Rep. Sara Feigenholtz
Filed: 3/22/2007
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1 | AMENDMENT TO HOUSE BILL 652
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2 | AMENDMENT NO. ______. Amend House Bill 652 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Act on the Aging is amended by | ||||||
5 | changing Section 4.02 as follows:
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6 | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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7 | Sec. 4.02. Community Care Program.
The Department shall | ||||||
8 | establish a program of services to
prevent unnecessary | ||||||
9 | institutionalization of persons age 60 and older in
need of | ||||||
10 | long term care or who are established as persons who suffer | ||||||
11 | from
Alzheimer's disease or a related disorder under the | ||||||
12 | Alzheimer's Disease
Assistance Act, thereby enabling them
to | ||||||
13 | remain in their own homes or in other living arrangements. Such
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14 | preventive services, which may be coordinated with other | ||||||
15 | programs for the
aged and monitored by area agencies on aging | ||||||
16 | in cooperation with the
Department, may include, but are not |
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1 | limited to, any or all of the following:
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2 | (a) home health services;
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3 | (b) home nursing services;
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4 | (c) homemaker services;
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5 | (d) personal assistant services
chore and housekeeping | ||||||
6 | services ;
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7 | (e) adult day services;
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8 | (f) home-delivered meals;
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9 | (g) education in self-care;
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10 | (h) personal care services;
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11 | (i) adult day health services;
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12 | (j) habilitation services;
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13 | (k) respite care;
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14 | (k-5) community reintegration services;
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15 | (K-6) flexible senior services; | ||||||
16 | (K-7) medication management; | ||||||
17 | (K-8) emergency home response;
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18 | (l) other nonmedical social services that may enable | ||||||
19 | the person
to become self-supporting; or
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20 | (m) clearinghouse for information provided by senior | ||||||
21 | citizen home owners
who want to rent rooms to or share | ||||||
22 | living space with other senior citizens.
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23 | An eligible individual shall have the right to choose among | ||||||
24 | the services above up to the monthly service cost maximums as | ||||||
25 | established by rule. Care plans established under this Section | ||||||
26 | shall be based on a 31-day month. The Department shall not |
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1 | establish rules or policies to limit services contained in the | ||||||
2 | care plan, including a service delivery month that reflects | ||||||
3 | more than 31 days.
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4 | The Department shall establish eligibility standards for | ||||||
5 | such
services taking into consideration the unique economic and | ||||||
6 | social needs
of the target population for whom they are to be | ||||||
7 | provided. Such eligibility
standards shall be based on the | ||||||
8 | recipient's ability to pay for services;
provided, however, | ||||||
9 | that in determining the amount and nature of services
for which | ||||||
10 | a person may qualify, consideration shall not be given to the
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11 | value of cash, property or other assets held in the name of the | ||||||
12 | person's
spouse pursuant to a written agreement dividing | ||||||
13 | marital property into equal
but separate shares or pursuant to | ||||||
14 | a transfer of the person's interest in a
home to his spouse, | ||||||
15 | provided that the spouse's share of the marital
property is not | ||||||
16 | made available to the person seeking such services.
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17 | Beginning July 1, 2002, the Department shall require as a | ||||||
18 | condition of
eligibility that all financially eligible | ||||||
19 | applicants and recipients apply
for and, beginning July 1, | ||||||
20 | 2007, if eligible, enroll in medical assistance
under Article V | ||||||
21 | of the Illinois Public Aid Code in accordance with rules
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22 | promulgated by the Department.
