Rep. Julie Hamos
Filed: 4/18/2008
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1 | AMENDMENT TO HOUSE BILL 5703
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2 | AMENDMENT NO. ______. Amend House Bill 5703 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 Sections 4.02 and 4.12 as follows:
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6 | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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7 | (Text of Section before amendment by P.A. 95-565 ) | ||||||
8 | Sec. 4.02. The Department shall establish a program of | ||||||
9 | services to
prevent unnecessary institutionalization of | ||||||
10 | persons age 60 and older in
need of long term care or who are | ||||||
11 | established as persons who suffer from
Alzheimer's disease or a | ||||||
12 | related disorder under the Alzheimer's Disease
Assistance Act, | ||||||
13 | thereby enabling them
to remain in their own homes or in other | ||||||
14 | living arrangements. Such
preventive services, which may be | ||||||
15 | coordinated with other programs for the
aged and monitored by | ||||||
16 | area agencies on aging in cooperation with the
Department, may |
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1 | include, but are not 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) home care aide services;
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5 | (d) chore and housekeeping services;
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6 | (e) adult day services;
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7 | (f) home-delivered meals;
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8 | (g) education in self-care;
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9 | (h) personal care services;
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10 | (i) adult day health services;
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11 | (j) habilitation services;
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12 | (k) respite care;
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13 | (k-5) community reintegration services;
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14 | (l) other nonmedical social services that may enable | ||||||
15 | the person
to become self-supporting; or
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16 | (m) clearinghouse for information provided by senior | ||||||
17 | citizen home owners
who want to rent rooms to or share | ||||||
18 | living space with other senior citizens.
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19 | The Department shall establish eligibility standards for | ||||||
20 | such
services taking into consideration the unique economic and | ||||||
21 | social needs
of the target population for whom they are to be | ||||||
22 | provided. Such eligibility
standards shall be based on the | ||||||
23 | recipient's ability to pay for services;
provided, however, | ||||||
24 | that in determining the amount and nature of services
for which | ||||||
25 | a person may qualify, consideration shall not be given to the
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26 | value of cash, property or other assets held in the name of the |
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1 | person's
spouse pursuant to a written agreement dividing | ||||||
2 | marital property into equal
but separate shares or pursuant to | ||||||
3 | a transfer of the person's interest in a
home to his spouse, | ||||||
4 | provided that the spouse's share of the marital
property is not | ||||||
5 | made available to the person seeking such services.
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6 | Beginning July 1, 2002, the Department shall require as a | ||||||
7 | condition of
eligibility that all financially eligible | ||||||
8 | applicants and recipients apply
for medical assistance
under | ||||||
9 | Article V of the Illinois Public Aid Code in accordance with | ||||||
10 | rules
promulgated by the Department.
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11 | The Department shall, in conjunction with the Department of | ||||||
12 | Public Aid (now Department of Healthcare and Family Services),
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13 | seek appropriate amendments under Sections 1915 and 1924 of the | ||||||
14 | Social
Security Act. The purpose of the amendments shall be to | ||||||
15 | extend eligibility
for home and community based services under | ||||||
16 | Sections 1915 and 1924 of the
Social Security Act to persons | ||||||
17 | who transfer to or for the benefit of a
spouse those amounts of | ||||||
18 | income and resources allowed under Section 1924 of
the Social | ||||||
19 | Security Act. Subject to the approval of such amendments, the
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20 | Department shall extend the provisions of Section 5-4 of the | ||||||
21 | Illinois
Public Aid Code to persons who, but for the provision | ||||||
22 | of home or
community-based services, would require the level of | ||||||
23 | care provided in an
institution, as is provided for in federal | ||||||
24 | law. Those persons no longer
found to be eligible for receiving | ||||||
25 | noninstitutional services due to changes
in the eligibility | ||||||
26 | criteria shall be given 60 days notice prior to actual
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1 | termination. Those persons receiving notice of termination may | ||||||
