Illinois General Assembly - Full Text of HB0240
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Full Text of HB0240  102nd General Assembly


Sen. Ann Gillespie

Filed: 1/5/2023





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2    AMENDMENT NO. ______. Amend House Bill 240 by replacing
3everything after the enacting clause with the following:
4    "Section 1. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.35 as follows:
6    (5 ILCS 100/5-45.35 new)
7    Sec. 5-45.35. Emergency rulemaking; rural emergency
8hospitals. To provide for the expeditious and timely
9implementation of this amendatory Act of the 102nd General
10Assembly, emergency rules implementing the inclusion of rural
11emergency hospitals in the definition of "hospital" in Section
123 of the Hospital Licensing Act may be adopted in accordance
13with Section 5-45 by the Department of Public Health. The
14adoption of emergency rules authorized by Section 5-45 and
15this Section is deemed to be necessary for the public
16interest, safety, and welfare.



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1    This Section is repealed one year after the effective date
2of this amendatory Act of the 102nd General Assembly.
3    Section 5. The Illinois Health Facilities Planning Act is
4amended by adding Section 8.9a as follows:
5    (20 ILCS 3960/8.9a new)
6    Sec. 8.9a. Extension of project completion date. Any party
7that has previously received approval by the State Board to
8re-establish a previously discontinued general acute care
9hospital in accordance with Section 8.9 of this Act shall have
10the automatic right to extend the project completion date
11listed by the party in the party's certificate of exemption
12application by providing notice to the State Board of the new
13project completion date.
14    Section 10. The Nursing Home Care Act is amended by
15changing Section 3-202.05 as follows:
16    (210 ILCS 45/3-202.05)
17    Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
19    (a) For the purpose of computing staff to resident ratios,
20direct care staff shall include:
21        (1) registered nurses;
22        (2) licensed practical nurses;



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1        (3) certified nurse assistants;
2        (4) psychiatric services rehabilitation aides;
3        (5) rehabilitation and therapy aides;
4        (6) psychiatric services rehabilitation coordinators;
5        (7) assistant directors of nursing;
6        (8) 50% of the Director of Nurses' time; and
7        (9) 30% of the Social Services Directors' time.
8    The Department shall, by rule, allow certain facilities
9subject to 77 Ill. Adm. Admin. Code 300.4000 and following
10(Subpart S) to utilize specialized clinical staff, as defined
11in rules, to count towards the staffing ratios.
12    Within 120 days of June 14, 2012 (the effective date of
13Public Act 97-689) this amendatory Act of the 97th General
14Assembly, the Department shall promulgate rules specific to
15the staffing requirements for facilities federally defined as
16Institutions for Mental Disease. These rules shall recognize
17the unique nature of individuals with chronic mental health
18conditions, shall include minimum requirements for specialized
19clinical staff, including clinical social workers,
20psychiatrists, psychologists, and direct care staff set forth
21in paragraphs (4) through (6) and any other specialized staff
22which may be utilized and deemed necessary to count toward
23staffing ratios.
24    Within 120 days of June 14, 2012 (the effective date of
25Public Act 97-689) this amendatory Act of the 97th General
26Assembly, the Department shall promulgate rules specific to



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1the staffing requirements for facilities licensed under the
2Specialized Mental Health Rehabilitation Act of 2013. These
3rules shall recognize the unique nature of individuals with
4chronic mental health conditions, shall include minimum
5requirements for specialized clinical staff, including
6clinical social workers, psychiatrists, psychologists, and
7direct care staff set forth in paragraphs (4) through (6) and
8any other specialized staff which may be utilized and deemed
9necessary to count toward staffing ratios.
10    (b) (Blank).
11    (b-5) For purposes of the minimum staffing ratios in this
12Section, all residents shall be classified as requiring either
13skilled care or intermediate care.
14    As used in this subsection:
15    "Intermediate care" means basic nursing care and other
16restorative services under periodic medical direction.
17    "Skilled care" means skilled nursing care, continuous
18skilled nursing observations, restorative nursing, and other
19services under professional direction with frequent medical
21    (c) Facilities shall notify the Department within 60 days
22after July 29, 2010 (the effective date of Public Act 96-1372)
23this amendatory Act of the 96th General Assembly, in a form and
24manner prescribed by the Department, of the staffing ratios in
25effect on July 29, 2010 (the effective date of Public Act
2696-1372) this amendatory Act of the 96th General Assembly for



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1both intermediate and skilled care and the number of residents
2receiving each level of care.
3    (d)(1) (Blank).
4    (2) (Blank).
5    (3) (Blank).
6    (4) (Blank).
7    (5) Effective January 1, 2014, the minimum staffing ratios
8shall be increased to 3.8 hours of nursing and personal care
9each day for a resident needing skilled care and 2.5 hours of
10nursing and personal care each day for a resident needing
11intermediate care.
12    (e) Ninety days after June 14, 2012 (the effective date of
13Public Act 97-689) this amendatory Act of the 97th General
14Assembly, a minimum of 25% of nursing and personal care time
15shall be provided by licensed nurses, with at least 10% of
16nursing and personal care time provided by registered nurses.
17These minimum requirements shall remain in effect until an
18acuity based registered nurse requirement is promulgated by
19rule concurrent with the adoption of the Resource Utilization
20Group classification-based payment methodology, as provided in
21Section 5-5.2 of the Illinois Public Aid Code. Registered
22nurses and licensed practical nurses employed by a facility in
23excess of these requirements may be used to satisfy the
24remaining 75% of the nursing and personal care time
25requirements. Notwithstanding this subsection, no staffing
26requirement in statute in effect on June 14, 2012 (the



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1effective date of Public Act 97-689) this amendatory Act of
2the 97th General Assembly shall be reduced on account of this
4    (f) The Department shall submit proposed rules for
5adoption by January 1, 2020 establishing a system for
6determining compliance with minimum staffing set forth in this
7Section and the requirements of 77 Ill. Adm. Code 300.1230
8adjusted for any waivers granted under Section 3-303.1.
9Compliance shall be determined quarterly by comparing the
10number of hours provided per resident per day using the
11Centers for Medicare and Medicaid Services' payroll-based
12journal and the facility's daily census, broken down by
13intermediate and skilled care as self-reported by the facility
14to the Department on a quarterly basis. The Department shall
15use the quarterly payroll-based journal and the self-reported
16census to calculate the number of hours provided per resident
17per day and compare this ratio to the minimum staffing
18standards required under this Section, as impacted by any
19waivers granted under Section 3-303.1. Discrepancies between
20job titles contained in this Section and the payroll-based
21journal shall be addressed by rule. The manner in which the
22Department requests payroll-based journal information to be
23submitted shall align with the federal Centers for Medicare
24and Medicaid Services' requirements that allow providers to
25submit the quarterly data in an aggregate manner.
26    (g) Monetary penalties for non-compliance. The Department



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1shall submit proposed rules for adoption by January 1, 2020
2establishing monetary penalties for facilities not in
3compliance with minimum staffing standards under this Section.
4Facilities shall be required to comply with the provisions of
5this subsection beginning January 1, 2025. No monetary penalty
6may be issued for noncompliance prior to during the revised
7implementation date period, which shall be January 1, 2025
8July 1, 2020 through December 31, 2021. If a facility is found
9to be noncompliant prior to during the revised implementation
10date period, the Department shall provide a written notice
11identifying the staffing deficiencies and require the facility
12to provide a sufficiently detailed correction plan that
13describes proposed and completed actions the facility will
14take or has taken, including hiring actions, to address the
15facility's failure to meet the statutory minimum staffing
16levels. Monetary penalties shall be imposed beginning no later
17than July 1, 2025, based on data for the quarter beginning
18January 1, 2025 through March 31, 2025 January 1, 2022 and
19quarterly thereafter and shall be based on the latest quarter
20for which the Department has data. Monetary penalties shall be
21established based on a formula that calculates on a daily
22basis the cost of wages and benefits for the missing staffing
23hours. All notices of noncompliance shall include the
24computations used to determine noncompliance and establishing
25the variance between minimum staffing ratios and the
26Department's computations. The penalty for the first offense



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1shall be 125% of the cost of wages and benefits for the missing
2staffing hours. The penalty shall increase to 150% of the cost
3of wages and benefits for the missing staffing hours for the
4second offense and 200% the cost of wages and benefits for the
5missing staffing hours for the third and all subsequent
6offenses. The penalty shall be imposed regardless of whether
7the facility has committed other violations of this Act during
8the same period that the staffing offense occurred. The
9penalty may not be waived, but the Department shall have the
10discretion to determine the gravity of the violation in
11situations where there is no more than a 10% deviation from the
12staffing requirements and make appropriate adjustments to the
13penalty. The Department is granted discretion to waive the
14penalty when unforeseen circumstances have occurred that
15resulted in call-offs of scheduled staff. This provision shall
16be applied no more than 6 times per quarter. Nothing in this
17Section diminishes a facility's right to appeal the imposition
18of a monetary penalty. No facility may appeal a notice of
19noncompliance issued during the revised implementation period.
20(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
21revised 2-28-22.)
22    Section 15. The Specialized Mental Health Rehabilitation
23Act of 2013 is amended by changing Section 1-102 as follows:
24    (210 ILCS 49/1-102)



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1    Sec. 1-102. Definitions. For the purposes of this Act,
2unless the context otherwise requires:
3    "Abuse" means any physical or mental injury or sexual
4assault inflicted on a consumer other than by accidental means
5in a facility.
6    "Accreditation" means any of the following:
7        (1) the Joint Commission;
8        (2) the Commission on Accreditation of Rehabilitation
9    Facilities;
10        (3) the Healthcare Facilities Accreditation Program;
11    or
12        (4) any other national standards of care as approved
13    by the Department.
14    "APRN" means an Advanced Practice Registered Nurse,
15nationally certified as a mental health or psychiatric nurse
16practitioner and licensed under the Nurse Practice Act.
17    "Applicant" means any person making application for a
18license or a provisional license under this Act.
19    "Consumer" means a person, 18 years of age or older,
20admitted to a mental health rehabilitation facility for
21evaluation, observation, diagnosis, treatment, stabilization,
22recovery, and rehabilitation.
23    "Consumer" does not mean any of the following:
24        (i) an individual requiring a locked setting;
25        (ii) an individual requiring psychiatric
26    hospitalization because of an acute psychiatric crisis;



