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| Public Act 101-0616 | ||||
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AN ACT concerning children.
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Be it enacted by the People of the State of Illinois, | ||||
represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
changing Section 5-5.23 as follows:
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(305 ILCS 5/5-5.23)
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(Text of Section after amendment by P.A. 101-461)
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Sec. 5-5.23. Children's mental health services.
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(a) The Department of Healthcare and Family Services, by | ||||
rule, shall require the screening and
assessment of
a child | ||||
prior to any Medicaid-funded admission to an inpatient hospital | ||||
for
psychiatric
services to be funded by Medicaid. The | ||||
screening and assessment shall include a
determination of the | ||||
appropriateness and availability of out-patient support
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services
for necessary treatment. The Department, by rule, | ||||
shall establish methods and
standards of payment for the | ||||
screening, assessment, and necessary alternative
support
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services.
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(b) The Department of Healthcare and Family Services, to | ||||
the extent allowable under federal law,
shall secure federal | ||||
financial participation for Individual Care Grant
expenditures | ||||
made
by the Department of Healthcare and Family Services for | ||||
the Medicaid optional service
authorized under
Section 1905(h) | ||||
of the federal Social Security Act, pursuant to the provisions
| ||
of Section
7.1 of the Mental Health and Developmental | ||
Disabilities Administrative Act. The
Department of Healthcare | ||
and Family Services may exercise the
authority under this | ||
Section as is necessary to administer
Individual Care Grants as | ||
authorized under Section 7.1 of the
Mental Health and | ||
Developmental Disabilities Administrative
Act.
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(c) The Department of Healthcare and Family Services shall | ||
work collaboratively with the Department of Children and Family
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Services and the Division of Mental Health of the Department of
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Human Services to implement subsections (a) and (b).
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(d) On and after July 1, 2012, the Department shall reduce | ||
any rate of reimbursement for services or other payments or | ||
alter any methodologies authorized by this Code to reduce any | ||
rate of reimbursement for services or other payments in | ||
accordance with Section 5-5e. | ||
(e) All rights, powers, duties, and responsibilities | ||
currently exercised by the Department of Human Services related | ||
to the Individual Care Grant program are transferred to the | ||
Department of Healthcare and Family Services with the transfer | ||
and transition of the Individual Care Grant program to the | ||
Department of Healthcare and Family Services to be completed | ||
and implemented within 6 months after the effective date of | ||
this amendatory Act of the 99th General Assembly. For the | ||
purposes of the Successor Agency Act, the Department of | ||
Healthcare and Family Services is declared to be the successor | ||
agency of the Department of Human Services, but only with | ||
respect to the functions of the Department of Human Services | ||
that are transferred to the Department of Healthcare and Family | ||
Services under this amendatory Act of the 99th General | ||
Assembly. | ||
(1) Each act done by the Department of Healthcare and | ||
Family Services in exercise of the transferred powers, | ||
duties, rights, and responsibilities shall have the same | ||
legal effect as if done by the Department of Human Services | ||
or its offices. | ||
(2) Any rules of the Department of Human Services that | ||
relate to the functions and programs transferred by this | ||
amendatory Act of the 99th General Assembly that are in | ||
full force on the effective date of this amendatory Act of | ||
the 99th General Assembly shall become the rules of the | ||
Department of Healthcare and Family Services. All rules | ||
transferred under this amendatory Act of the 99th General | ||
Assembly are hereby amended such that the term "Department" | ||
shall be defined as the Department of Healthcare and Family | ||
Services and all references to the "Secretary" shall be | ||
changed to the "Director of Healthcare and Family Services | ||
or his or her designee". As soon as practicable hereafter, | ||
the Department of Healthcare and Family Services shall | ||
revise and clarify the rules to reflect the transfer of | ||
rights, powers, duties, and responsibilities affected by | ||
this amendatory Act of the 99th General Assembly, using the | ||
procedures for recodification of rules available under the | ||
