Full Text of SB2610 99th General Assembly
SB2610ham001 99TH GENERAL ASSEMBLY | Rep. Jim Durkin Filed: 5/24/2016
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| 1 | | AMENDMENT TO SENATE BILL 2610
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 2610 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the | 5 | | Continuum of Care Services for the Developmentally Disabled | 6 | | Act. | 7 | | Section 5. Purpose. The purpose of this Act is to authorize | 8 | | a new type of license for organizations providing services to | 9 | | individuals with developmental disabilities to be known as a | 10 | | continuum of care license; to define the requirements for a | 11 | | continuum of care facility to receive and maintain such a | 12 | | license; to establish a process for the development of an | 13 | | alternative budget-neutral reimbursement mechanism for such a | 14 | | facility; and to authorize a request to the federal government | 15 | | for a waiver pursuant to the federal Social Security Act.
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| 1 | | Section 10. Definitions. As used in this Act, unless the | 2 | | context requires otherwise:
| 3 | | "Applicable requirements of law" means State and federal | 4 | | statutes, rules, regulations, and guidance, as such may from | 5 | | time to time be amended or revised, governing the rights, | 6 | | protections, and services, including reimbursement for such | 7 | | services, afforded to individuals with developmental | 8 | | disabilities.
| 9 | | "Campus group home" means a residential facility meeting | 10 | | the requirements of Section 30 of this Act and operated as part | 11 | | of a continuum of care facility licensed under this Act.
| 12 | | "Continuum of care facility" means a legally incorporated | 13 | | entity that provides a comprehensive range of programs, | 14 | | services, and supports for adults with developmental | 15 | | disabilities, positioned at a central geographic campus | 16 | | facility, and including all of the following:
| 17 | | (1) community-integrated living arrangements provided | 18 | | within reasonable geographic proximity of the campus and in | 19 | | accordance with applicable requirements of law;
| 20 | | (2) employment opportunities, including both on-campus | 21 | | compensated work opportunities and off-campus supported | 22 | | employment opportunities provided in accordance with | 23 | | applicable requirements of law;
| 24 | | (3) developmental training programs and services | 25 | | provided in accordance with applicable requirements of | 26 | | law;
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| 1 | | (4) on-campus community living facility opportunities | 2 | | provided on-campus and in accordance with applicable | 3 | | requirements of law;
| 4 | | (5) campus group home opportunities as authorized and | 5 | | defined in this Act and provided in accordance with | 6 | | applicable requirements of law; and
| 7 | | (6) medically complex for the developmentally disabled | 8 | | facility opportunities provided on-campus and in | 9 | | accordance with applicable requirements of law.
| 10 | | "Continuum of care license" means a license issued to a | 11 | | continuum of care facility in accordance with the terms of this | 12 | | Act.
| 13 | | "Continuum of care plan" means a formal, written plan | 14 | | meeting the requirements of Section 25 of this Act.
| 15 | | "Facility constituent elements" means the particular, | 16 | | discrete programs, services, and supports delineated in the | 17 | | definition of "continuum of care facility" and provided | 18 | | collectively by the facility.
| 19 | | Section 15. Powers and duties. The Secretary of Human | 20 | | Services, acting in consultation and coordination as necessary | 21 | | with the Director of Public Health and the Director of | 22 | | Healthcare and Family Services, shall, within 12 months after | 23 | | the effective date of this Act, establish a system of licensure | 24 | | for continuum of care facilities, in accordance with this Act, | 25 | | for the following purposes:
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| 1 | | (1) protecting the welfare, safety, and rights of | 2 | | individuals with developmental disabilities;
| 3 | | (2) providing additional options for care and services | 4 | | for individuals with developmental disabilities; and
| 5 | | (3) providing a model of care that can transition | 6 | | individuals with developmental disabilities in a seamless | 7 | | and timely manner across the continuum of residential care | 8 | | settings and supportive services, training, education, and | 9 | | employment opportunities in a manner that maximizes | 10 | | beneficiary choice and satisfaction.
