Rep. Michelle Mussman

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that for the calendar year beginning January 1, 2026, and each calendar year thereafter, a nursing facility must spend at least 90% of its adjusted total revenue on resident care and other resident-related costs, as defined. Requires each nursing facility to provide as part of its financial reporting information necessary for the Department of Healthcare and Family Services to administer and enforce the provisions of the amendatory Act. Provides that such information shall be subject to audit provisions and comply with any applicable uniform standards under the Code. Provides that all non-allowable costs, related party adjustments, or compensation to owners reported shall be excluded from the calculation of the amount spent on resident care and other resident-related costs. Requires 25% of costs associated with contract nursing staff to be deducted from the amount spent on resident care and other resident-related costs. Provides that for the calendar year beginning January 1, 2027, and each calendar year thereafter, the Department shall use the required financial reporting submissions to determine whether each nursing facility has met the minimum resident care percent requirement. Provides that if a facility has not met the minimum resident care percent requirement, the amount defined by the facility's total adjusted revenue shall be treated as a vendor overpayment. Requires the Department to recover the full amount of any vendor overpayment by reducing future payments, requiring direct payment to the Department, or any other method permitted under the Code. Requires the Department to adopt rules.

Amends the Illinois Lottery Law. Provides that the Department of the Lottery shall offer a special Lyme Disease Innovation instant scratch-off game for the benefit of the Lyme Disease Innovation Program with net revenue deposited into the Lyme Disease Awareness Fund. Grants the Department of the Lottery rulemaking powers. Adds references to the Lyme Disease Innovation scratch-off game to various provisions in the Act. Provides that the Department shall offer the game upon the discontinuation of the first game that is discontinued under certain provisions of the law. Amends the Department of Natural Resources (Conservation) Law of the Civil Administrative Code of Illinois. Specifies that the Lyme Disease Innovation Program shall be funded through moneys in the Lyme Disease Awareness Fund, including revenue generated from the Lyme Disease Innovation scratch-off game.

Amends the Liquor Control Act of 1934. Increases the self-distribution limit for class 3 brewers that meet certain requirements to not more than 77,500 (instead of 6,200) gallons of beer from each in-state or out-of-state class 3 brewery premises, which shall not exceed 232,500 (instead of 18,600) gallons annually in the aggregate, that is manufactured at a wholly owned class 3 brewer's in-state or out-of-state licensed premises to retail licensees and class 3 brewers and to certain brewers, class 1 brewers, and class 2 brewers. Provides that a special event retailer's license (not-for-profit) shall allow the licensee to sell and offer for sale, at retail, alcoholic liquors for consumption on or off the premises specified in the license (instead of for use or consumption), but not for resale in any form and only at the location and on the specific dates designated for the special event in the license. Provides that, subject to certain conditions, a special use permit license shall allow the sale or offering for sale of certain transferred or delivered alcoholic liquor at retail for consumption on or off the premises specified in the license. Provides that a retail licensee or manufacturer with retail privileges may operate a loyalty program, reward program, or mug club for alcoholic liquors the retailer or manufacturer with retail privileges is licensed to sell so long as the price of the product is not below the retail licensee's or manufacturer with retail privileges' costs. Provides that a retail licensee or licensed manufacturer with retail privileges may offer incentives to consumers for participation in a rewards program, loyalty program, or mug club. Set forth further provisions concerning rewards programs, loyalty programs, and mug clubs. Makes conforming and other changes.

Amends the Mental Health and Developmental Disabilities Administrative Act. Requires the Department of Healthcare and Family Services, in collaboration with the Department of Human Services, to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel who are not subject to the Bureau of Labor Statistics' average wage increases and who work in residential and community day services settings. Provides that for services delivered on or after January 1, 2026, the rates shall include adjustments to employment-related expenses as defined by rule by the Department of Human Services. Requires the Department of Human Services to adopt rules, including emergency rules, to implement the rate increases. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to submit a Title XIX State Plan amendment to the federal Centers for Medicare and Medicaid Services that shall include an increase in the rate methodology sufficient to provide for a wage rate of 150% of the statewide, regional, or local minimum wage for services delivered on or after January 1, 2026, for all direct support personnel and all other frontline personnel at ID/DD and MC/DD facilities. Provides that the State Plan amendment shall provide wage increases for all residential non-executive direct care staff. Effective immediately.

