Rep. La Shawn K. Ford

Filed: 5/17/2018





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2    AMENDMENT NO. ______. Amend House Bill 5868 by replacing
3lines 7 through 24 on page 1 and lines 1 through 23 on page 2
4with the following:
5"affected by costs and increasing rates of recidivism due to an
6increase in the need for additional comprehensive
7community-based continuum of care services for persons with
8opioid and other substance use disorders. According to the
9Centers for Disease Control and Prevention, there has been a
10600% increase in the incidence of opioid use disorders since
111999, creating an increased need for treatment and other
12recovery support services. Most persons with substance use
13disorders also face co-existing social and economic challenges
14including poverty, job insecurity, and a lack of safe and sober
15living environments. The current health care system is often
16too expensive, fragmented, and disjointed to sufficiently
17address the needs of persons with substance use disorders.
18Consequently, we are at a pivotal time in history when



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1insurance companies are having to become more innovative in
2their approaches to contain costs and improve the outcomes of
3those persons with substance use disorders. Hospitals are also
4contemplating new and innovative ways to reduce their costs and
5rates of recidivism, improve the outcomes of those persons with
6substance use disorders, and monitor these persons with a
7greater level of care in order to achieve the highest level of
8multiple performance outcomes at a time when performance
9metrics matter more than ever. The State of Illinois has the
10opportunity to lead the nation by supporting and amplifying the
11most comprehensive and vertically integrated approach to
12recovery that can effectively address the root causes of
13substance use disorders, while stabilizing other co-existing
14social, economic, and housing conditions that can impair a
15person's long-term recovery. In addition to helping persons
16achieve physical recovery from a substance use disorder, it is
17also important to help them find new meaning in their personal
18lives by rebuilding and strengthening their family
19relationships, community ties, and spiritual development.
20Recovery housing can facilitate this holistic approach to
21recovery and help persons replace their need for substances
22with more meaningful elements of life. Therefore, it is the
23purpose of this Act to provide Illinois citizens with greater
24access to a more robust and holistic continuum of behavioral
25health care services and supports by providing health care
26coverage for recovery housing for persons with substance use



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1disorders."; and
2on page 3, lines 2 and 3, by changing "Residential extended
3care services and supports for drug addicted persons" to
4"Recovery housing for persons with substance use disorders";
6on page 3, by replacing lines 5 through 7 with the following:
7    ""Substance use disorder" and "case management" have the
8meanings ascribed to those terms in Section 1-10 of the
9Substance Use Disorder Act."; and
10on page 3, by inserting after line 12 the following:
11    ""Recovery housing" means a residential extended care
12treatment facility or a recovery home as defined and licensed
13in 77 Illinois Administrative Code, Part 2060, by the Illinois
14Department of Human Services, Division of Substance Use
15Prevention and Recovery."; and
16by replacing lines 17 through 25 on page 3 and all of pages 4
17and 5 with the following:
18"recovery housing for persons with substance use disorders who
19are at risk of a relapse following discharge from a health care
20clinic, federally qualified health center, hospital withdrawal
21management program or any other licensed withdrawal management
22program, or hospital emergency department so long as all of the



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1following conditions are met:
2        (1) A health care clinic, federally qualified health
3    center, hospital withdrawal management program or any
4    other licensed withdrawal management program, or hospital
5    emergency department has conducted an individualized
6    assessment, using criteria established by the American
7    Society of Addiction Medicine, of the person's condition
8    prior to discharge and has identified the person as being
9    at risk of a relapse and in need of supportive services,
10    including employment and training and case management, to
11    maintain long-term recovery. A determination of whether a
12    person is in need of supportive services shall also be
13    based on whether the person has a history of poverty, job
14    insecurity, and lack of a safe and sober living
15    environment.
16        (2) The recovery housing is administered by a
17    community-based agency that is licensed by or under
18    contract with the Department of Human Services, Division of
19    Substance Use Prevention and Recovery.
20        (3) The recovery housing is administered by a
21    community-based agency as described in paragraph (2) upon
22    the referral of a health care clinic, federally qualified
23    health center, hospital withdrawal management program or
24    any other licensed withdrawal management program, or
25    hospital emergency department.
26    (c) Based on the individualized needs assessment, any



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1coverage provided in accordance with this Section may include,
2but not be limited to, the following:
3        (1) Substance use disorder treatment services that are
4    in accordance with licensure standards promulgated by the
5    Department of Human Services, Division of Substance Use
6    Prevention and Recovery.
7        (2) Transitional housing services, including food or
8    meal plans.
9        (3) Individualized case management and referral
10    services, including case management and social services
11    for the families of persons who are seeking treatment for a
12    substance use disorder.
13        (4) Job training or placement services.
14    (d) The insurer may rate each community-based agency that
15is licensed by or under contract with the Department of Human
16Services, Division of Substance Use Prevention and Recovery to
17provide recovery housing based on an evaluation of each
18agency's ability to:
19        (1) reduce health care costs;
20        (2) reduce recidivism rates for persons suffering from
21    a substance use disorder;
22        (3) improve outcomes;
23        (4) track persons with substance use disorders; and
24        (5) improve the quality of life of persons with
25    substance use disorders through the utilization of
26    sustainable recovery, education, employment, and housing



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1    services.
2    The insurer may publish the results of the ratings on its
3official website and shall, on an annual basis, update the
4posted results."; and
5by deleting lines 7 through 24 on page 6 and all of pages 7
6through 9.