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1        (iii) an individual under 18 years of age;
2        (iv) an individual who is actively suicidal or violent
3    toward others;
4        (v) an individual who has been found unfit to stand
5    trial and is currently subject to a court order requiring
6    placement in secure inpatient care in the custody of the
7    Department of Human Services pursuant to Section 104-17 of
8    the Code of Criminal Procedure of 1963;
9        (vi) an individual who has been found not guilty by
10    reason of insanity and is currently subject to a court
11    order requiring placement in secure inpatient care in the
12    custody of the Department of Human Services pursuant to
13    Section 5-2-4 of the Unified Code of Corrections based on
14    committing a violent act, such as sexual assault, assault
15    with a deadly weapon, arson, or murder;
16        (vii) an individual subject to temporary detention and
17    examination under Section 3-607 of the Mental Health and
18    Developmental Disabilities Code;
19        (viii) an individual deemed clinically appropriate for
20    inpatient admission in a State psychiatric hospital; and
21        (ix) an individual transferred by the Department of
22    Corrections pursuant to Section 3-8-5 of the Unified Code
23    of Corrections.
24    "Consumer record" means a record that organizes all
25information on the care, treatment, and rehabilitation
26services rendered to a consumer in a specialized mental health



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1rehabilitation facility.
2    "Controlled drugs" means those drugs covered under the
3federal Comprehensive Drug Abuse Prevention Control Act of
41970, as amended, or the Illinois Controlled Substances Act.
5    "Department" means the Department of Public Health.
6    "Discharge" means the full release of any consumer from a
8    "Drug administration" means the act in which a single dose
9of a prescribed drug or biological is given to a consumer. The
10complete act of administration entails removing an individual
11dose from a container, verifying the dose with the
12prescriber's orders, giving the individual dose to the
13consumer, and promptly recording the time and dose given.
14    "Drug dispensing" means the act entailing the following of
15a prescription order for a drug or biological and proper
16selection, measuring, packaging, labeling, and issuance of the
17drug or biological to a consumer.
18    "Emergency" means a situation, physical condition, or one
19or more practices, methods, or operations which present
20imminent danger of death or serious physical or mental harm to
21consumers of a facility.
22    "Facility" means a specialized mental health
23rehabilitation facility that provides at least one of the
24following services: (1) triage center; (2) crisis
25stabilization; (3) recovery and rehabilitation supports; or
26(4) transitional living units for 3 or more persons. The



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1facility shall provide a 24-hour program that provides
2intensive support and recovery services designed to assist
3persons, 18 years or older, with mental disorders to develop
4the skills to become self-sufficient and capable of increasing
5levels of independent functioning. It includes facilities that
6meet the following criteria:
7        (1) 100% of the consumer population of the facility
8    has a diagnosis of serious mental illness;
9        (2) no more than 15% of the consumer population of the
10    facility is 65 years of age or older;
11        (3) none of the consumers are non-ambulatory;
12        (4) none of the consumers have a primary diagnosis of
13    moderate, severe, or profound intellectual disability; and
14        (5) the facility must have been licensed under the
15    Specialized Mental Health Rehabilitation Act or the
16    Nursing Home Care Act immediately preceding July 22, 2013
17    (the effective date of this Act) and qualifies as an
18    institute for mental disease under the federal definition
19    of the term.
20    "Facility" does not include the following:
21        (1) a home, institution, or place operated by the
22    federal government or agency thereof, or by the State of
23    Illinois;
24        (2) a hospital, sanitarium, or other institution whose
25    principal activity or business is the diagnosis, care, and
26    treatment of human illness through the maintenance and



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1    operation as organized facilities therefor which is
2    required to be licensed under the Hospital Licensing Act;
3        (3) a facility for child care as defined in the Child
4    Care Act of 1969;
5        (4) a community living facility as defined in the
6    Community Living Facilities Licensing Act;
7        (5) a nursing home or sanitarium sanatorium operated
8    solely by and for persons who rely exclusively upon
9    treatment by spiritual means through prayer, in accordance
10    with the creed or tenets of any well-recognized church or
11    religious denomination; however, such nursing home or
12    sanitarium sanatorium shall comply with all local laws and
13    rules relating to sanitation and safety;
14        (6) a facility licensed by the Department of Human
15    Services as a community-integrated living arrangement as
16    defined in the Community-Integrated Living Arrangements
17    Licensure and Certification Act;
18        (7) a supportive residence licensed under the
19    Supportive Residences Licensing Act;
20        (8) a supportive living facility in good standing with
21    the program established under Section 5-5.01a of the
22    Illinois Public Aid Code, except only for purposes of the
23    employment of persons in accordance with Section 3-206.01
24    of the Nursing Home Care Act;
25        (9) an assisted living or shared housing establishment
26    licensed under the Assisted Living and Shared Housing Act,



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1    except only for purposes of the employment of persons in
2    accordance with Section 3-206.01 of the Nursing Home Care
3    Act;
4        (10) an Alzheimer's disease management center
5    alternative health care model licensed under the
6    Alternative Health Care Delivery Act;
7        (11) a home, institution, or other place operated by
8    or under the authority of the Illinois Department of
9    Veterans' Affairs;
10        (12) a facility licensed under the ID/DD Community
11    Care Act;
12        (13) a facility licensed under the Nursing Home Care
13    Act after July 22, 2013 (the effective date of this Act);
14    or
15        (14) a facility licensed under the MC/DD Act.
16    "Executive director" means a person who is charged with
17the general administration and supervision of a facility
18licensed under this Act and who is a licensed nursing home
19administrator, licensed practitioner of the healing arts, or
20qualified mental health professional.
21    "Guardian" means a person appointed as a guardian of the
22person or guardian of the estate, or both, of a consumer under
23the Probate Act of 1975.
24    "Identified offender" means a person who meets any of the
25following criteria:
26        (1) Has been convicted of, found guilty of,



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1    adjudicated delinquent for, found not guilty by reason of
2    insanity for, or found unfit to stand trial for, any
3    felony offense listed in Section 25 of the Health Care
4    Worker Background Check Act, except for the following:
5            (i) a felony offense described in Section 10-5 of
6        the Nurse Practice Act;
7            (ii) a felony offense described in Section 4, 5,
8        6, 8, or 17.02 of the Illinois Credit Card and Debit
9        Card Act;
10            (iii) a felony offense described in Section 5,
11        5.1, 5.2, 7, or 9 of the Cannabis Control Act;
12            (iv) a felony offense described in Section 401,
13        401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois
14        Controlled Substances Act; and
15            (v) a felony offense described in the
16        Methamphetamine Control and Community Protection Act.
17        (2) Has been convicted of, adjudicated delinquent for,
18    found not guilty by reason of insanity for, or found unfit
19    to stand trial for, any sex offense as defined in
20    subsection (c) of Section 10 of the Sex Offender
21    Management Board Act.
22    "Transitional living units" are residential units within a
23facility that have the purpose of assisting the consumer in
24developing and reinforcing the necessary skills to live
25independently outside of the facility. The duration of stay in
26such a setting shall not exceed 120 days for each consumer.



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1Nothing in this definition shall be construed to be a
2prerequisite for transitioning out of a facility.
3    "Licensee" means the person, persons, firm, partnership,
4association, organization, company, corporation, or business
5trust to which a license has been issued.
6    "Misappropriation of a consumer's property" means the
7deliberate misplacement, exploitation, or wrongful temporary
8or permanent use of a consumer's belongings or money without
9the consent of a consumer or his or her guardian.
10    "Neglect" means a facility's failure to provide, or
11willful withholding of, adequate medical care, mental health
12treatment, psychiatric rehabilitation, personal care, or
13assistance that is necessary to avoid physical harm and mental
14anguish of a consumer.
15    "Personal care" means assistance with meals, dressing,
16movement, bathing, or other personal needs, maintenance, or
17general supervision and oversight of the physical and mental
18well-being of an individual who is incapable of maintaining a
19private, independent residence or who is incapable of managing
20his or her person, whether or not a guardian has been appointed
21for such individual. "Personal care" shall not be construed to
22confine or otherwise constrain a facility's pursuit to develop
23the skills and abilities of a consumer to become
24self-sufficient and capable of increasing levels of
25independent functioning.
26    "Recovery and rehabilitation supports" means a program



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1that facilitates a consumer's longer-term symptom management
2and stabilization while preparing the consumer for
3transitional living units by improving living skills and
4community socialization. The duration of stay in such a
5setting shall be established by the Department by rule.
6    "Restraint" means:
7        (i) a physical restraint that is any manual method or
8    physical or mechanical device, material, or equipment
9    attached or adjacent to a consumer's body that the
10    consumer cannot remove easily and restricts freedom of
11    movement or normal access to one's body; devices used for
12    positioning, including, but not limited to, bed rails,
13    gait belts, and cushions, shall not be considered to be
14    restraints for purposes of this Section; or
15        (ii) a chemical restraint that is any drug used for
16    discipline or convenience and not required to treat
17    medical symptoms; the Department shall, by rule, designate
18    certain devices as restraints, including at least all
19    those devices that have been determined to be restraints
20    by the United States Department of Health and Human
21    Services in interpretive guidelines issued for the
22    purposes of administering Titles XVIII and XIX of the
23    federal Social Security Act. For the purposes of this Act,
24    restraint shall be administered only after utilizing a
25    coercive free environment and culture.
26    "Self-administration of medication" means consumers shall



