103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB1911

 

Introduced 2/9/2023, by Sen. Laura Fine

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 100/5-45.35 new
20 ILCS 301/55-30
305 ILCS 5/5-47 new

    Creates the Substance Use Disorder Residential and Detox Rate Equity Act. Requires the General Assembly to appropriate sufficient funds to the Department of Human Services, for State Fiscal Year 2024 and for each State fiscal year thereafter, to ensure reimbursement rates will be increased and subsequently adjusted upward by an amount equal to the Consumer Price Index-U from the previous year, not to exceed 5% in any State fiscal year, for licensed or certified community-based substance use disorder treatment providers under community service grant programs for persons with substance use disorders, including, but not limited to, certain residential and withdrawal management services provided in accordance with criteria established by the American Society of Addiction Medicine. Effective immediately.


LRB103 26966 KTG 53331 b

 

 

A BILL FOR

 

SB1911LRB103 26966 KTG 53331 b

1    AN ACT concerning substance use disorders.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the
5Substance Use Disorder Residential and Detox Rate Equity Act.
 
6    Section 5. Funding for licensed or certified
7community-based substance use disorder treatment providers.
8Beginning on July 1, 2023 for State Fiscal Year 2024, and for
9each State fiscal year thereafter, the General Assembly shall
10appropriate sufficient funds to the Department of Human
11Services to ensure reimbursement rates will be increased and
12subsequently adjusted upward by an amount equal to the
13Consumer Price Index-U from the previous year, not to exceed
145% in any State fiscal year, for licensed or certified
15community-based substance use disorder treatment providers
16under community service grant programs for persons with
17substance use disorders, including, but not limited to, the
18following services provided in accordance with ASAM criteria
19as set forth in the American Society of Addiction Medicine's
20most recent edition of The ASAM Criteria: Treatment Criteria
21for Addictive, Substance-Related, and Co-Occurring Conditions:
22        (1) ASAM level 3.5 Clinically Managed High-Intensity
23    Residential Services for adults;

 

 

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1        (2) ASAM level 3.5 Clinically Managed Medium-Intensity
2    Residential Services for adolescents;
3        (3) ASAM level 3.2 Clinically Managed Residential
4    Withdrawal Management;
5        (4) ASAM level 3.7 Medically Monitored Intensive
6    Inpatient Services for adults and Medically Monitored
7    High-Intensity Inpatient Services for adolescents; and
8        (5) ASAM level 3.1 Clinically Managed Low-Intensity
9    Residential Services for adults and adolescents.
10    If there is a decrease in the Consumer Price Index-U,
11rates shall remain unchanged for that State fiscal year. The
12Department of Human Services shall increase the grant contract
13amount awarded to each eligible community-based substance use
14disorder treatment provider to ensure that the level and
15number of services provided under community service grant
16programs shall not be reduced by increasing the amount
17available to each provider under the community service grant
18programs to address the increased rate for each such service.
19    The Department shall adopt rules, including emergency
20rules in accordance with Section 5-45 of the Illinois
21Administrative Procedure Act, to implement the provisions of
22this Act.
23    As used in this Act, "Consumer Price Index-U" means the
24index published by the Bureau of Labor Statistics of the
25United States Department of Labor that measures the average
26change in prices of goods and services purchased by all urban

 

 

SB1911- 3 -LRB103 26966 KTG 53331 b

1consumers, United States city average, all items, 1982-84 =
2100.
 
3    Section 10. The Illinois Administrative Procedure Act is
4amended by adding Section 5-45.35 as follows:
 
5    (5 ILCS 100/5-45.35 new)
6    Sec. 5-45.35. Emergency rulemaking; Substance Use Disorder
7Residential and Detox Rate Equity. To provide for the
8expeditious and timely implementation of the Substance Use
9Disorder Residential and Detox Rate Equity Act, emergency
10rules implementing the Substance Use Disorder Residential and
11Detox Rate Equity Act may be adopted in accordance with
12Section 5-45 by the Department of Human Services. The adoption
13of emergency rules authorized by Section 5-45 and this Section
14is deemed to be necessary for the public interest, safety, and
15welfare.
16    This Section is repealed one year after the effective date
17of this amendatory Act of the 103rd General Assembly.
 