Illinois Administrative Procedure Act, except that | ||
existing title, part, and section numbering for the | ||
affected rules may be retained. The Department of | ||
Healthcare and Family Services, consistent with its | ||
authority to do so as granted by this amendatory Act of the | ||
99th General Assembly, shall propose and adopt any other | ||
rules under the Illinois Administrative Procedure Act as | ||
necessary to administer the Individual Care Grant program. | ||
These rules may include, but are not limited to, the | ||
application process and eligibility requirements for | ||
recipients. | ||
(3) All unexpended appropriations and balances and | ||
other funds available for use in connection with any | ||
functions of the Individual Care Grant program shall be | ||
transferred for the use of the Department of Healthcare and | ||
Family Services to operate the Individual Care Grant | ||
program. Unexpended balances shall be expended only for the | ||
purpose for which the appropriation was originally made. | ||
The Department of Healthcare and Family Services shall | ||
exercise all rights, powers, duties, and responsibilities | ||
for operation of the Individual Care Grant program. | ||
(4) Existing personnel and positions of the Department | ||
of Human Services pertaining to the administration of the | ||
Individual Care Grant program shall be transferred to the | ||
Department of Healthcare and Family Services with the | ||
transfer and transition of the Individual Care Grant | ||
program to the Department of Healthcare and Family | ||
Services. The status and rights of Department of Human | ||
Services employees engaged in the performance of the | ||
functions of the Individual Care Grant program shall not be | ||
affected by this amendatory Act of the 99th General | ||
Assembly. The rights of the employees, the State of | ||
Illinois, and its agencies under the Personnel Code and | ||
applicable collective bargaining agreements or under any | ||
pension, retirement, or annuity plan shall not be affected | ||
by this amendatory Act of the 99th General Assembly. All | ||
transferred employees who are members of collective | ||
bargaining units shall retain their seniority, continuous | ||
service, salary, and accrued benefits. | ||
(5) All books, records, papers, documents, property | ||
(real and personal), contracts, and pending business | ||
pertaining to the powers, duties, rights, and | ||
responsibilities related to the functions of the | ||
Individual Care Grant program, including, but not limited | ||
to, material in electronic or magnetic format and necessary | ||
computer hardware and software, shall be delivered to the | ||
Department of Healthcare and Family Services; provided, | ||
however, that the delivery of this information shall not | ||
violate any applicable confidentiality constraints. | ||
(6) Whenever reports or notices are now required to be
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made or given or papers or documents furnished or served by | ||
any person to or upon the Department of Human Services in | ||
connection with any of the functions transferred by this | ||
amendatory Act of the 99th General Assembly, the same shall | ||
be made, given, furnished, or served in the same manner to | ||
or upon the Department of Healthcare and Family Services. | ||
(7) This amendatory Act of the 99th General Assembly | ||
shall not affect any act done, ratified, or canceled or any | ||
right occurring or established or any action or proceeding | ||
had or commenced in an administrative, civil, or criminal | ||
cause regarding the Department of Human Services before the | ||
effective date of this amendatory Act of the 99th General | ||
Assembly; and those actions or proceedings may be defended, | ||
prosecuted, and continued by the Department of Human | ||
Services. | ||
(f) (Blank). | ||
(g) Family Support Program. The Department of Healthcare | ||
and Family Services shall restructure the Family Support | ||
Program, formerly known as the Individual Care Grant program, | ||
to enable early treatment of youth, emerging adults, and | ||
transition-age adults with a serious mental illness or serious | ||
emotional disturbance. | ||
(1) As used in this subsection and in subsections (h) | ||
through (s): | ||
(A) "Youth" means a person under the age of 18. | ||
(B) "Emerging adult" means a person who is 18 | ||
through 20 years of age. | ||
(C) "Transition-age adult" means a person who is 21 | ||
through 25 years of age. | ||
(2) The Department shall amend 89 Ill.
Adm. Code 139 in | ||
accordance with this Section and consistent with the | ||
timelines outlined in this Section. | ||
(3) Implementation of any amended requirements shall | ||
be completed within 8 months of the adoption of any | ||
amendment to 89 Ill.
Adm. Code 139 that is consistent with | ||
the provisions of this Section. | ||
(4) To align the Family Support Program with the | ||
Medicaid system of care, the services available to a youth, | ||
emerging adult, or transition-age adult through the Family | ||
Support Program shall include all Medicaid community-based | ||
mental health treatment services and all Family Support | ||
Program services included under 89 Ill.
