104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1765 Introduced 2/5/2025, by Sen. Omar Aquino SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.01a Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision concerning applications for the expansion of supportive living dementia care settings, removes language permitting the Department of Healthcare and Family Services to approve such applications only if the application has no more than one non-dementia care unit for each dementia care unit. LRB104 10148 KTG 20220 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1765 Introduced 2/5/2025, by Sen. Omar Aquino SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.01a 305 ILCS 5/5-5.01a Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision concerning applications for the expansion of supportive living dementia care settings, removes language permitting the Department of Healthcare and Family Services to approve such applications only if the application has no more than one non-dementia care unit for each dementia care unit. LRB104 10148 KTG 20220 b LRB104 10148 KTG 20220 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1765 Introduced 2/5/2025, by Sen. Omar Aquino SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.01a 305 ILCS 5/5-5.01a 305 ILCS 5/5-5.01a Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision concerning applications for the expansion of supportive living dementia care settings, removes language permitting the Department of Healthcare and Family Services to approve such applications only if the application has no more than one non-dementia care unit for each dementia care unit. LRB104 10148 KTG 20220 b LRB104 10148 KTG 20220 b LRB104 10148 KTG 20220 b A BILL FOR SB1765LRB104 10148 KTG 20220 b SB1765 LRB104 10148 KTG 20220 b SB1765 LRB104 10148 KTG 20220 b 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 5. The Illinois Public Aid Code is amended by 5 changing 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 9 for a program of supportive living facilities that seek to 10 promote resident independence, dignity, respect, and 11 well-being in the most cost-effective manner. 12 A supportive living facility is (i) a free-standing 13 facility or (ii) a distinct physical and operational entity 14 within a mixed-use building that meets the criteria 15 established in subsection (d). A supportive living facility 16 integrates housing with health, personal care, and supportive 17 services and is a designated setting that offers residents 18 their own separate, private, and distinct living units. 19 Sites for the operation of the program shall be selected 20 by the Department based upon criteria that may include the 21 need for services in a geographic area, the availability of 22 funding, and the site's ability to meet the standards. 23 (b) Beginning July 1, 2014, subject to federal approval, 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1765 Introduced 2/5/2025, by Sen. Omar Aquino SYNOPSIS AS INTRODUCED: 305 ILCS 5/5-5.01a 305 ILCS 5/5-5.01a 305 ILCS 5/5-5.01a Amends the Medical Assistance Article of the Illinois Public Aid Code. In a provision concerning applications for the expansion of supportive living dementia care settings, removes language permitting the Department of Healthcare and Family Services to approve such applications only if the application has no more than one non-dementia care unit for each dementia care unit. LRB104 10148 KTG 20220 b LRB104 10148 KTG 20220 b LRB104 10148 KTG 20220 b A BILL FOR 305 ILCS 5/5-5.01a LRB104 10148 KTG 20220 b SB1765 LRB104 10148 KTG 20220 b SB1765- 2 -LRB104 10148 KTG 20220 b SB1765 - 2 - LRB104 10148 KTG 20220 b SB1765 - 2 - LRB104 10148 KTG 20220 b 1 the Medicaid rates for supportive living facilities shall be 2 equal to the supportive living facility Medicaid rate 3 effective on June 30, 2014 increased by 8.85%. Once the 4 assessment imposed at Article V-G of this Code is determined 5 to be a permissible tax under Title XIX of the Social Security 6 Act, the Department shall increase the Medicaid rates for 7 supportive living facilities effective on July 1, 2014 by 8 9.09%. The Department shall apply this increase retroactively 9 to coincide with the imposition of the assessment in Article 10 V-G of this Code in accordance with the approval for federal 11 financial participation by the Centers for Medicare and 12 Medicaid Services. 13 The Medicaid rates for supportive living facilities 14 effective on July 1, 2017 must be equal to the rates in effect 15 for supportive living facilities on June 30, 2017 increased by 16 2.8%. 17 The Medicaid rates for supportive living facilities 18 effective on July 1, 2018 must be equal to the rates in effect 19 for supportive living facilities on June 30, 2018. 20 Subject to federal approval, the Medicaid rates for 21 supportive living services on and after July 1, 2019 must be at 22 least 54.3% of the average total nursing facility services per 23 diem for the geographic areas defined by the Department while 24 maintaining the rate differential for dementia care and must 25 be updated whenever the total nursing facility service per 26 diems are updated. Beginning July 1, 2022, upon the SB1765 - 2 - LRB104 10148 KTG 20220 b SB1765- 3 -LRB104 10148 KTG 20220 b SB1765 - 3 - LRB104 10148 KTG 20220 b SB1765 - 3 - LRB104 10148 KTG 20220 b 1 implementation of the Patient Driven Payment Model, Medicaid 2 rates for supportive living services must be at least 54.3% of 3 the average total nursing services per diem rate for the 4 geographic areas. For purposes of this provision, the average 5 total nursing services per diem rate shall include all add-ons 6 for nursing facilities for the geographic area provided for in 7 Section 5-5.2. The rate differential for dementia care must be 8 maintained in these rates and the rates shall be updated 9 whenever nursing facility per diem rates are updated. 