Sen. Terry Link
Filed: 2/7/2006
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1 | AMENDMENT TO SENATE BILL 2381
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2 | AMENDMENT NO. ______. Amend Senate Bill 2381 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Older Adult Services Act is amended by | ||||||
5 | changing Section 25 as follows: | ||||||
6 | (320 ILCS 42/25)
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7 | Sec. 25. Older adult services restructuring. No later than | ||||||
8 | January 1, 2005, the Department shall commence the process of | ||||||
9 | restructuring the older adult services delivery system. | ||||||
10 | Priority shall be given to both the expansion of services and | ||||||
11 | the development of new services in priority service areas. | ||||||
12 | Subject to the availability of funding, the restructuring shall | ||||||
13 | include, but not be limited to, the following:
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14 | (1) Planning. The Department shall develop a plan to | ||||||
15 | restructure the State's service delivery system for older | ||||||
16 | adults. The plan shall include a schedule for the | ||||||
17 | implementation of the initiatives outlined in this Act and all | ||||||
18 | other initiatives identified by the participating agencies to | ||||||
19 | fulfill the purposes of this Act. Financing for older adult | ||||||
20 | services shall be based on the principle that "money follows | ||||||
21 | the individual". The plan shall also identify potential | ||||||
22 | impediments to delivery system restructuring and include any | ||||||
23 | known regulatory or statutory barriers. | ||||||
24 | (2) Comprehensive case management. The Department shall |
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1 | implement a statewide system of holistic comprehensive case | ||||||
2 | management. The system shall include the identification and | ||||||
3 | implementation of a universal, comprehensive assessment tool | ||||||
4 | to be used statewide to determine the level of functional, | ||||||
5 | cognitive, socialization, and financial needs of older adults. | ||||||
6 | This tool shall be supported by an electronic intake, | ||||||
7 | assessment, and care planning system linked to a central | ||||||
8 | location. "Comprehensive case management" includes services | ||||||
9 | and coordination such as (i) comprehensive assessment of the | ||||||
10 | older adult (including the physical, functional, cognitive, | ||||||
11 | psycho-social, and social needs of the individual); (ii) | ||||||
12 | development and implementation of a service plan with the older | ||||||
13 | adult to mobilize the formal and family resources and services | ||||||
14 | identified in the assessment to meet the needs of the older | ||||||
15 | adult, including coordination of the resources and services | ||||||
16 | with any other plans that exist for various formal services, | ||||||
17 | such as hospital discharge plans, and with the information and | ||||||
18 | assistance services; (iii) coordination and monitoring of | ||||||
19 | formal and family service delivery, including coordination and | ||||||
20 | monitoring to ensure that services specified in the plan are | ||||||
21 | being provided; (iv) periodic reassessment and revision of the | ||||||
22 | status of the older adult with the older adult or, if | ||||||
23 | necessary, the older adult's designated representative; and | ||||||
24 | (v) in accordance with the wishes of the older adult, advocacy | ||||||
25 | on behalf of the older adult for needed services or resources. | ||||||
26 | (3) Coordinated point of entry. The Department shall | ||||||
27 | implement and publicize a statewide coordinated point of entry | ||||||
28 | using a uniform name, identity, logo, and toll-free number. | ||||||
29 | (4) Public web site. The Department shall develop a public | ||||||
30 | web site that provides links to available services, resources, | ||||||
31 | and reference materials concerning caregiving, diseases, and | ||||||
32 | best practices for use by professionals, older adults, and | ||||||
33 | family caregivers. | ||||||
34 | (5) Expansion of older adult services. The Department shall |
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1 | expand older adult services that promote independence and | ||||||
2 | permit older adults to remain in their own homes and | ||||||
3 | communities. | ||||||
4 | (6) Consumer-directed home and community-based services. | ||||||
5 | The Department shall expand the range of service options | ||||||
6 | available to permit older adults to exercise maximum choice and | ||||||
7 | control over their care. | ||||||
8 | (7) Comprehensive delivery system. The Department shall | ||||||
9 | expand opportunities for older adults to receive services in | ||||||
10 | systems that integrate acute and chronic care. | ||||||
11 | (8) Enhanced transition and follow-up services. The | ||||||
12 | Department shall implement a program of transition from one | ||||||
13 | residential setting to another and follow-up services, | ||||||
14 | regardless of residential setting, pursuant to rules with | ||||||
15 | respect to (i) resident eligibility, (ii) assessment of the | ||||||
16 | resident's health, cognitive, social, and financial needs, | ||||||
17 | (iii) development of transition plans, and (iv) the level of | ||||||
18 | services that must be available before transitioning a resident | ||||||
19 | from one setting to another. | ||||||
20 | (9) Family caregiver support. The Department shall develop | ||||||
21 | strategies for public and private financing of services that | ||||||
22 | supplement and support family caregivers.