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1be responsible for the control, management, and use of their
2own medication.
3    "Crisis stabilization" means a secure and separate unit
4that provides short-term behavioral, emotional, or psychiatric
5crisis stabilization as an alternative to hospitalization or
6re-hospitalization for consumers from residential or community
7placement. The duration of stay in such a setting shall not
8exceed 21 days for each consumer.
9    "Therapeutic separation" means the removal of a consumer
10from the milieu to a room or area which is designed to aid in
11the emotional or psychiatric stabilization of that consumer.
12    "Triage center" means a non-residential 23-hour center
13that serves as an alternative to emergency room care,
14hospitalization, or re-hospitalization for consumers in need
15of short-term crisis stabilization. Consumers may access a
16triage center from a number of referral sources, including
17family, emergency rooms, hospitals, community behavioral
18health providers, federally qualified health providers, or
19schools, including colleges or universities. A triage center
20may be located in a building separate from the licensed
21location of a facility, but shall not be more than 1,000 feet
22from the licensed location of the facility and must meet all of
23the facility standards applicable to the licensed location. If
24the triage center does operate in a separate building, safety
25personnel shall be provided, on site, 24 hours per day and the
26triage center shall meet all other staffing requirements



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1without counting any staff employed in the main facility
3(Source: P.A. 102-1053, eff. 6-10-22; revised 8-24-22.)
4    Section 20. The Hospital Licensing Act is amended by
5changing Section 3 as follows:
6    (210 ILCS 85/3)
7    Sec. 3. As used in this Act:
8    (A) "Hospital" means any institution, place, building,
9buildings on a campus, or agency, public or private, whether
10organized for profit or not, devoted primarily to the
11maintenance and operation of facilities for the diagnosis and
12treatment or care of 2 or more unrelated persons admitted for
13overnight stay or longer in order to obtain medical, including
14obstetric, psychiatric and nursing, care of illness, disease,
15injury, infirmity, or deformity.
16    The term "hospital", without regard to length of stay,
17shall also include:
18        (a) any facility which is devoted primarily to
19    providing psychiatric and related services and programs
20    for the diagnosis and treatment or care of 2 or more
21    unrelated persons suffering from emotional or nervous
22    diseases;
23        (b) all places where pregnant females are received,
24    cared for, or treated during delivery irrespective of the



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1    number of patients received; and .
2        (c) on and after January 1, 2023, a rural emergency
3    hospital, as that term is defined under subsection
4    (kkk)(2) of Section 1861 of the federal Social Security
5    Act; to provide for the expeditious and timely
6    implementation of this amendatory Act of the 102nd General
7    Assembly, emergency rules to implement the changes made to
8    the definition of "hospital" by this amendatory Act of the
9    102nd General Assembly may be adopted by the Department
10    subject to the provisions of Section 5-45 of the Illinois
11    Administrative Procedure Act.
12    The term "hospital" includes general and specialized
13hospitals, tuberculosis sanitaria, mental or psychiatric
14hospitals and sanitaria, and includes maternity homes,
15lying-in homes, and homes for unwed mothers in which care is
16given during delivery.
17    The term "hospital" does not include:
18        (1) any person or institution required to be licensed
19    pursuant to the Nursing Home Care Act, the Specialized
20    Mental Health Rehabilitation Act of 2013, the ID/DD
21    Community Care Act, or the MC/DD Act;
22        (2) hospitalization or care facilities maintained by
23    the State or any department or agency thereof, where such
24    department or agency has authority under law to establish
25    and enforce standards for the hospitalization or care
26    facilities under its management and control;



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1        (3) hospitalization or care facilities maintained by
2    the federal government or agencies thereof;
3        (4) hospitalization or care facilities maintained by
4    any university or college established under the laws of
5    this State and supported principally by public funds
6    raised by taxation;
7        (5) any person or facility required to be licensed
8    pursuant to the Substance Use Disorder Act;
9        (6) any facility operated solely by and for persons
10    who rely exclusively upon treatment by spiritual means
11    through prayer, in accordance with the creed or tenets of
12    any well-recognized church or religious denomination;
13        (7) an Alzheimer's disease management center
14    alternative health care model licensed under the
15    Alternative Health Care Delivery Act; or
16        (8) any veterinary hospital or clinic operated by a
17    veterinarian or veterinarians licensed under the
18    Veterinary Medicine and Surgery Practice Act of 2004 or
19    maintained by a State-supported or publicly funded
20    university or college.
21    (B) "Person" means the State, and any political
22subdivision or municipal corporation, individual, firm,
23partnership, corporation, company, association, or joint stock
24association, or the legal successor thereof.
25    (C) "Department" means the Department of Public Health of
26the State of Illinois.



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1    (D) "Director" means the Director of Public Health of the
2State of Illinois.
3    (E) "Perinatal" means the period of time between the
4conception of an infant and the end of the first month after
6    (F) "Federally designated organ procurement agency" means
7the organ procurement agency designated by the Secretary of
8the U.S. Department of Health and Human Services for the
9service area in which a hospital is located; except that in the
10case of a hospital located in a county adjacent to Wisconsin
11which currently contracts with an organ procurement agency
12located in Wisconsin that is not the organ procurement agency
13designated by the U.S. Secretary of Health and Human Services
14for the service area in which the hospital is located, if the
15hospital applies for a waiver pursuant to 42 U.S.C. USC
161320b-8(a), it may designate an organ procurement agency
17located in Wisconsin to be thereafter deemed its federally
18designated organ procurement agency for the purposes of this
20    (G) "Tissue bank" means any facility or program operating
21in Illinois that is certified by the American Association of
22Tissue Banks or the Eye Bank Association of America and is
23involved in procuring, furnishing, donating, or distributing
24corneas, bones, or other human tissue for the purpose of
25injecting, transfusing, or transplanting any of them into the
26human body. "Tissue bank" does not include a licensed blood



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1bank. For the purposes of this Act, "tissue" does not include
3    (H) "Campus", as this term terms applies to operations,
4has the same meaning as the term "campus" as set forth in
5federal Medicare regulations, 42 CFR 413.65.
6(Source: P.A. 99-180, eff. 7-29-15; 100-759, eff. 1-1-19.)
7    Section 25. The Behavior Analyst Licensing Act is amended
8by changing Sections 30, 35, and 150 as follows:
9    (225 ILCS 6/30)
10    (Section scheduled to be repealed on January 1, 2028)
11    Sec. 30. Qualifications for behavior analyst license.
12    (a) A person qualifies to be licensed as a behavior
13analyst if that person:
14        (1) has applied in writing or electronically on forms
15    prescribed by the Department;
16        (2) is a graduate of a graduate level program in the
17    field of behavior analysis or a related field with an
18    equivalent course of study in behavior analysis approved
19    by the Department from a regionally accredited university
20    approved by the Department;
21        (3) has completed at least 500 hours of supervision of
22    behavior analysis, as defined by rule;
23        (4) has qualified for and passed the examination for
24    the practice of behavior analysis as authorized by the



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1    Department; and
2        (5) has paid the required fees.
3    (b) The Department may issue a license to a certified
4behavior analyst seeking licensure as a licensed behavior
5analyst who (i) does not have the supervised experience as
6described in paragraph (3) of subsection (a), (ii) applies for
7licensure before July 1, 2028, and (iii) has completed all of
8the following:
9        (1) has applied in writing or electronically on forms
10    prescribed by the Department;
11        (2) is a graduate of a graduate level program in the
12    field of behavior analysis from a regionally accredited
13    university approved by the Department;
14        (3) submits evidence of certification by an
15    appropriate national certifying body as determined by rule
16    of the Department;
17        (4) has passed the examination for the practice of
18    behavior analysis as authorized by the Department; and
19        (5) has paid the required fees.
20    (c) An applicant has 3 years after the date of application
21to complete the application process. If the process has not
22been completed in 3 years, the application shall be denied,
23the fee shall be forfeited, and the applicant must reapply and
24meet the requirements in effect at the time of reapplication.
25    (d) Each applicant for licensure as a an behavior analyst
26shall have his or her fingerprints submitted to the Illinois



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1State Police in an electronic format that complies with the
2form and manner for requesting and furnishing criminal history
3record information as prescribed by the Illinois State Police.
4These fingerprints shall be transmitted through a live scan
5fingerprint vendor licensed by the Department. These
6fingerprints shall be checked against the Illinois State
7Police and Federal Bureau of Investigation criminal history
8record databases now and hereafter filed, including, but not
9limited to, civil, criminal, and latent fingerprint databases.
10The Illinois State Police shall charge a fee for conducting
11the criminal history records check, which shall be deposited
12in the State Police Services Fund and shall not exceed the
13actual cost of the records check. The Illinois State Police
14shall furnish, pursuant to positive identification, records of
15Illinois convictions as prescribed under the Illinois Uniform
16Conviction Information Act and shall forward the national
17criminal history record information to the Department.
18(Source: P.A. 102-953, eff. 5-27-22; revised 8-19-22.)
19    (225 ILCS 6/35)
20    (Section scheduled to be repealed on January 1, 2028)
21    Sec. 35. Qualifications for assistant behavior analyst
23    (a) A person qualifies to be licensed as an assistant
24behavior analyst if that person:
25        (1) has applied in writing or electronically on forms



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1    prescribed by the Department;
2        (2) is a graduate of a bachelor's level program in the
3    field of behavior analysis or a related field with an
4    equivalent course of study in behavior analysis approved
5    by the Department from a regionally accredited university
6    approved by the Department;
7        (3) has met the supervised work experience;
8        (4) has qualified for and passed the examination for
9    the practice of behavior analysis as a licensed assistant
10    behavior analyst as authorized by the Department; and
11        (5) has paid the required fees.
12    (b) The Department may issue a license to a certified
13assistant behavior analyst seeking licensure as a licensed
14assistant behavior analyst who (i) does not have the
15supervised experience as described in paragraph (3) of
16subsection (a), (ii) applies for licensure before July 1,
172028, and (iii) has completed all of the following:
18        (1) has applied in writing or electronically on forms
19    prescribed by the Department;
20        (2) is a graduate of a bachelor's bachelors level
21    program in the field of behavior analysis;
22        (3) submits evidence of certification by an
23    appropriate national certifying body as determined by rule
24    of the Department;
25        (4) has passed the examination for the practice of
26    behavior analysis as authorized by the Department; and



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1        (5) has paid the required fees.
2    (c) An applicant has 3 years after the date of application
3to complete the application process. If the process has not
4been completed in 3 years, the application shall be denied,
5the fee shall be forfeited, and the applicant must reapply and
6meet the requirements in effect at the time of reapplication.
7    (d) Each applicant for licensure as an assistant behavior
8analyst shall have his or her fingerprints submitted to the
9Illinois State Police in an electronic format that complies
10with the form and manner for requesting and furnishing
11criminal history record information as prescribed by the
12Illinois State Police. These fingerprints shall be transmitted
13through a live scan fingerprint vendor licensed by the
14Department. These fingerprints shall be checked against the
15Illinois State Police and Federal Bureau of Investigation
16criminal history record databases now and hereafter filed,
17including, but not limited to, civil, criminal, and latent
18fingerprint databases. The Illinois State Police shall charge
19a fee for conducting the criminal history records check, which
20shall be deposited in the State Police Services Fund and shall
21not exceed the actual cost of the records check. The Illinois
22State Police shall furnish, pursuant to positive
23identification, records of Illinois convictions as prescribed
24under the Illinois Uniform Conviction Information Act and
25shall forward the national criminal history record information
26to the Department.



