Full Text of HB1950 102nd General Assembly
HB1950eng 102ND GENERAL ASSEMBLY |
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| 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 1. Short title. This Act may be cited as the | 5 | | Medicaid Technical Assistance Act. | 6 | | Section 3. Findings. The General Assembly finds as | 7 | | follows: | 8 | | (1) This Act seeks to remedy a fraction of a much | 9 | | larger broken system by addressing access to health care, | 10 | | managed care organization reform, mental and substance | 11 | | abuse treatment services, and services to address the | 12 | | social determinants of health. | 13 | | (2) Illinois transitioned Medicaid services to managed | 14 | | care with the goals of achieving better health outcomes | 15 | | for the Medicaid population and reducing the per capita | 16 | | costs of health care. | 17 | | (3) Illinois benefits when people have support | 18 | | constructing the sturdy foundation of health and | 19 | | well-being that we all need to reach our potential. | 20 | | Medicaid managed care can be a vital tool in ensuring that | 21 | | people have the full range of supports that form this | 22 | | foundation, including services from community providers | 23 | | that address behavioral health needs, as well as related |
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| 1 | | services that help people access food, housing, and | 2 | | employment.
| 3 | | (4) However, there are barriers that prevent Illinois | 4 | | from fully realizing the benefits of Medicaid managed | 5 | | care. The 2 devastating years of the State budget impasse | 6 | | resulted in 2 years of lost opportunity for community | 7 | | providers to invest in the people, systems, and technology | 8 | | that are necessary for them to participate in Medicaid | 9 | | managed care. A recent survey by the Illinois | 10 | | Collaboration on Youth of more than 130 community | 11 | | providers revealed that the majority do not have contracts | 12 | | with managed care organizations, and most do not have | 13 | | adequate billing and technology infrastructure sufficient | 14 | | for Medicaid billing now or in the future. The survey also | 15 | | revealed that community-based providers primarily serving | 16 | | people of color are the least prepared to participate in | 17 | | Medicaid managed care. | 18 | | (5) The disparity in readiness between providers | 19 | | primarily serving people of color and those who serve a | 20 | | more mixed or white clientele is especially urgent because | 21 | | 62% of Illinois' Medicaid recipients are people of color. | 22 | | Racial disparities in behavioral health care result in | 23 | | significant human and financial costs to both the | 24 | | individual and to the State.
| 25 | | (6) The COVID-19 pandemic has further exacerbated the | 26 | | health disparities experienced by communities of color. |
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| 1 | | COVID-19 has increased both the Medicaid-eligible | 2 | | population in Illinois, and increased the demand for | 3 | | behavioral health services, as Illinois residents grapple | 4 | | with trauma, death, job loss, depression, suicide, | 5 | | addiction, and exposure to violence. In addition, COVID-19 | 6 | | threatens the stability and viability of community-based | 7 | | providers, further straining the healthcare safety net for | 8 | | people who depend on Medicaid for these essential | 9 | | services. | 10 | | (7) Lack of support for a diversity of providers | 11 | | reduces choice for Medicaid recipients and may incentivize | 12 | | managed care organizations to focus on a narrow selection | 13 | | of community partners. Having some choice in which | 14 | | providers people see for these essential services and | 15 | | having access to providers who understand their community, | 16 | | culture, and language has been demonstrated to reduce | 17 | | disparities in health outcomes and improve health and | 18 | | well-being across the lifespan.
| 19 | | (8) The Medicaid managed care system lacks consistent, | 20 | | statewide support for community providers, creating | 21 | | inefficiency and duplication. Providers need targeted | 22 | | trainings focused on their levels of readiness, learning | 23 | | collaboratives to provide group-level support for those | 24 | | experiencing similar challenges, and a mechanism to | 25 | | identify problems that need systemic solutions. Illinois | 26 | | could receive up to 70% in Medicaid matching funds from |
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| 1 | | the federal government to supplement the costs of | 2 | | operating a Medicaid Technical Assistance Center. | 3 | | (9) When community-based healthcare providers are able | 4 | | to contract with managed care organizations to deliver | 5 | | Medicaid services, people can access the care they need, | 6 | | in their communities, from providers they trust.
| 7 | | Section 5. Definitions. As used in this Act: | 8 | | "Behavioral health providers" means mental health and | 9 | | substance use disorder providers. | 10 | | "Department" means the Department of Healthcare and Family | 11 | | Services. | 12 | | "Health care providers" means organizations who provide | 13 | | physical, mental, substance use disorder, or social | 14 | | determinant of health services. | 15 | | "Health equity" means providing care that does not vary in | 16 | | quality because of personal characteristics such as gender, | 17 | | ethnicity, geographic location, and socioeconomic status.
