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


Rep. Camille Y. Lilly

Filed: 3/18/2021





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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;
6by replacing line 22 on page 70 through line 21 on page 72 with
7the following:
8    "(320 ILCS 20/3.1 new)
9    Sec. 3.1. Adult protective services dementia training.
10    (a) This Section shall apply to any person who is employed
11by the Department in the Adult Protective Services division,
12or is contracted with the Department, and works on the
13development or implementation of social services to respond to
14and prevent adult abuse, neglect, or exploitation.
15    (b) The Department shall implement a dementia training
16program that must include instruction on the identification of



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1people with dementia, risks such as wandering, communication
2impairments, and elder abuse, and the best practices for
3interacting with people with dementia.
4    (c) Training of at least 2 hours shall be completed at the
5start of employment with the Adult Protective Services
6division. Persons who are employees of the Adult Protective
7Services division on the effective date of this amendatory Act
8of the 102nd General Assembly shall complete this training
9within 6 months after the effective date of this amendatory
10Act of the 102nd General Assembly. The training shall cover
11the following subjects:
12        (1) Alzheimer's disease and dementia.
13        (2) Safety risks.
14        (3) Communication and behavior.
15    (d) Annual continuing education shall include at least 2
16hours of dementia training covering the subjects described in
17subsection (c).
18    (e) This Section is designed to address gaps in current
19dementia training requirements for Adult Protective Services
20officials and improve the quality of training. If laws or
21rules existing on the effective date of this amendatory Act of
22the 102nd General Assembly contain more rigorous training
23requirements for Adult Protective Service officials, those
24laws or rules shall apply. Where there is overlap between this
25Section and other laws and rules, the Department shall
26interpret this Section to avoid duplication of requirements



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1while ensuring that the minimum requirements set in this
2Section are met.
3    (f) The Department may adopt rules for the administration
4of this Section."; and
5on page 147, by replacing lines 1 through 21 with the
7    "Sec. 14-14. Increasing access to primary care in
8hospitals. The Department of Healthcare and Family Services
9shall develop a program to facilitate coordination between
10Federally Qualified Health Centers (FQHCs) and safety net
11hospitals, with the goal of increasing care coordination,
12managing chronic diseases, and addressing the social
13determinants of health on or before December 31, 2021.
14Coordination between FQHCs and safety hospitals may include,
15but is not limited to, embedding FQHC staff in hospitals,
16utilizing health information technology for care coordination,
17and enabling FQHCs to connect hospital patients to
18community-based resources when needed to provide whole-person
19care. In addition, the Department shall develop a payment
20methodology to allow FQHCs to provide care coordination
21services, including, but not limited to, chronic disease
22management and behavioral health services. The Department of
23Healthcare and Family Services shall develop a payment
24methodology to allow for FQHC care coordination services by no
25later than December 31, 2021."; and



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1on page 180, line 5, after the period, by inserting
2"Expenditures from the Fund shall be subject to
3appropriation."; and
4by replacing line 15 on page 222 through line 18 on page 226
5with the following:
6    "Section 185-1. Short title. This Article may be cited as
7the Medicaid Technical Assistance Act. References in this
8Article to "this Act" mean this Article.
9    Section 185-3. Findings. The General Assembly finds as
11        (1) This Act seeks to remedy a fraction of a much
12    larger broken system by addressing access to health care,
13    managed care organization reform, mental and substance
14    abuse treatment services, and services to address the
15    social determinants of health.
16        (2) Illinois transitioned Medicaid services to managed
17    care with the goals of achieving better health outcomes
18    for the Medicaid population and reducing the per capita
19    costs of health care.
20        (3) Illinois benefits when people have support
21    constructing the sturdy foundation of health and
22    well-being that we all need to reach our potential.



