Full Text of HB0449 102nd General Assembly
HB0449enr 102ND GENERAL ASSEMBLY |
| | HB0449 Enrolled | | LRB102 05132 RLC 15153 b |
|
| 1 | | AN ACT concerning health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 1. Short title. This Act may be cited as the | 5 | | Housing is Recovery Pilot Program Act. | 6 | | Section 3. Definitions. As used in this Act: | 7 | | "Individual at high risk of unnecessary | 8 | | institutionalization" means a person who has a serious mental | 9 | | illness who is homeless (or will be homeless upon hospital | 10 | | discharge or correctional facility release) and who has had: | 11 | | (1) three or more psychiatric inpatient hospital | 12 | | admissions within the most recent 12-month period; | 13 | | (2) three or more stays in a State or county | 14 | | correctional facility in the State of Illinois within the | 15 | | most recent 12-month period; or | 16 | | (3) a disability determination due to a serious mental | 17 | | illness and has been incarcerated in a State or county | 18 | | correctional facility in Illinois for the most recent 12 | 19 | | consecutive months. | 20 | | "Individual at high risk of overdose" means a person with | 21 | | a substance use disorder who is homeless (or will be homeless | 22 | | upon hospital discharge or correctional facility release) who | 23 | | has had: |
| | | HB0449 Enrolled | - 2 - | LRB102 05132 RLC 15153 b |
|
| 1 | | (A) three or more hospital inpatient or inpatient | 2 | | detoxification admissions for a substance use disorder | 3 | | within the most recent 12-month period; | 4 | | (B) three or more stays in a State or county | 5 | | correctional facility in the State of Illinois within the | 6 | | most recent 12-month period; or | 7 | | (C) one or more drug overdoses in the last 12 months. | 8 | | "Engagement services" means home-based or community-based | 9 | | visits that assist the individual with maintaining his or her | 10 | | housing, and providing other wrap-around support, including | 11 | | linkage to mental health or substance use recovery support | 12 | | services. Such engagement services shall align with | 13 | | Medicaid-covered tenancy support services, and Medicaid | 14 | | community-based mental health and substance use treatment | 15 | | services, including case management, to ensure alignment with | 16 | | any existing or future Illinois Medicaid benefits, waivers or | 17 | | State plan amendments that include these services, and to | 18 | | maximize any potential federal Medicaid matching dollars that | 19 | | may be available to support engagement services. | 20 | | "Homeless" means the definition used by the U.S. | 21 | | Department of Health and Human Services, Health Resources and | 22 | | Services Administration in Section 330(h)(5)(A) of the Public | 23 | | Health Services Act (42 U.S.C. 254(b)). Under Section | 24 | | 330(h)(5)(A), a homeless individual is an individual who lacks | 25 | | housing (without regard to whether the individual is a member | 26 | | of a family), including an individual whose primary residence |
| | | HB0449 Enrolled | - 3 - | LRB102 05132 RLC 15153 b |
|
| 1 | | during the night is a supervised public or private facility | 2 | | that provides temporary living accommodations, and an | 3 | | individual who is a resident in transitional housing. This | 4 | | includes individuals who are doubled up with other households. | 5 | | "Serious mental illness" means meeting both the diagnostic | 6 | | and functioning criteria consistent with the definition of | 7 | | Serious Mental Illness in the most current edition of the | 8 | | Illinois Department of Human Services/Division of Mental | 9 | | Health Community Mental Health Provider Manual. | 10 | | "Substance use disorder" as defined in Section 1-10 of the | 11 | | Substance Use Disorder Act. | 12 | | Section 5. Establishment of program. Subject to | 13 | | appropriation, the Housing is Recovery pilot program shall be | 14 | | established and administered by the Department of Human | 15 | | Services, Division of Mental Health. The purpose of the | 16 | | program is to prevent a person with a serious mental illness | 17 | | who is at high risk of unnecessary institutionalization, or a | 18 | | person with a substance use disorder who is at high risk of | 19 | | overdose, due to homelessness, a lack of access to recovery | 20 | | support services, and repeating cycles of hospitalizations or | 21 | | justice system involvement from being institutionalized or | 22 | | dying. This will be accomplished by enabling affordable | 23 | | housing through the use of a bridge rental subsidy combined | 24 | | with access to recovery support services or treatment. The | 25 | | triple aim of Housing is Recovery is: |
