HB 4745

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Full Text of HB4745
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	HB4745 - 104th General Assembly
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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4745
Introduced , by Rep. Jay Hoffman
SYNOPSIS AS INTRODUCED:
305 ILCS 5/5-5.01a
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning the supportive living facilities program, removes a provision that permits the expansion of supportive living dementia care settings to include elderly non-dementia units in addition to new dementia care units, if the supportive living site is not located within 4 miles of an existing supportive living program site in specified counties.
LRB104 18883 KTG 32328 b
A BILL FOR
		HB4745		LRB104 18883 KTG 32328 b
1    AN ACT concerning public aid.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Public Aid Code is amended by
5changing Section 5-5.01a as follows:
6    (305 ILCS 5/5-5.01a)
7    Sec. 5-5.01a. Supportive living facilities program.
8    (a) The Department shall establish and provide oversight
9for a program of supportive living facilities that seek to
10promote resident independence, dignity, respect, and
11well-being in the most cost-effective manner.
12    A supportive living facility is (i) a free-standing
13facility or (ii) a distinct physical and operational entity
14within a mixed-use building that meets the criteria
15established in subsection (d). A supportive living facility
16integrates housing with health, personal care, and supportive
17services and is a designated setting that offers residents
18their own separate, private, and distinct living units.
19     Sites for the operation of the program shall be selected
20by the Department based upon criteria that may include the
21need for services in a geographic area, the availability of
22funding, and the site's ability to meet the standards.
23    (b) Beginning July 1, 2014, subject to federal approval,
		HB4745	- 2 -	LRB104 18883 KTG 32328 b
1the Medicaid rates for supportive living facilities shall be
2equal to the supportive living facility Medicaid rate
3effective on June 30, 2014 increased by 8.85%. Once the
4assessment imposed at Article V-G of this Code is determined
5to be a permissible tax under Title XIX of the Social Security
6Act, the Department shall increase the Medicaid rates for
7supportive living facilities effective on July 1, 2014 by
89.09%. The Department shall apply this increase retroactively
9to coincide with the imposition of the assessment in Article
10V-G of this Code in accordance with the approval for federal
11financial participation by the Centers for Medicare and
12Medicaid Services.
13    The Medicaid rates for supportive living facilities
14effective on July 1, 2017 must be equal to the rates in effect
15for supportive living facilities on June 30, 2017 increased by
162.8%.
17    The Medicaid rates for supportive living facilities
18effective on July 1, 2018 must be equal to the rates in effect
19for supportive living facilities on June 30, 2018.
20    Subject to federal approval, the Medicaid rates for
21supportive living services on and after July 1, 2019 must be at
22least 54.3% of the average total nursing facility services per
23diem for the geographic areas defined by the Department while
24maintaining the rate differential for dementia care and must
25be updated whenever the total nursing facility service per
26diems are updated. Beginning July 1, 2022, upon the
		HB4745	- 3 -	LRB104 18883 KTG 32328 b
1implementation of the Patient Driven Payment Model, Medicaid
2rates for supportive living services must be at least 54.3% of
3the average total nursing services per diem rate for the
4geographic areas. For purposes of this provision, the average
5total nursing services per diem rate shall include all add-ons
6for nursing facilities for the geographic area provided for in
7Section 5-5.2. The rate differential for dementia care must be
8maintained in these rates and the rates shall be updated
9whenever nursing facility per diem rates are updated.
10    Subject to federal approval, beginning January 1, 2024,
11the dementia care rate for supportive living services must be
12no less than the non-dementia care supportive living services
13rate multiplied by 1.5.
14    (b-5) Subject to federal approval, beginning January 1,
152025, Medicaid rates for supportive living services must be at
16least 54.75% of the average total nursing facility per diem
17rate for the geographic areas defined by the Department and
18shall include all add-ons for nursing facilities for the
19geographic area provided for in Section 5-5.2.
20    (c) The Department may adopt rules to implement this
21Section. Rules that establish or modify the services,
22standards, and conditions for participation in the program
23shall be adopted by the Department in consultation with the
24Department on Aging, the Department of Rehabilitation
25Services, and the Department of Mental Health and
26Developmental Disabilities (or their successor agencies).