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23 | The Department shall, in conjunction with the Department of | ||||||
24 | Public Aid (now Department of Healthcare and Family Services),
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25 | seek appropriate amendments under Sections 1915 and 1924 of the | ||||||
26 | Social
Security Act. The purpose of the amendments shall be to |
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1 | extend eligibility
for home and community based services under | ||||||
2 | Sections 1915 and 1924 of the
Social Security Act to persons | ||||||
3 | who transfer to or for the benefit of a
spouse those amounts of | ||||||
4 | income and resources allowed under Section 1924 of
the Social | ||||||
5 | Security Act. Subject to the approval of such amendments, the
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6 | Department shall extend the provisions of Section 5-4 of the | ||||||
7 | Illinois
Public Aid Code to persons who, but for the provision | ||||||
8 | of home or
community-based services, would require the level of | ||||||
9 | care provided in an
institution, as is provided for in federal | ||||||
10 | law. Those persons no longer
found to be eligible for receiving | ||||||
11 | noninstitutional services due to changes
in the eligibility | ||||||
12 | criteria shall be given 60 days notice prior to actual
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13 | termination. Those persons receiving notice of termination may | ||||||
14 | contact the
Department and request the determination be | ||||||
15 | appealed at any time during the
60 day notice period. With the | ||||||
16 | exception of the lengthened notice and time
frame for the | ||||||
17 | appeal request, the appeal process shall follow the normal
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18 | procedure. In addition, each person affected regardless of the
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19 | circumstances for discontinued eligibility shall be given | ||||||
20 | notice and the
opportunity to purchase the necessary services | ||||||
21 | through the Community Care
Program. If the individual does not | ||||||
22 | elect to purchase services, the
Department shall advise the | ||||||
23 | individual of alternative services. The target
population | ||||||
24 | identified for the purposes of this Section are persons age 60
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25 | and older with an identified service need. Priority shall be | ||||||
26 | given to those
who are at imminent risk of |
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1 | institutionalization. The services shall be
provided to | ||||||
2 | eligible persons age 60 and older to the extent that the cost
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3 | of the services together with the other personal maintenance
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4 | expenses of the persons are reasonably related to the standards
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5 | established for care in a group facility appropriate to the | ||||||
6 | person's
condition. These non-institutional services, pilot | ||||||
7 | projects or
experimental facilities may be provided as part of | ||||||
8 | or in addition to
those authorized by federal law or those | ||||||
9 | funded and administered by the
Department of Human Services. | ||||||
10 | The Departments of Human Services, Healthcare and Family | ||||||
11 | Services,
Public Health, Veterans' Affairs, and Commerce and | ||||||
12 | Economic Opportunity and
other appropriate agencies of State, | ||||||
13 | federal and local governments shall
cooperate with the | ||||||
14 | Department on Aging in the establishment and development
of the | ||||||
15 | non-institutional services. The Department shall require an | ||||||
16 | annual
audit from all chore/housekeeping and homemaker vendors | ||||||
17 | contracting with
the Department under this Section. The annual | ||||||
18 | audit shall assure that each
audited vendor's procedures are in | ||||||
19 | compliance with Department's financial
reporting guidelines | ||||||
20 | requiring an administrative and employee wage and benefits cost | ||||||
21 | split as defined in administrative rules. The audit is a public | ||||||
22 | record under
the Freedom of Information Act. The Department | ||||||
23 | shall execute, relative to
the nursing home prescreening | ||||||
24 | project, written inter-agency
agreements with the Department | ||||||
25 | of Human Services and the Department
of Healthcare and Family | ||||||
26 | Services, to effect the following: (1) intake procedures and |
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1 | common
eligibility criteria for those persons who are receiving | ||||||
2 | non-institutional
services; and (2) the establishment and | ||||||
3 | development of non-institutional
services in areas of the State | ||||||
4 | where they are not currently available or are
undeveloped. On | ||||||
5 | and after July 1, 1996, all nursing home prescreenings for
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6 | individuals 60 years of age or older shall be conducted by the | ||||||
7 | Department.
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8 | As part of the Department on Aging's routine training of | ||||||
9 | case managers and case manager supervisors, the Department may | ||||||
10 | include information on family futures planning for persons who | ||||||
11 | are age 60 or older and who are caregivers of their adult | ||||||
12 | children with developmental disabilities. The content of the | ||||||
13 | training shall be at the Department's discretion. | ||||||
14 | The Department is authorized to establish a system of | ||||||
15 | recipient copayment
for services provided under this Section, | ||||||
16 | such copayment to be based upon
the recipient's ability to pay | ||||||
17 | but in no case to exceed the actual cost of
the services | ||||||
18 | provided. Additionally, any portion of a person's income which
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19 | is equal to or less than the federal poverty standard shall not | ||||||
20 | be
considered by the Department in determining the copayment. | ||||||
21 | The level of
such copayment shall be adjusted whenever | ||||||
22 | necessary to reflect any change
in the officially designated | ||||||
23 | federal poverty standard.