2 | contact the
Department and request the determination be | ||||||
3 | appealed at any time during the
60 day notice period. With the | ||||||
4 | exception of the lengthened notice and time
frame for the | ||||||
5 | appeal request, the appeal process shall follow the normal
| ||||||
6 | procedure. In addition, each person affected regardless of the
| ||||||
7 | circumstances for discontinued eligibility shall be given | ||||||
8 | notice and the
opportunity to purchase the necessary services | ||||||
9 | through the Community Care
Program. If the individual does not | ||||||
10 | elect to purchase services, the
Department shall advise the | ||||||
11 | individual of alternative services. The target
population | ||||||
12 | identified for the purposes of this Section are persons age 60
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13 | and older with an identified service need. Priority shall be | ||||||
14 | given to those
who are at imminent risk of | ||||||
15 | institutionalization. The services shall be
provided to | ||||||
16 | eligible persons age 60 and older to the extent that the cost
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17 | of the services together with the other personal maintenance
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18 | expenses of the persons are reasonably related to the standards
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19 | established for care in a group facility appropriate to the | ||||||
20 | person's
condition. These non-institutional services, pilot | ||||||
21 | projects or
experimental facilities may be provided as part of | ||||||
22 | or in addition to
those authorized by federal law or those | ||||||
23 | funded and administered by the
Department of Human Services. | ||||||
24 | The Departments of Human Services, Healthcare and Family | ||||||
25 | Services,
Public Health, Veterans' Affairs, and Commerce and | ||||||
26 | Economic Opportunity and
other appropriate agencies of State, |
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1 | federal and local governments shall
cooperate with the | ||||||
2 | Department on Aging in the establishment and development
of the | ||||||
3 | non-institutional services. The Department shall require an | ||||||
4 | annual
audit from all chore/housekeeping and home care aide | ||||||
5 | vendors contracting with
the Department under this Section. The | ||||||
6 | annual audit shall assure that each
audited vendor's procedures | ||||||
7 | are in compliance with Department's financial
reporting | ||||||
8 | guidelines requiring an administrative and employee wage and | ||||||
9 | benefits cost split as defined in administrative rules. The | ||||||
10 | audit is a public record under
the Freedom of Information Act. | ||||||
11 | The Department shall execute, relative to
the nursing home | ||||||
12 | prescreening project, written inter-agency
agreements with the | ||||||
13 | Department of Human Services and the Department
of Healthcare | ||||||
14 | and Family Services, to effect the following: (1) intake | ||||||
15 | procedures and common
eligibility criteria for those persons | ||||||
16 | who are receiving non-institutional
services; and (2) the | ||||||
17 | establishment and development of non-institutional
services in | ||||||
18 | areas of the State where they are not currently available or | ||||||
19 | are
undeveloped. On and after July 1, 1996, all nursing home | ||||||
20 | prescreenings for
individuals 60 years of age or older shall be | ||||||
21 | conducted by the Department.
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22 | As part of the Department on Aging's routine training of | ||||||
23 | care coordinators and care coordinator supervisors case | ||||||
24 | managers and case manager supervisors , the Department may | ||||||
25 | include information on family futures planning for persons who | ||||||
26 | are age 60 or older and who are caregivers of their adult |
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1 | children with developmental disabilities. The content of the | ||||||
2 | training shall be at the Department's discretion. | ||||||
3 | The Department's case management program shall be a fully | ||||||
4 | integrated care coordination program. The care coordination | ||||||
5 | program shall incorporate the concepts of client direction and | ||||||
6 | consumer focus and shall take into account the client's needs | ||||||
7 | and preferences. Comprehensive care coordination shall include | ||||||
8 | activities such as: (1) comprehensive assessment of the client; | ||||||
9 | (2) development and implementation of a service plan with the | ||||||
10 | client to mobilize the formal and informal resources and | ||||||
11 | services identified in the assessment to meet the needs of the | ||||||
12 | client, including coordination of the resources and services | ||||||
13 | with (A) any other plans that exist for various formal | ||||||
14 | services, such as hospital discharge plans, and (B) the | ||||||
15 | information and assistance services; (3) coordination and | ||||||
16 | monitoring of formal service delivery and monitoring of | ||||||
17 | informal service delivery, regardless of the funding source, to | ||||||
18 | ensure that services specified in the plan are being provided; | ||||||
19 | (4) assistance with the completion of applications for | ||||||
20 | services, referrals to non-government funded services, health | ||||||
