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1 | AN ACT concerning the Department on Aging.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Illinois Act on the Aging is amended by | ||||||
5 | adding Section 4.02c as follows: | ||||||
6 | (20 ILCS 105/4.02c new) | ||||||
7 | Sec. 4.02c. Comprehensive Care in Residential Settings | ||||||
8 | Demonstration Project.
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9 | (a) The Department may establish and fund a demonstration | ||||||
10 | program of bundled services designed to support the specialized | ||||||
11 | needs of clients currently residing in projects that were | ||||||
12 | formerly designated as Community Based Residential Facilities | ||||||
13 | and licensed under the Assisted Living and Shared Housing Act. | ||||||
14 | (b) The demonstration program must include, at a minimum: | ||||||
15 | (1) 3 meals per day; | ||||||
16 | (2) routine housekeeping services; | ||||||
17 | (3) 24-hour-a-day security; | ||||||
18 | (4) an emergency response system; | ||||||
19 | (5) personal laundry and linen service; | ||||||
20 | (6) assistance with activities of daily living; | ||||||
21 | (7) medication management; and | ||||||
22 | (8) money management. | ||||||
23 | Optional services, such as transportation and social | ||||||
24 | activities, may be provided. | ||||||
25 | (c) Reimbursement for the program shall be based on the | ||||||
26 | client's level of need and functional impairment, as determined | ||||||
27 | by the Department. Clients must meet all eligibility | ||||||
28 | requirements established by rule. The Department may establish | ||||||
29 | a capitated reimbursement mechanism based on the client's level | ||||||
30 | of need and functional impairment. Reimbursement for program | ||||||
31 | must be made to the Department-contracted provider delivering | ||||||
32 | the services. |
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1 | (d) The Department shall adopt rules and provide oversight | ||||||
2 | for the project, with assistance and advice provided by the | ||||||
3 | Assisted Living and Shared Housing Advisory Board and Assisted | ||||||
4 | Living and Shared Housing Quality of Life Committee. | ||||||
5 | The project may be funded through the Department | ||||||
6 | appropriations that may include Medicaid waiver funds. | ||||||
7 | (e) Before January 1, 2008, the Department, in consultation | ||||||
8 | with the Assisted Living and Shared Housing Advisory Board, | ||||||
9 | must report to the General Assembly on the results of the | ||||||
10 | demonstration project. The report must include, without | ||||||
11 | limitation, any recommendations for changes or improvements, | ||||||
12 | including changes or improvements in the administration of the | ||||||
13 | program and an evaluation.
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14 | Section 10. The Assisted Living and Shared Housing Act is | ||||||
15 | amended by changing Sections 90 and 140 as follows:
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16 | (210 ILCS 9/90)
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17 | Sec. 90. Contents of service delivery contract. A contract | ||||||
18 | between an
establishment and a resident must be entitled | ||||||
19 | "assisted living
establishment
contract" or "shared housing | ||||||
20 | establishment contract" as applicable, shall be
printed in no | ||||||
21 | less
than 12 point type, and shall include at least the | ||||||
22 | following elements in the
body or through
supporting documents | ||||||
23 | or attachments:
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24 | (1) the name, street address, and mailing address of | ||||||
25 | the establishment;
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26 | (2) the name and mailing address of the owner or owners | ||||||
27 | of the
establishment and, if
the owner or owners are not | ||||||
28 | natural persons, the type of business entity of the
owner
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29 | or owners;
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30 | (3) the name and mailing address of the managing agent | ||||||
31 | of the
establishment, whether
hired under a management | ||||||
32 | agreement or lease agreement, if the managing agent is
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33 | different from the owner or owners;
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34 | (4) the name and address of at least one natural person |
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1 | who is authorized
to accept
service on behalf of the owners | ||||||
2 | and managing agent;
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3 | (5) a statement describing the license status of the | ||||||
4 | establishment and the
license status
of all providers of | ||||||
5 | health-related or supportive services to a resident under
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6 | arrangement with the establishment;
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7 | (6) the duration of the contract;
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8 | (7) the base rate to be paid by the resident and a | ||||||
9 | description of the
services to be
provided as part of this | ||||||