18    Section 15. The Substance Use Disorder Act is amended by
19changing Section 55-30 as follows:
 
20    (20 ILCS 301/55-30)
21    Sec. 55-30. Rate increase.
22    (a) The Department shall by rule develop the increased

 

 

SB1911- 4 -LRB103 26966 KTG 53331 b

1rate methodology and annualize the increased rate beginning
2with State fiscal year 2018 contracts to licensed providers of
3community-based substance use disorder intervention or
4treatment, based on the additional amounts appropriated for
5the purpose of providing a rate increase to licensed
6providers. The Department shall adopt rules, including
7emergency rules under subsection (y) of Section 5-45 of the
8Illinois Administrative Procedure Act, to implement the
9provisions of this Section.
10    (b) (Blank).
11    (c) Beginning on July 1, 2022, the Division of Substance
12Use Prevention and Recovery shall increase reimbursement rates
13for all community-based substance use disorder treatment and
14intervention services by 47%, including, but not limited to,
15all of the following:
16        (1) Admission and Discharge Assessment.
17        (2) Level 1 (Individual).
18        (3) Level 1 (Group).
19        (4) Level 2 (Individual).
20        (5) Level 2 (Group).
21        (6) Case Management.
22        (7) Psychiatric Evaluation.
23        (8) Medication Assisted Recovery.
24        (9) Community Intervention.
25        (10) Early Intervention (Individual).
26        (11) Early Intervention (Group).

 

 

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1    Beginning in State Fiscal Year 2023, and every State
2fiscal year thereafter, reimbursement rates for those
3community-based substance use disorder treatment and
4intervention services shall be adjusted upward by an amount
5equal to the Consumer Price Index-U from the previous year,
6not to exceed 2% in any State fiscal year. If there is a
7decrease in the Consumer Price Index-U, rates shall remain
8unchanged for that State fiscal year. The Department shall
9adopt rules, including emergency rules in accordance with the
10Illinois Administrative Procedure Act, to implement the
11provisions of this Section.
12    As used in this subsection, "consumer price index-u" means
13the index published by the Bureau of Labor Statistics of the
14United States Department of Labor that measures the average
15change in prices of goods and services purchased by all urban
16consumers, United States city average, all items, 1982-84 =
17100.
18    (d) Beginning in State Fiscal Year 2024, the Division of
19Substance Use Prevention and Recovery shall increase
20reimbursement rates for all community-based substance use
21disorder treatment and intervention services by 100%,
22including, but not limited to, the following services provided
23in accordance with ASAM criteria as set forth in the American
24Society of Addiction Medicine's most recent edition of The
25ASAM Criteria: Treatment Criteria for Addictive,
26Substance-Related, and Co-Occurring Conditions:

 

 

SB1911- 6 -LRB103 26966 KTG 53331 b

1        (1) ASAM level 3.5 Clinically Managed High-Intensity
2    Residential Services for adults;
3        (2) ASAM level 3.5 Clinically Managed Medium-Intensity
4    Residential Services for adolescents;
5        (3) ASAM level 3.2 Clinically Managed Residential
6    Withdrawal Management;
7        (4) ASAM level 3.7 Medically Monitored Intensive
8    Inpatient Services for adults and Medically Monitored
9    High-Intensity Inpatient Services for adolescents; and
10        (5) ASAM level 3.1 Clinically Managed Low-Intensity
11    Residential Services for adults and adolescents.
12    Beginning in State Fiscal Year 2024, and every State
13fiscal year thereafter, reimbursement rates for those
14community-based substance use disorder treatment and
15intervention services shall be adjusted upward by an amount
16equal to the Consumer Price Index-U from the previous year,
17not to exceed 5% in any State fiscal year. If there is a
18decrease in the Consumer Price Index-U, rates shall remain
19unchanged for that State fiscal year. The Department shall
20adopt rules, including emergency rules under Section 5-45 of
21the Illinois Administrative Procedure Act, to implement the
22provisions of this subsection.
23    As used in this subsection, "Consumer Price Index-U" means
24the index published by the Bureau of Labor Statistics of the
25United States Department of Labor that measures the average
26change in prices of goods and services purchased by all urban