10 Subject to federal approval, beginning January 1, 2024, 11 the dementia care rate for supportive living services must be 12 no less than the non-dementia care supportive living services 13 rate multiplied by 1.5. 14 (b-5) Subject to federal approval, beginning January 1, 15 2025, Medicaid rates for supportive living services must be at 16 least 54.75% of the average total nursing services per diem 17 rate for the geographic areas defined by the Department and 18 shall include all add-ons for nursing facilities for the 19 geographic area provided for in Section 5-5.2. 20 (c) The Department may adopt rules to implement this 21 Section. Rules that establish or modify the services, 22 standards, and conditions for participation in the program 23 shall be adopted by the Department in consultation with the 24 Department on Aging, the Department of Rehabilitation 25 Services, and the Department of Mental Health and 26 Developmental Disabilities (or their successor agencies). SB1765 - 3 - LRB104 10148 KTG 20220 b SB1765- 4 -LRB104 10148 KTG 20220 b SB1765 - 4 - LRB104 10148 KTG 20220 b SB1765 - 4 - LRB104 10148 KTG 20220 b 1 (d) Subject to federal approval by the Centers for 2 Medicare and Medicaid Services, the Department shall accept 3 for consideration of certification under the program any 4 application for a site or building where distinct parts of the 5 site or building are designated for purposes other than the 6 provision 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 23 selected as supportive living facilities and are in good 24 standing with the Department's rules are exempt from the 25 provisions of the Nursing Home Care Act and the Illinois 26 Health Facilities Planning Act. SB1765 - 4 - LRB104 10148 KTG 20220 b SB1765- 5 -LRB104 10148 KTG 20220 b SB1765 - 5 - LRB104 10148 KTG 20220 b SB1765 - 5 - LRB104 10148 KTG 20220 b 1 (f) Section 9817 of the American Rescue Plan Act of 2021 2 (Public Law 117-2) authorizes a 10% enhanced federal medical 3 assistance percentage for supportive living services for a 4 12-month period from April 1, 2021 through March 31, 2022. 5 Subject to federal approval, including the approval of any 6 necessary waiver amendments or other federally required 7 documents or assurances, for a 12-month period the Department 8 must pay a supplemental $26 per diem rate to all supportive 9 living facilities with the additional federal financial 10 participation funds that result from the enhanced federal 11 medical assistance percentage from April 1, 2021 through March 12 31, 2022. The Department may issue parameters around how the 13 supplemental payment should be spent, including quality 14 improvement activities. The Department may alter the form, 15 methods, or timeframes concerning the supplemental per diem 16 rate to comply with any subsequent changes to federal law, 17 changes made by guidance issued by the federal Centers for 18 Medicare and Medicaid Services, or other changes necessary to 19 receive the enhanced federal medical assistance percentage. 20 (g) All applications for the expansion of supportive 21 living dementia care settings involving sites not approved by 22 the Department by January 1, 2024 (Public Act 103-102) may 23 allow new elderly non-dementia units in addition to new 24 dementia care units. The Department may approve such 25 applications only if the application has: (1) no more than one 26 non-dementia care unit for each dementia care unit and (2) the SB1765 - 5 - LRB104 10148 KTG 20220 b SB1765- 6 -LRB104 10148 KTG 20220 b SB1765 - 6 - LRB104 10148 KTG 20220 b SB1765 - 6 - LRB104 10148 KTG 20220 b 1 proposed site is not located within 4 miles of an existing 2 supportive living program site in Cook County (including the 3 City of Chicago), not located within 12 miles of an existing 4 supportive living program site in Alexander, Bond, Boone, 5 Calhoun, Champaign, Clinton, DeKalb, DuPage, Fulton, Grundy, 6 Henry, Jackson, Jersey, Johnson, Kane, Kankakee, Kendall, 7 Lake, Macon, Macoupin, Madison, Marshall, McHenry, McLean, 8 Menard, Mercer, Monroe, Peoria, Piatt, Rock Island, Sangamon, 9 Stark, St. Clair, Tazewell, Vermilion, Will, Williamson, 10 Winnebago, or Woodford counties, or not located within 25 11 miles of an existing supportive living program site in any 12 other county. 13 (h) Beginning January 1, 2025, subject to federal 14 approval, for a person who is a resident of a supportive living 15 facility under this Section, the monthly personal needs 16 allowance shall be $120 per month. 17 (i) (h) As stated in the supportive living program home 18 and community-based service waiver approved by the federal 19 Centers for Medicare and Medicaid Services, and beginning July 20 1, 2025, the Department must maintain the rate add-on 21 implemented on January 1, 2023 for the provision of 2 meals per 22 day at no less than $6.15 per day. 23 (j) (f) Subject to federal approval, the Department shall 24 allow a certified medication aide to administer medication in 25 a supportive living facility. For purposes of this subsection, 26 "certified medication aide" means a person who has met the SB1765 - 6 - LRB104 10148 KTG 20220 b SB1765- 7 -LRB104 10148 KTG 20220 b SB1765 - 7 - LRB104 10148 KTG 20220 b SB1765 - 7 - LRB104 10148 KTG 20220 b SB1765 - 7 - LRB104 10148 KTG 20220 b