HB5162 93RD GENERAL ASSEMBLY

LRB093 15222 DRJ 45974 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB5162

Introduced 02/05/04, by Joseph M. Lyons

SYNOPSIS AS INTRODUCED:

New Act

Creates the Priority for In-Home and Community Support Services Act. Requires the Department on Aging and the departments of Human Services and Public Aid to establish programs of in-home and community support services for adults with long-term care needs who have been placed inappropriately in an institutional setting. Requires the head of each department to designate multidisciplinary teams throughout the State to assist with evaluations of persons concerning their eligibility for the programs. Authorizes demonstration projects.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning long-term care.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Priority for In-Home and Community Support Services Act.

Section 5. Findings and policy.

(a) The Legislature finds as follows:

(1) In-home and community support services have not been sufficiently available to many adults with long-term care needs.

(2) Many adults with long-term care needs have already been placed in institutional settings, because in-home and community support services or funds to pay for these services have not been available to them.

(3) In some instances placement of adults with long-term care needs in institutional settings can result in emotional and social problems for these adults and their families.

(4) For many adults with long-term care needs, it is less costly for the State to provide in-home and community support services than it is to provide care in institutional settings.

(b) The Legislature declares that it is the policy of this State:

(1) To increase the availability of in-home and community support services for adults with long-term care needs.

(2) That the priority recipients of in-home and community support services, pursuant to this Act, shall be the elderly and disabled adults who already have been placed inappropriately in an institutional setting.

(3) That a variety of agencies, facilities, and individuals shall be encouraged to provide in-home and community support services.

Section 10. Definitions. In this Act:

"Adult with long-term care needs" means an adult who has a physical or mental limitation that restricts his or her ability to carry out activities of daily living and impedes his or her ability to live independently and who already has been placed inappropriately in an institutional setting.

"Agreement" means a contract, grant, or other method of payment.

"Department" means the Department on Aging, the Department of Human Services, or the Department of Public Aid, as applicable to the population served by each agency respectively.

"In-home and community support services" means health and social services and other assistance required to enable adults with long-term care needs to remain in their places of residence. These services include, but are not limited to, medical and diagnostic services; professional nursing; physical, occupational, and speech therapy; dietary and nutrition services; home health aide services; personal care assistance services; companion and attendant services; handyman, chore, and homemaker services; respite care; counseling services; transportation; small rent subsidies; various devices that lessen the effects of disabilities; and other appropriate and necessary social services.

"Institutional settings" means residential care facilities, intermediate care and skilled nursing facilities and units and hospitals, and State institutions for individuals who are mentally ill or mentally retarded or who have related conditions.

"Personal care assistance services" means services that are required by an adult with long-term care needs to achieve greater physical independence. These services may be consumer-directed and include, but are not limited to, the following:

(1) Routine bodily functions, such as bowel or bladder care.

(2) Dressing.

(3) Preparation and consumption of food.

(4) Moving in and out of bed.

(5) Routine bathing.

(6) Ambulation.

(7) Any other similar activity of daily living.

"Provider" means any entity, agency, facility, or individual who offers or plans to offer any in-home or community support services.

"Severe disability" means a disability that results in a person having a severe and chronic physical, sensory, or cognitive limitation that restricts the person's ability to carry out the normal activities of daily living and to live independently.

Section 15. Programs; rules.

(a) The Department shall establish and administer programs of in-home and community support services for adults with long-term care needs, by itself or in cooperation with the federal government. Programs and services under this Act may include, but are not limited to, the program and services provided under Section 4.02 of the Illinois Act on the Aging.

(b) Subject to appropriation, an adult with long-term care needs who applies for services under any program established under this Act is entitled to receive services under the program if the Department determines that the adult is eligible according to the criteria set forth in Section 20.

(c) The Department shall adopt rules, including rules that specify the criteria to be used in ranking proposals, as necessary for the effective administration of any programs of in-home and community support services established under this Act. The Department shall consult with consumers of in-home and community support services, representatives of such consumers, and providers of such services in developing the rules.

Section 20. Eligibility. An adult with long-term care needs is eligible for in-home and community support services under this Act if the Department determines that the adult:

(1) already has been placed inappropriately in an institutional setting;

(2) has a need for in-home and community support services; and

(3) has no or insufficient personal income or other support from public services, family members, and neighbors.

Section 25. Multidisciplinary teams.

(a) The Department shall designate several multidisciplinary teams throughout the State to assist the Department with evaluations of adults with long-term care needs. Each multidisciplinary team must include at least one social services professional or health care professional and, whenever possible, the adult with long-term care needs and a member of the adult's family or a designated representative.

(b) For each adult with long-term care needs evaluated by a multidisciplinary team, the team shall assist the Department with the following:

(1) Determining the adult's eligibility for in-home and community support services.

(2) Developing a plan of services for the adult, in cooperation with the probable providers of the services, whenever those providers are not members of the team.

(3) Arranging for the provision of the needed services.

(4) Reevaluating the adult periodically to determine his or her continuing need for the services.

(5) Consulting when possible with the adult's attending physician, if any.

Section 30. Delivery of services.

(a) In order to provide in-home and community support services, the Department may use its own staff and its designees and may enter into agreements with providers.

(b) Each agreement entered into under subsection (a) must specify, among other things, the types of in-home and community support services to be provided, the cost of the services, the method of payment, and the criteria to be used for evaluating the provision of services.

(c) The Department shall solicit proposals from providers who would like to provide in-home and community support services under this Act. A provider must submit a proposal in the form and manner required by the Department. The Department shall select proposals according to rankings based on the criteria developed in rules.

(d) The Department may not refuse to pay a relative of an adult with long-term care needs for the provision of in-home and community support services or personal care assistance services if the relative is qualified to provide the services and the payment is not prohibited by federal law or regulation.

Section 35. Funding of programs.

(a) The Department may apply for and use any federal or private moneys and other support that becomes available to carry out any program of in-home and community support services established under this Act.

(b) The Department shall develop, whenever practicable, sliding fee scales for in-home and community support services provided under this Act.

(c) The Department may make payments directly to adults with long-term care needs through the use of vouchers to enable such adults to purchase in-home and community support services under this Act.

(d) The Department shall disburse moneys under this Act in a manner that ensures, to the extent practicable, equitable distribution of services among adults with long-term care needs and among the various regions of the State.

Section 40. Demonstration projects. The Department may initiate demonstration projects to test new ways of providing in-home and community support services, including, but not limited to, projects that test the ability of hospitals, skilled nursing facilities, or intermediate care facilities to provide these services in ancillary facilities or through affiliates.