| | | HB0449 Enrolled | - 4 - | LRB102 05132 RLC 15153 b |
|
| 1 | | (1) preventing institutionalization and overdose | 2 | | deaths; | 3 | | (2) improving health outcomes and access to recovery | 4 | | support services; and | 5 | | (3) reducing State costs. | 6 | | Section 10. Eligibility. An individual meeting the | 7 | | requirements listed in this Section shall be eligible to | 8 | | receive a Housing is Recovery bridge rental subsidy for | 9 | | purposes of stabilizing his or her mental illness or substance | 10 | | use disorder. | 11 | | (1) An individual at high risk of unnecessary | 12 | | institutionalization who is 21 years of age or older, or | 13 | | is aging out of guardianship under the Department of | 14 | | Children and Family Services, and who is eligible to | 15 | | enroll in, or is enrolled in, Medicaid for purposes of | 16 | | receiving mental health treatment pursuant to 89 Ill. Adm. | 17 | | Code 140. | 18 | | (2) An individual at high risk of overdose who is 21 | 19 | | years of age or older, or is aging out of guardianship | 20 | | under the Department of Children and Family Services, and | 21 | | who is eligible to enroll in, or is enrolled in, Medicaid | 22 | | for purposes of receiving substance use treatment. | 23 | | Section 15. Housing is Recovery bridge rental subsidy. A | 24 | | bridge rental subsidy received by an individual (the "subsidy |
| | | HB0449 Enrolled | - 5 - | LRB102 05132 RLC 15153 b |
|
| 1 | | holder") pursuant to this Act shall mirror the subsidies | 2 | | issued by the Department of Human Services, Division of Mental | 3 | | Health through the Moving On Program. The rental subsidy shall | 4 | | be for scattered-site rental units owned by a landlord or for | 5 | | rental units secured through a master lease. The rental | 6 | | subsidy shall assist the subsidy holder with monthly rental | 7 | | payments for rent that does not exceed the Fair Market Rent | 8 | | published annually for that year by the U.S. Department of | 9 | | Housing and Urban Development. The Department of Human | 10 | | Services, Division of Mental Health, shall have the discretion | 11 | | to allow a subsidy to apply to rent up to 120% of the Fair | 12 | | Market Rent if this is justified by the lack of available | 13 | | affordable housing in the local housing market. Community | 14 | | Mental Health Centers certified pursuant to 59 Ill. Adm. Code | 15 | | 132 or supported housing service providers participating in | 16 | | this pilot program shall be responsible for assisting the | 17 | | subsidy holder with maintaining his or her housing that is | 18 | | supported by the bridge rental subsidy and either providing or | 19 | | coordinating engagement services with a mental health or | 20 | | substance use treatment provider. | 21 | | (1) The subsidy holder shall be responsible for | 22 | | contributing 30% of his or her income toward the cost of | 23 | | rent (zero income does not preclude participation). | 24 | | (2) The subsidy holder must agree to sign a lease with | 25 | | a landlord or a sublease agreement with the Community | 26 | | Mental Health Center or the housing services provider that |
| | | HB0449 Enrolled | - 6 - | LRB102 05132 RLC 15153 b |
|
| 1 | | has a master lease for the rental unit and agree to | 2 | | engagement services initiated by the supported housing | 3 | | provider, the Community Mental Health Center or contracted | 4 | | mental health or substance use treatment provider at least | 5 | | 2 times a month, with at least one of those visits being a | 6 | | home visit. The engagement services shall be permitted in | 7 | | a home-based or community-based setting, and do not | 8 | | require a clinic visit. | 9 | | (3) A goal of this program is to encourage the subsidy | 10 | | holder to engage in mental health and substance use | 11 | | recovery support services or treatment when the individual | 12 | | is ready. However, this is a Housing First model that does | 13 | | not require abstinence from substance or alcohol use and | 14 | | does not require mental health or substance use treatment. | 15 | | (4) If a subsidy holder does not have an income due to | 16 | | a psychiatric disability, he or she shall be offered the | 17 | | opportunity for assistance with filing a "SOAR | 18 | | application" (Supplemental Security Income (SSI)/Social | 19 | | Security Disability Income (SSDI), Outreach, Access and | 20 | | Recovery application) by the Community Mental Health | 21 | | Center participating in the Housing is Recovery program | 22 | | that is providing his or her mental health support or | 23 | | treatment within 6 months of the initiation of mental | 24 | | health services. If the subsidy holder is only receiving | 25 | | housing support services, the housing services provider | 26 | | must partner with a Community Mental Health Center to do |