| 11 | | Section 20. Licensing standards. The Secretary of Human | 12 | | Services shall, within 12 months after the effective date of | 13 | | this Act, file rules establishing standards for licensing of | 14 | | continuum of care facilities under a single license. These | 15 | | rules shall ensure that an applicant for licensure:
| 16 | | (1) meets the definition of "continuum of care | 17 | | facility" and provides all of the programs, services, and | 18 | | supports required by that definition;
| 19 | | (2) develops, submits, and maintains adherence to a | 20 | | continuum of care plan that meets the requirements of | 21 | | Section 25 of this Act;
| 22 | | (3) meets the regulatory requirements set forth in | 23 | | Section 30 of this Act;
| 24 | | (4) meets such requirements as the Secretary of Human | 25 | | Services may determine appropriate for renewal of |
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| 1 | | licensure or for amendment of licensure to account for | 2 | | changes in the composition of facility constituent | 3 | | elements providing programs or services under the license; | 4 | | and
| 5 | | (5) meets such other requirements as the Secretary of | 6 | | Human Services may determine appropriate for the effective | 7 | | implementation of this Act.
| 8 | | Section 25. Continuum of care plan. An applicant for a | 9 | | continuum of care license shall submit to the Secretary of | 10 | | Human Services, in such form and manner as the Secretary of | 11 | | Human Services shall require, a continuum of care plan that | 12 | | demonstrates how the applicant will:
| 13 | | (1) undertake a comprehensive approach to facilitating | 14 | | the movement of individuals to the most appropriate site | 15 | | and level of care and services provided based on that | 16 | | individual's preference and needs;
| 17 | | (2) provide for the seamless integrated transition of | 18 | | individuals between and among the required care settings | 19 | | and services in a manner that addresses the individual's | 20 | | location on the spectrum of disability and progression | 21 | | along the age spectrum;
| 22 | | (3) maximize employment and training opportunities | 23 | | consistent with the individual's preferences and | 24 | | capabilities; | 25 | | (4) provide programs, services, and supports geared to |
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| 1 | | addressing the demand for services for a growing population | 2 | | of aging individuals and individuals who need the services | 3 | | offered by a medically complex for the developmentally | 4 | | disabled facility;
and | 5 | | (5) demonstrate a commitment to providing informed, | 6 | | free, and meaningful choice regarding the type of community | 7 | | in which the individual prefers to live and the type of | 8 | | employment opportunities or developmental training the | 9 | | individual prefers to receive; beneficiary engagement; | 10 | | annual care planning and ongoing treatment focused on the | 11 | | needs and preferences of the individual and adherence to | 12 | | other applicable requirements of law relevant to | 13 | | protecting the rights and welfare of individuals with | 14 | | developmental disabilities; and | 15 | | (6) use an evidence-based assessment tool, approved by | 16 | | the Department of Human Services and the Department of | 17 | | Healthcare and Family Services, to periodically reassess | 18 | | and confirm that individuals receiving more intense or | 19 | | restrictive services continue to require, or to choose if | 20 | | applicable, that level of support and services. | 21 | | Section 30. Applicable requirements. The Secretary of | 22 | | Human Services, acting as appropriate through or in | 23 | | coordination with the Director of Public Health, shall in | 24 | | licensing a continuum of care facility ensure the following:
| 25 | | (1) community-integrated living arrangements provided |
