Illinois General Assembly - Full Text of HB0158
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Full Text of HB0158  102nd General Assembly


Rep. Camille Y. Lilly

Filed: 3/17/2021





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2    AMENDMENT NO. ______. Amend House Bill 158, AS AMENDED,
3with reference to page and line numbers of House Amendment No.
41, by deleting line 20 on page 64 through line 18 on page 70;
6on page 71, by replacing lines 2 and 3 with "by the Department
7in the Adult Protective Services division, or is contracted
8with the Department, and works on the development or
9implementation of social"; and
10on page 71, line 5, by deleting ", subject to appropriation";
12on page 71, line 6, by deleting "develop and"; and
13on page 147, by replacing lines 1 through 21 with the



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1    "Sec. 14-14. Increasing access to primary care in
2hospitals. The Department of Healthcare and Family Services
3shall develop a program to facilitate coordination between
4Federally Qualified Health Centers (FQHCs) and safety net
5hospitals, with the goal of increasing care coordination,
6managing chronic diseases, and addressing the social
7determinants of health on or before December 31, 2021.
8Coordination between FQHCs and safety hospitals may include,
9but is not limited to, embedding FQHC staff in hospitals,
10utilizing health information technology for care coordination,
11and enabling FQHCs to connect hospital patients to
12community-based resources when needed to provide whole-person
13care. In addition, the Department shall develop a payment
14methodology to allow FQHCs to provide care coordination
15services, including, but not limited to, chronic disease
16management and behavioral health services. The Department of
17Healthcare and Family Services shall develop a payment
18methodology to allow for FQHC care coordination services by no
19later than December 31, 2021."; and
20on page 180, line 5, after the period, by inserting
21"Expenditures from the Fund shall be subject to
22appropriation."; and
23by replacing line 15 on page 222 through line 18 on page 226
24with the following:



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1    "Section 185-1. Short title. This Article may be cited as
2the Medicaid Technical Assistance Act. References in this
3Article to "this Act" mean this Article.
4    Section 185-3. Findings. The General Assembly finds as
6        (1) This Act seeks to remedy a fraction of a much
7    larger broken system by addressing access to health care,
8    managed care organization reform, mental and substance
9    abuse treatment services, and services to address the
10    social determinants of health.
11        (2) Illinois transitioned Medicaid services to managed
12    care with the goals of achieving better health outcomes
13    for the Medicaid population and reducing the per capita
14    costs of health care.
15        (3) Illinois benefits when people have support
16    constructing the sturdy foundation of health and
17    well-being that we all need to reach our potential.
18    Medicaid managed care can be a vital tool in ensuring that
19    people have the full range of supports that form this
20    foundation, including services from community providers
21    that address behavioral health needs, as well as related
22    services that help people access food, housing, and
23    employment.
24        (4) However, there are barriers that prevent Illinois



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1    from fully realizing the benefits of Medicaid managed
2    care. The 2 devastating years of the State budget impasse
3    resulted in 2 years of lost opportunity for community
4    providers to invest in the people, systems, and technology
5    that are necessary for them to participate in Medicaid
6    managed care. A recent survey by the Illinois
7    Collaboration on Youth of more than 130 community
8    providers revealed that the majority do not have contracts
9    with managed care organizations, and most do not have
10    adequate billing and technology infrastructure sufficient
11    for Medicaid billing now or in the future. The survey also
12    revealed that community-based providers primarily serving
13    people of color are the least prepared to participate in
14    Medicaid managed care.
15        (5) The disparity in readiness between providers
16    primarily serving people of color and those who serve a
17    more mixed or white clientele is especially urgent because
18    62% of Illinois' Medicaid recipients are people of color.
19    Racial disparities in behavioral health care result in
20    significant human and financial costs to both the
21    individual and to the State.
22        (6) The COVID-19 pandemic has further exacerbated the
23    health disparities experienced by communities of color.
24    COVID-19 has increased both the Medicaid-eligible
25    population in Illinois, and increased the demand for
26    behavioral health services, as Illinois residents grapple



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1    with trauma, death, job loss, depression, suicide,
2    addiction, and exposure to violence. In addition, COVID-19
3    threatens the stability and viability of community-based
4    providers, further straining the health care safety net
5    for people who depend on Medicaid for these essential
6    services.
7        (7) Lack of support for a diversity of providers
8    reduces choice for Medicaid recipients and may incentivize
9    managed care organizations to focus on a narrow selection
10    of community partners. Having some choice in which
11    providers people see for these essential services and
12    having access to providers who understand their community,
13    culture, and language has been demonstrated to reduce
14    disparities in health outcomes and improve health and
15    well-being across the life span.
16        (8) The Medicaid managed care system lacks consistent,
17    statewide support for community providers, creating
18    inefficiency and duplication. Providers need targeted
19    trainings focused on their levels of readiness, learning
20    collaboratives to provide group-level support for those
21    experiencing similar challenges, and a mechanism to
22    identify problems that need systemic solutions. Illinois
23    could receive up to 70% in Medicaid matching funds from
24    the federal government to supplement the costs of
25    operating a Medicaid Technical Assistance Center.
26        (9) When community-based health care providers are