| | | HB0449 Enrolled | - 7 - | LRB102 05132 RLC 15153 b |
|
| 1 | | SOAR applications for individuals who elect to apply for a | 2 | | psychiatric disability. A subsidy holder is not required | 3 | | to apply for a disability determination. | 4 | | (5) The subsidy holder, if he or she is eligible, must | 5 | | apply for rental assistance or housing through the | 6 | | appropriate Public Housing Authority within 6 months of | 7 | | receiving a Housing is Recovery bridge rental subsidy or | 8 | | agree to apply when it is permissible to do so, and also be | 9 | | placed on the Illinois Housing Development Authority's | 10 | | Statewide Referral Network. | 11 | | Section 20. Identification and referral of eligible | 12 | | individuals prior to hospital discharge or correctional | 13 | | facility release for purposes of rapid housing post | 14 | | discharge/release and illness stability. The pilot program is | 15 | | intended to enable affordable housing to avoid | 16 | | institutionalization or overdose death by providing for | 17 | | connection to housing through a variety of settings, including | 18 | | in hospitals, county jails, prisons, homeless shelters and | 19 | | inpatient detoxification facilities and the referral process | 20 | | established must take this into account. Within 2 months of | 21 | | the effective date of this Act, the Department of Human | 22 | | Services, Division of Mental Health, in partnership with the | 23 | | Department of Healthcare and Family Services and the | 24 | | Department of Human Services, Division of Substance Use | 25 | | Prevention and Recovery (SUPR), the Department of Corrections, |
| | | HB0449 Enrolled | - 8 - | LRB102 05132 RLC 15153 b |
|
| 1 | | and with meaningful stakeholder input through a working group | 2 | | of Community Mental Health Centers, homeless service | 3 | | providers, substance use treatment providers, hospitals with | 4 | | inpatient psychiatric units or detoxification units, | 5 | | representatives from county jails, persons with lived | 6 | | experience, and family support organizations, shall develop a | 7 | | process for identifying and referring eligible individuals for | 8 | | the Housing is Recovery program prior to hospital discharge or | 9 | | correctional system release, or other appropriate place for | 10 | | referral, including homeless shelters. The process developed | 11 | | shall aim to enable rapid access to housing | 12 | | post-discharge/release to avoid unnecessary | 13 | | institutionalization or a return to homelessness or unstable | 14 | | housing. The working group shall meet at least monthly prior | 15 | | to development of an administrative rule or policy established | 16 | | to carry out the intent of this Act. The Department of Human | 17 | | Services, Division of Mental Health, shall explore ways to | 18 | | collaborate with the U.S. Department of Housing and Urban | 19 | | Development's Coordinated Entry System and other ways for | 20 | | electronic referral. The Department of Human Services, | 21 | | Division of Mental Health, and the Department of Healthcare | 22 | | and Family Services shall collaborate to ensure that the | 23 | | referral process aligns with any existing or future Medicaid | 24 | | waivers or State plan amendments for tenancy support services. | 25 | | Section 25. Participating Community Mental Health Centers |
| | | HB0449 Enrolled | - 9 - | LRB102 05132 RLC 15153 b |
|