Adm. Code 139. No | ||
person receiving services through the Family Support | ||
Program or the Specialized Family Support Program shall | ||
become a Medicaid enrollee unless Medicaid eligibility | ||
criteria are met and the person is enrolled in Medicaid. No | ||
part of this Section creates an entitlement to services | ||
through the Family Support Program, the Specialized Family | ||
Support Program, or the Medicaid program. | ||
(5) The Family Support Program shall align with the | ||
following system of care principles: | ||
(A) Treatment and support services shall be based | ||
on the results of an integrated behavioral health | ||
assessment and treatment plan using an instrument | ||
approved by the Department of Healthcare and Family | ||
Services. | ||
(B)
Strong interagency collaboration between all | ||
State agencies the parent or legal guardian is involved | ||
with for services, including the Department of | ||
Healthcare and Family Services, the Department of | ||
Human Services, the Department of Children and Family | ||
Services, the Department of Juvenile Justice, and the | ||
Illinois State Board of Education. | ||
(C)
Individualized, strengths-based practices and | ||
trauma-informed treatment approaches. | ||
(D)
For a youth, full participation of the parent | ||
or legal guardian at all levels of treatment through a | ||
process that is family-centered and youth-focused. The | ||
process shall include consideration of the services | ||
and supports the parent, legal guardian, or caregiver | ||
requires for family stabilization, and shall connect | ||
such person or persons to services based on available | ||
insurance coverage. | ||
(h) Eligibility for the Family Support Program. | ||
Eligibility criteria established under 89 Ill.
Adm. Code 139 | ||
for the Family Support Program shall include the following: | ||
(1) Individuals applying to the program must be under | ||
the age of 26. | ||
(2) Requirements for parental or legal guardian | ||
involvement are applicable to youth and to emerging adults | ||
or transition-age adults who have a guardian appointed | ||
under Article XIa of the Probate Act. | ||
(3)
Youth, emerging adults, and transition-age adults | ||
are eligible for services under the Family Support Program | ||
upon their third inpatient admission to a hospital or | ||
similar treatment facility for the primary purpose of | ||
psychiatric treatment within the most recent 12 months and | ||
are hospitalized for the purpose of psychiatric treatment. | ||
(4)
School participation for emerging adults applying | ||
for services under the Family Support Program may be waived | ||
by request of the individual at the sole discretion of the | ||
Department of Healthcare and Family Services. | ||
(5) School participation is not applicable to | ||
transition-age adults. | ||
(i) Notification of Family Support Program and Specialized | ||
Family Support Program services. | ||
(1) Within 12 months after the effective date of this | ||
amendatory Act of the 101st General Assembly, the | ||
Department of Healthcare and Family Services, with | ||
meaningful stakeholder input through a working group of | ||
psychiatric hospitals, Family Support Program providers, | ||
family support organizations, the Community and | ||
Residential Services Authority, a statewide association | ||
representing a majority of hospitals, a statewide | ||
association representing physicians, and foster care | ||
alumni advocates, shall establish a clear process by which | ||
a youth's or emerging adult's parents, guardian, or | ||
caregiver, or the emerging adult or transition-age adult, | ||
is identified, notified, and educated about the Family | ||
Support Program and the Specialized Family Support Program | ||
upon a first psychiatric inpatient hospital admission, and | ||
any following psychiatric inpatient admissions. | ||
Notification and education may take place through a Family | ||
Support Program coordinator, a mobile crisis response | ||
provider, a Comprehensive Community Based Youth Services | ||
provider, the Community and Residential Services | ||
Authority, or any other designated provider or coordinator | ||
identified by the Department of Healthcare and Family | ||
Services. In developing this process, the Department of | ||
Healthcare and Family Services and the working group shall | ||
take into account the unique needs of emerging adults and | ||
transition-age adults without parental involvement who are | ||
eligible for services under the Family Support Program. The | ||
Department of Healthcare and Family Services and the | ||
working group shall ensure the appropriate provider or | ||
coordinator is required to assist individuals and their | ||
parents, guardians, or caregivers, as applicable, in the | ||