21 | promotion, and ensuring continuity of care across care | ||||||
22 | settings; (5) periodic reassessment and revision of the | ||||||
23 | client's care plan, if necessary, to reflect any changes in the | ||||||
24 | client's needs; and (6) in accordance with the wishes of the | ||||||
25 | client, advocacy on behalf of the client for needed services or | ||||||
26 | resources. |
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1 | A comprehensive assessment shall be performed, using a | ||||||
2 | holistic tool identified by the Department and supported by an | ||||||
3 | electronic intake assessment and care planning system linked to | ||||||
4 | a central location. The comprehensive assessment process shall | ||||||
5 | include a face to face interview in the client's home or | ||||||
6 | temporary overnight abode and shall determine the level of | ||||||
7 | physical, functional, cognitive, psycho-social, financial, and | ||||||
8 | social needs of the client. Assessment interviews shall | ||||||
9 | accommodate the scheduling needs of the client and the client's | ||||||
10 | representative or representatives, who shall participate at | ||||||
11 | the discretion of the client. The Department shall provide | ||||||
12 | guidelines for determining the conditions under which a | ||||||
13 | comprehensive assessment shall be performed and the activities | ||||||
14 | of care coordination offered to each care recipient. The care | ||||||
15 | plan shall include the needs identified by the assessment and | ||||||
16 | incorporate the goals and preferences of the client. Care plans | ||||||
17 | shall also include all services needed by the client regardless | ||||||
18 | of the funding source and delineate between services provided, | ||||||
19 | services unavailable, and services refused by the client. Case | ||||||
20 | coordination units shall be reimbursed for care coordination in | ||||||
21 | a manner reflective of the actual cost of providing care | ||||||
22 | coordination. By July 1, 2009, the Department shall develop a | ||||||
23 | rate structure, after collection and review of information from | ||||||
24 | case coordination units and advocates for care recipients, | ||||||
25 | regarding the activities of coordination provided. The | ||||||
26 | Department shall reevaluate the rate structure every other year |
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1 | thereafter. | ||||||
2 | The Department is authorized to establish a system of | ||||||
3 | recipient copayment
for services provided under this Section, | ||||||
4 | such copayment to be based upon
the recipient's ability to pay | ||||||
5 | but in no case to exceed the actual cost of
the services | ||||||
6 | provided. Additionally, any portion of a person's income which
| ||||||
7 | is equal to or less than the federal poverty standard shall not | ||||||
8 | be
considered by the Department in determining the copayment. | ||||||
9 | The level of
such copayment shall be adjusted whenever | ||||||
10 | necessary to reflect any change
in the officially designated | ||||||
11 | federal poverty standard.
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12 | The Department, or the Department's authorized | ||||||
13 | representative, shall
recover the amount of moneys expended for | ||||||
14 | services provided to or in
behalf of a person under this | ||||||
15 | Section by a claim against the person's
estate or against the | ||||||
16 | estate of the person's surviving spouse, but no
recovery may be | ||||||
17 | had until after the death of the surviving spouse, if
any, and | ||||||
18 | then only at such time when there is no surviving child who
is | ||||||
19 | under age 21, blind, or permanently and totally disabled. This
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20 | paragraph, however, shall not bar recovery, at the death of the | ||||||
21 | person, of
moneys for services provided to the person or in | ||||||
22 | behalf of the person under
this Section to which the person was | ||||||
23 | not entitled;
provided that such recovery shall not be enforced | ||||||
24 | against any real estate while
it is occupied as a homestead by | ||||||
25 | the surviving spouse or other dependent, if no
claims by other | ||||||
26 | creditors have been filed against the estate, or, if such
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1 | claims have been filed, they remain dormant for failure of | ||||||
2 | prosecution or
failure of the claimant to compel administration | ||||||
3 | of the estate for the purpose
of payment. This paragraph shall | ||||||
4 | not bar recovery from the estate of a spouse,
under Sections | ||||||
5 | 1915 and 1924 of the Social Security Act and Section 5-4 of the
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6 | Illinois Public Aid Code, who precedes a person receiving | ||||||
7 | services under this
Section in death. All moneys for services
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8 | paid to or in behalf of the person under this Section shall be | ||||||
9 | claimed for
recovery from the deceased spouse's estate. | ||||||
10 | "Homestead", as used
in this paragraph, means the dwelling | ||||||
11 | house and
contiguous real estate occupied by a surviving spouse
| ||||||
12 | or relative, as defined by the rules and regulations of the | ||||||
13 | Department of Healthcare and Family Services, regardless of the | ||||||
14 | value of the property.
