103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2792
 
Introduced 1/17/2024, by Sen. Michael W. Halpin
 
SYNOPSIS AS INTRODUCED:
 
305 ILCS 5/5-2.11 new
    Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires the Department of Human Services, in consultation with the Department of Healthcare and Family Services, to develop a caregiver program to provide direct payments to caregivers of individuals enrolled in the medical assistance program who are disabled for less than 12 months as a result of a diagnosed illness or related treatment. Sets forth the components of the caregiver program, including, but not limited to: (i) criteria applicable to a caregiver, which shall include, but not be limited to, a limitation on the total hours of a caregiver's outside employment plus hours of providing care to the enrollee to ensure that the complete plan of care is delivered; (ii) payment of caregiver services at the personal assistant level of care and pay rate; (iii) limitations on the number of reimbursable hours of personal services; and (iv) utilization of the determination of need evaluation and other comprehensive assessment tools as criteria for determining eligibility and developing service plans under the caregiver program. Requires the Department of Healthcare and Family Services to apply, by January 1, 2025, for any waivers or State Plan amendments necessary for implementation of the caregiver program. Permits the Department of Human services to adopt any rules necessary to implement and administer the caregiver program. Effective immediately.


LRB103 36854 KTG 66966 b

 
 
A BILL FOR
 
SB2792LRB103 36854 KTG 66966 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 
5adding Section 5-2.11 as follows:
 
6    (305 ILCS 5/5-2.11 new)
7    Sec. 5-2.11. Paid caregiver program.
8    (a) The Department of Human Services, in consultation with 
9the Department of Healthcare and Family Services, shall 
10develop a caregiver program to provide direct payments to 
11caregivers of individuals enrolled in the medical assistance 
12program who are disabled for less than 12 months as a result of 
13a diagnosed illness or related treatment. The components of 
14the caregiver program shall include the following:
15        (1) Criteria applicable to a caregiver, which shall 
16    include, but not be limited to, a limitation on the total 
17    hours of a caregiver's outside employment plus hours of 
18    providing care to the enrollee to ensure that the complete 
19    plan of care is delivered.
20        (2) The determination of the personal care or similar 
21    services for which payment may be made. Caregivers shall 
22    be paid at the personal assistant level of care and pay 
23    rate. In those instances in which the enrollee requires 
 
 
SB2792- 2 -LRB103 36854 KTG 66966 b

1    specialized services (for example, services provided by a 
2    certified nursing assistant, licensed practical nurse, or 
3    registered nurse) and the caregiver has the corresponding 
4    certification or licensure, the caregiver shall be paid 
5    the higher rate for the specialized services only. The 
6    specialized services the enrollee is authorized to receive 
7    shall be defined and approved in the services plan.
8        (3) The method for determining that the amount of 
9    personal care or similar services provided by the 
10    caregiver is "extraordinary care" that exceeds the 
11    ordinary care that would be provided to an enrollee 
12    without a disability.
13        (4) Limitations on the number of hours of personal 
14    services that will be reimbursed.
15        (5) Utilization of the determination of need 
16    evaluation and other comprehensive assessment tools as 
17    criteria for determining eligibility and developing 
18    service plans under the caregiver program.
19        (6) Determination of how or whether the provision of 
20    personal care by the caregiver is in the best interest of 
21    the enrollee.
22        (7) Use of procedures that ensure that payments are 
23    made for services rendered.
24        (8) Assurances that the enrollee is capable of 
25    communicating his or her needs.
26        (9) Assurances that the caregiver is emotionally, 
 
 
SB2792- 3 -LRB103 36854 KTG 66966 b

1    physically, and cognitively able to provide the necessary 
2    care to the enrollee.
3    (b) By January 1, 2025, the Department of Healthcare and 
4Family Services shall apply for any State plan amendments or 
5waivers as may be necessary to implement the caregiver program 
6developed under this Section.
7    (c) The Department of Human Services may adopt any rules 
8necessary for the implementation and administration of the 
9caregiver program developed under this Section.
 
10    Section 99. Effective date. This Act takes effect upon 
11becoming law.