completion of the application or referral process for the | ||
Family Support Program or the Specialized Family Support | ||
Program. | ||
(2) Upon a youth's, emerging adult's or transition-age | ||
adult's second psychiatric inpatient hospital admission, | ||
prior to hospital discharge, the hospital must, if it is | ||
aware of the patient's prior psychiatric inpatient | ||
hospital admission, ensure that the youth's parents, | ||
guardian, or caregiver, or the emerging adult or | ||
transition-age adult, has have been notified of the Family | ||
Support Program and the Specialized Family Support Program | ||
prior to hospital discharge. | ||
(3) Psychiatric lockout as last resort. | ||
(A) Prior to referring any youth to the Department | ||
of Children and Family Services for the filing of a | ||
petition in accordance with subparagraph (c) of | ||
paragraph (1) of Section 2-4 of the Juvenile Court Act | ||
of 1987 alleging that the youth is dependent because | ||
the youth was left in a psychiatric hospital beyond | ||
medical necessity, the hospital shall attempt to | ||
contact educate the youth and the youth's parents, | ||
guardian, or caregiver about the Family Support | ||
Program and the Specialized Family Support Program and | ||
shall assist with connections to the designated Family | ||
Support Program coordinator in the service area by | ||
providing educational materials developed by the | ||
Department of Healthcare and Family Services. Once | ||
this process has begun, any such youth shall be | ||
considered a youth for whom an application for the | ||
Family Support Program is pending with the Department | ||
of Healthcare and Family Services or an active | ||
application for the Family Support Program was being | ||
reviewed by the Department for the purposes of | ||
subsection (a) of Section 2-4b subparagraph (b) of | ||
paragraph (1) of Section 2-4 of the Juvenile Court Act | ||
of 1987, or for the purposes of subsection (a) of | ||
Section 5-711 of the Juvenile Court Act of 1987. | ||
(B) No state agency or hospital shall coach a | ||
parent or guardian of a youth in a psychiatric hospital | ||
inpatient unit to lock out or otherwise relinquish | ||
custody of a youth to the Department of Children and | ||
Family Services for the sole purpose of obtaining | ||
necessary mental health treatment for the youth. In the | ||
absence of abuse or neglect, a psychiatric lockout or | ||
custody relinquishment to the Department of Children | ||
and Family Services shall only be considered as the | ||
option of last resort. Nothing in this Section shall | ||
prohibit discussion of medical treatment options or a | ||
referral to legal counsel. | ||
(4) Development of new Family Support Program | ||
services. | ||
(A) Development of specialized therapeutic | ||
residential treatment for youth and emerging adults | ||
with high-acuity mental health conditions. Through a | ||
working group led by the Department of Healthcare and | ||
Family Services that includes the Department of | ||
Children and Family Services and residential treatment | ||
providers for youth and emerging adults, the | ||
Department of Healthcare and Family Services, within | ||
12 months after the effective date of this amendatory | ||
Act of the 101st General Assembly, shall develop a plan | ||
for the development of specialized therapeutic | ||
residential treatment beds similar to a qualified | ||
residential treatment program, as defined in the | ||
federal Family First Prevention Services Act, for | ||
youth in the Family Support Program with high-acuity | ||
mental health needs. The Department of Healthcare and | ||
Family Services and the Department of Children and | ||
Family Services shall work together to maximize | ||
federal funding through Medicaid and Title IV-E of the | ||
Social Security Act in the development and | ||
implementation of this plan. | ||
(B) Using the Department of Children and Family | ||
Services' beyond medical necessity data over the last 5 | ||
years and any other relevant, available data, the | ||
Department of Healthcare and Family Services shall | ||
assess the estimated number of these specialized | ||
high-acuity residential treatment beds that are needed | ||
in each region of the State based on the number of | ||
youth remaining in psychiatric hospitals beyond | ||
medical necessity and the number of youth placed | ||
out-of-state who need this level of care. The | ||
Department of Healthcare and Family Services shall | ||
report the results of this assessment to the General | ||
Assembly by no later than December 31, 2020. | ||
(C) Development of an age-appropriate therapeutic | ||
residential treatment model for emerging adults and | ||
transition-age adults. Within 30 months after the | ||
