated system. The Department of Human
12 Services shall encourage the establishment of services in each
13 area of the State which cover the services categories described
14 below. What specific services are provided under each service
15 category shall be based on local needs; special attention shall
16 be given to unserved and underserved populations, including
17 children and youth, racial and ethnic minorities, and the
18 elderly. The service categories shall include:
19     (a) Prevention: services designed primarily to reduce the
20 incidence and ameliorate the severity of developmental
21 disabilities, mental illness and alcohol and drug dependence;
22     (b) Client Assessment and Diagnosis: services designed to
23 identify persons with developmental disabilities, mental
24 illness and alcohol and drug dependency; to determine the
25 extent of the disability and the level of functioning;



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1 information obtained through client evaluation can be used in
2 individual treatment and habilitation plans; to assure
3 appropriate placement and to assist in program evaluation;
4     (c) Case Coordination: services to provide information and
5 assistance to persons with a disability disabled persons to
6 insure that they obtain needed services provided by the private
7 and public sectors; case coordination services should be
8 available to individuals whose functioning level or history of
9 institutional recidivism or long-term care indicate that such
10 assistance is required for successful community living;
11     (d) Crisis and Emergency: services to assist individuals
12 and their families through crisis periods, to stabilize
13 individuals under stress and to prevent unnecessary
14 institutionalization;
15     (e) Treatment, Habilitation and Support: services designed
16 to help individuals develop skills which promote independence
17 and improved levels of social and vocational functioning and
18 personal growth; and to provide non-treatment support services
19 which are necessary for successful community living;
20     (f) Community Residential Alternatives to Institutional
21 Settings, including Intermediate Care Facilities for the
22 Developmentally Disabled and Long Term Care for Under Age 22
23 facilities: services to provide living arrangements for
24 persons unable to live independently; the level of supervision,
25 services provided and length of stay at community residential
26 alternatives will vary by the type of program and the needs and



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1 functioning level of the residents; other services may be
2 provided in a community residential alternative, including an
3 Intermediate Care Facility for the Developmentally Disabled or
4 a Long Term Care for Under Age 22 facility, which promote the
5 acquisition of independent living skills and integration with
6 the community.
7 (Source: P.A. 89-507, eff. 7-1-97.)
8     (405 ILCS 30/3)  (from Ch. 91 1/2, par. 903)
9     Sec. 3. Responsibilities for Community Services. Pursuant
10 to this Act, the Department of Human Services shall facilitate
11 the establishment of a comprehensive and coordinated array of
12 community services based upon a federal, State and local
13 partnership. In order to assist in implementation of this Act,
14 the Department shall prescribe and publish rules and
15 regulations. The Department may request the assistance of other
16 State agencies, local government entities, direct services
17 providers, trade associations, and others in the development of
18 these regulations or other policies related to community
19 services.
20     The Department shall assume the following roles and
21 responsibilities for community services:
22     (a) Service Priorities. Within the service categories
23 described in Section 2 of this Act, establish and publish
24 priorities for community services to be rendered, and priority
25 populations to receive these services.



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1     (b) Planning. By January 1, 1994 and by January 1 of each
2 third year thereafter, prepare and publish a Plan which
3 describes goals and objectives for community services
4 state-wide and for regions and subregions needs assessment,
5 steps and time-tables for implementation of the goals also
6 shall be included; programmatic goals and objectives for
7 community services shall cover the service categories defined
8 in Section 2 of this Act; the Department shall insure local
9 participation in the planning process.
10     (c) Public Information and Education. Develop programs
11 aimed at improving the relationship between communities and
12 their disabled residents with disabilities; prepare and
13 disseminate public information and educational materials on
14 the prevention of developmental disabilities, mental illness,
15 and alcohol or drug dependence, and on available treatment and
16 habilitation services for persons with these disabilities.
17     (d) Quality Assurance. Promulgate minimum program
18 standards, rules and regulations to insure that Department
19 funded services maintain acceptable quality and assure
20 enforcement of these standards through regular monitoring of
21 services and through program evaluation; this applies except
22 where this responsibility is explicitly given by law to another
23 State agency.
24     (d-5) Accreditation requirements for providers of mental
25 health and substance abuse treatment services. Except when the
26 federal or State statutes authorizing a program, or the federal