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| 1 | | by such licensee meet all otherwise applicable | 2 | | requirements of law pertaining to such arrangements, | 3 | | including those set forth in the Community-Integrated | 4 | | Living Arrangements Licensure and Certification Act, | 5 | | except that a continuum of care facility may, consistent | 6 | | with all applicable requirements of law, prioritize the | 7 | | movement of individuals into or out of | 8 | | community-integrated living arrangements from or into | 9 | | other residential facility constituent elements;
| 10 | | (2) on-campus and off-campus employment opportunities | 11 | | provided by the licensee meet all otherwise applicable | 12 | | requirements of law pertaining to such opportunities;
| 13 | | (3) developmental training programs and services | 14 | | provided by the licensee meet all otherwise applicable | 15 | | requirements of law pertaining to such programs and | 16 | | services;
| 17 | | (4) community living facility opportunities provided | 18 | | by the licensee meet all otherwise applicable requirements | 19 | | of law pertaining to such opportunities;
| 20 | | (5) campus group homes provided by the licensee meet | 21 | | all otherwise applicable requirements of law pertaining to | 22 | | an ID/DD facility under the ID/DD Community Care Act;
| 23 | | (6) medically complex for the developmentally disabled | 24 | | facility opportunities provided by the licensee meet all | 25 | | otherwise applicable requirements of law pertaining to | 26 | | such opportunities;
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| 1 | | (7) the applicant complies with such other | 2 | | requirements as the Secretary of Human Services may | 3 | | consider necessary and appropriate to carry out the | 4 | | purposes of this Act and other applicable requirements of | 5 | | law. | 6 | | A continuum of care license may be issued to a continuum of | 7 | | care facility upon the adoption of the rules provided for in | 8 | | Section 20 of this Act.
| 9 | | Section 35. Existing and future programs and services.
| 10 | | (a) To the extent necessary to carry out the purposes of | 11 | | this Act and to maintain eligibility for reimbursement for | 12 | | services under applicable State and federal programs, | 13 | | including Title XIX of the federal Social Security Act, | 14 | | facility constituent elements of an entity licensed as a | 15 | | continuum of care facility may be considered to be licensed | 16 | | pursuant to the otherwise applicable requirements of law as set | 17 | | forth in Section 30 of this Act.
| 18 | | (b) In the event that a continuum of care facility ceases | 19 | | to retain licensure as a continuum of care facility, facility | 20 | | constituent elements that meet all otherwise applicable | 21 | | requirements of law with respect to such element as set forth | 22 | | in Section 30 of this Act shall be deemed to be licensed | 23 | | pursuant to such requirements.
| 24 | | (c) Residents of campus group homes and | 25 | | community-integrated living arrangements that are facility |
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| 1 | | constituent elements shall continue to be beneficiaries of and | 2 | | have the rights and protections provided to residents of ID/DD | 3 | | facilities and community-integrated living arrangements, | 4 | | respectively, under the consent decree entered by the United | 5 | | States District Court for the Northern District of Illinois in | 6 | | the matter of Ligas v. Hamos, No. 1:05-CV-4331 on June 15, 2011 | 7 | | (Ligas).
While the consent decree in Ligas remains in effect, | 8 | | members of the class in Ligas residing in ID/DD facilities on | 9 | | June 15, 2011 may move to community-integrated living | 10 | | arrangements as they chose to do so; members of the class in | 11 | | Ligas admitted to ID/DD facilities after June 15, 2011 must | 12 | | enroll on the Prioritization of Urgency of Need for Services | 13 | | waiting list and be selected for community-integrated living | 14 | | arrangements services prior to moving. | 15 | | (d) A continuum of care licensee shall be permitted to add | 16 | | new facility constituent elements under its license provided | 17 | | that it demonstrates a need for the new facility constituent | 18 | | elements and that the facility constituent elements meet all | 19 | | applicable requirements of law.