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1    Medicaid managed care can be a vital tool in ensuring that
2    people have the full range of supports that form this
3    foundation, including services from community providers
4    that address behavioral health needs, as well as related
5    services that help people access food, housing, and
6    employment.
7        (4) However, there are barriers that prevent Illinois
8    from fully realizing the benefits of Medicaid managed
9    care. The 2 devastating years of the State budget impasse
10    resulted in 2 years of lost opportunity for community
11    providers to invest in the people, systems, and technology
12    that are necessary for them to participate in Medicaid
13    managed care. A recent survey by the Illinois
14    Collaboration on Youth of more than 130 community
15    providers revealed that the majority do not have contracts
16    with managed care organizations, and most do not have
17    adequate billing and technology infrastructure sufficient
18    for Medicaid billing now or in the future. The survey also
19    revealed that community-based providers primarily serving
20    people of color are the least prepared to participate in
21    Medicaid managed care.
22        (5) The disparity in readiness between providers
23    primarily serving people of color and those who serve a
24    more mixed or white clientele is especially urgent because
25    62% of Illinois' Medicaid recipients are people of color.
26    Racial disparities in behavioral health care result in



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1    significant human and financial costs to both the
2    individual and to the State.
3        (6) The COVID-19 pandemic has further exacerbated the
4    health disparities experienced by communities of color.
5    COVID-19 has increased both the Medicaid-eligible
6    population in Illinois, and increased the demand for
7    behavioral health services, as Illinois residents grapple
8    with trauma, death, job loss, depression, suicide,
9    addiction, and exposure to violence. In addition, COVID-19
10    threatens the stability and viability of community-based
11    providers, further straining the health care safety net
12    for people who depend on Medicaid for these essential
13    services.
14        (7) Lack of support for a diversity of providers
15    reduces choice for Medicaid recipients and may incentivize
16    managed care organizations to focus on a narrow selection
17    of community partners. Having some choice in which
18    providers people see for these essential services and
19    having access to providers who understand their community,
20    culture, and language has been demonstrated to reduce
21    disparities in health outcomes and improve health and
22    well-being across the life span.
23        (8) The Medicaid managed care system lacks consistent,
24    statewide support for community providers, creating
25    inefficiency and duplication. Providers need targeted
26    trainings focused on their levels of readiness, learning



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1    collaboratives to provide group-level support for those
2    experiencing similar challenges, and a mechanism to
3    identify problems that need systemic solutions. Illinois
4    could receive up to 70% in Medicaid matching funds from
5    the federal government to supplement the costs of
6    operating a Medicaid Technical Assistance Center.
7        (9) When community-based health care providers are
8    able to contract with managed care organizations to
9    deliver Medicaid services, people can access the care they
10    need, in their communities, from providers they trust.
11    Section 185-5. Definitions. As used in this Act:
12    "Behavioral health providers" means mental health and
13substance use disorder providers.
14    "Department" means the Department of Healthcare and Family
16    "Health care providers" means organizations who provide
17physical, mental, substance use disorder, or social
18determinant of health services.
19    "Health equity" means providing care that does not vary in
20quality because of personal characteristics such as gender,
21ethnicity, geographic location, and socioeconomic status.
22    "Network adequacy" means a Medicaid beneficiaries' ability
23to access all necessary provider types within time and
24distance standards as defined in the Managed Care Organization
25model contract.



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1    "Service deserts" means geographic areas of the State with
2no or limited Medicaid providers that accept Medicaid.
3    "Social determinants of health" means any conditions that
4impact an individual's health, including, but not limited to,
5access to healthy food, safety, education, and housing
7    "Stakeholders" means, but are not limited to, health care
8providers, advocacy organizations, managed care organizations,
9Medicaid beneficiaries, and State and city partners.
10    Section 185-10. Medicaid Technical Assistance Center. The
11Department of Healthcare and Family Services shall establish a
12Medicaid Technical Assistance Center. The Medicaid Technical
13Assistance Center shall operate as a cross-system educational
14resource to strengthen the business infrastructure of health
15care provider organizations in Illinois to ultimately increase
16the capacity, access, health equity, and quality of Illinois'
17Medicaid managed care program, HealthChoice Illinois, and
18YouthCare, the Medicaid managed care program for children and
19youth who receive Medicaid health services through the
20Department of Children and Family Services. The Medicaid
21Technical Assistance Center shall be established within the
22Department's Office of Medicaid Innovation.
23    Section 185-15. Collaboration. The Medicaid Technical
24Assistance Center shall collaborate with public and private