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15 | The Department shall develop procedures to enhance | ||||||
16 | availability of
services on evenings, weekends, and on an | ||||||
17 | emergency basis to meet the
respite needs of caregivers. | ||||||
18 | Procedures shall be developed to permit the
utilization of | ||||||
19 | services in successive blocks of 24 hours up to the monthly
| ||||||
20 | maximum established by the Department. Workers providing these | ||||||
21 | services
shall be appropriately trained.
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22 | Beginning on the effective date of this Amendatory Act of | ||||||
23 | 1991, no person
may perform chore/housekeeping and home care | ||||||
24 | aide services under a program
authorized by this Section unless | ||||||
25 | that person has been issued a certificate
of pre-service to do | ||||||
26 | so by his or her employing agency. Information
gathered to |
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1 | effect such certification shall include (i) the person's name,
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2 | (ii) the date the person was hired by his or her current | ||||||
3 | employer, and
(iii) the training, including dates and levels. | ||||||
4 | Persons engaged in the
program authorized by this Section | ||||||
5 | before the effective date of this
amendatory Act of 1991 shall | ||||||
6 | be issued a certificate of all pre- and
in-service training | ||||||
7 | from his or her employer upon submitting the necessary
| ||||||
8 | information. The employing agency shall be required to retain | ||||||
9 | records of
all staff pre- and in-service training, and shall | ||||||
10 | provide such records to
the Department upon request and upon | ||||||
11 | termination of the employer's contract
with the Department. In | ||||||
12 | addition, the employing agency is responsible for
the issuance | ||||||
13 | of certifications of in-service training completed to their
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14 | employees.
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15 | The Department is required to develop a system to ensure | ||||||
16 | that persons
working as home care aides and chore housekeepers | ||||||
17 | receive increases in their
wages when the federal minimum wage | ||||||
18 | is increased by requiring vendors to
certify that they are | ||||||
19 | meeting the federal minimum wage statute for home care aides
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20 | and chore housekeepers. An employer that cannot ensure that the | ||||||
21 | minimum
wage increase is being given to home care aides and | ||||||
22 | chore housekeepers
shall be denied any increase in | ||||||
23 | reimbursement costs.
