96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB3194


 
Introduced 2/9/2010, by Sen. M. Maggie Crotty
 
SYNOPSIS AS INTRODUCED:
 		





 


  




20 ILCS 505/5.35a new





20 ILCS 1705/54
  from Ch. 91 1/2, par. 100-54








     Amends the Children and Family Services Act and the Mental Health and Developmental Disabilities Administrative Act. Provides that beginning on the effective date of this amendatory Act, the Department of Human Services shall have the sole and exclusive authority to establish rates for residential services provided to children and adolescents with a developmental disability as defined in the Mental Health and Developmental Disabilities Code. Effective immediately.
  















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FISCAL NOTE ACT MAY APPLY
















 


 


A BILL FOR









 




  






SB3194

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    AN ACT concerning State government.
  
 
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    Be it enacted by the People of the State of Illinois,
 
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represented in the General Assembly:
  
 
 
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    Section 5. The Children and Family Services Act is amended 
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by adding Section 5.35a as follows:
 
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    (20 ILCS 505/5.35a new)
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    Sec. 5.35a. Residential services for children with 
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developmental disabilities; rate-setting authority. Beginning 
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on the effective date of this amendatory Act of the 96th 
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General Assembly, the Department of Human Services shall have 
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the sole and exclusive authority to establish rates for 
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residential services provided to children and adolescents with 
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a developmental disability as defined in the Mental Health and 
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Developmental Disabilities Code.
 
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    Section 10. The Mental Health and Developmental 
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Disabilities Administrative Act is amended  by changing Section 
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54 as follows:
 



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    (20 ILCS 1705/54)  (from Ch. 91 1/2, par. 100-54)



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    Sec. 54. Establishment of rates for purchase of services. 

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    (a) It is the purpose of this Section to establish 
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procedures
for the development, calculation, and communication 
 


 






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of rates promulgated
by the Department for the
purchase of 
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services for persons with a developmental disability, and 
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persons
with mental illness; to require the promulgation of 
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rules which specify the
treatment of costs for purposes of 
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establishing rates for various purchase
care program 
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categories; to require that rates be equitable, 
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understandable,
and established through an open, public 
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process; and to require the delineation
of where purchase care, 
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grant-in-aid, and other payment mechanisms are most

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appropriately utilized.  The Department's rate-setting policy 
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should stimulate
the development of cost effective, clinically 
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appropriate, community-based
residential, and other support 
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services for recipients according to an
annual
statement of 
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purchase care goals and objectives.

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    (b) The Department shall establish rates in all instances 
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where services
are purchased by the Department for a specific 
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recipient from a specific
community service provider for which 
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the Department has the responsibility
for establishing payment 
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rates.  When determining rates, the Department shall
take into 
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consideration differences in the costs of doing business among 
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the
various geographic regions of the State and shall set rates 
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that reflect those
differences.  The Department may, for various 
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program
categories, adopt rates that are set by other State 
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agencies.

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    (c) The Department shall perform the following duties:


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        (1) Develop rate-setting methodologies for purchase 
 


 






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    care program
categories.


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        (2) Promulgate rules and regulations governing 
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    rate-setting, treatment
of costs, treatment of occupancy, 
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    and payment and contracting processes
for purchase care.


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        (3) Collect cost and performance information from care 
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    providers.  The
Department may stipulate forms, unit of 
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    service definitions, reporting
procedures and reporting 
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    intervals.


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        (4) Calculate purchase of care reimbursement rates for 
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    specific providers
based on the promulgated rate 
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    methodology for that program category.


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        (5) Negotiate and implement purchase of care contracts 
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    with specific
providers.


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        (6) Develop an annual statement of purchase care goals 
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    and objectives
detailing maximum units of service by 
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    program category to be purchased.
The plan for each fiscal 
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    year shall be completed by May 1 of the previous
fiscal 
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    year.


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        (7) Conduct an annual review and prepare an annual 
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    report of rates and
units of service purchased, comparing 
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    the annual purchase of care statement
with actual services 
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    purchased, and the actual cost of providing those
services.

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    The report shall be made available by May 1.


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        (8) Establish and promulgate a process and criteria for 
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    appealing rates.


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        (9) Develop and promulgate standards and criteria by 
 


 






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    which provider
performance shall be evaluated.


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        (10) Set rates based on published methodologies and 
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    subject to the
availability
of funds appropriated by the 
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    General Assembly.


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        (11) Establish and promulgate a policy regarding 
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    applicability of income
offsets in rate calculation or 
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    payment processes.


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        (12) Develop criteria for selection of payment 
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    mechanisms to be employed
in funding community services.

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    (d) The Department may investigate and employ alternative 
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rate setting
approaches and engage in demonstration projects.  
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These approaches
must be
publicly articulated by the 
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Department, identifying the purpose and scope
of the 
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alternative approach and evaluation to be conducted.

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    (e) (Blank). 

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    (f) Beginning on the effective date of this amendatory Act 
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of the 96th General Assembly, the Department of Human Services 
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shall have the sole and exclusive authority to establish rates 
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for residential services provided to children and adolescents 
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with a developmental disability as defined in the Mental Health 
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and Developmental Disabilities Code. 
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(Source: P.A. 89-58, eff. 1-1-96; 89-507, eff. 7-1-97; 90-423, 
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eff.
8-15-97.)

 
 
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    Section 99. Effective date. This Act takes effect upon 
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becoming law.