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24 | The Department, or the Department's authorized | ||||||
25 | representative, shall
recover the amount of moneys expended for | ||||||
26 | services provided to or in
behalf of a person under this |
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1 | Section by a claim against the person's
estate or against the | ||||||
2 | estate of the person's surviving spouse, but no
recovery may be | ||||||
3 | had until after the death of the surviving spouse, if
any, and | ||||||
4 | then only at such time when there is no surviving child who
is | ||||||
5 | under age 21, blind, or permanently and totally disabled. This
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6 | paragraph, however, shall not bar recovery, at the death of the | ||||||
7 | person, of
moneys for services provided to the person or in | ||||||
8 | behalf of the person under
this Section to which the person was | ||||||
9 | not entitled;
provided that such recovery shall not be enforced | ||||||
10 | against any real estate while
it is occupied as a homestead by | ||||||
11 | the surviving spouse or other dependent, if no
claims by other | ||||||
12 | creditors have been filed against the estate, or, if such
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13 | claims have been filed, they remain dormant for failure of | ||||||
14 | prosecution or
failure of the claimant to compel administration | ||||||
15 | of the estate for the purpose
of payment. This paragraph shall | ||||||
16 | not bar recovery from the estate of a spouse,
under Sections | ||||||
17 | 1915 and 1924 of the Social Security Act and Section 5-4 of the
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18 | Illinois Public Aid Code, who precedes a person receiving | ||||||
19 | services under this
Section in death. All moneys for services
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20 | paid to or in behalf of the person under this Section shall be | ||||||
21 | claimed for
recovery from the deceased spouse's estate. | ||||||
22 | "Homestead", as used
in this paragraph, means the dwelling | ||||||
23 | house and
contiguous real estate occupied by a surviving spouse
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24 | or relative, as defined by the rules and regulations of the | ||||||
25 | Department of Healthcare and Family Services, regardless of the | ||||||
26 | value of the property.
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1 | The Department shall increase the effectiveness of the | ||||||
2 | existing Community Care Program by: | ||||||
3 | (1) ensuring that homemaker services, personal | ||||||
4 | assistant services, and emergency home response are | ||||||
5 | available on evenings and weekends; | ||||||
6 | (2) ensuring that care plans contain the services that | ||||||
7 | eligible participants' need, not limited to specific | ||||||
8 | blocks of time, as identified by the comprehensive | ||||||
9 | assessment tool selected by the Department for use | ||||||
10 | statewide, up to the total monthly service cost maximum | ||||||
11 | allowed for each service; | ||||||
12 | (3) ensuring that the participants have the right to | ||||||
13 | chose the services contained in their care plan and to | ||||||
14 | direct how those services are provided, based on | ||||||
15 | administrative rules established by the Department; | ||||||
16 | (4) ensuring that the determination of need tool is | ||||||
17 | accurate in determining the participants' level of need; to | ||||||
18 | achieve this, the Department, in conjunction with the Older | ||||||
19 | Adult Services Advisory Committee, shall institute a study | ||||||
20 | of the relationship between the Determination of Need | ||||||
21 | scores, level of need, Service Cost Maximums and the | ||||||
22 | development and utilization of service plans no later than | ||||||
23 | November 1, 2007; findings and recommendations shall be | ||||||
24 | presented to the General Assembly no later than January 1, | ||||||
25 | 2008; recommendations shall include all needed changes to | ||||||
26 | the service cost maximums schedule and additional covered |
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1 | services; | ||||||
2 | (5) ensuring that clients have appropriate levels of | ||||||
3 | service by increasing Service Cost Maximums; on July 1, | ||||||
4 | 2007, the Service Cost Maximums shall be increased by 25%; | ||||||
5 | on July 1, 2008, Service Cost Maximums shall be increased | ||||||
6 | based on the results of the study as required by subpart | ||||||
7 | (4) above;
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8 | (6) ensuring that the clients have the full benefit of | ||||||
9 | Service Cost Maximums by permitting the unused balance to | ||||||
10 | be used for the purpose of paying for flexible senior | ||||||
11 | services; | ||||||
12 | (7) ensuring that homemakers can provide personal care | ||||||