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24 | The Community Care Program Advisory Committee is created in | ||||||
25 | the Department on Aging. The Director shall appoint individuals | ||||||
26 | to serve in the Committee, who shall serve at their own |
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1 | expense. Members of the Committee must abide by all applicable | ||||||
2 | ethics laws. The Committee shall advise the Department on | ||||||
3 | issues related to the Department's program of services to | ||||||
4 | prevent unnecessary institutionalization. The Committee shall | ||||||
5 | meet on a bi-monthly basis and shall serve to identify and | ||||||
6 | advise the Department on present and potential issues affecting | ||||||
7 | the service delivery network, the program's clients, and the | ||||||
8 | Department and to recommend solution strategies. Persons | ||||||
9 | appointed to the Committee shall be appointed on, but not | ||||||
10 | limited to, their own and their agency's experience with the | ||||||
11 | program, geographic representation, and willingness to serve. | ||||||
12 | The Director shall appoint members to the Committee to | ||||||
13 | represent provider, advocacy, policy research, and other | ||||||
14 | constituencies committed to the delivery of high quality home | ||||||
15 | and community-based services to older adults. Representatives | ||||||
16 | shall be appointed to ensure representation from community care | ||||||
17 | providers including, but not limited to, adult day service | ||||||
18 | providers, homemaker providers, case coordination and case | ||||||
19 | management units, emergency home response providers, statewide | ||||||
20 | trade or labor unions that represent home care
homecare aides | ||||||
21 | and direct care staff, area agencies on aging, adults over age | ||||||
22 | 60, membership organizations representing older adults, and | ||||||
23 | other organizational entities, providers of care, or | ||||||
24 | individuals with demonstrated interest and expertise in the | ||||||
25 | field of home and community care as determined by the Director. | ||||||
26 | Nominations may be presented from any agency or State |
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1 | association with interest in the program. The Director, or his | ||||||
2 | or her designee, shall serve as the permanent co-chair of the | ||||||
3 | advisory committee. One other co-chair shall be nominated and | ||||||
4 | approved by the members of the committee on an annual basis. | ||||||
5 | Committee members' terms of appointment shall be for 4 years | ||||||
6 | with one-quarter of the appointees' terms expiring each year. A | ||||||
7 | member shall continue to serve until his or her replacement is | ||||||
8 | named. The Department shall fill vacancies that have a | ||||||
9 | remaining term of over one year, and this replacement shall | ||||||
10 | occur through the annual replacement of expiring terms. The | ||||||
11 | Director shall designate Department staff to provide technical | ||||||
12 | assistance and staff support to the committee. Department | ||||||
13 | representation shall not constitute membership of the | ||||||
14 | committee. All Committee papers, issues, recommendations, | ||||||
15 | reports, and meeting memoranda are advisory only. The Director, | ||||||
16 | or his or her designee, shall make a written report, as | ||||||
17 | requested by the Committee, regarding issues before the | ||||||
18 | Committee.
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19 | The Department on Aging and the Department of Human | ||||||
20 | Services
shall cooperate in the development and submission of | ||||||
21 | an annual report on
programs and services provided under this | ||||||
22 | Section. Such joint report
shall be filed with the Governor and | ||||||
23 | the General Assembly on or before
September 30 each year.
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24 | The requirement for reporting to the General Assembly shall | ||||||
25 | be satisfied
by filing copies of the report with the Speaker, | ||||||
26 | the Minority Leader and
the Clerk of the House of |
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| |||||||
1 | Representatives and the President, the Minority
Leader and the | ||||||
2 | Secretary of the Senate and the Legislative Research Unit,
as | ||||||
3 | required by Section 3.1 of the General Assembly Organization | ||||||
4 | Act and
filing such additional copies with the State Government | ||||||
5 | Report Distribution
Center for the General Assembly as is | ||||||
6 | required under paragraph (t) of
Section 7 of the State Library | ||||||
7 | Act.
| ||||||
8 | Those persons previously found eligible for receiving | ||||||
9 | non-institutional
services whose services were discontinued | ||||||
10 | under the Emergency Budget Act of
Fiscal Year 1992, and who do | ||||||
11 | not meet the eligibility standards in effect
on or after July | ||||||
12 | 1, 1992, shall remain ineligible on and after July 1,
1992. | ||||||
13 | Those persons previously not required to cost-share and who | ||||||
14 | were
required to cost-share effective March 1, 1992, shall | ||||||
15 | continue to meet
cost-share requirements on and after July 1, | ||||||
16 | 1992. Beginning July 1, 1992,
all clients will be required to | ||||||
17 | meet
eligibility, cost-share, and other requirements and will | ||||||
18 | have services
discontinued or altered when they fail to meet | ||||||
19 | these requirements.