		HB4745	- 4 -	LRB104 18883 KTG 32328 b
1    (d) Subject to federal approval by the Centers for
2Medicare and Medicaid Services, the Department shall accept
3for consideration of certification under the program any
4application for a site or building where distinct parts of the
5site or building are designated for purposes other than the
6provision of supportive living services, but only if:
7        (1) those distinct parts of the site or building are
8    not designated for the purpose of providing assisted
9    living services as required under the Assisted Living and
10    Shared Housing Act;
11        (2) those distinct parts of the site or building are
12    completely separate from the part of the building used for
13    the provision of supportive living program services,
14    including separate entrances;
15        (3) those distinct parts of the site or building do
16    not share any common spaces with the part of the building
17    used for the provision of supportive living program
18    services; and
19        (4) those distinct parts of the site or building do
20    not share staffing with the part of the building used for
21    the provision of supportive living program services.
22    (e) Facilities or distinct parts of facilities which are
23selected as supportive living facilities and are in good
24standing with the Department's rules are exempt from the
25provisions of the Nursing Home Care Act and the Illinois
26Health Facilities Planning Act.
		HB4745	- 5 -	LRB104 18883 KTG 32328 b
1    (f) Section 9817 of the American Rescue Plan Act of 2021
2(Public Law 117-2) authorizes a 10% enhanced federal medical
3assistance percentage for supportive living services for a
412-month period from April 1, 2021 through March 31, 2022.
5Subject to federal approval, including the approval of any
6necessary waiver amendments or other federally required
7documents or assurances, for a 12-month period the Department
8must pay a supplemental $26 per diem rate to all supportive
9living facilities with the additional federal financial
10participation funds that result from the enhanced federal
11medical assistance percentage from April 1, 2021 through March
1231, 2022. The Department may issue parameters around how the
13supplemental payment should be spent, including quality
14improvement activities. The Department may alter the form,
15methods, or timeframes concerning the supplemental per diem
16rate to comply with any subsequent changes to federal law,
17changes made by guidance issued by the federal Centers for
18Medicare and Medicaid Services, or other changes necessary to
19receive the enhanced federal medical assistance percentage.
20    (g) (Blank). [All applications for the expansion of ]
21[supportive living dementia care settings involving sites not ]
22[approved by the Department by January 1, 2024 may allow new ]
23[elderly non-dementia units in addition to new dementia care ]
24[units. The Department may approve such applications only if ]
25[the application has: (1) no more than one non-dementia care ]
26[unit for each dementia care unit and (2) the site is not ]
		HB4745	- 6 -	LRB104 18883 KTG 32328 b
1[located within 4 miles of an existing supportive living ]
2[program site in Cook County (including the City of Chicago), ]
3[not located within 12 miles of an existing supportive living ]
4[program site in Alexander, Bond, Boone, Calhoun, Champaign, ]
5[Clinton, DeKalb, DuPage, Fulton, Grundy, Henry, Jackson, ]
6[Jersey, Johnson, Kane, Kankakee, Kendall, Lake, Macon, ]
7[Macoupin, Madison, Marshall, McHenry, McLean, Menard, Mercer, ]
8[Monroe, Peoria, Piatt, Rock Island, Sangamon, Stark, St. ]
9[Clair, Tazewell, Vermilion, Will, Williamson, Winnebago, or ]
10[Woodford counties, or not located within 25 miles of an ]
11[existing supportive living program site in any other county.]
12    (h) Beginning January 1, 2025, subject to federal
13approval, for a person who is a resident of a supportive living
14facility under this Section, the monthly personal needs
15allowance shall be $120 per month.
16    (i) As stated in the supportive living program home and
17community-based service waiver approved by the federal Centers
18for Medicare and Medicaid Services, and beginning July 1,
192025, the Department must maintain the rate add-on implemented
20on January 1, 2023 for the provision of 2 meals per day at no
21less than $6.15 per day.
22    (j) Subject to federal approval, the Department shall
23allow a certified medication aide to administer medication in
24a supportive living facility. For purposes of this subsection,
25"certified medication aide" means a person who has met the
26qualifications for certification under Section 79 of the
		HB4745	- 7 -	LRB104 18883 KTG 32328 b
1Assisted Living and Shared Housing Act and assists with
2medication administration while under the supervision of a
3registered professional nurse as authorized by Section 50-75
4of the Nurse Practice Act. The Department may adopt rules to
5implement this subsection.
6(Source: P.A. 103-102, Article 20, Section 20-5, eff. 1-1-24;
7103-102, Article 100, Section 100-5, eff. 1-1-24; 103-593,
8Article 15, Section 15-5, eff. 6-7-24; 103-593, Article 100,
9Section 100-5, eff. 6-7-24; 103-593, Article 165, Section
10165-5, eff. 6-7-24; 103-605, eff. 7-1-24; 103-886, eff.
118-9-24; 104-9, eff. 6-16-25; 104-417, eff. 8-15-25; revised
129-12-25.)