SB0545 102ND GENERAL ASSEMBLY

LRB102 15664 KTG 21028 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB0545

Introduced 2/23/2021, by Sen. Sara Feigenholtz

SYNOPSIS AS INTRODUCED:

210 ILCS 49/5-108 new

Amends the Specialized Mental Health Rehabilitation Act of 2013. Requires the Department of Healthcare and Family Services to establish a demonstration pilot program for crisis stabilization services for residents of facilities licensed under the Act. Provides that the pilot program shall be undertaken to prevent unnecessary inpatient hospitalization for behavioral health services. Provides that the licensure of crisis stabilization units by the Department of Public Health shall not be required in order for a facility to qualify for participation in the pilot program. Requires a facility to have had a contractual relationship with a Medicaid managed care organization for the delivery of crisis stabilization services on or before the effective date of the amendatory Act. Provides that the pilot program shall only be offered to individuals who are enrolled in Medicaid managed care plans and reside in facilities that are participating in the pilot program. Requires a participating facility, in conjunction with the Medicaid managed care organization, to collect data including, but not limited to: patient diagnosis, required treatment, duration of stay, and cost of treatment. Requires the Department to collect the data from the facilities and compile a report that compares the costs of the pilot program to similar inpatient care for diagnosis. Provides that the rate for crisis stabilization services under the pilot program shall be negotiated but in no instance may it be less than 150% of the rate in effect for recovery and rehabilitation services. Provides that the pilot program shall have a 3-year duration and shall consist of no more than 40 beds. Effective July 1, 2021.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Specialized Mental Health Rehabilitation Act of 2013 is amended by adding Section 5-108 as follows:

(210 ILCS 49/5-108 new)

Sec. 5-108. Crisis Stabilization and Data Collection Pilot Program. As used in this Section:

"Medicaid managed care organization" has the meaning ascribed to the term "managed care organizations" in Section 5-30.1 of the Illinois Public Aid Code.

"Medicaid managed care plan" means a health care plan operated by a managed care organization under the Medical Assistance Program established in Article V of the Illinois Public Aid Code.

The Department of Healthcare and Family Services shall establish a demonstration pilot program for crisis stabilization services for residents of facilities licensed under this Act. The pilot program shall be undertaken to prevent unnecessary inpatient hospitalization for behavioral health services. The licensure of crisis stabilization units by the Department of Public Health shall not be required in order for a facility to qualify for participation in the pilot program. To qualify for participation, a facility must have had a contractual relationship with a Medicaid managed care organization for the delivery of crisis stabilization services on or before the effective date of this amendatory Act of the 102nd General Assembly. The pilot program shall only be offered to individuals who are enrolled in Medicaid managed care plans and reside in facilities that are participating in the pilot program. A participating facility, in conjunction with the Medicaid managed care organization, shall collect data including, but not limited to: patient diagnosis, required treatment, duration of stay, and cost of treatment. The Medicaid managed care organization, in coordination with the participating facility, shall establish levels of care for those residents who are in need of crisis stabilization services. The Department of Healthcare and Family Services shall collect the data from the facilities and shall compile a report that compares the costs of the pilot program to similar inpatient care for diagnosis. The rate for crisis stabilization services under the pilot program shall be negotiated with the Medicaid managed care organization but in no instance may it be less than 150% of the rate in effect for recovery and rehabilitation services. The Department of Healthcare and Family Services shall build incentive payments for Medicaid managed care plans into the pilot program to encourage crisis stabilization unit utilization in lieu of inpatient psychiatric hospitalization. The pilot program shall be in operation for 3 years beginning on the effective date of this amendatory Act of the 102nd General Assembly and shall consist of no more than 40 beds.

Section 99. Effective date. This Act takes effect July 1, 2021.