| ||||||
20 | Notwithstanding any other rulemaking authority that may | ||||||
21 | exist, neither the Governor nor any agency or agency head under | ||||||
22 | the jurisdiction of the Governor has any authority to make or | ||||||
23 | promulgate rules to implement or enforce the provisions of this | ||||||
24 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
25 | Governor believes that rules are necessary to implement or | ||||||
26 | enforce the provisions of this amendatory Act of the 95th |
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| |||||||
1 | General Assembly, the Governor may suggest rules to the General | ||||||
2 | Assembly by filing them with the Clerk of the House and | ||||||
3 | Secretary of the Senate and by requesting that the General | ||||||
4 | Assembly authorize such rulemaking by law, enact those | ||||||
5 | suggested rules into law, or take any other appropriate action | ||||||
6 | in the General Assembly's discretion. Nothing contained in this | ||||||
7 | amendatory Act of the 95th General Assembly shall be | ||||||
8 | interpreted to grant rulemaking authority under any other | ||||||
9 | Illinois statute where such authority is not otherwise | ||||||
10 | explicitly given. For the purposes of this amendatory Act of | ||||||
11 | the 95th General Assembly, "rules" is given the meaning | ||||||
12 | contained in Section 1-70 of the Illinois Administrative | ||||||
13 | Procedure Act, and "agency" and "agency head" are given the | ||||||
14 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
15 | Administrative Procedure Act to the extent that such | ||||||
16 | definitions apply to agencies or agency heads under the | ||||||
17 | jurisdiction of the Governor. | ||||||
18 | (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, | ||||||
19 | eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; | ||||||
20 | 95-473, eff. 8-27-07; revised 10-30-07.)
| ||||||
21 | (Text of Section after amendment by P.A. 95-565 ) | ||||||
22 | Sec. 4.02. Community Care Program. The Department shall | ||||||
23 | establish a program of services to
prevent unnecessary | ||||||
24 | institutionalization of persons age 60 and older in
need of | ||||||
25 | long term care or who are established as persons who suffer |
| |||||||
| |||||||
1 | from
Alzheimer's disease or a related disorder under the | ||||||
2 | Alzheimer's Disease
Assistance Act, thereby enabling them
to | ||||||
3 | remain in their own homes or in other living arrangements. Such
| ||||||
4 | preventive services, which may be coordinated with other | ||||||
5 | programs for the
aged and monitored by area agencies on aging | ||||||
6 | in cooperation with the
Department, may include, but are not | ||||||
7 | limited to, any or all of the following:
| ||||||
8 | (a) (blank);
| ||||||
9 | (b) (blank);
| ||||||
10 | (c) home care aide services;
| ||||||
11 | (d) personal assistant services;
| ||||||
12 | (e) adult day services;
| ||||||
13 | (f) home-delivered meals;
| ||||||
14 | (g) education in self-care;
| ||||||
15 | (h) personal care services;
| ||||||
16 | (i) adult day health services;
| ||||||
17 | (j) habilitation services;
| ||||||
18 | (k) respite care;
| ||||||
19 | (k-5) community reintegration services;
| ||||||
20 | (k-6) flexible senior services; | ||||||
21 | (k-7) medication management; | ||||||
22 | (k-8) emergency home response;
| ||||||
23 | (l) other nonmedical social services that may enable | ||||||
24 | the person
to become self-supporting; or
| ||||||
25 | (m) clearinghouse for information provided by senior | ||||||
26 | citizen home owners
who want to rent rooms to or share |
| |||||||
| |||||||
1 | living space with other senior citizens.
| ||||||
2 | The Department shall establish eligibility standards for | ||||||
3 | such
services taking into consideration the unique economic and | ||||||
4 | social needs
of the target population for whom they are to be | ||||||
5 | provided. Such eligibility
standards shall be based on the | ||||||
6 | recipient's ability to pay for services;
provided, however, | ||||||
7 | that in determining the amount and nature of services
for which | ||||||
8 | a person may qualify, consideration shall not be given to the
| ||||||
9 | value of cash, property or other assets held in the name of the | ||||||
10 | person's
spouse pursuant to a written agreement dividing | ||||||
11 | marital property into equal
but separate shares or pursuant to | ||||||
12 | a transfer of the person's interest in a
home to his spouse, | ||||||
13 | provided that the spouse's share of the marital
property is not | ||||||
14 | made available to the person seeking such services.