13 | services that may or may not involve contact with clients, | ||||||
14 | including but not limited to: | ||||||
15 | (A) bathing; | ||||||
16 | (B) grooming; | ||||||
17 | (C) toileting; | ||||||
18 | (D) nail care; | ||||||
19 | (E) transferring; | ||||||
20 | (F) respiratory services; | ||||||
21 | (G) exercise; or | ||||||
22 | (H) positioning; | ||||||
23 | (8) ensuring that the client has choice in how in-home | ||||||
24 | services are provided by including personal assistant | ||||||
25 | services in the list of services that may be provided by | ||||||
26 | the Community Care Program; |
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1 | (9) ensuring that homemaker program vendors are not | ||||||
2 | restricted from hiring homemakers who are family members of | ||||||
3 | clients or recommended by clients; the Department may not, | ||||||
4 | by rule or policy, require homemakers who are family | ||||||
5 | members of clients or recommended by clients to accept | ||||||
6 | assignments in homes other than the client; and | ||||||
7 | (10) ensuring that the State may access maximum federal | ||||||
8 | matching funds by seeking approval for the Centers for | ||||||
9 | Medicare and Medicaid Services for modifications to the | ||||||
10 | State's home and community based services waiver and | ||||||
11 | additional waiver opportunities in order to maximize | ||||||
12 | federal matching funds; this shall include, but not be | ||||||
13 | limited to, modification that reflects all changes in the | ||||||
14 | mandatory Community Care Program services and all | ||||||
15 | increases in the Services Cost Maximum. | ||||||
16 | By January 1, 2009 or as soon after the end of the Cash and | ||||||
17 | Counseling Demonstration Project as is practicable, the | ||||||
18 | Department shall promulgate rules concerning personal | ||||||
19 | assistant services to include, but need not be limited to, | ||||||
20 | qualifications, employment screening, rights under fair labor | ||||||
21 | standards, training, fiduciary agent, and supervision | ||||||
22 | requirements. All applicants shall be subject to the provisions | ||||||
23 | of the Health Care Worker Background Check Act.
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24 | The Department shall develop procedures to enhance | ||||||
25 | availability of
services on evenings, weekends, and on an | ||||||
26 | emergency basis to meet the
respite needs of caregivers. |
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1 | Procedures shall be developed to permit the
utilization of | ||||||
2 | services in successive blocks of 24 hours up to the monthly
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3 | maximum established by the Department. Workers providing these | ||||||
4 | services
shall be appropriately trained.
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5 | Beginning on the effective date of this Amendatory Act of | ||||||
6 | 1991, no person
may perform chore/housekeeping and homemaker | ||||||
7 | services under a program
authorized by this Section unless that | ||||||
8 | person has been issued a certificate
of pre-service to do so by | ||||||
9 | his or her employing agency. Information
gathered to effect | ||||||
10 | such certification shall include (i) the person's name,
(ii) | ||||||
11 | the date the person was hired by his or her current employer, | ||||||
12 | and
(iii) the training, including dates and levels. Persons | ||||||
13 | engaged in the
program authorized by this Section before the | ||||||
14 | effective date of this
amendatory Act of 1991 shall be issued a | ||||||
15 | certificate of all pre- and
in-service training from his or her | ||||||
16 | employer upon submitting the necessary
information. The | ||||||
17 | employing agency shall be required to retain records of
all | ||||||
18 | staff pre- and in-service training, and shall provide such | ||||||
19 | records to
the Department upon request and upon termination of | ||||||
20 | the employer's contract
with the Department. In addition, the | ||||||
21 | employing agency is responsible for
the issuance of | ||||||
22 | certifications of in-service training completed to their
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23 | employees.
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24 | The Department is required to develop a system to ensure | ||||||
25 | that persons
working as homemakers and chore housekeepers | ||||||
26 | receive increases in their
wages when the federal minimum wage |
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1 | is increased by requiring vendors to
certify that they are | ||||||
2 | meeting the federal minimum wage statute for homemakers
and | ||||||
3 | chore housekeepers. An employer that cannot ensure that the | ||||||
4 | minimum
wage increase is being given to homemakers and chore | ||||||
5 | housekeepers
shall be denied any increase in reimbursement | ||||||
6 | costs.