 

 

SB1911- 7 -LRB103 26966 KTG 53331 b

1consumers, United States city average, all items, 1982-84 =
2100. The Department of Human Services shall increase the grant
3contract amount awarded to each eligible community-based
4substance use disorder treatment provider to ensure that the
5level and number of services provided under community service
6grant programs shall not be reduced by increasing the amount
7available to each provider under the community service grant
8programs to address the increased rate for each such service.
9(Source: P.A. 101-81, eff. 7-12-19; 102-699, eff. 4-19-22.)
 
10    Section 20. The Illinois Public Aid Code is amended by
11adding Section 5-47 as follows:
 
12    (305 ILCS 5/5-47 new)
13    Sec. 5-47. Reimbursement rates; substance use disorder
14treatment providers and facilities. Beginning on December 1,
152024, the Department of Human Services' Division of Substance
16Use Prevention and Recovery, in conjunction with the
17Department of Healthcare and Family Services, shall provide a
18100% increase in reimbursement rates for all community-based
19substance use disorder treatment services, including, but not
20limited to, the following services provided in accordance with
21ASAM criteria as set forth in the American Society of
22Addiction Medicine's most recent edition of The ASAM Criteria:
23Treatment Criteria for Addictive, Substance-Related, and
24Co-Occurring Conditions:

 

 

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1        (1) ASAM level 3.5 Clinically Managed High-Intensity
2    Residential Services for adults;
3        (2) ASAM level 3.5 Clinically Managed Medium-Intensity
4    Residential Services for adolescents;
5        (3) ASAM level 3.2 Clinically Managed Residential
6    Withdrawal Management;
7        (4) ASAM level 3.7 Medically Monitored Intensive
8    Inpatient Services for adults and Medically Monitored
9    High-Intensity Inpatient Services for adolescents; and
10        (5) ASAM level 3.1 Clinically Managed Low-Intensity
11    Residential Services for adults and adolescents.
12    No existing or future reimbursement rates or add-ons shall
13be reduced or changed to address this proposed rate increase.
14No later than 3 months after the effective date of this
15amendatory Act of the 103rd General Assembly, the Department
16of Healthcare and Family Services shall immediately submit any
17necessary application to the federal Centers for Medicare and
18Medicaid Services to implement the requirements of this
19Section. Beginning on December 1, 2024, and for every State
20fiscal year thereafter, reimbursement rates for those
21community-based substance use disorder treatment services
22shall be adjusted upward by an amount equal to the Consumer
23Price Index-U from the previous year, not to exceed 5% in any
24State fiscal year. If there is a decrease in the Consumer Price
25Index-U, rates shall remain unchanged for that State fiscal
26year. The Department of Human Services and the Department of

 

 

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1Healthcare and Family Services shall adopt rules, including
2emergency rules in accordance with Section 5-45 of the
3Illinois Administrative Procedure Act, as necessary to
4implement the provisions of this Section.
5    As used in this Section, "Consumer Price Index-U" means
6the index published by the Bureau of Labor Statistics of the
7United States Department of Labor that measures the average
8change in prices of goods and services purchased by all urban
9consumers, United States city average, all items, 1982-84
10=100.
 
11    Section 99. Effective date. This Act takes effect upon
12becoming law.