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1partners throughout the State to identify, establish, and
2maintain best practices necessary for health providers to
3ensure their capacity to participate in HealthChoice Illinois
4or YouthCare. The Medicaid Technical Assistance Center shall
5administer the following:
6        (1) Outreach and engagement: The Medicaid Technical
7    Assistance Center shall undertake efforts to identify and
8    engage community-based providers offering behavioral
9    health services or services addressing the social
10    determinants of health, especially those predominantly
11    serving communities of color or those operating within or
12    near service deserts, for the purpose of offering training
13    and technical assistance to them through the Medicaid
14    Technical Assistance Center. Outreach and engagement
15    services may be subcontracted.
16        (2) Trainings: The Medicaid Technical Assistance
17    Center shall create and administer ongoing trainings for
18    health care providers. Trainings may be subcontracted. The
19    Medicaid Technical Assistance Center shall provide
20    in-person and web-based trainings. In-person training
21    shall be conducted throughout the State. All trainings
22    must be free of charge. The Medicaid Technical Assistance
23    Center shall administer post-training surveys and
24    incorporate feedback. Training content and delivery must
25    be reflective of Illinois providers' varying levels of
26    readiness, resources, and client populations.



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1        (3) Web-based resources: The Medicaid Technical
2    Assistance Center shall maintain an independent, easy to
3    navigate, and up-to-date website that includes, but is not
4    limited to: recorded training archives, a training
5    calendar, provider resources and tools, up-to-date
6    explanations of Department and managed care organization
7    guidance, a running database of frequently asked questions
8    and contact information for key staff members of the
9    Department, managed care organizations, and the Medicaid
10    Technical Assistance Center.
11        (4) Learning collaboratives: The Medicaid Technical
12    Assistance Center shall host regional learning
13    collaboratives that will supplement the Medicaid Technical
14    Assistance Center training curriculum to bring together
15    groups of stakeholders to share issues and best practices,
16    and to escalate issues. Leadership of the Department and
17    managed care organizations shall attend learning
18    collaboratives on a quarterly basis.
19        (5) Network adequacy reports: The Medicaid Technical
20    Assistance Center shall publicly release a report on
21    Medicaid provider network adequacy within the first 3
22    years of implementation and annually thereafter. The
23    reports shall identify provider service deserts and health
24    care disparities by race and ethnicity.
25        (6) Equitable delivery system: The Medicaid Technical
26    Assistance Center is committed to the principle that all



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1    Medicaid recipients have accessible and equitable physical
2    and mental health care services. All providers served
3    through the Medicaid Technical Assistance Center shall
4    deliver services notwithstanding the patient's race,
5    color, gender, gender identity, age, ancestry, marital
6    status, military status, religion, national origin,
7    disability status, sexual orientation, order of protection
8    status, as defined under Section 1-103 of the Illinois
9    Human Rights Act, or immigration status.
10    Section 185-20. Federal financial participation. The
11Department of Healthcare and Family Services, to the extent
12allowable under federal law, shall maximize federal financial
13participation for any moneys appropriated to the Department
14for the Medicaid Technical Assistance Center. Any federal
15financial participation funds obtained in accordance with this
16Section shall be used for the further development and
17expansion of the Medicaid Technical Assistance Center. All
18federal financial participation funds obtained under this
19subsection shall be deposited into the Medicaid Technical
20Assistance Center Fund created under Section 25.
21    Section 185-25. Medicaid Technical Assistance Center Fund.
22The Medicaid Technical Assistance Center Fund is created as a
23special fund in the State treasury. The Fund shall consist of
24any moneys appropriated to the Department of Healthcare and



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1Family Services for the purposes of this Act and any federal
2financial participation funds obtained as provided under
3Section 20. Subject to appropriation, moneys in the Fund shall
4be used for carrying out the purposes of this Act and for no
5other purpose. All interest earned on the moneys in the Fund
6shall be deposited into the Fund.
7    Section 185-90. The State Finance Act is amended by adding
8Section 5.935 as follows:
9    (30 ILCS 105/5.935 new)
10    Sec. 5.935. The Medicaid Technical Assistance Center