Full Text of HB4801 103rd General Assembly
HB4801 103RD GENERAL ASSEMBLY | | | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB4801 Introduced 2/6/2024, by Rep. Robyn Gabel SYNOPSIS AS INTRODUCED: | | | Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to maintain the rate add-on implemented on January 1, 2023 for the provision of 2 meals per day at no less than $6.15 per day as stated in the supportive living program home and community-based service waiver approved by the federal Centers for Medicare and Medicaid Services. |
| |
| | A BILL FOR |
| | | | HB4801 | | LRB103 38207 KTG 68341 b |
|
| 1 | | AN ACT concerning public aid. | 2 | | Be it enacted by the People of the State of Illinois, | 3 | | represented in the General Assembly: | 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-5.01a as follows: | 6 | | (305 ILCS 5/5-5.01a) | 7 | | Sec. 5-5.01a. Supportive living facilities program. | 8 | | (a) The Department shall establish and provide oversight | 9 | | for a program of supportive living facilities that seek to | 10 | | promote resident independence, dignity, respect, and | 11 | | well-being in the most cost-effective manner. | 12 | | A supportive living facility is (i) a free-standing | 13 | | facility or (ii) a distinct physical and operational entity | 14 | | within a mixed-use building that meets the criteria | 15 | | established in subsection (d). A supportive living facility | 16 | | integrates housing with health, personal care, and supportive | 17 | | services and is a designated setting that offers residents | 18 | | their own separate, private, and distinct living units. | 19 | | Sites for the operation of the program shall be selected | 20 | | by the Department based upon criteria that may include the | 21 | | need for services in a geographic area, the availability of | 22 | | funding, and the site's ability to meet the standards. | 23 | | (b) Beginning July 1, 2014, subject to federal approval, |
| | | HB4801 | - 2 - | LRB103 38207 KTG 68341 b |
|
| 1 | | the Medicaid rates for supportive living facilities shall be | 2 | | equal to the supportive living facility Medicaid rate | 3 | | effective on June 30, 2014 increased by 8.85%. Once the | 4 | | assessment imposed at Article V-G of this Code is determined | 5 | | to be a permissible tax under Title XIX of the Social Security | 6 | | Act, the Department shall increase the Medicaid rates for | 7 | | supportive living facilities effective on July 1, 2014 by | 8 | | 9.09%. The Department shall apply this increase retroactively | 9 | | to coincide with the imposition of the assessment in Article | 10 | | V-G of this Code in accordance with the approval for federal | 11 | | financial participation by the Centers for Medicare and | 12 | | Medicaid Services. | 13 | | The Medicaid rates for supportive living facilities | 14 | | effective on July 1, 2017 must be equal to the rates in effect | 15 | | for supportive living facilities on June 30, 2017 increased by | 16 | | 2.8%. | 17 | | The Medicaid rates for supportive living facilities | 18 | | effective on July 1, 2018 must be equal to the rates in effect | 19 | | for supportive living facilities on June 30, 2018. | 20 | | Subject to federal approval, the Medicaid rates for | 21 | | supportive living services on and after July 1, 2019 must be at | 22 | | least 54.3% of the average total nursing facility services per | 23 | | diem for the geographic areas defined by the Department while | 24 | | maintaining the rate differential for dementia care and must | 25 | | be updated whenever the total nursing facility service per | 26 | | diems are updated. Beginning July 1, 2022, upon the |
| | | HB4801 | - 3 - | LRB103 38207 KTG 68341 b |
|
| 1 | | implementation of the Patient Driven Payment Model, Medicaid | 2 | | rates for supportive living services must be at least 54.3% of | 3 | | the average total nursing services per diem rate for the | 4 | | geographic areas. For purposes of this provision, the average | 5 | | total nursing services per diem rate shall include all add-ons | 6 | | for nursing facilities for the geographic area provided for in | 7 | | Section 5-5.2. The rate differential for dementia care must be | 8 | | maintained in these rates and the rates shall be updated | 9 | | whenever nursing facility per diem rates are updated. | 10 | | Subject to federal approval, beginning January 1, 2024, | 11 | | the dementia care rate for supportive living services must be | 12 | | no less than the non-dementia care supportive living services | 13 | | rate multiplied by 1.5. | 14 | | (c) The Department may adopt rules to implement this | 15 | | Section. Rules that establish or modify the services, | 16 | | standards, and conditions for participation in the program | 17 | | shall be adopted by the Department in consultation with the | 18 | | Department on Aging, the Department of Rehabilitation | 19 | | Services, and the Department of Mental Health and | 20 | | Developmental Disabilities (or their successor agencies). | 21 | | (d) Subject to federal approval by the Centers for | 22 | | Medicare and Medicaid Services, the Department shall accept | 23 | | for consideration of certification under the program any | 24 | | application for a site or building where distinct parts of the | 25 | | site or building are designated for purposes other than the | 26 | | provision of supportive living services, but only if: |