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1(Source: P.A. 102-953, eff. 5-27-22; revised 8-19-22.)
2    (225 ILCS 6/150)
3    (Section scheduled to be repealed on January 1, 2028)
4    Sec. 150. License restrictions and limitations.
5Notwithstanding the exclusion in paragraph (2) of subsection
6(c) of Section 20 that permits an individual to implement a
7behavior analytic treatment plan under the extended authority,
8direction, and supervision of a licensed behavior analyst or
9licensed assistant behavior analyst, no No business
10organization shall provide, attempt to provide, or offer to
11provide behavior analysis services unless every member,
12partner, shareholder, director, officer, holder of any other
13ownership interest, agent, and employee who renders applied
14behavior analysis services holds a currently valid license
15issued under this Act. No business shall be created that (i)
16has a stated purpose that includes behavior analysis, or (ii)
17practices or holds itself out as available to practice
18behavior analysis therapy, unless it is organized under the
19Professional Service Corporation Act or Professional Limited
20Liability Company Act. Nothing in this Act shall preclude
21individuals licensed under this Act from practicing directly
22or indirectly for a physician licensed to practice medicine in
23all its branches under the Medical Practice Act of 1987 or for
24any legal entity as provided under subsection (c) of Section
2522.2 of the Medical Practice Act of 1987.



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1(Source: P.A. 102-953, eff. 5-27-22.)
2    Section 30. The Podiatric Medical Practice Act of 1987 is
3amended by adding Section 18.1 as follows:
4    (225 ILCS 100/18.1 new)
5    Sec. 18.1. Fee waivers. Notwithstanding any provision of
6law to the contrary, during State Fiscal Year 2023, the
7Department shall allow individuals a one-time waiver of fees
8imposed under Section 18 of this Act. No individual may
9benefit from such a waiver more than once. If an individual has
10already paid a fee required under Section 18 for Fiscal Year
112023, then the Department shall apply the money paid for that
12fee as a credit to the next required fee.
13    Section 35. The Illinois Public Aid Code is amended by
14changing Sections 5-5.2, 5-5.7b, and 5B-2 follows:
15    (305 ILCS 5/5-5.2)  (from Ch. 23, par. 5-5.2)
16    Sec. 5-5.2. Payment.
17    (a) All nursing facilities that are grouped pursuant to
18Section 5-5.1 of this Act shall receive the same rate of
19payment for similar services.
20    (b) It shall be a matter of State policy that the Illinois
21Department shall utilize a uniform billing cycle throughout
22the State for the long-term care providers.



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1    (c) (Blank).
2    (c-1) Notwithstanding any other provisions of this Code,
3the methodologies for reimbursement of nursing services as
4provided under this Article shall no longer be applicable for
5bills payable for nursing services rendered on or after a new
6reimbursement system based on the Patient Driven Payment Model
7(PDPM) has been fully operationalized, which shall take effect
8for services provided on or after the implementation of the
9PDPM reimbursement system begins. For the purposes of this
10amendatory Act of the 102nd General Assembly, the
11implementation date of the PDPM reimbursement system and all
12related provisions shall be July 1, 2022 if the following
13conditions are met: (i) the Centers for Medicare and Medicaid
14Services has approved corresponding changes in the
15reimbursement system and bed assessment; and (ii) the
16Department has filed rules to implement these changes no later
17than June 1, 2022. Failure of the Department to file rules to
18implement the changes provided in this amendatory Act of the
19102nd General Assembly no later than June 1, 2022 shall result
20in the implementation date being delayed to October 1, 2022.
21    (d) The new nursing services reimbursement methodology
22utilizing the Patient Driven Payment Model, which shall be
23referred to as the PDPM reimbursement system, taking effect
24July 1, 2022, upon federal approval by the Centers for
25Medicare and Medicaid Services, shall be based on the



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1        (1) The methodology shall be resident-centered,
2    facility-specific, cost-based, and based on guidance from
3    the Centers for Medicare and Medicaid Services.
4        (2) Costs shall be annually rebased and case mix index
5    quarterly updated. The nursing services methodology will
6    be assigned to the Medicaid enrolled residents on record
7    as of 30 days prior to the beginning of the rate period in
8    the Department's Medicaid Management Information System
9    (MMIS) as present on the last day of the second quarter
10    preceding the rate period based upon the Assessment
11    Reference Date of the Minimum Data Set (MDS).
12        (3) Regional wage adjustors based on the Health
13    Service Areas (HSA) groupings and adjusters in effect on
14    April 30, 2012 shall be included, except no adjuster shall
15    be lower than 1.06.
16        (4) PDPM nursing case mix indices in effect on March
17    1, 2022 shall be assigned to each resident class at no less
18    than 0.7858 of the Centers for Medicare and Medicaid
19    Services PDPM unadjusted case mix values, in effect on
20    March 1, 2022, utilizing an index maximization approach.
21        (5) The pool of funds available for distribution by
22    case mix and the base facility rate shall be determined
23    using the formula contained in subsection (d-1).
24        (6) The Department shall establish a variable per diem
25    staffing add-on in accordance with the most recent
26    available federal staffing report, currently the Payroll



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1    Based Journal, for the same period of time, and if
2    applicable adjusted for acuity using the same quarter's
3    MDS. The Department shall rely on Payroll Based Journals
4    provided to the Department of Public Health to make a
5    determination of non-submission. If the Department is
6    notified by a facility of missing or inaccurate Payroll
7    Based Journal data or an incorrect calculation of
8    staffing, the Department must make a correction as soon as
9    the error is verified for the applicable quarter.
10        Facilities with at least 70% of the staffing indicated
11    by the STRIVE study shall be paid a per diem add-on of $9,
12    increasing by equivalent steps for each whole percentage
13    point until the facilities reach a per diem of $14.88.
14    Facilities with at least 80% of the staffing indicated by
15    the STRIVE study shall be paid a per diem add-on of $14.88,
16    increasing by equivalent steps for each whole percentage
17    point until the facilities reach a per diem add-on of
18    $23.80. Facilities with at least 92% of the staffing
19    indicated by the STRIVE study shall be paid a per diem
20    add-on of $23.80, increasing by equivalent steps for each
21    whole percentage point until the facilities reach a per
22    diem add-on of $29.75. Facilities with at least 100% of
23    the staffing indicated by the STRIVE study shall be paid a
24    per diem add-on of $29.75, increasing by equivalent steps
25    for each whole percentage point until the facilities reach
26    a per diem add-on of $35.70. Facilities with at least 110%



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1    of the staffing indicated by the STRIVE study shall be
2    paid a per diem add-on of $35.70, increasing by equivalent
3    steps for each whole percentage point until the facilities
4    reach a per diem add-on of $38.68. Facilities with at
5    least 125% or higher of the staffing indicated by the
6    STRIVE study shall be paid a per diem add-on of $38.68.
7    Beginning April 1, 2023, no nursing facility's variable
8    staffing per diem add-on shall be reduced by more than 5%
9    in 2 consecutive quarters. For the quarters beginning July
10    1, 2022 and October 1, 2022, no facility's variable per
11    diem staffing add-on shall be calculated at a rate lower
12    than 85% of the staffing indicated by the STRIVE study. No
13    facility below 70% of the staffing indicated by the STRIVE
14    study shall receive a variable per diem staffing add-on
15    after December 31, 2022.
16        (7) For dates of services beginning July 1, 2022, the
17    PDPM nursing component per diem for each nursing facility
18    shall be the product of the facility's (i) statewide PDPM
19    nursing base per diem rate, $92.25, adjusted for the
20    facility average PDPM case mix index calculated quarterly
21    and (ii) the regional wage adjuster, and then add the
22    Medicaid access adjustment as defined in (e-3) of this
23    Section. Transition rates for services provided between
24    July 1, 2022 and October 1, 2023 shall be the greater of
25    the PDPM nursing component per diem or:
26            (A) for the quarter beginning July 1, 2022, the



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1        RUG-IV nursing component per diem;
2            (B) for the quarter beginning October 1, 2022, the
3        sum of the RUG-IV nursing component per diem
4        multiplied by 0.80 and the PDPM nursing component per
5        diem multiplied by 0.20;
6            (C) for the quarter beginning January 1, 2023, the
7        sum of the RUG-IV nursing component per diem
8        multiplied by 0.60 and the PDPM nursing component per
9        diem multiplied by 0.40;
10            (D) for the quarter beginning April 1, 2023, the
11        sum of the RUG-IV nursing component per diem
12        multiplied by 0.40 and the PDPM nursing component per
13        diem multiplied by 0.60;
14            (E) for the quarter beginning July 1, 2023, the
15        sum of the RUG-IV nursing component per diem
16        multiplied by 0.20 and the PDPM nursing component per
17        diem multiplied by 0.80; or
18            (F) for the quarter beginning October 1, 2023 and
19        each subsequent quarter, the transition rate shall end
20        and a nursing facility shall be paid 100% of the PDPM
21        nursing component per diem.
22    (d-1) Calculation of base year Statewide RUG-IV nursing
23base per diem rate.
24        (1) Base rate spending pool shall be:
25            (A) The base year resident days which are
26        calculated by multiplying the number of Medicaid