| ||||||
15 | Beginning July 1, 2002, the Department shall require as a | ||||||
16 | condition of
eligibility that all financially eligible | ||||||
17 | applicants apply
for medical assistance
under Article V of the | ||||||
18 | Illinois Public Aid Code in accordance with rules
promulgated | ||||||
19 | by the Department.
| ||||||
20 | Beginning January 1, 2008, the Department shall require as | ||||||
21 | a condition of eligibility that all new financially eligible | ||||||
22 | applicants apply for and enroll in medical assistance under | ||||||
23 | Article V of the Illinois Public Aid Code in accordance with | ||||||
24 | rules promulgated by the Department.
| ||||||
25 | The Department shall, in conjunction with the Department of | ||||||
26 | Public Aid (now Department of Healthcare and Family Services),
|
| |||||||
| |||||||
1 | seek appropriate amendments under Sections 1915 and 1924 of the | ||||||
2 | Social
Security Act. The purpose of the amendments shall be to | ||||||
3 | extend eligibility
for home and community based services under | ||||||
4 | Sections 1915 and 1924 of the
Social Security Act to persons | ||||||
5 | who transfer to or for the benefit of a
spouse those amounts of | ||||||
6 | income and resources allowed under Section 1924 of
the Social | ||||||
7 | Security Act. Subject to the approval of such amendments, the
| ||||||
8 | Department shall extend the provisions of Section 5-4 of the | ||||||
9 | Illinois
Public Aid Code to persons who, but for the provision | ||||||
10 | of home or
community-based services, would require the level of | ||||||
11 | care provided in an
institution, as is provided for in federal | ||||||
12 | law. Those persons no longer
found to be eligible for receiving | ||||||
13 | noninstitutional services due to changes
in the eligibility | ||||||
14 | criteria shall be given 60 days notice prior to actual
| ||||||
15 | termination. Those persons receiving notice of termination may | ||||||
16 | contact the
Department and request the determination be | ||||||
17 | appealed at any time during the
60 day notice period. With the | ||||||
18 | exception of the lengthened notice and time
frame for the | ||||||
19 | appeal request, the appeal process shall follow the normal
| ||||||
20 | procedure. In addition, each person affected regardless of the
| ||||||
21 | circumstances for discontinued eligibility shall be given | ||||||
22 | notice and the
opportunity to purchase the necessary services | ||||||
23 | through the Community Care
Program. If the individual does not | ||||||
24 | elect to purchase services, the
Department shall advise the | ||||||
25 | individual of alternative services. The target
population | ||||||
26 | identified for the purposes of this Section are persons age 60
|
| |||||||
| |||||||
1 | and older with an identified service need. Priority shall be | ||||||
2 | given to those
who are at imminent risk of | ||||||
3 | institutionalization. The services shall be
provided to | ||||||
4 | eligible persons age 60 and older to the extent that the cost
| ||||||
5 | of the services together with the other personal maintenance
| ||||||
6 | expenses of the persons are reasonably related to the standards
| ||||||
7 | established for care in a group facility appropriate to the | ||||||
8 | person's
condition. These non-institutional services, pilot | ||||||
9 | projects or
experimental facilities may be provided as part of | ||||||
10 | or in addition to
those authorized by federal law or those | ||||||
11 | funded and administered by the
Department of Human Services. | ||||||
12 | The Departments of Human Services, Healthcare and Family | ||||||
13 | Services,
Public Health, Veterans' Affairs, and Commerce and | ||||||
14 | Economic Opportunity and
other appropriate agencies of State, | ||||||
15 | federal and local governments shall
cooperate with the | ||||||
16 | Department on Aging in the establishment and development
of the | ||||||
17 | non-institutional services. The Department shall require an | ||||||
18 | annual
audit from all
chore/housekeeping and home care aide | ||||||
19 | vendors contracting with
the Department under this Section. The | ||||||
20 | annual audit shall assure that each
audited vendor's procedures | ||||||
21 | are in compliance with Department's financial
reporting | ||||||
22 | guidelines requiring an administrative and employee wage and | ||||||
23 | benefits cost split as defined in administrative rules. The | ||||||
24 | audit is a public record under
the Freedom of Information Act. | ||||||
25 | The Department shall execute, relative to
the nursing home | ||||||
26 | prescreening project, written inter-agency
agreements with the |
| |||||||
| |||||||
1 | Department of Human Services and the Department
of Healthcare | ||||||
2 | and Family Services, to effect the following: (1) intake | ||||||
3 | procedures and common
eligibility criteria for those persons | ||||||
4 | who are receiving non-institutional
services; and (2) the | ||||||
5 | establishment and development of non-institutional
services in | ||||||
6 | areas of the State where they are not currently available or | ||||||
7 | are
undeveloped. On and after July 1, 1996, all nursing home | ||||||
8 | prescreenings for
individuals 60 years of age or older shall be | ||||||
9 | conducted by the Department.