| 1 | | and housing service provider responsibilities for locating and | 2 | | transitioning the individual into housing, assisting in | 3 | | retaining housing, and the provision of engagement and | 4 | | recovery support services. The Department of Human Services, | 5 | | Division of Mental Health, shall select interested Community | 6 | | Mental Health Centers that are certified pursuant to 59 Ill. | 7 | | Adm. Code 132 and interested housing service providers for | 8 | | participation in the Housing is Recovery program. | 9 | | (1) For purposes of incentivizing continuity of care, | 10 | | the same participating Community Mental Health Center may | 11 | | be responsible for providing both the housing support and | 12 | | the mental health or substance use engagement, recovery | 13 | | support services and treatment to a subsidy holder. If a | 14 | | housing support services provider does not also provide | 15 | | the mental health or substance use treatment services the | 16 | | individual engages in, there must be strong coordination | 17 | | of care between the housing services provider and the | 18 | | treatment provider. | 19 | | (2) The provider must demonstrate that the rental | 20 | | units secured through this program pass minimum quality | 21 | | inspection standards. | 22 | | (3) Community Mental Health Centers providing housing | 23 | | support through this program shall be responsible for any | 24 | | SOAR applications for a subsidy holder that has a | 25 | | psychiatric disability who does not have SSI or SSDI if | 26 | | the subsidy holder chooses to apply for disability. A |
| | | HB0449 Enrolled | - 10 - | LRB102 05132 RLC 15153 b |
|
| 1 | | housing services provider delivering the housing support | 2 | | services through this program must contract with a | 3 | | Community Mental Health Center to provide assistance with | 4 | | SOAR applications to subsidy holders electing to apply for | 5 | | SSI or SSDI within 6 months of the subsidy holder | 6 | | receiving the subsidy. | 7 | | (4) Service providers shall be permitted to engage in | 8 | | master leasing to secure apartments for those who are hard | 9 | | to house due to criminal backgrounds, history of substance | 10 | | use and stigma. | 11 | | Section 30. Securing rental housing units for purposes of | 12 | | immediate temporary housing following hospital discharge or | 13 | | release from a correctional facility while a long-term rental | 14 | | unit is secured. Up to 20% of the available annual | 15 | | appropriation for the Housing is Recovery program shall be | 16 | | available to Community Mental Health Centers or the housing | 17 | | services provider for purposes of securing critical time | 18 | | intervention rental units to house an eligible individual | 19 | | immediately following discharge from a hospitalization or | 20 | | release from a correctional facility because locating an | 21 | | apartment unit for a longer-term one-year lease and the | 22 | | related move-in can take up to 3 months. Such temporary units | 23 | | may be used for immediate temporary housing, not to exceed 90 | 24 | | days for purposes of preventing the individual from reentering | 25 | | homelessness or unstable housing, or avoiding unnecessary |
| | | HB0449 Enrolled | - 11 - | LRB102 05132 RLC 15153 b |
|
| 1 | | institutionalization. The Department of Human Services, | 2 | | Division of Mental Health, shall allow providers to certify | 3 | | that such rental units meet minimum housing quality standards | 4 | | and ensure a process by which community providers are able to | 5 | | secure vacant rental units for the purpose of immediate | 6 | | short-term housing post-hospital discharge or correctional | 7 | | system release while a longer term housing rental unit is | 8 | | secured. | 9 | | Section 35. Basic move-in expenses. The Housing is | 10 | | Recovery program shall include reasonable payment for the | 11 | | basic move-in expenses of the subsidy holder, including, but | 12 | | not limited to, payment of a security deposit and other | 13 | | move-in fees or expenses, and basic household supplies and | 14 | | furnishings. | 15 | | Section 40. Subsidy administration. The bridge rental | 16 | | subsidy administration (such as payment of rent to the | 17 | | landlord and other administration expenses) and quality | 18 | | inspection of the rental units may be done by community-based | 19 | | organizations with experience and expertise in housing subsidy | 20 | | administration and by Community Mental Health Centers that the | 21 | | Department of Human Services, Division of Mental Health, | 22 | | determines have the administrative infrastructure for subsidy | 23 | | administration. Such organizations shall manage and administer | 24 | | all aspects of the subsidy (such as payment of rent, quality |
| | | HB0449 Enrolled | - 12 - | LRB102 05132 RLC 15153 b |
|