| 20 | | Section 40. Reimbursement rules. The Secretary of Human | 21 | | Services and the Director of Healthcare and Family Services | 22 | | shall:
| 23 | | (1) ensure that reimbursement utilizing federal and | 24 | | State resources for services provided to eligible | 25 | | beneficiaries through a continuum of care facility |
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| 1 | | comports with the following requirements:
| 2 | | (A) such services shall be reimbursed in a | 3 | | budget-neutral manner such that reimbursement for | 4 | | services provided by the facility constituent elements | 5 | | of a continuum of care licensee shall be neither | 6 | | greater nor lesser than the reimbursement received for | 7 | | such services provided by that facility constituent | 8 | | element prior to the licensing of the continuum of care | 9 | | facility, adjusted to take into account any subsequent | 10 | | changes in reimbursement for such similar services, | 11 | | or, if the facility constituent element is a new | 12 | | facility reimbursement for the services provided by | 13 | | the new facility shall be no less than the | 14 | | reimbursement received for such services by a | 15 | | comparable facility constituent element of that | 16 | | continuum of care facility; and
| 17 | | (B) a continuum of care licensee shall enter into a | 18 | | single provider agreement with the Director of | 19 | | Healthcare and Family Services or the Secretary of | 20 | | Human Services; changes that may occur from time to | 21 | | time in the facility constituent elements under the | 22 | | continuum of care license shall be addressed as may be | 23 | | required by applicable requirements of law through | 24 | | amendments to the provider agreement; the Director of | 25 | | Healthcare and Family Services shall make all | 26 | | reasonable efforts to ensure that all facility |
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| 1 | | constituent elements that are approved parts of a | 2 | | continuum of care license remain qualified for | 3 | | reimbursement under relevant State and federal | 4 | | programs including Title XIX of the federal Social | 5 | | Security Act; and
| 6 | | (2) in cooperation with interested stakeholders, | 7 | | develop an alternative payment methodology for a continuum | 8 | | of care facility; the initial methodology shall produce | 9 | | payments that are budget neutral as compared to the | 10 | | services provided by the licensee prior to the | 11 | | implementation of the continuum of care license; the | 12 | | effectiveness of the methodology and corresponding rate | 13 | | levels shall be evaluated 18 months following the | 14 | | implementation of the methodology and every 12 months | 15 | | thereafter and shall be adjusted as necessary, subject to | 16 | | appropriation. | 17 | | Section 45. The Department of Healthcare and Family | 18 | | Services Law of the
Civil Administrative Code of Illinois is | 19 | | amended by adding Section 2205-13 as follows: | 20 | | (20 ILCS 2205/2205-13 new) | 21 | | Sec. 2205-13. Authorization to secure a federal waiver | 22 | | pursuant to the federal Social Security Act or a State plan | 23 | | amendment. | 24 | | (a) The Director of Healthcare and Family Services, in |
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| 1 | | collaboration and coordination with the Secretary of Human | 2 | | Services, shall develop and submit to the United States | 3 | | Department of Health and Human Services, Centers for Medicare | 4 | | and Medicaid Services, Center for Medicaid and State | 5 | | Operations, a request for a waiver pursuant to the federal | 6 | | Social Security Act or a State plan amendment consistent with | 7 | | the purpose of subsection (b) of this Section and requirements | 8 | | of subsection (c) of this Section. | 9 | | (b) The purpose of the waiver or a State plan amendment | 10 | | authorized by subsection (a) of this Section is to obtain | 11 | | approval for the use of funds under Title XIX of the federal | 12 | | Social Security Act to provide for an alternative model of | 13 | | licensure, reimbursement, and quality assurance for services | 14 | | to individuals with developmental disabilities consistent with | 15 | | the Continuum of Care Services for the Developmentally Disabled | 16 | | Act. | 17 | | (c) A waiver or a State plan amendment requested pursuant | 18 | | to this authorization must involve the licensure of a continuum | 19 | | of care facility pursuant to and consistent with all | 20 | | requirements of the Continuum of Care Services for the | 21 | | Developmentally Disabled Act and a proposal for a reimbursement | 22 | | methodology developed under paragraph (2) of Section 40 of the | 23 | | Continuum of Care Services for the Developmentally Disabled | 24 | | Act. ".
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