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1 regulations implementing a program, are to the contrary,
2 accreditation shall be accepted by the Department in lieu of
3 the Department's facility or program certification or
4 licensure onsite review requirements and shall be accepted as a
5 substitute for the Department's administrative and program
6 monitoring requirements, except as required by subsection
7 (d-10), in the case of:
8         (1) Any organization from which the Department
9     purchases mental health or substance abuse services and
10     that is accredited under any of the following: the
11     Comprehensive Accreditation Manual for Behavioral Health
12     Care (Joint Commission on Accreditation of Healthcare
13     Organizations (JCAHO)); the Comprehensive Accreditation
14     Manual for Hospitals (JCAHO); the Standards Manual for the
15     Council on Accreditation for Children and Family Services
16     (Council on Accreditation for Children and Family Services
17     (COA)); or the Standards Manual for Organizations Serving
18     People with Disabilities (the Rehabilitation Accreditation
19     Commission (CARF)).
20         (2) Any mental health facility or program licensed or
21     certified by the Department, or any substance abuse service
22     licensed by the Department, that is accredited under any of
23     the following: the Comprehensive Accreditation Manual for
24     Behavioral Health Care (JCAHO); the Comprehensive
25     Accreditation Manual for Hospitals (JCAHO); the Standards
26     Manual for the Council on Accreditation for Children and



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1     Family Services (COA); or the Standards Manual for
2     Organizations Serving People with Disabilities (CARF).
3         (3) Any network of providers from which the Department
4     purchases mental health or substance abuse services and
5     that is accredited under any of the following: the
6     Comprehensive Accreditation Manual for Behavioral Health
7     Care (JCAHO); the Comprehensive Accreditation Manual for
8     Hospitals (JCAHO); the Standards Manual for the Council on
9     Accreditation for Children and Family Services (COA); the
10     Standards Manual for Organizations Serving People with
11     Disabilities (CARF); or the National Committee for Quality
12     Assurance. A provider organization that is part of an
13     accredited network shall be afforded the same rights under
14     this subsection.
15     (d-10) For mental health and substance abuse services, the
16 Department may develop standards or promulgate rules that
17 establish additional standards for monitoring and licensing
18 accredited programs, services, and facilities that the
19 Department has determined are not covered by the accreditation
20 standards and processes. These additional standards for
21 monitoring and licensing accredited programs, services, and
22 facilities and the associated monitoring must not duplicate the
23 standards and processes already covered by the accrediting
24 bodies.
25     (d-15) The Department shall be given proof of compliance
26 with fire and health safety standards, which must be submitted



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1 as required by rule.
2     (d-20) The Department, by accepting the survey or
3 inspection of an accrediting organization, does not forfeit its
4 rights to perform inspections at any time, including contract
5 monitoring to ensure that services are provided in accordance
6 with the contract. The Department reserves the right to monitor
7 a provider of mental health and substance abuse treatment
8 services when the survey or inspection of an accrediting
9 organization has established any deficiency in the
10 accreditation standards and processes.
11     (d-25) On and after the effective date of this amendatory
12 Act of the 92nd General Assembly, the accreditation
13 requirements of this Section apply to contracted organizations
14 that are already accredited.
15     (e) Program Evaluation. Develop a system for conducting
16 evaluation of the effectiveness of community services,
17 according to preestablished performance standards; evaluate
18 the extent to which performance according to established
19 standards aids in achieving the goals of this Act; evaluation
20 data also shall be used for quality assurance purposes as well
21 as for planning activities.
22     (f) Research. Conduct research in order to increase
23 understanding of mental illness, developmental disabilities
24 and alcohol and drug dependence.
25     (g) Technical Assistance. Provide technical assistance to
26 provider agencies receiving funds or serving clients in order