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1        residents in each nursing home as indicated in the MDS
2        data defined in paragraph (4) by 365.
3            (B) Each facility's nursing component per diem in
4        effect on July 1, 2012 shall be multiplied by
5        subsection (A).
6            (C) Thirteen million is added to the product of
7        subparagraph (A) and subparagraph (B) to adjust for
8        the exclusion of nursing homes defined in paragraph
9        (5).
10        (2) For each nursing home with Medicaid residents as
11    indicated by the MDS data defined in paragraph (4),
12    weighted days adjusted for case mix and regional wage
13    adjustment shall be calculated. For each home this
14    calculation is the product of:
15            (A) Base year resident days as calculated in
16        subparagraph (A) of paragraph (1).
17            (B) The nursing home's regional wage adjustor
18        based on the Health Service Areas (HSA) groupings and
19        adjustors in effect on April 30, 2012.
20            (C) Facility weighted case mix which is the number
21        of Medicaid residents as indicated by the MDS data
22        defined in paragraph (4) multiplied by the associated
23        case weight for the RUG-IV 48 grouper model using
24        standard RUG-IV procedures for index maximization.
25            (D) The sum of the products calculated for each
26        nursing home in subparagraphs (A) through (C) above



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1        shall be the base year case mix, rate adjusted
2        weighted days.
3        (3) The Statewide RUG-IV nursing base per diem rate:
4            (A) on January 1, 2014 shall be the quotient of the
5        paragraph (1) divided by the sum calculated under
6        subparagraph (D) of paragraph (2);
7            (B) on and after July 1, 2014 and until July 1,
8        2022, shall be the amount calculated under
9        subparagraph (A) of this paragraph (3) plus $1.76; and
10            (C) beginning July 1, 2022 and thereafter, $7
11        shall be added to the amount calculated under
12        subparagraph (B) of this paragraph (3) of this
13        Section.
14        (4) Minimum Data Set (MDS) comprehensive assessments
15    for Medicaid residents on the last day of the quarter used
16    to establish the base rate.
17        (5) Nursing facilities designated as of July 1, 2012
18    by the Department as "Institutions for Mental Disease"
19    shall be excluded from all calculations under this
20    subsection. The data from these facilities shall not be
21    used in the computations described in paragraphs (1)
22    through (4) above to establish the base rate.
23    (e) Beginning July 1, 2014, the Department shall allocate
24funding in the amount up to $10,000,000 for per diem add-ons to
25the RUGS methodology for dates of service on and after July 1,



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1        (1) $0.63 for each resident who scores in I4200
2    Alzheimer's Disease or I4800 non-Alzheimer's Dementia.
3        (2) $2.67 for each resident who scores either a "1" or
4    "2" in any items S1200A through S1200I and also scores in
5    RUG groups PA1, PA2, BA1, or BA2.
6    (e-1) (Blank).
7    (e-2) For dates of services beginning January 1, 2014 and
8ending September 30, 2023, the RUG-IV nursing component per
9diem for a nursing home shall be the product of the statewide
10RUG-IV nursing base per diem rate, the facility average case
11mix index, and the regional wage adjustor. For dates of
12service beginning July 1, 2022 and ending September 30, 2023,
13the Medicaid access adjustment described in subsection (e-3)
14shall be added to the product.
15    (e-3) A Medicaid Access Adjustment of $4 adjusted for the
16facility average PDPM case mix index calculated quarterly
17shall be added to the statewide PDPM nursing per diem for all
18facilities with annual Medicaid bed days of at least 70% of all
19occupied bed days adjusted quarterly. For each new calendar
20year and for the 6-month period beginning July 1, 2022, the
21percentage of a facility's occupied bed days comprised of
22Medicaid bed days shall be determined by the Department
23quarterly. For dates of service beginning January 1, 2023, the
24Medicaid Access Adjustment shall be increased to $4.75. This
25subsection shall be inoperative on and after January 1, 2028.
26    (f) (Blank).



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1    (g) Notwithstanding any other provision of this Code, on
2and after July 1, 2012, for facilities not designated by the
3Department of Healthcare and Family Services as "Institutions
4for Mental Disease", rates effective May 1, 2011 shall be
5adjusted as follows:
6        (1) (Blank);
7        (2) (Blank);
8        (3) Facility rates for the capital and support
9    components shall be reduced by 1.7%.
10    (h) Notwithstanding any other provision of this Code, on
11and after July 1, 2012, nursing facilities designated by the
12Department of Healthcare and Family Services as "Institutions
13for Mental Disease" and "Institutions for Mental Disease" that
14are facilities licensed under the Specialized Mental Health
15Rehabilitation Act of 2013 shall have the nursing,
16socio-developmental, capital, and support components of their
17reimbursement rate effective May 1, 2011 reduced in total by
19    (i) On and after July 1, 2014, the reimbursement rates for
20the support component of the nursing facility rate for
21facilities licensed under the Nursing Home Care Act as skilled
22or intermediate care facilities shall be the rate in effect on
23June 30, 2014 increased by 8.17%.
24    (j) Notwithstanding any other provision of law, subject to
25federal approval, effective July 1, 2019, sufficient funds
26shall be allocated for changes to rates for facilities



10200HB0240sam001- 39 -LRB102 05098 KTG 42451 a

1licensed under the Nursing Home Care Act as skilled nursing
2facilities or intermediate care facilities for dates of
3services on and after July 1, 2019: (i) to establish, through
4June 30, 2022 a per diem add-on to the direct care per diem
5rate not to exceed $70,000,000 annually in the aggregate
6taking into account federal matching funds for the purpose of
7addressing the facility's unique staffing needs, adjusted
8quarterly and distributed by a weighted formula based on
9Medicaid bed days on the last day of the second quarter
10preceding the quarter for which the rate is being adjusted.
11Beginning July 1, 2022, the annual $70,000,000 described in
12the preceding sentence shall be dedicated to the variable per
13diem add-on for staffing under paragraph (6) of subsection
14(d); and (ii) in an amount not to exceed $170,000,000 annually
15in the aggregate taking into account federal matching funds to
16permit the support component of the nursing facility rate to
17be updated as follows:
18        (1) 80%, or $136,000,000, of the funds shall be used
19    to update each facility's rate in effect on June 30, 2019
20    using the most recent cost reports on file, which have had
21    a limited review conducted by the Department of Healthcare
22    and Family Services and will not hold up enacting the rate
23    increase, with the Department of Healthcare and Family
24    Services.
25        (2) After completing the calculation in paragraph (1),
26    any facility whose rate is less than the rate in effect on



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1    June 30, 2019 shall have its rate restored to the rate in
2    effect on June 30, 2019 from the 20% of the funds set
3    aside.
4        (3) The remainder of the 20%, or $34,000,000, shall be
5    used to increase each facility's rate by an equal
6    percentage.
7    (k) During the first quarter of State Fiscal Year 2020,
8the Department of Healthcare of Family Services must convene a
9technical advisory group consisting of members of all trade
10associations representing Illinois skilled nursing providers
11to discuss changes necessary with federal implementation of
12Medicare's Patient-Driven Payment Model. Implementation of
13Medicare's Patient-Driven Payment Model shall, by September 1,
142020, end the collection of the MDS data that is necessary to
15maintain the current RUG-IV Medicaid payment methodology. The
16technical advisory group must consider a revised reimbursement
17methodology that takes into account transparency,
18accountability, actual staffing as reported under the
19federally required Payroll Based Journal system, changes to
20the minimum wage, adequacy in coverage of the cost of care, and
21a quality component that rewards quality improvements.
22    (l) The Department shall establish per diem add-on
23payments to improve the quality of care delivered by
24facilities, including:
25        (1) Incentive payments determined by facility
26    performance on specified quality measures in an initial



10200HB0240sam001- 41 -LRB102 05098 KTG 42451 a

1    amount of $70,000,000. Nothing in this subsection shall be
2    construed to limit the quality of care payments in the
3    aggregate statewide to $70,000,000, and, if quality of
4    care has improved across nursing facilities, the
5    Department shall adjust those add-on payments accordingly.
6    The quality payment methodology described in this
7    subsection must be used for at least State Fiscal Year
8    2023. Beginning with the quarter starting July 1, 2023,
9    the Department may add, remove, or change quality metrics
10    and make associated changes to the quality payment
11    methodology as outlined in subparagraph (E). Facilities
12    designated by the Centers for Medicare and Medicaid
13    Services as a special focus facility or a hospital-based
14    nursing home do not qualify for quality payments.
15            (A) Each quality pool must be distributed by
16        assigning a quality weighted score for each nursing
17        home which is calculated by multiplying the nursing
18        home's quality base period Medicaid days by the
19        nursing home's star rating weight in that period.
20            (B) Star rating weights are assigned based on the
21        nursing home's star rating for the LTS quality star
22        rating. As used in this subparagraph, "LTS quality
23        star rating" means the long-term stay quality rating
24        for each nursing facility, as assigned by the Centers
25        for Medicare and Medicaid Services under the Five-Star
26        Quality Rating System. The rating is a number ranging