effective date of this amendatory Act of the 101st | ||
General Assembly, the Department of Healthcare and | ||
Family Services, in partnership with the Department of | ||
Human Services' Division of Mental Health and with | ||
significant and meaningful stakeholder input through a | ||
working group of providers and other stakeholders, | ||
shall develop a supportive housing model for emerging | ||
adults and transition-age adults receiving services | ||
through the Family Support Program who need | ||
residential treatment and support to enable recovery. | ||
Such a model shall be age-appropriate and shall allow | ||
the residential component of the model to be in a | ||
community-based setting combined with intensive | ||
community-based mental health services. | ||
(j) Workgroup to develop a plan for improving access to | ||
substance use treatment. The Department of Healthcare and | ||
Family Services and the Department of Human Services' Division | ||
of Substance Use Prevention and Recovery shall co-lead a | ||
working group that includes Family Support Program providers, | ||
family support organizations, and other stakeholders over a | ||
12-month period beginning in the first quarter of calendar year | ||
2020 to develop a plan for increasing access to substance use | ||
treatment services for youth, emerging adults, and | ||
transition-age adults who are eligible for Family Support | ||
Program services. | ||
(k) Appropriation. Implementation of this Section shall be | ||
limited by the State's annual appropriation to the Family | ||
Support Program. Spending within the Family Support Program | ||
appropriation shall be further limited for the new Family | ||
Support Program services to be developed accordingly: | ||
(1) Targeted use of specialized therapeutic | ||
residential treatment for youth and emerging adults with | ||
high-acuity mental health conditions through appropriation | ||
limitation. No more than 12% of all annual Family Support | ||
Program funds shall be spent on this level of care in any | ||
given state fiscal year. | ||
(2) Targeted use of residential treatment model | ||
established for emerging adults and transition-age adults | ||
through appropriation limitation. No more than one-quarter | ||
of all annual Family Support Program funds shall be spent | ||
on this level of care in any given state fiscal year. | ||
(l) Exhausting third party insurance coverage first. | ||
(A) A parent, legal guardian, emerging adult, or | ||
transition-age adult with private insurance coverage shall | ||
work with the Department of Healthcare and Family Services, | ||
or its designee, to identify insurance coverage for any and | ||
all benefits covered by their plan. If insurance | ||
cost-sharing by any method for treatment is | ||
cost-prohibitive for the parent, legal guardian, emerging | ||
adult, or transition-age adult, Family Support Program | ||
funds may be applied as a payer of last resort toward | ||
insurance cost-sharing for purposes of using private | ||
insurance coverage to the fullest extent for the | ||
recommended treatment. If the Department, or its agent, has | ||
a concern relating to the parent's, legal guardian's, | ||
emerging adult's, or transition-age adult's insurer's | ||
compliance with Illinois or federal insurance requirements | ||
relating to the coverage of mental health or substance use | ||
disorders, it shall refer all relevant information to the | ||
applicable regulatory authority. | ||
(B) The Department of Healthcare and Family Services | ||
shall use Medicaid funds first for an individual who has | ||
Medicaid coverage if the treatment or service recommended | ||
using an integrated behavioral health assessment and | ||
treatment plan (using the instrument approved by the | ||
Department of Healthcare and Family Services) is covered by | ||
Medicaid. | ||
(C) If private or public insurance coverage does not | ||
cover the needed treatment or service, Family Support | ||
Program funds shall be used to cover the services offered | ||
through the Family Support Program. | ||
(m) Service authorization. A youth, emerging adult, or | ||
transition-age adult enrolled in the Family Support Program or | ||
the Specialized Family Support Program shall be eligible to | ||
receive a mental health treatment service covered by the | ||
applicable program if the medical necessity criteria | ||
established by the Department of Healthcare and Family Services | ||
are met. | ||
(n) Streamlined application. The Department of Healthcare | ||
and Family Services shall revise the Family Support Program | ||
applications and the application process to reflect the changes | ||
made to this Section by this amendatory Act of the 101st | ||
General Assembly within 8 months after the adoption of any | ||
amendments to 89 Ill.