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23 | (10) Quality standards and quality improvement. The | ||||||
24 | Department shall establish a core set of uniform quality | ||||||
25 | standards for all providers that focus on outcomes and take | ||||||
26 | into consideration consumer choice and satisfaction, and the | ||||||
27 | Department shall require each provider to implement a | ||||||
28 | continuous quality improvement process to address consumer | ||||||
29 | issues. The continuous quality improvement process must | ||||||
30 | benchmark performance, be person-centered and data-driven, and | ||||||
31 | focus on consumer satisfaction.
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32 | (11) Workforce. The Department shall develop strategies to | ||||||
33 | attract and retain a qualified and stable worker pool, provide | ||||||
34 | living wages and benefits, and create a work environment that |
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1 | is conducive to long-term employment and career development. | ||||||
2 | Resources such as grants, education, and promotion of career | ||||||
3 | opportunities may be used. | ||||||
4 | (12) Coordination of services. The Department shall | ||||||
5 | identify methods to better coordinate service networks to | ||||||
6 | maximize resources and minimize duplication of services and | ||||||
7 | ease of application. | ||||||
8 | (13) Barriers to services. The Department shall identify | ||||||
9 | barriers to the provision, availability, and accessibility of | ||||||
10 | services and shall implement a plan to address those barriers. | ||||||
11 | The plan shall: (i) identify barriers, including but not | ||||||
12 | limited to, statutory and regulatory complexity, reimbursement | ||||||
13 | issues, payment issues, and labor force issues; (ii) recommend | ||||||
14 | changes to State or federal laws or administrative rules or | ||||||
15 | regulations; (iii) recommend application for federal waivers | ||||||
16 | to improve efficiency and reduce cost and paperwork; (iv) | ||||||
17 | develop innovative service delivery models; and (v) recommend | ||||||
18 | application for federal or private service grants. | ||||||
19 | (14) Reimbursement and funding. The Department shall | ||||||
20 | investigate and evaluate costs and payments by defining costs | ||||||
21 | to implement a uniform, audited provider cost reporting system | ||||||
22 | to be considered by all Departments in establishing payments. | ||||||
23 | To the extent possible, multiple cost reporting mandates shall | ||||||
24 | not be imposed. | ||||||
25 | (15) Medicaid nursing home cost containment and Medicare | ||||||
26 | utilization. The Department of Healthcare and Family Services | ||||||
27 | (formerly Department of Public Aid ) , in collaboration with the | ||||||
28 | Department on Aging and the Department of Public Health and in | ||||||
29 | consultation with the Advisory Committee, shall propose a plan | ||||||
30 | to contain Medicaid nursing home costs and maximize Medicare | ||||||
31 | utilization. The plan must not impair the ability of an older | ||||||
32 | adult to choose among available services. The plan shall | ||||||
33 | include, but not be limited to, (i) techniques to maximize the | ||||||
34 | use of the most cost-effective services without sacrificing |
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1 | quality and (ii) methods to identify and serve older adults in | ||||||
2 | need of minimal services to remain independent, but who are | ||||||
3 | likely to develop a need for more extensive services in the | ||||||
4 | absence of those minimal services. | ||||||
5 | (16) Bed reduction. The Department of Public Health shall | ||||||
6 | implement a nursing home conversion program to reduce the | ||||||
7 | number of Medicaid-certified nursing home beds in areas with | ||||||
8 | excess beds. The Department of Healthcare and Family Services