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1        from 0 (lowest) to 5 (highest).
2                (i) Zero-star or one-star rating has a weight
3            of 0.
4                (ii) Two-star rating has a weight of 0.75.
5                (iii) Three-star rating has a weight of 1.5.
6                (iv) Four-star rating has a weight of 2.5.
7                (v) Five-star rating has a weight of 3.5.
8            (C) Each nursing home's quality weight score is
9        divided by the sum of all quality weight scores for
10        qualifying nursing homes to determine the proportion
11        of the quality pool to be paid to the nursing home.
12            (D) The quality pool is no less than $70,000,000
13        annually or $17,500,000 per quarter. The Department
14        shall publish on its website the estimated payments
15        and the associated weights for each facility 45 days
16        prior to when the initial payments for the quarter are
17        to be paid. The Department shall assign each facility
18        the most recent and applicable quarter's STAR value
19        unless the facility notifies the Department within 15
20        days of an issue and the facility provides reasonable
21        evidence demonstrating its timely compliance with
22        federal data submission requirements for the quarter
23        of record. If such evidence cannot be provided to the
24        Department, the STAR rating assigned to the facility
25        shall be reduced by one from the prior quarter.
26            (E) The Department shall review quality metrics



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1        used for payment of the quality pool and make
2        recommendations for any associated changes to the
3        methodology for distributing quality pool payments in
4        consultation with associations representing long-term
5        care providers, consumer advocates, organizations
6        representing workers of long-term care facilities, and
7        payors. The Department may establish, by rule, changes
8        to the methodology for distributing quality pool
9        payments.
10            (F) The Department shall disburse quality pool
11        payments from the Long-Term Care Provider Fund on a
12        monthly basis in amounts proportional to the total
13        quality pool payment determined for the quarter.
14            (G) The Department shall publish any changes in
15        the methodology for distributing quality pool payments
16        prior to the beginning of the measurement period or
17        quality base period for any metric added to the
18        distribution's methodology.
19        (2) Payments based on CNA tenure, promotion, and CNA
20    training for the purpose of increasing CNA compensation.
21    It is the intent of this subsection that payments made in
22    accordance with this paragraph be directly incorporated
23    into increased compensation for CNAs. As used in this
24    paragraph, "CNA" means a certified nursing assistant as
25    that term is described in Section 3-206 of the Nursing
26    Home Care Act, Section 3-206 of the ID/DD Community Care



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1    Act, and Section 3-206 of the MC/DD Act. The Department
2    shall establish, by rule, payments to nursing facilities
3    equal to Medicaid's share of the tenure wage increments
4    specified in this paragraph for all reported CNA employee
5    hours compensated according to a posted schedule
6    consisting of increments at least as large as those
7    specified in this paragraph. The increments are as
8    follows: an additional $1.50 per hour for CNAs with at
9    least one and less than 2 years' experience plus another
10    $1 per hour for each additional year of experience up to a
11    maximum of $6.50 for CNAs with at least 6 years of
12    experience. For purposes of this paragraph, Medicaid's
13    share shall be the ratio determined by paid Medicaid bed
14    days divided by total bed days for the applicable time
15    period used in the calculation. In addition, and additive
16    to any tenure increments paid as specified in this
17    paragraph, the Department shall establish, by rule,
18    payments supporting Medicaid's share of the
19    promotion-based wage increments for CNA employee hours
20    compensated for that promotion with at least a $1.50
21    hourly increase. Medicaid's share shall be established as
22    it is for the tenure increments described in this
23    paragraph. Qualifying promotions shall be defined by the
24    Department in rules for an expected 10-15% subset of CNAs
25    assigned intermediate, specialized, or added roles such as
26    CNA trainers, CNA scheduling "captains", and CNA



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1    specialists for resident conditions like dementia or
2    memory care or behavioral health.
3    (m) The Department shall work with nursing facility
4industry representatives to design policies and procedures to
5permit facilities to address the integrity of data from
6federal reporting sites used by the Department in setting
7facility rates.
8(Source: P.A. 101-10, eff. 6-5-19; 101-348, eff. 8-9-19;
9102-77, eff. 7-9-21; 102-558, eff. 8-20-21; 102-1035, eff.
11    (305 ILCS 5/5-5.7b)
12    Sec. 5-5.7b. Pandemic related stability payments to
13ambulance service providers in response to COVID-19.
14    (a) Definitions. As used in this Section:
15    "Ambulance Services Industry" means the industry that is
16comprised of "Qualifying Ground Ambulance Service Providers",
17as defined in this Section.
18    "Qualifying Ground Ambulance Service Provider" means a
19"vehicle service provider," as that term is defined in Section
203.85 of the Emergency Medical Services (EMS) Systems Act,
21which operates licensed ambulances for the purpose of
22providing emergency, non-emergency ambulance services, or both
23emergency and non-emergency ambulance services. The term
24"Qualifying Ground Ambulance Service Provider" is limited to
25ambulance and EMS agencies that are privately held and



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1nonprofit organizations headquartered within the State and
2licensed by the Department of Public Health as of March 12,
4    "Eligible worker" means a staff member of a Qualifying
5Ground Ambulance Service Provider engaged in "essential work",
6as defined by Section 9901 of the ARPA and related federal
7guidance, and (1) whose total pay is below 150% of the average
8annual wage for all occupations in the worker's county of
9residence, as defined by the BLS Occupational Employment and
10Wage Statistics or (2) is not exempt from the federal Fair
11Labor Standards Act overtime provisions.
12    (b) Purpose. The Department may receive federal funds
13under the authority of legislation passed in response to the
14Coronavirus epidemic, including, but not limited to, the
15American Rescue Plan Act of 2021, P.L. 117-2 (the "ARPA").
16Upon receipt or availability of such State or federal funds,
17and subject to appropriations for their use, the Department
18shall establish and administer programs for purposes allowable
19under Section 9901 of the ARPA to provide financial assistance
20to Qualifying Ground Ambulance Service Providers for premium
21pay for eligible workers, to provide reimbursement for
22eligible expenditures, and to provide support following the
23negative economic impact of the COVID-19 public health
24emergency on the Ambulance Services Industry. Financial
25assistance may include, but is not limited to, grants, expense
26reimbursements, or subsidies.



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1    (b-1) By December 31, 2022, the Department shall obtain
2appropriate documentation from Qualifying Ground Ambulance
3Service Providers to ascertain an accurate count of the number
4of licensed vehicles available to serve enrollees in the
5State's medical assistance programs, which shall be known as
6the "total eligible vehicles". By February 28, 2023,
7Qualifying Ground Ambulance Service Providers shall be
8initially notified of their eligible award, which shall be the
9product of (i) the total amount of funds allocated under this
10Section and (ii) a quotient, the numerator of which is the
11number of licensed ground ambulance vehicles of an individual
12Qualifying Ground Ambulance Service Provider and the
13denominator of which is the total eligible vehicles. After
14March 31, 2024, any unobligated funds shall be reallocated pro
15rata to the remaining Qualifying Ground Ambulance Service
16Providers that are able to prove up eligible expenses in
17excess of their initial award amount until all such
18appropriated funds are exhausted.
19    Providers shall indicate to the Department what portion of
20their award they wish to allocate under the purposes outlined
21under paragraphs (d), (e), or (f), if applicable, of this
23    (c) Non-Emergency Service Certification. To be eligible
24for funding under this Section, a Qualifying Ground Ambulance
25Service Provider that provides non-emergency services to
26institutional residents must certify whether or not it is able



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1to that it will provide non-emergency ambulance services to
2individuals enrolled in the State's Medical Assistance Program
3and residing in non-institutional settings for at least one
4year following the receipt of funding pursuant to this
5amendatory Act of the 102nd General Assembly. Certification
6indicating that a provider has such an ability does not mean
7that a provider is required to accept any or all requested
8transports. The provider shall maintain the certification in
9its records. The provider shall also maintain documentation of
10all non-emergency ambulance services for the period covered by
11the certification. The provider shall produce the
12certification and supporting documentation upon demand by the
13Department or its representative. Failure to comply shall
14result in recovery of any payments made by the Department.
15    (d) Premium Pay Initiative. Subject to paragraph (c) of
16this Section, the Department shall establish a Premium Pay
17Initiative to distribute awards to each Qualifying Ground
18Ambulance Service Provider for the purpose of providing
19premium pay to eligible workers.
20        (1) Financial assistance pursuant to this paragraph
21    (d) shall be scaled based on a process determined by the
22    Department. The amount awarded to each Qualifying Ground
23    Ambulance Service Provider shall be up to $13 per hour for
24    each eligible worker employed.
25        (2) The financial assistance awarded shall only be
26    expended for premium pay for eligible workers, which must



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1    be in addition to any wages or remuneration the eligible
2    worker has already received and shall be subject to the
3    other requirements and limitations set forth in the ARPA
4    and related federal guidance.
5        (3) Upon receipt of funds, the Qualifying Ground
6    Ambulance Service Provider shall distribute funds such
7    that an eligible worker receives an amount up to $13 per
8    hour but no more than $25,000 for the duration of the
9    program. The Qualifying Ground Ambulance Service Provider
10    shall provide a written certification to the Department
11    acknowledging compliance with this paragraph (d).
12        (4) No portion of these funds shall be spent on
13    volunteer staff.
14        (5) These funds shall not be used to make retroactive
15    premium payments prior to the effective date of this
16    amendatory Act of the 102nd General Assembly.
17        (6) The Department shall require each Qualifying
18    Ground Ambulance Service Provider that receives funds
19    under this paragraph (d) to submit appropriate
20    documentation acknowledging compliance with State and
21    federal law on an annual basis.
22    (e) COVID-19 Response Support Initiative. Subject to
23paragraph (c) of this Section and based on an application
24filed by a Qualifying Ground Ambulance Service Provider, the
25Department shall establish the Ground Ambulance COVID-19
26Response Support Initiative. The purpose of the award shall be