| | | HB4801 | - 4 - | LRB103 38207 KTG 68341 b |
|
| 1 | | (1) those distinct parts of the site or building are | 2 | | not designated for the purpose of providing assisted | 3 | | living services as required under the Assisted Living and | 4 | | Shared Housing Act; | 5 | | (2) those distinct parts of the site or building are | 6 | | completely separate from the part of the building used for | 7 | | the provision of supportive living program services, | 8 | | including separate entrances; | 9 | | (3) those distinct parts of the site or building do | 10 | | not share any common spaces with the part of the building | 11 | | used for the provision of supportive living program | 12 | | services; and | 13 | | (4) those distinct parts of the site or building do | 14 | | not share staffing with the part of the building used for | 15 | | the provision of supportive living program services. | 16 | | (e) Facilities or distinct parts of facilities which are | 17 | | selected as supportive living facilities and are in good | 18 | | standing with the Department's rules are exempt from the | 19 | | provisions of the Nursing Home Care Act and the Illinois | 20 | | Health Facilities Planning Act. | 21 | | (f) Section 9817 of the American Rescue Plan Act of 2021 | 22 | | (Public Law 117-2) authorizes a 10% enhanced federal medical | 23 | | assistance percentage for supportive living services for a | 24 | | 12-month period from April 1, 2021 through March 31, 2022. | 25 | | Subject to federal approval, including the approval of any | 26 | | necessary waiver amendments or other federally required |
| | | HB4801 | - 5 - | LRB103 38207 KTG 68341 b |
|
| 1 | | documents or assurances, for a 12-month period the Department | 2 | | must pay a supplemental $26 per diem rate to all supportive | 3 | | living facilities with the additional federal financial | 4 | | participation funds that result from the enhanced federal | 5 | | medical assistance percentage from April 1, 2021 through March | 6 | | 31, 2022. The Department may issue parameters around how the | 7 | | supplemental payment should be spent, including quality | 8 | | improvement activities. The Department may alter the form, | 9 | | methods, or timeframes concerning the supplemental per diem | 10 | | rate to comply with any subsequent changes to federal law, | 11 | | changes made by guidance issued by the federal Centers for | 12 | | Medicare and Medicaid Services, or other changes necessary to | 13 | | receive the enhanced federal medical assistance percentage. | 14 | | (g) All applications for the expansion of supportive | 15 | | living dementia care settings involving sites not approved by | 16 | | the Department on January 1, 2024 ( the effective date of | 17 | | Public Act 103-102) this amendatory Act of the 103rd General | 18 | | Assembly may allow new elderly non-dementia units in addition | 19 | | to new dementia care units. The Department may approve such | 20 | | applications only if the application has: (1) no more than one | 21 | | non-dementia care unit for each dementia care unit and (2) the | 22 | | site is not located within 4 miles of an existing supportive | 23 | | living program site in Cook County (including the City of | 24 | | Chicago), not located within 12 miles of an existing | 25 | | supportive living program site in DuPage County, Kane County, | 26 | | Lake County, McHenry County, or Will County, or not located |
| | | HB4801 | - 6 - | LRB103 38207 KTG 68341 b |
|
| 1 | | within 25 miles of an existing supportive living program site | 2 | | in any other county. | 3 | | (h) As stated in the supportive living program home and | 4 | | community-based service waiver approved by the federal Centers | 5 | | for Medicare and Medicaid Services, the Department must | 6 | | maintain the rate add-on implemented on January 1, 2023 for | 7 | | the provision of 2 meals per day at no less than $6.15 per day. | 8 | | (Source: P.A. 102-43, eff. 7-6-21; 102-699, eff. 4-19-22; | 9 | | 103-102, Article 20, Section 20-5, eff. 1-1-24; 103-102, | 10 | | Article 100, Section 100-5, eff. 1-1-24; revised 12-15-23.) |
|