| 1 | | inspections) on behalf of the subsidy holder. | 2 | | Section 45. Landlord education and stigma reduction plan | 3 | | and materials. The Department of Human Services, Division of | 4 | | Mental Health, with meaningful input from stakeholders, shall | 5 | | develop a plan for educating prospective landlords that may | 6 | | lease to individuals receiving a bridge rental subsidy through | 7 | | the Housing is Recovery program. This educational plan shall | 8 | | include written materials that indicate that individuals with | 9 | | psychiatric disabilities and substance use disorders often | 10 | | have criminal justice involvement due to their previously | 11 | | untreated mental health or substance use condition and periods | 12 | | of homelessness. Implementation of this plan shall be rolled | 13 | | out in conjunction with the implementation of the Housing is | 14 | | Recovery program. | 15 | | Section 50. State agency coordination. The Department of | 16 | | Human Services, Division of Mental Health, shall partner with | 17 | | SUPR to ensure coordination of the services required pursuant | 18 | | to this Act and all substance use recovery support services | 19 | | and treatment for which SUPR has oversight. The Department of | 20 | | Human Services, Division of Mental Health, shall also work | 21 | | with the Department of Healthcare and Family Services to | 22 | | maximize all recovery support services and treatment that are | 23 | | or can be covered by Medicaid. |
| | | HB0449 Enrolled | - 13 - | LRB102 05132 RLC 15153 b |
|
| 1 | | Section 55. Provider and State agency education on the | 2 | | pilot program. The Department of Human Services, Division of | 3 | | Mental Health shall put together written materials on the | 4 | | Housing is Recovery program and eligibility criteria for | 5 | | purposes of educating participating providers, county jails, | 6 | | the Department of Corrections, hospitals and other relevant | 7 | | stakeholders on the program. The Department of Human Services, | 8 | | Division of Mental Health, shall engage in an ongoing | 9 | | education effort to ensure that all stakeholders are aware of | 10 | | the program and how to screen for eligibility and referral. | 11 | | Section 60. Reimbursement for subsidy administration, | 12 | | housing support and engagement services and other program | 13 | | costs. The Department of Human Services, Division of Mental | 14 | | Health shall develop a reimbursement approach for community | 15 | | providers doing subsidy administration that covers all costs | 16 | | of subsidy administration, quality inspection and other | 17 | | services. The Department of Human Services, Division of Mental | 18 | | Health shall also develop a reimbursement approach that covers | 19 | | all costs incurred by Community Mental Health Centers and | 20 | | housing services providers for identifying and securing rental | 21 | | units for subsidy holders, including all travel related to | 22 | | finding and locating an apartment and move-in of the subsidy | 23 | | holder, quality inspections for temporary housing units, | 24 | | completing and submitting SOAR applications, the costs | 25 | | associated with obtaining necessary documents associated with |
| | | HB0449 Enrolled | - 14 - | LRB102 05132 RLC 15153 b |
|
| 1 | | obtaining a lease for the subsidy holder (such as obtaining a | 2 | | State ID); for engagement services not covered by Medicaid; | 3 | | and for any other reasonable and necessary costs associated | 4 | | with the program outlined in this Act. Reimbursement shall | 5 | | also include all costs associated with collecting and tracking | 6 | | data for purposes of program evaluation and improvement. At | 7 | | the discretion of the Department of Human Services, Division | 8 | | of Mental Health, up to 5% of the annual appropriation may be | 9 | | applied to growing mental health or substance use treatment or | 10 | | recovery support capacity if a participating provider in the | 11 | | Housing is Recovery program demonstrates an inability to take | 12 | | eligible individuals due to such capacity limitations. | 13 | | Section 65. Subsidy termination. The subsidy holder shall | 14 | | continue to hold the subsidy until he or she receives a housing | 15 | | voucher or rental subsidy through a Public Housing Authority | 16 | | unless: | 17 | | (1) The individual has a stay in a nursing home, | 18 | | Institution for Mental Disease (IMD) or specialized mental | 19 | | health rehabilitation facility (SMHRF) exceeding 6 | 20 | | consecutive months. During a stay in nursing home, IMD or | 21 | | SMHRF of less than 6 months, the program will continue to | 22 | | pay the subsidized portion of the rent in order to | 23 | | maintain the housing unit for the subsidy holder upon | 24 | | discharge. | 25 | | (2) The individual has a stay in a correctional |