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1to reimburse Qualifying Ground Ambulance Service Providers for
2eligible expenses under Section 9901 of the ARPA related to
3the public health impacts of the COVID-19 public health
4emergency, including, but not limited to: (i) costs incurred
5due to the COVID-19 public health emergency; (ii) costs
6related to vaccination programs, including vaccine incentives;
7(iii) costs related to COVID-19 testing; (iv) costs related to
8COVID-19 prevention and treatment equipment; (v) expenses for
9medical supplies; (vi) expenses for personal protective
10equipment; (vii) costs related to isolation and quarantine;
11(viii) costs for ventilation system installation and
12improvement; (ix) costs related to other emergency response
13equipment, such as ground ambulances, ventilators, cardiac
14monitoring equipment, defibrillation equipment, pacing
15equipment, ambulance stretchers, and radio equipment; and (x)
16other emergency medical response expenses. costs related to
17COVID-19 testing for patients, COVID-19 prevention and
18treatment equipment, medical supplies, personal protective
19equipment, and other emergency medical response treatments.
20        (1) The award shall be for eligible obligated
21    expenditures incurred no earlier than May 1, 2022 and no
22    later than June 30, 2024 2023. Expenditures under this
23    paragraph must be incurred by June 30, 2025.
24        (2) Funds awarded under this paragraph (e) shall not
25    be expended for premium pay to eligible workers.
26        (3) The Department shall require each Qualifying



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1    Ground Ambulance Service Provider that receives funds
2    under this paragraph (e) to submit appropriate
3    documentation acknowledging compliance with State and
4    federal law on an annual basis. For purchases of medical
5    equipment or other capital expenditures, the Qualifying
6    Ground Ambulance Service Provider shall include
7    documentation that describes the harm or need to be
8    addressed by the expenditures and how that capital
9    expenditure is appropriate to address that identified harm
10    or need.
11    (f) Ambulance Industry Recovery Program. If the Department
12designates the Ambulance Services Industry as an "impacted
13industry", as defined by the ARPA and related federal
14guidance, the Department shall establish the Ambulance
15Industry Recovery Grant Program, to provide aid to Qualifying
16Ground Ambulance Service Providers that experienced staffing
17losses due to the COVID-19 public health emergency.
18        (1) Funds awarded under this paragraph (f) shall not
19    be expended for premium pay to eligible workers.
20        (2) Each Qualifying Ground Ambulance Service Provider
21    that receives funds under this paragraph (f) shall comply
22    with paragraph (c) of this Section.
23        (3) The Department shall require each Qualifying
24    Ground Ambulance Service Provider that receives funds
25    under this paragraph (f) to submit appropriate
26    documentation acknowledging compliance with State and



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1    federal law on an annual basis.
2(Source: P.A. 102-699, eff. 4-19-22.)
3    (305 ILCS 5/5B-2)  (from Ch. 23, par. 5B-2)
4    Sec. 5B-2. Assessment; no local authorization to tax.
5    (a) For the privilege of engaging in the occupation of
6long-term care provider, beginning July 1, 2011 through June
730, 2022, or upon federal approval by the Centers for Medicare
8and Medicaid Services of the long-term care provider
9assessment described in subsection (a-1), whichever is later,
10an assessment is imposed upon each long-term care provider in
11an amount equal to $6.07 times the number of occupied bed days
12due and payable each month. Notwithstanding any provision of
13any other Act to the contrary, this assessment shall be
14construed as a tax, but shall not be billed or passed on to any
15resident of a nursing home operated by the nursing home
17    (a-1) For the privilege of engaging in the occupation of
18long-term care provider for each occupied non-Medicare bed
19day, beginning July 1, 2022, an assessment is imposed upon
20each long-term care provider in an amount varying with the
21number of paid Medicaid resident days per annum in the
22facility with the following schedule of occupied bed tax
23amounts. This assessment is due and payable each month. The
24tax shall follow the schedule below and be rebased by the
25Department on an annual basis. The Department shall publish



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1each facility's rebased tax rate according to the schedule in
2this Section 30 days prior to the beginning of the 6-month
3period beginning July 1, 2022 and thereafter 30 days prior to
4the beginning of each calendar year which shall incorporate
5the number of paid Medicaid days used to determine each
6facility's rebased tax rate.
7        (1) 0-5,000 paid Medicaid resident days per annum,
8    $10.67.
9        (2) 5,001-15,000 paid Medicaid resident days per
10    annum, $19.20.
11        (3) 15,001-35,000 paid Medicaid resident days per
12    annum, $22.40.
13        (4) 35,001-55,000 paid Medicaid resident days per
14    annum, $19.20.
15        (5) 55,001-65,000 paid Medicaid resident days per
16    annum, $13.86.
17        (6) 65,001+ paid Medicaid resident days per annum,
18    $10.67.
19        (7) Any non-profit nursing facilities without
20    Medicaid-certified beds or any nursing facility owned and
21    operated by a county government, $7 per occupied bed day.
22    The changes made by this amendatory Act of the 102nd
23    General Assembly to this paragraph (7) shall be
24    implemented only upon federal approval.
25    Notwithstanding any provision of any other Act to the
26contrary, this assessment shall be construed as a tax but



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1shall not be billed or passed on to any resident of a nursing
2home operated by the nursing home provider.
3    For each new calendar year and for the 6-month period
4beginning July 1, 2022, a facility's paid Medicaid resident
5days per annum shall be determined using the Department's
6Medicaid Management Information System to include Medicaid
7resident days for the year ending 9 months earlier.
8    (b) Nothing in this amendatory Act of 1992 shall be
9construed to authorize any home rule unit or other unit of
10local government to license for revenue or impose a tax or
11assessment upon long-term care providers or the occupation of
12long-term care provider, or a tax or assessment measured by
13the income or earnings or occupied bed days of a long-term care
15    (c) The assessment imposed by this Section shall not be
16due and payable, however, until after the Department notifies
17the long-term care providers, in writing, that the payment
18methodologies to long-term care providers required under
19Section 5-5.2 of this Code have been approved by the Centers
20for Medicare and Medicaid Services of the U.S. Department of
21Health and Human Services and that the waivers under 42 CFR
22433.68 for the assessment imposed by this Section, if
23necessary, have been granted by the Centers for Medicare and
24Medicaid Services of the U.S. Department of Health and Human
26(Source: P.A. 102-1035, eff. 5-31-22.)



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1    Section 40. The Rebuild Illinois Mental Health Workforce
2Act is amended by changing Sections 20-10 and 20-20 as
4    (305 ILCS 66/20-10)
5    Sec. 20-10. Medicaid funding for community mental health
6services. Medicaid funding for the specific community mental
7health services listed in this Act shall be adjusted and paid
8as set forth in this Act. Such payments shall be paid in
9addition to the base Medicaid reimbursement rate and add-on
10payment rates per service unit.
11    (a) The payment adjustments shall begin on July 1, 2022
12for State Fiscal Year 2023 and shall continue for every State
13fiscal year thereafter.
14        (1) Individual Therapy Medicaid Payment rate for
15    services provided under the H0004 Code:
16            (A) The Medicaid total payment rate for individual
17        therapy provided by a qualified mental health
18        professional shall be increased by no less than $9 per
19        service unit.
20            (B) The Medicaid total payment rate for individual
21        therapy provided by a mental health professional shall
22        be increased by no less then $9 per service unit.
23        (2) Community Support - Individual Medicaid Payment
24    rate for services provided under the H2015 Code: All



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1    community support - individual services shall be increased
2    by no less than $15 per service unit.
3        (3) Case Management Medicaid Add-on Payment for
4    services provided under the T1016 code: All case
5    management services rates shall be increased by no less
6    than $15 per service unit.
7        (4) Assertive Community Treatment Medicaid Add-on
8    Payment for services provided under the H0039 code: The
9    Medicaid total payment rate for assertive community
10    treatment services shall increase by no less than $8 per
11    service unit.
12        (5) Medicaid user-based directed payments.
13            (A) For each State fiscal year, a monthly directed
14        payment shall be paid to a community mental health
15        provider of community support team services based on
16        the number of Medicaid users of community support team
17        services documented by Medicaid fee-for-service and
18        managed care encounter claims delivered by that
19        provider in the base year. The Department of
20        Healthcare and Family Services shall make the monthly
21        directed payment to each provider entitled to directed
22        payments under this Act by no later than the last day
23        of each month throughout each State fiscal year.
24                (i) The monthly directed payment for a
25            community support team provider shall be
26            calculated as follows: The sum total number of



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1            individual Medicaid users of community support
2            team services delivered by that provider
3            throughout the base year, multiplied by $4,200 per
4            Medicaid user, divided into 12 equal monthly
5            payments for the State fiscal year.
6                (ii) As used in this subparagraph, "user"
7            means an individual who received at least 200
8            units of community support team services (H2016)
9            during the base year.
10            (B) For each State fiscal year, a monthly directed
11        payment shall be paid to each community mental health
12        provider of assertive community treatment services
13        based on the number of Medicaid users of assertive
14        community treatment services documented by Medicaid
15        fee-for-service and managed care encounter claims
16        delivered by the provider in the base year.
17                (i) The monthly direct payment for an
18            assertive community treatment provider shall be
19            calculated as follows: The sum total number of
20            Medicaid users of assertive community treatment
21            services provided by that provider throughout the
22            base year, multiplied by $6,000 per Medicaid user,
23            divided into 12 equal monthly payments for that
24            State fiscal year.
25                (ii) As used in this subparagraph, "user"
26            means an individual that received at least 300



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1            units of assertive community treatment services
2            during the base year.
3            (C) The base year for directed payments under this
4        Section shall be calendar year 2019 for State Fiscal
5        Year 2023 and State Fiscal Year 2024. For the State
6        fiscal year beginning on July 1, 2024, and for every
7        State fiscal year thereafter, the base year shall be
8        the calendar year that ended 18 months prior to the
9        start of the State fiscal year in which payments are
10        made.
11    (b) Subject to federal approval, a one-time directed
12payment must be made in calendar year 2023 for community
13mental health services provided by community mental health
14providers. The one-time directed payment shall be for an
15amount appropriated for these purposes. The one-time directed
16payment shall be for services for Integrated Assessment and
17Treatment Planning and other intensive services, including,
18but not limited to, services for Mobile Crisis Response,
19crisis intervention, medication monitoring, and group
21(Source: P.A. 102-699, eff. 4-19-22.)
22    (305 ILCS 66/20-20)
23    Sec. 20-20. Base Medicaid rates or add-on payments.
24    (a) For services under subsection (a) of Section 20-10. No
25base Medicaid rate or Medicaid rate add-on payment or any