Adm. Code 139. | ||
(o) Study of reimbursement policies during planned and | ||
unplanned absences of youth and emerging adults in Family | ||
Support Program residential treatment settings. The Department | ||
of Healthcare and Family Services shall undertake a study of | ||
those standards of the Department of Children and Family | ||
Services and other states for reimbursement of residential | ||
treatment during planned and unplanned absences to determine if | ||
reimbursing residential providers for such unplanned absences | ||
positively impacts the availability of residential treatment | ||
for youth and emerging adults. The Department of Healthcare and | ||
Family Services shall begin the study on July 1, 2019 and shall | ||
report its findings and the results of the study to the General | ||
Assembly, along with any recommendations for or against | ||
adopting a similar policy, by December 31, 2020. | ||
(p) Public awareness and educational campaign for all | ||
relevant providers. The Department of Healthcare and Family | ||
Services shall engage in a public awareness campaign to educate | ||
hospitals with psychiatric units, crisis response providers | ||
such as Screening, Assessment and Support Services providers | ||
and Comprehensive Community Based Youth Services agencies, | ||
schools, and other community institutions and providers across | ||
Illinois on the changes made by this amendatory Act of the | ||
101st General Assembly to the Family Support Program. The | ||
Department of Healthcare and Family Services shall produce | ||
written materials geared for the appropriate target audience, | ||
develop webinars, and conduct outreach visits over a 12-month | ||
period beginning after implementation of the changes made to | ||
this Section by this amendatory Act of the 101st General | ||
Assembly. | ||
(q) Maximizing federal matching funds for the Family | ||
Support Program and the Specialized Family Support Program. The | ||
Department of Healthcare and Family Services, as the sole | ||
Medicaid State agency, shall seek approval from the federal | ||
Centers for Medicare and Medicaid Services within 12 months | ||
after the effective date of this amendatory Act of the 101st | ||
General Assembly to draw additional federal Medicaid matching | ||
funds for individuals served under the Family Support Program | ||
or the Specialized Family Support Program who are not covered | ||
by the Department's medical assistance programs. The | ||
Department of Children and Family Services, as the State agency | ||
responsible for administering federal funds pursuant to Title | ||
IV-E of the Social Security Act, shall submit a State Plan to | ||
the federal government within 12 months after the effective | ||
date of this amendatory Act of the 101st General Assembly to | ||
maximize the use of federal Title IV-E prevention funds through | ||
the federal Family First Prevention Services Act, to provide | ||
mental health and substance use disorder treatment services and | ||
supports, including, but not limited to, the provision of | ||
short-term crisis and transition beds post-hospitalization for | ||
youth who are at imminent risk of entering Illinois' youth | ||
welfare system solely due to the inability to access mental | ||
health or substance use treatment services. | ||
(r) Outcomes and data reported annually to the General | ||
Assembly. Beginning in 2021, the Department of Healthcare and | ||
Family Services shall submit an annual report to the General | ||
Assembly that includes the following information with respect | ||
to the time period covered by the report: | ||
(1) The number and ages of youth, emerging adults, and | ||
transition-age adults who requested services under the | ||
Family Support Program and the Specialized Family Support | ||
Program and the services received. | ||
(2) The number and ages of youth, emerging adults, and | ||
transition-age adults who requested services under the | ||
Specialized Family Support Program who were eligible for | ||
services based on the number of hospitalizations. | ||
(3) The number and ages of youth, emerging adults, and | ||
transition-age adults who applied for Family Support | ||
Program or Specialized Family Support Program services but | ||
did not receive any services. | ||
(s) Rulemaking authority. Unless a timeline is otherwise | ||
specified in a subsection, if amendments to 89 Ill. Adm. Code | ||
139 are needed for implementation of this Section, such | ||
amendments shall be filed by the Department of Healthcare and | ||
Family Services within one year after the effective date of | ||
this amendatory Act of the 101st General Assembly. | ||
(Source: P.A. 101-461, eff. 1-1-20.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law. | ||