| | | HB0449 Enrolled | - 15 - | LRB102 05132 RLC 15153 b |
|
| 1 | | facility exceeding 6 consecutive months. During a | 2 | | correctional facility stay of less than 6 months, the | 3 | | program will continue to pay the subsidized portion of the | 4 | | rent in order to maintain the housing unit for the subsidy | 5 | | holder. | 6 | | (3) A subsidy does not terminate if the subsidy holder | 7 | | is required to move multiple times due to landlord | 8 | | eviction or does not engage in treatment, as the target | 9 | | population for this pilot program is expected to have | 10 | | multiple barriers to remaining housed. | 11 | | Section 70. Developing public-private partnerships to | 12 | | expand affordable housing options for those with serious | 13 | | mental illnesses. The Department of Human Services, Division | 14 | | of Mental Health shall work with the Department of Healthcare | 15 | | and Family Services, Medicaid managed care organizations and | 16 | | hospitals across the State to develop public-private | 17 | | partnerships to incentivize private funding from hospitals and | 18 | | managed care organizations to match State dollars invested in | 19 | | the Housing is Recovery program for purposes of preventing | 20 | | repeated preventable hospitalizations, overdose deaths and | 21 | | unnecessary institutionalization. | 22 | | Section 75. Data collection and program evaluation. | 23 | | (a) For purposes of evaluating the effectiveness of the | 24 | | Housing is Recovery program and for making improvements to the |
| | | HB0449 Enrolled | - 16 - | LRB102 05132 RLC 15153 b |
|
| 1 | | program, the Department of Human Services, Division of Mental | 2 | | Health shall contract with an independent outside research | 3 | | organization with expertise in housing services for | 4 | | individuals with serious mental illnesses and substance use | 5 | | disorders to evaluate the program's effectiveness on enabling | 6 | | housing stability, reducing hospitalizations and justice | 7 | | system involvement, encouraging engagement in mental health | 8 | | and substance use treatment, fostering employment engagement, | 9 | | and reducing institutionalization and overdose deaths. Such | 10 | | evaluation shall commence after 4 years of implementation of | 11 | | the program and shall be submitted to the General Assembly by | 12 | | the end of the fifth year of implementation. For purposes of | 13 | | assisting with this evaluation, the working group established | 14 | | pursuant to Section 20 shall also make recommendations to the | 15 | | Department of Human Services, Division of Mental Health, | 16 | | regarding what data must be tracked by providers and the | 17 | | Department of Human Services, Division of Mental Health, to | 18 | | evaluate the program and to make future changes to the program | 19 | | to ensure its effectiveness in meeting the triple aim stated | 20 | | in Section 5. | 21 | | (b) Beginning after the first 12 months of implementation | 22 | | and on an annual basis, the Department of Human Services, | 23 | | Division of Mental Health, shall track and make public the | 24 | | following information: (1) the number of individuals receiving | 25 | | subsidies in reporting period (12-month average); (2) | 26 | | participant demographics including age, race, gender identity, |
| | | HB0449 Enrolled | - 17 - | LRB102 05132 RLC 15153 b |
|
| 1 | | and primary language; (3) the average duration of time | 2 | | individuals are enrolled in the program (by months); (4) the | 3 | | number of individuals removed from the program and reasons for | 4 | | removal; (5) the number of grievances filed by participants | 5 | | and a summary of grievance type; and (6) program referral | 6 | | sources. Reports shall be generated on an annual basis and | 7 | | publicly posted on the Department of Human Services website. | 8 | | Section 80. Act subject to appropriation. This Act is | 9 | | subject to appropriation. The appropriation shall be divided | 10 | | equally between bridge subsidies issued to individuals who are | 11 | | at high risk of unnecessary institutionalization and those who | 12 | | are at high risk of overdose. | 13 | | Section 85. Rulemaking authority. Any administrative rules | 14 | | necessary to implement this Act shall be filed within 12 | 15 | | months following the effective date of this Act.
| 16 | | Section 99. Effective date. This Act takes effect upon | 17 | | becoming law.
|
|