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1other payment for the provision of Medicaid community mental
2health services in place on July 1, 2021 shall be diminished or
3changed to make the reimbursement changes required by this
4Act. Any payments required under this Act that are delayed due
5to implementation challenges or federal approval shall be made
6retroactive to July 1, 2022 for the full amount required by
7this Act regardless of the amount a provider bills Illinois'
8Medical Assistance Program (via a Medicaid managed care
9organization or the Department of Healthcare and Family
10Services directly) for such services.
11    (b) For directed payments under subsection (b) of Section
1220-10. No base Medicaid rate payment or any other payment for
13the provision of Medicaid community mental health services in
14place on January 1, 2023 shall be diminished or changed to make
15the reimbursement changes required by this Act. The Department
16of Healthcare and Family Services must pay the directed
17payment in one installment within 60 days of receiving federal
19(Source: P.A. 102-699, eff. 4-19-22.)
20    Section 45. The Code of Criminal Procedure of 1963 is
21amended by changing Sections 104-17 and 104-23 as follows:
22    (725 ILCS 5/104-17)  (from Ch. 38, par. 104-17)
23    Sec. 104-17. Commitment for treatment; treatment plan.
24    (a) If the defendant is eligible to be or has been released



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1on pretrial release or on his own recognizance, the court
2shall select the least physically restrictive form of
3treatment therapeutically appropriate and consistent with the
4treatment plan. The placement may be ordered either on an
5inpatient or an outpatient basis.
6    (b) If the defendant's disability is mental, the court may
7order him placed for secure treatment in the custody of the
8Department of Human Services, or the court may order him
9placed in the custody of any other appropriate public or
10private mental health facility or treatment program which has
11agreed to provide treatment to the defendant. If the most
12serious charge faced by the defendant is a misdemeanor, the
13court shall order outpatient treatment, unless the court finds
14good cause on the record to order inpatient treatment. If the
15court orders the defendant to inpatient treatment placed in
16the custody of the Department of Human Services, the
17Department shall evaluate the defendant to determine the most
18appropriate to which secure facility to receive the defendant
19shall be transported and, within 20 days of the transmittal by
20the clerk of the circuit court of the court's placement court
21order, notify the court of sheriff of the designated facility
22to receive the defendant. The Department shall admit the
23defendant to a secure facility within 60 days of the
24transmittal of the court's placement order, unless the
25Department can demonstrate good faith efforts at placement and
26a lack of bed and placement availability. If placement cannot



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1be made within 60 days of the transmittal of the court's
2placement order and the Department has demonstrated good faith
3efforts at placement and a lack of bed and placement
4availability, the Department shall provide an update to the
5ordering court every 30 days until the defendant is placed.
6Once bed and placement availability is determined, the
7Department shall notify Upon receipt of that notice, the
8sheriff who shall promptly transport the defendant to the
9designated facility. If the defendant is placed in the custody
10of the Department of Human Services, the defendant shall be
11placed in a secure setting. During the period of time required
12to determine bed and placement availability at the designated
13facility, the appropriate placement the defendant shall remain
14in jail. If during the course of evaluating the defendant for
15placement, the Department of Human Services determines that
16the defendant is currently fit to stand trial, it shall
17immediately notify the court and shall submit a written report
18within 7 days. In that circumstance the placement shall be
19held pending a court hearing on the Department's report.
20Otherwise, upon completion of the placement process, including
21identifying bed and placement availability, the sheriff shall
22be notified and shall transport the defendant to the
23designated facility. If, within 60 20 days of the transmittal
24by the clerk of the circuit court of the court's placement
25court order, the Department fails to provide notify the
26sheriff with notice of bed and placement availability at the



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1designated facility, of the identity of the facility to which
2the defendant shall be transported, the sheriff shall contact
3a designated person within the Department to inquire about
4when a placement will become available at the designated
5facility as well as bed and placement and bed availability at
6other secure facilities. If, within 20 days of the transmittal
7by the clerk of the circuit court of the placement court order,
8the Department fails to notify the sheriff of the identity of
9the facility to which the defendant shall be transported, the
10sheriff shall notify the Department of its intent to transfer
11the defendant to the nearest secure mental health facility
12operated by the Department and inquire as to the status of the
13placement evaluation and availability for admission to such
14facility operated by the Department by contacting a designated
15person within the Department. The Department shall respond to
16the sheriff within 2 business days of the notice and inquiry by
17the sheriff seeking the transfer and the Department shall
18provide the sheriff with the status of the evaluation,
19information on bed and placement availability, and an
20estimated date of admission for the defendant and any changes
21to that estimated date of admission. If the Department
22notifies the sheriff during the 2 business day period of a
23facility operated by the Department with placement
24availability, the sheriff shall promptly transport the
25defendant to that facility. The placement may be ordered
26either on an inpatient or an outpatient basis.



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1    (c) If the defendant's disability is physical, the court
2may order him placed under the supervision of the Department
3of Human Services which shall place and maintain the defendant
4in a suitable treatment facility or program, or the court may
5order him placed in an appropriate public or private facility
6or treatment program which has agreed to provide treatment to
7the defendant. The placement may be ordered either on an
8inpatient or an outpatient basis.
9    (d) The clerk of the circuit court shall within 5 days of
10the entry of the order transmit to the Department, agency or
11institution, if any, to which the defendant is remanded for
12treatment, the following:
13        (1) a certified copy of the order to undergo
14    treatment. Accompanying the certified copy of the order to
15    undergo treatment shall be the complete copy of any report
16    prepared under Section 104-15 of this Code or other report
17    prepared by a forensic examiner for the court;
18        (2) the county and municipality in which the offense
19    was committed;
20        (3) the county and municipality in which the arrest
21    took place;
22        (4) a copy of the arrest report, criminal charges,
23    arrest record; and
24        (5) all additional matters which the Court directs the
25    clerk to transmit.
26    (e) Within 30 days of admission to the designated facility



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1entry of an order to undergo treatment, the person supervising
2the defendant's treatment shall file with the court, the
3State, and the defense a report assessing the facility's or
4program's capacity to provide appropriate treatment for the
5defendant and indicating his opinion as to the probability of
6the defendant's attaining fitness within a period of time from
7the date of the finding of unfitness. For a defendant charged
8with a felony, the period of time shall be one year. For a
9defendant charged with a misdemeanor, the period of time shall
10be no longer than the sentence if convicted of the most serious
11offense. If the report indicates that there is a substantial
12probability that the defendant will attain fitness within the
13time period, the treatment supervisor shall also file a
14treatment plan which shall include:
15        (1) A diagnosis of the defendant's disability;
16        (2) A description of treatment goals with respect to
17    rendering the defendant fit, a specification of the
18    proposed treatment modalities, and an estimated timetable
19    for attainment of the goals;
20        (3) An identification of the person in charge of
21    supervising the defendant's treatment.
22(Source: P.A. 100-27, eff. 1-1-18; 101-652, eff. 1-1-23.)
23    (725 ILCS 5/104-23)  (from Ch. 38, par. 104-23)
24    Sec. 104-23. Unfit defendants. Cases involving an unfit
25defendant who demands a discharge hearing or a defendant who



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1cannot become fit to stand trial and for whom no special
2provisions or assistance can compensate for his disability and
3render him fit shall proceed in the following manner:
4    (a) Upon a determination that there is not a substantial
5probability that the defendant will attain fitness within the
6time period set in subsection (e) of Section 104-17 of this
7Code from the original finding of unfitness, the court shall
8hold a discharge hearing within 60 days, unless good cause is
9shown for the delay. a defendant or the attorney for the
10defendant may move for a discharge hearing pursuant to the
11provisions of Section 104-25. The discharge hearing shall be
12held within 120 days of the filing of a motion for a discharge
13hearing, unless the delay is occasioned by the defendant.
14    (b) If at any time the court determines that there is not a
15substantial probability that the defendant will become fit to
16stand trial or to plead within the time period set in
17subsection (e) of Section 104-17 of this Code from the date of
18the original finding of unfitness, or if at the end of the time
19period set in subsection (e) of Section 104-17 of this Code
20from that date the court finds the defendant still unfit and
21for whom no special provisions or assistance can compensate
22for his disabilities and render him fit, the State shall
23request the court:
24        (1) To set the matter for hearing pursuant to Section
25    104-25 unless a hearing has already been held pursuant to
26    paragraph (a) of this Section; or



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1        (2) To release the defendant from custody and to
2    dismiss with prejudice the charges against him; or
3        (3) To remand the defendant to the custody of the
4    Department of Human Services and order a hearing to be
5    conducted pursuant to the provisions of the Mental Health
6    and Developmental Disabilities Code, as now or hereafter
7    amended. The Department of Human Services shall have 7
8    days from the date it receives the defendant to prepare
9    and file the necessary petition and certificates that are
10    required for commitment under the Mental Health and
11    Developmental Disabilities Code. If the defendant is
12    committed to the Department of Human Services pursuant to
13    such hearing, the court having jurisdiction over the
14    criminal matter shall dismiss the charges against the
15    defendant, with the leave to reinstate. In such cases the
16    Department of Human Services shall notify the court, the
17    State's attorney and the defense attorney upon the
18    discharge of the defendant. A former defendant so
19    committed shall be treated in the same manner as any other
20    civilly committed patient for all purposes including
21    admission, selection of the place of treatment and the
22    treatment modalities, entitlement to rights and
23    privileges, transfer, and discharge. A defendant who is
24    not committed shall be remanded to the court having
25    jurisdiction of the criminal matter for disposition
26    pursuant to subparagraph (1) or (2) of paragraph (b) of



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1    this Section.
2    (c) If the defendant is restored to fitness and the
3original charges against him are reinstated, the speedy trial
4provisions of Section 103-5 shall commence to run.
5(Source: P.A. 98-1025, eff. 8-22-14.)
6    Section 99. Effective date. This Act takes effect upon
7becoming law.".