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1    able to contract with managed care organizations to
2    deliver Medicaid services, people can access the care they
3    need, in their communities, from providers they trust.
4    Section 185-5. Definitions. As used in this Act:
5    "Behavioral health providers" means mental health and
6substance use disorder providers.
7    "Department" means the Department of Healthcare and Family
9    "Health care providers" means organizations who provide
10physical, mental, substance use disorder, or social
11determinant of health services.
12    "Health equity" means providing care that does not vary in
13quality because of personal characteristics such as gender,
14ethnicity, geographic location, and socioeconomic status.
15    "Network adequacy" means a Medicaid beneficiaries' ability
16to access all necessary provider types within time and
17distance standards as defined in the Managed Care Organization
18model contract.
19    "Service deserts" means geographic areas of the State with
20no or limited Medicaid providers that accept Medicaid.
21    "Social determinants of health" means any conditions that
22impact an individual's health, including, but not limited to,
23access to healthy food, safety, education, and housing
25    "Stakeholders" means, but are not limited to, health care



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1providers, advocacy organizations, managed care organizations,
2Medicaid beneficiaries, and State and city partners.
3    Section 185-10. Medicaid Technical Assistance Center. The
4Department of Healthcare and Family Services shall establish a
5Medicaid Technical Assistance Center. The Medicaid Technical
6Assistance Center shall operate as a cross-system educational
7resource to strengthen the business infrastructure of health
8care provider organizations in Illinois to ultimately increase
9the capacity, access, health equity, and quality of Illinois'
10Medicaid managed care program, HealthChoice Illinois, and
11YouthCare, the Medicaid managed care program for children and
12youth who receive Medicaid health services through the
13Department of Children and Family Services. The Medicaid
14Technical Assistance Center shall be established within the
15Department's Office of Medicaid Innovation.
16    Section 185-15. Collaboration. The Medicaid Technical
17Assistance Center shall collaborate with public and private
18partners throughout the State to identify, establish, and
19maintain best practices necessary for health providers to
20ensure their capacity to participate in HealthChoice Illinois
21or YouthCare. The Medicaid Technical Assistance Center shall
22administer the following:
23        (1) Outreach and engagement: The Medicaid Technical
24    Assistance Center shall undertake efforts to identify and



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1    engage community-based providers offering behavioral
2    health services or services addressing the social
3    determinants of health, especially those predominantly
4    serving communities of color or those operating within or
5    near service deserts, for the purpose of offering training
6    and technical assistance to them through the Medicaid
7    Technical Assistance Center. Outreach and engagement
8    services may be subcontracted.
9        (2) Trainings: The Medicaid Technical Assistance
10    Center shall create and administer ongoing trainings for
11    health care providers. Trainings may be subcontracted. The
12    Medicaid Technical Assistance Center shall provide
13    in-person and web-based trainings. In-person training
14    shall be conducted throughout the State. All trainings
15    must be free of charge. The Medicaid Technical Assistance
16    Center shall administer post-training surveys and
17    incorporate feedback. Training content and delivery must
18    be reflective of Illinois providers' varying levels of
19    readiness, resources, and client populations.
20        (3) Web-based resources: The Medicaid Technical
21    Assistance Center shall maintain an independent, easy to
22    navigate, and up-to-date website that includes, but is not
23    limited to: recorded training archives, a training
24    calendar, provider resources and tools, up-to-date
25    explanations of Department and managed care organization
26    guidance, a running database of frequently asked questions



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1    and contact information for key staff members of the
2    Department, managed care organizations, and the Medicaid
3    Technical Assistance Center.
4        (4) Learning collaboratives: The Medicaid Technical
5    Assistance Center shall host regional learning
6    collaboratives that will supplement the Medicaid Technical
7    Assistance Center training curriculum to bring together
8    groups of stakeholders to share issues and best practices,
9    and to escalate issues. Leadership of the Department and
10    managed care organizations shall attend learning
11    collaboratives on a quarterly basis.
12        (5) Network adequacy reports: The Medicaid Technical
13    Assistance Center shall publicly release a report on
14    Medicaid provider network adequacy within the first 3
15    years of implementation and annually thereafter. The
16    reports shall identify provider service deserts and health
17    care disparities by race and ethnicity.
18        (6) Equitable delivery system: The Medicaid Technical
19    Assistance Center is committed to the principle that all
20    Medicaid recipients have accessible and equitable physical
21    and mental health care services. All providers served
22    through the Medicaid Technical Assistance Center shall
23    deliver services notwithstanding the patient's race,
24    color, gender, gender identity, age, ancestry, marital
25    status, military status, religion, national origin,
26    disability status, sexual orientation, order of protection



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1    status, as defined under Section 1-103 of the Illinois
2    Human Rights Act, or immigration status.
3    Section 185-20. Federal financial participation. The
4Department of Healthcare and Family Services, to the extent
5allowable under federal law, shall maximize federal financial
6participation for any moneys appropriated to the Department
7for the Medicaid Technical Assistance Center. Any federal
8financial participation funds obtained in accordance with this
9Section shall be used for the further development and
10expansion of the Medicaid Technical Assistance Center. All
11federal financial participation funds obtained under this
12subsection shall be deposited into the Medicaid Technical
13Assistance Center Fund created under Section 25.
14    Section 185-25. Medicaid Technical Assistance Center Fund.
15The Medicaid Technical Assistance Center Fund is created as a
16special fund in the State treasury. The Fund shall consist of
17any moneys appropriated to the Department of Healthcare and
18Family Services for the purposes of this Act and any federal
19financial participation funds obtained as provided under
20Section 20. Subject to appropriation, moneys in the Fund shall
21be used for carrying out the purposes of this Act and for no
22other purpose. All interest earned on the moneys in the Fund
23shall be deposited into the Fund.



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1    Section 185-90. The State Finance Act is amended by adding
2Section 5.935 as follows:
3    (30 ILCS 105/5.935 new)
4    Sec. 5.935. The Medicaid Technical Assistance Center