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9 | Public Aid shall investigate changes to the Medicaid nursing | ||||||
10 | facility reimbursement system in order to reduce beds. Such | ||||||
11 | changes may include, but are not limited to, incentive payments | ||||||
12 | that will enable facilities to adjust to the restructuring and | ||||||
13 | expansion of services required by the Older Adult Services Act, | ||||||
14 | including adjustments for the voluntary closure or layaway of | ||||||
15 | nursing home beds certified under Title XIX of the federal | ||||||
16 | Social Security Act. Any savings shall be reallocated to fund | ||||||
17 | home-based or community-based older adult services pursuant to | ||||||
18 | Section 20. | ||||||
19 | (17) Financing. The Department shall investigate and | ||||||
20 | evaluate financing options for older adult services and shall | ||||||
21 | make recommendations in the report required by Section 15 | ||||||
22 | concerning the feasibility of these financing arrangements. | ||||||
23 | These arrangements shall include, but are not limited to: | ||||||
24 | (A) private long-term care insurance coverage for | ||||||
25 | older adult services; | ||||||
26 | (B) enhancement of federal long-term care financing | ||||||
27 | initiatives; | ||||||
28 | (C) employer benefit programs such as medical savings | ||||||
29 | accounts for long-term care; | ||||||
30 | (D) individual and family cost-sharing options; | ||||||
31 | (E) strategies to reduce reliance on government | ||||||
32 | programs; | ||||||
33 | (F) fraudulent asset divestiture and financial | ||||||
34 | planning prevention; and |
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1 | (G) methods to supplement and support family and | ||||||
2 | community caregiving. | ||||||
3 | (18) Older Adult Services Demonstration Grants. The | ||||||
4 | Department shall implement a program of demonstration grants | ||||||
5 | that will assist in the restructuring of the older adult | ||||||
6 | services delivery system, and shall provide funding for | ||||||
7 | innovative service delivery models and system change and | ||||||
8 | integration initiatives pursuant to subsection (g) of Section | ||||||
9 | 20. | ||||||
10 | (19) Bed need methodology update. For the purposes of | ||||||
11 | determining areas with excess beds, the Departments shall | ||||||
12 | provide information and assistance to the Health Facilities | ||||||
13 | Planning Board to update the Bed Need Methodology for Long-Term | ||||||
14 | Care to update the assumptions used to establish the | ||||||
15 | methodology to make them consistent with modern older adult | ||||||
16 | services.
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17 | (20) Affordable housing. The Departments shall utilize the | ||||||
18 | recommendations of Illinois' Annual Comprehensive Housing | ||||||
19 | Plan, as developed by the Affordable Housing Task Force through | ||||||
20 | the Governor's Executive Order 2003-18, in their efforts to | ||||||
21 | address the affordable housing needs of older adults.
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22 | The Older Adult Services Advisory Committee shall | ||||||
23 | investigate innovative and promising practices operating as | ||||||
24 | demonstration or pilot projects in Illinois and in other | ||||||
25 | states. The Department on Aging shall provide the Older Adult | ||||||
26 | Services Advisory Committee with a list of all demonstration or | ||||||
27 | pilot projects funded by the Department on Aging, including | ||||||
28 | those specified by rule, law, policy memorandum, or funding | ||||||
29 | arrangement. The Committee shall work with the Department on | ||||||
30 | Aging to evaluate the viability of expanding these programs | ||||||
31 | into other areas of the State.
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32 | (Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05; | ||||||
33 | revised 12-15-05.)".
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