| 18 | | "Network adequacy" means a Medicaid beneficiaries' ability | 19 | | to access all necessary provider types within time and | 20 | | distance standards as defined in the Managed Care Organization | 21 | | model contract. | 22 | | "Service deserts" means geographic areas of the State with | 23 | | no or limited Medicaid providers that accept Medicaid. | 24 | | "Social determinants of health" means any conditions that | 25 | | impact an individual's health, including, but not limited to, |
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| 1 | | access to healthy food, safety, education, and housing | 2 | | stability. | 3 | | "Stakeholders" means, but are not limited to, health care | 4 | | providers, advocacy organizations, managed care organizations, | 5 | | Medicaid beneficiaries, and State and city partners. | 6 | | Section 10. Medicaid Technical Assistance Center. The | 7 | | Department of Healthcare and Family Services shall establish a | 8 | | Medicaid Technical Assistance Center. The Medicaid Technical | 9 | | Assistance Center shall operate as a cross-system educational | 10 | | resource to strengthen the business infrastructure of health | 11 | | care provider organizations in Illinois to ultimately increase | 12 | | the capacity, access, health equity, and quality of Illinois' | 13 | | Medicaid managed care program, HealthChoice Illinois, and | 14 | | YouthCare, the Medicaid managed care program for children and | 15 | | youth who receive Medicaid health services through the | 16 | | Department of Children and Family Services. The Medicaid | 17 | | Technical Assistance Center shall be established within the | 18 | | Department's Office of Medicaid Innovation. | 19 | | Section 15. Collaboration. The Medicaid Technical | 20 | | Assistance Center shall collaborate with public and private | 21 | | partners throughout the State to identify, establish, and | 22 | | maintain best practices necessary for health providers to | 23 | | ensure their capacity to participate in HealthChoice Illinois | 24 | | or YouthCare. The Medicaid Technical Assistance Center shall |
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| 1 | | administer the following: | 2 | | (1) Outreach and engagement: The Medicaid Technical | 3 | | Assistance Center shall undertake efforts to identify and | 4 | | engage community-based providers offering behavioral | 5 | | health services or services addressing the social | 6 | | determinants of health, especially those predominantly | 7 | | serving communities of color or those operating within or | 8 | | near service deserts, for the purpose of offering training | 9 | | and technical assistance to them through the Medicaid | 10 | | Technical Assistance Center. Outreach and engagement | 11 | | services may be subcontracted. | 12 | | (2) Trainings: The Medicaid Technical Assistance | 13 | | Center shall create and administer ongoing trainings for | 14 | | health care providers. Trainings may be subcontracted. The | 15 | | Medicaid Technical Assistance Center shall provide | 16 | | in-person and web-based trainings. In-person training | 17 | | shall be conducted throughout the State. All trainings | 18 | | must be free of charge. The Medicaid Technical Assistance | 19 | | Center shall administer post-training surveys and | 20 | | incorporate feedback. Training content and delivery must | 21 | | be reflective of Illinois providers' varying levels of | 22 | | readiness, resources, and client populations. | 23 | | (3) Web-based resources: The Medicaid Technical | 24 | | Assistance Center shall maintain an independent, easy to | 25 | | navigate, and up-to-date website that includes, but is not | 26 | | limited to: recorded training archives, a training |
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| 1 | | calendar, provider resources and tools, up-to-date | 2 | | explanations of Department and managed care organization | 3 | | guidance, a running database of frequently asked questions | 4 | | and contact information for key staff members of the | 5 | | Department, managed care organizations, and the Medicaid | 6 | | Technical Assistance Center. | 7 | | (4) Learning collaboratives: The Medicaid Technical | 8 | | Assistance Center shall host regional learning | 9 | | collaboratives that will supplement the Medicaid Technical | 10 | | Assistance Center training curriculum to bring together | 11 | | groups of stakeholders to share issues and best practices, | 12 | | and to escalate issues. Leadership of the Department and | 13 | | managed care organizations shall attend learning | 14 | | collaboratives on a quarterly basis. | 15 | | (5) Network adequacy reports: The Medicaid Technical | 16 | | Assistance Center shall publicly release a report on | 17 | | Medicaid provider network adequacy within the first 3 | 18 | | years of implementation and annually thereafter. The | 19 | | reports shall identify provider service deserts and health | 20 | | care disparities by race and ethnicity. | 21 | | (6) Equitable delivery system: The Medicaid Technical | 22 | | Assistance Center is committed to the principle that all | 23 | | Medicaid recipients have accessible and equitable physical | 24 | | and mental healthcare services. All providers served | 25 | | through the Medicaid Technical Assistance Center shall | 26 | | deliver services notwithstanding the patient's race, |
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| 1 | | color, gender, gender identity, age, ancestry, marital | 2 | | status, military status, religion, national origin, | 3 | | disability status, sexual orientation, order of protection | 4 | | status, as defined under Section 1-103 of the Illinois | 5 | | Human Rights Act, or immigration status. | 6 | | Section 20. Federal financial participation. The | 7 | | Department of Healthcare and Family Services, to the extent | 8 | | allowable under federal law, shall maximize federal financial | 9 | | participation for any moneys appropriated to the Department | 10 | | for the Medicaid Technical Assistance Center. Any federal | 11 | | financial participation funds obtained in accordance with this | 12 | | Section shall be used for the further development and | 13 | | expansion of the Medicaid Technical Assistance Center. All | 14 | | federal financial participation funds obtained under this | 15 | | subsection shall be deposited into the Medicaid Technical | 16 | | Assistance Center Fund created under Section 25. | 17 | | Section 25. Medicaid Technical Assistance Center Fund. The | 18 | | Medicaid Technical Assistance Center Fund is created as a | 19 | | special fund in the State treasury. The Fund shall consist of | 20 | | any moneys appropriated to the Department of Healthcare and | 21 | | Family Services for the purposes of this Act and any federal | 22 | | financial participation funds obtained as provided under | 23 | | Section 20. Moneys in the Fund shall be used for carrying out | 24 | | the purposes of this Act and for no other purpose. All interest |
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| 1 | | earned on the moneys in the Fund shall be deposited into the | 2 | | Fund. | 3 | | Section 90. The State Finance Act is amended by adding | 4 | | Section 5.935 as follows: | 5 | | (30 ILCS 105/5.935 new) | 6 | | Sec. 5.935. The Medicaid Technical Assistance Center Fund.
| 7 | | Section 99. Effective date. This Act takes effect upon | 8 | | becoming law.
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