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1 to assist these agencies in providing appropriate, quality
2 services; also provide assistance and guidance to other State
3 agencies and local governmental bodies serving the disabled in
4 order to strengthen their efforts to provide appropriate
5 community services; and assist provider agencies in accessing
6 other available funding, including federal, State, local,
7 third-party and private resources.
8     (h) Placement Process. Promote the appropriate placement
9 of clients in community services through the development and
10 implementation of client assessment and diagnostic instruments
11 to assist in identifying the individual's service needs; client
12 assessment instruments also can be utilized for purposes of
13 program evaluation; whenever possible, assure that placements
14 in State-operated facilities are referrals from community
15 agencies.
16     (i) Interagency Coordination. Assume leadership in
17 promoting cooperation among State health and human service
18 agencies to insure that a comprehensive, coordinated community
19 services system is in place; to insure persons with a
20 disability disabled persons access to needed services; and to
21 insure continuity of care and allow clients to move among
22 service settings as their needs change; also work with other
23 agencies to establish effective prevention programs.
24     (j) Financial Assistance. Provide financial assistance to
25 local provider agencies through purchase-of-care contracts and
26 grants, pursuant to Section 4 of this Act.



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1 (Source: P.A. 92-755, eff. 8-2-02.)
2     (405 ILCS 30/4)  (from Ch. 91 1/2, par. 904)
3     Sec. 4. Financing for Community Services. The Department of
4 Human Services is authorized to provide financial
5 reimbursement assistance to eligible private service
6 providers, corporations, local government entities or
7 voluntary associations for the provision of services to persons
8 with mental illness, persons with a developmental disability
9 and alcohol and drug dependent persons living in the community
10 for the purpose of achieving the goals of this Act.
11     The Department shall utilize the following funding
12 mechanisms for community services:
13         (1) Purchase of Care Contracts: services purchased on a
14     predetermined fee per unit of service basis from private
15     providers or governmental entities. Fee per service rates
16     are set by an established formula which covers some portion
17     of personnel, supplies, and other allowable costs, and
18     which makes some allowance for geographic variations in
19     costs as well as for additional program components.
20         (2) Grants: sums of money which the Department grants
21     to private providers or governmental entities pursuant to
22     the grant recipient's agreement to provide certain
23     services, as defined by departmental grant guidelines, to
24     an approximate number of service recipients. Grant levels
25     are set through consideration of personnel, supply and



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1     other allowable costs, as well as other funds available to
2     the program.
3         (3) Other Funding Arrangements: funding mechanisms may
4     be established on a pilot basis in order to examine the
5     feasibility of alternative financing arrangements for the
6     provision of community services.
7     The Department shall strive to establish and maintain an
8 equitable system of payment which allows encourages providers
9 to improve persons with disabilities' their clients'
10 capabilities for independence and reduces their reliance on
11 community or State-operated services. The Governor shall
12 appoint a commission by July 1, 2007, or as soon thereafter as
13 possible, to prioritize a strategy for identifying a stream of
14 revenue to address gaps and prioritize use of that revenue on
15 rates and reimbursements for community services and supports.
16 The commission shall have representation from the Department,
17 the General Assembly, persons with disabilities and mental
18 illness, community providers, unions, and trade associations.
19 The rate and reimbursement methodologies must reflect the cost
20 of providing services and supports, recognize individual
21 disability needs, and consider geographic differences,
22 transportation costs, required staffing ratios, and mandates
23 not currently funded.
24     In accepting Department funds, providers shall recognize
25 their responsibility to be accountable to the Department and
26 the State for the delivery of services which are consistent



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1 with the philosophies and goals of this Act and the rules and
2 regulations promulgated under it.
3 (Source: P.A. 88-380; 89-507, eff. 7-1-97.)
4     Section 99. Effective date. This Act takes effect upon
5 becoming law.