Creates the Homeschool Act. Requires the State Board of Education to create a Homeschool Declaration Form to be used by a homeschool administrator to submit information indicating that a child is enrolled in a homeschool program to the principal of the public school or to the school district that the homeschooled child would otherwise attend. Provides that a student enrolled in a homeschool program in which the homeschool administrator has not notified the public school or school district with the Homeschool Declaration Form is considered truant, with penalties applying. Provides that if a child in a homeschool program seeks to enroll part time in a public school or participate in any public school activities taking place on or off of school grounds, the homeschool administrator must submit proof that the child has received all required immunizations and health examinations or a signed Certificate of Religious Exemption. Sets forth requirements for homeschool administrators and programs and reporting requirements. Makes conforming and other changes in the Freedom of Information Act, the School Code, and the Illinois School Student Records Act, including requiring (rather than allowing) nonpublic schools to register with the State Board of Education.

Creates the Local Accessory Dwelling Unit Act. Provides that a unit of local government may not prohibit the building or usage of accessory dwelling units in the unit of local government. Provides that a unit of local government may provide reasonable regulations relating to the size and location of accessory dwelling units similar to other accessory structures unless a regulation would have the effect of prohibiting accessory dwelling units. Provides that, for the purposes of the Act, a regulation is considered to have the effect of prohibiting an accessory dwelling unit if it: (1) explicitly disallows the construction of accessory dwelling units; (2) imposes fees other than building permit review; (3) applies standards that would render such units inconsistent with other local land use laws; (4) imposes design, bulk, and density standards that would physically preclude the project; (5) requires off-street parking spaces; or (6) requires corrections of nonconformities of the principal dwelling unit. Provides that that a unit of local government shall approve or deny an application for a permit to create or serve an accessory dwelling unit by right and without discretionary review. Requires the unit of local government to either approve or deny the application to create or serve an accessory dwelling unit within 60 days from the date the unit of local government receives a completed application if there is an existing single-family or multi-family dwelling on the lot. Provides that, if the unit of local government has not approved or denied the completed application within 60 days, then the application shall be deemed approved unless the Act provides for additional time. Provides that, if a unit of local government denies an application for an accessory dwelling unit, then the unit of local government shall return a full set of comments to the applicant in writing with a list of items that are defective or deficient and a description of how the application can be remedied by the applicant. Provides that a unit of local government shall not deny an application for a permit to create an accessory dwelling unit due to the correction of nonconforming zoning conditions, building code violations, or unpermitted structures that do not present a threat to public health and safety and are not affected by the construction of the accessory dwelling unit. Defines terms. Limits home rule powers.

Creates the Rural Hospital Task Force Act. Establishes the Rural Hospital Task Force within the Department of Public Health for the purpose of investigating the current state of rural hospitals and providing recommendations to prevent further closures of rural hospitals and to potentially expand rural hospital services. Provides that the Task Force shall convene to conduct business on at least 4 separate days. Requires the Department of Public Health to provide administrative and other support to the Task Force. Requires each agency and entity represented on the Task Force to share with the Task Force any data of the agency or entity necessary to achieve the purpose of the Task Force. Provides that all findings and recommendations made by the Task Force must be reported to the General Assembly before January 1, 2027. Provides that the Task Force is dissolved, and the Act is repealed, on January 1, 2027

Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed after January 1, 2027 shall provide coverage for disposable incontinence supplies for any person with a disability. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, the School Code, the Health Maintenance Organization Act, the Limited Health Service Organization Act, and the Voluntary Health Services Plans Act to require coverage under those provisions.

Amends the Children with Disabilities Article of the School Code. Requires the State Board of Education to provide regulatory guidance to relevant stakeholders regarding individualized education program evaluations.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Healthcare and Family Services to file an amendment to the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities that removes the 5 hour per day billing maximums placed on providers of community day services. The amendment shall not modify monthly and yearly billing maximums for providers of community day services. Effective January 1, 2026.