10 | rate;
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11 | (8) a description of any additional services to be | ||||||
12 | provided for an
additional fee by the
establishment | ||||||
13 | directly or by a third party provider under arrangement | ||||||
14 | with the
establishment;
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15 | (9) the fee schedules outlining the cost of any | ||||||
16 | additional services;
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17 | (10) a description of the process through which the | ||||||
18 | contract may be
modified, amended,
or terminated;
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19 | (11) a description of the establishment's complaint | ||||||
20 | resolution process
available to
residents and notice of the | ||||||
21 | availability of the Department on Aging's Senior
Helpline
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22 | for
complaints;
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23 | (12) the name of the resident's designated | ||||||
24 | representative, if any;
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25 | (13) the resident's obligations in order to maintain | ||||||
26 | residency and
receive
services including compliance with | ||||||
27 | all assessments required under Section 15;
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28 | (14) the billing and payment procedures and | ||||||
29 | requirements;
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30 | (15) a statement affirming the resident's freedom to | ||||||
31 | receive services from
service
providers with whom the | ||||||
32 | establishment does not have a contractual arrangement,
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33 | which may also disclaim liability on the part of the
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34 | establishment for those services;
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35 | (16) a statement that medical assistance under Article | ||||||
36 | V or Article VI of
the Illinois
Public Aid Code is not |
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1 | available for payment for services provided in an
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2 | establishment , excluding contracts executed with residents | ||||||
3 | residing in licensed establishments participating in the | ||||||
4 | Department on Aging's Comprehensive Care in Residential | ||||||
5 | Settings Demonstration Project ;
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6 | (17) a statement detailing the admission, risk | ||||||
7 | management, and residency
termination
criteria and | ||||||
8 | procedures;
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9 | (18) a statement listing the rights specified in | ||||||
10 | Section 95 and
acknowledging that, by contracting with the | ||||||
11 | assisted
living or shared
housing establishment, the | ||||||
12 | resident does not forfeit those rights; and
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13 | (19) a statement detailing the Department's annual | ||||||
14 | on-site review process
including
what documents contained | ||||||
15 | in a resident's personal file shall be reviewed by
the | ||||||
16 | on-site reviewer as defined by rule.
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17 | (Source: P.A. 91-656, eff. 1-1-01.)
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18 | (210 ILCS 9/140)
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19 | Sec. 140. State and private funding. Nothing in this Act | ||||||
20 | shall:
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21 | (1) require or authorize the State agency responsible | ||||||
22 | for the
administration
of the medical
assistance program | ||||||
23 | established under Article V and Article VI of the Illinois
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24 | Public Aid
Code to approve, supply, or cover services | ||||||
25 | provided in an assisted living or
shared housing
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26 | establishment , with the exception of licensed facilities | ||||||
27 | that participate in the Department on Aging's | ||||||
28 | Comprehensive Care in Residential Settings Demonstration | ||||||
29 | Project, which may be covered under provisions of the | ||||||
30 | Illinois Public Aid Code ;
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31 | (2) require an agency or a managed care organization to | ||||||
32 | approve, supply,
or
cover services
provided in an assisted | ||||||
33 | living or shared housing establishment; or
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34 | (3) require any other third party payer to approve, | ||||||
35 | supply or cover
medically necessary home
care services |
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1 | provided in an assisted living establishment.
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2 | (Source: P.A. 91-656, eff. 1-1-01.)
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3 | (20 ILCS 105/4.02b rep.) (from Ch. 23, par. 6104.02b)
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4 | Section 90. The Illinois Act on the Aging is amended by | ||||||
5 | repealing Section 4.02b.
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