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7 | The Community Care Program Advisory Committee is created in | ||||||
8 | the Department on Aging. The Director shall appoint individuals | ||||||
9 | to serve in the Committee, who shall serve at their own | ||||||
10 | expense. Members of the Committee must abide by all applicable | ||||||
11 | ethics laws. The Committee shall advise the Department on | ||||||
12 | issues related to the Department's program of services to | ||||||
13 | prevent unnecessary institutionalization. The Committee shall | ||||||
14 | meet on a bi-monthly basis and shall serve to identify and | ||||||
15 | advise the Department on present and potential issues affecting | ||||||
16 | the service delivery network, the program's clients, and the | ||||||
17 | Department and to recommend solution strategies. Persons | ||||||
18 | appointed to the Committee shall be appointed on, but not | ||||||
19 | limited to, their own and their agency's experience with the | ||||||
20 | program, geographic representation, and willingness to serve. | ||||||
21 | The Committee shall include, but not be limited to, | ||||||
22 | representatives from the following agencies and organizations: | ||||||
23 | (a) at least 4 adult day service representatives; | ||||||
24 | (b) at least 4 case coordination unit representatives; | ||||||
25 | (c) at least 4 representatives from in-home direct care | ||||||
26 | service agencies; |
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1 | (d) at least 2 representatives of statewide trade or | ||||||
2 | labor unions that represent in-home direct care service | ||||||
3 | staff;
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4 | (e) at least 2 representatives of Area Agencies on | ||||||
5 | Aging; | ||||||
6 | (f) at least 2 non-provider representatives from a | ||||||
7 | policy, advocacy, research, or other service organization; | ||||||
8 | (g) at least 2 representatives from a statewide | ||||||
9 | membership organization for senior citizens; and | ||||||
10 | (h) at least 2 citizen members 60 years of age or | ||||||
11 | older. | ||||||
12 | Nominations may be presented from any agency or State | ||||||
13 | association with interest in the program. The Director, or his | ||||||
14 | or her designee, shall serve as the permanent co-chair of the | ||||||
15 | advisory committee. One other co-chair shall be nominated and | ||||||
16 | approved by the members of the committee on an annual basis. | ||||||
17 | Committee members' terms of appointment shall be for 4 years | ||||||
18 | with one-quarter of the appointees' terms expiring each year. | ||||||
19 | At no time may a member serve more than one consecutive term in | ||||||
20 | any capacity on the committee. The Department shall fill | ||||||
21 | vacancies that have a remaining term of over one year, and this | ||||||
22 | replacement shall occur through the annual replacement of | ||||||
23 | expiring terms. The Director shall designate Department staff | ||||||
24 | to provide technical assistance and staff support to the | ||||||
25 | committee. Department representation shall not constitute | ||||||
26 | membership of the committee. All Committee papers, issues, |
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1 | recommendations, reports, and meeting memoranda are advisory | ||||||
2 | only. The Director, or his or her designee, shall make a | ||||||
3 | written report, as requested by the Committee, regarding issues | ||||||
4 | before the Committee.
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5 | The Department on Aging and the Department of Human | ||||||
6 | Services
shall cooperate in the development and submission of | ||||||
7 | an annual report on
programs and services provided under this | ||||||
8 | Section. Such joint report
shall be filed with the Governor and | ||||||
9 | the General Assembly on or before
September 30 each year.
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10 | The requirement for reporting to the General Assembly shall | ||||||
11 | be satisfied
by filing copies of the report with the Speaker, | ||||||
12 | the Minority Leader and
the Clerk of the House of | ||||||
13 | Representatives and the President, the Minority
Leader and the | ||||||
14 | Secretary of the Senate and the Legislative Research Unit,
as | ||||||
15 | required by Section 3.1 of the General Assembly Organization | ||||||
16 | Act and
filing such additional copies with the State Government | ||||||
17 | Report Distribution
Center for the General Assembly as is | ||||||
18 | required under paragraph (t) of
Section 7 of the State Library | ||||||
19 | Act.
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20 | Those persons previously found eligible for receiving | ||||||
21 | non-institutional
services whose services were discontinued | ||||||
22 | under the Emergency Budget Act of
Fiscal Year 1992, and who do | ||||||
23 | not meet the eligibility standards in effect
on or after July | ||||||
24 | 1, 1992, shall remain ineligible on and after July 1,
1992. | ||||||
25 | Those persons previously not required to cost-share and who | ||||||
26 | were
required to cost-share effective March 1, 1992, shall |
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1 | continue to meet
cost-share requirements on and after July 1, | ||||||
2 | 1992. Beginning July 1, 1992,
all clients will be required to | ||||||
3 | meet
eligibility, cost-share, and other requirements and will | ||||||
4 | have services
discontinued or altered when they fail to meet | ||||||
5 | these requirements.
| ||||||
6 | For the purposes of this Section, "flexible senior | ||||||
7 | services" refers to services that require one-time or periodic | ||||||
8 | expenditures including, but not limited to, respite care, home | ||||||
9 | modification, assistive technology, housing assistance, and | ||||||
10 | transportation.
| ||||||
11 | (Source: P.A. 93-85, eff. 1-1-04; 93-902, eff. 8-10-04; 94-48, | ||||||
12 | eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, eff. 7-26-05; | ||||||
13 | 94-954, eff. 6-27-06.)".
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