| ||||||
10 | As part of the Department on Aging's routine training of | ||||||
11 | care coordinators and care coordinator supervisors case | ||||||
12 | managers and case manager supervisors , the Department may | ||||||
13 | include information on family futures planning for persons who | ||||||
14 | are age 60 or older and who are caregivers of their adult | ||||||
15 | children with developmental disabilities. The content of the | ||||||
16 | training shall be at the Department's discretion. | ||||||
17 | The Department's case management program shall be a fully | ||||||
18 | integrated care coordination program. The care coordination | ||||||
19 | program shall incorporate the concepts of client direction and | ||||||
20 | consumer focus and shall take into account the client's needs | ||||||
21 | and preferences. Comprehensive care coordination shall include | ||||||
22 | activities such as: (1) comprehensive assessment of the client; | ||||||
23 | (2) development and implementation of a service plan with the | ||||||
24 | client to mobilize the formal and informal resources and | ||||||
25 | services identified in the assessment to meet the needs of the | ||||||
26 | client, including coordination of the resources and services |
| |||||||
| |||||||
1 | with (A) any other plans that exist for various formal | ||||||
2 | services, such as hospital discharge plans, and (B) the | ||||||
3 | information and assistance services; (3) coordination and | ||||||
4 | monitoring of formal service delivery and monitoring of | ||||||
5 | informal service delivery, regardless of the funding source, to | ||||||
6 | ensure that services specified in the plan are being provided; | ||||||
7 | (4) assistance with the completion of applications for | ||||||
8 | services, referrals to non-government funded services, health | ||||||
9 | promotion, and ensuring continuity of care across care | ||||||
10 | settings; (5) periodic reassessment and revision of the | ||||||
11 | client's care plan, if necessary, to reflect any changes in the | ||||||
12 | client's needs; and (6) in accordance with the wishes of the | ||||||
13 | client, advocacy on behalf of the client for needed services or | ||||||
14 | resources. | ||||||
15 | A comprehensive assessment shall be performed, using a | ||||||
16 | holistic tool identified by the Department and supported by an | ||||||
17 | electronic intake assessment and care planning system linked to | ||||||
18 | a central location. The comprehensive assessment process shall | ||||||
19 | include a face to face interview in the client's home or | ||||||
20 | temporary overnight abode and shall determine the level of | ||||||
21 | physical, functional, cognitive, psycho-social, financial, and | ||||||
22 | social needs of the client. Assessment interviews shall | ||||||
23 | accommodate the scheduling needs of the client and the client's | ||||||
24 | representative or representatives, who shall participate at | ||||||
25 | the discretion of the client. The Department shall provide | ||||||
26 | guidelines for determining the conditions under which a |
| |||||||
| |||||||
1 | comprehensive assessment shall be performed and the activities | ||||||
2 | of care coordination offered to each care recipient. The care | ||||||
3 | plan shall include the needs identified by the assessment and | ||||||
4 | incorporate the goals and preferences of the client. Care plans | ||||||
5 | shall also include all services needed by the client regardless | ||||||
6 | of the funding source and delineate between services provided, | ||||||
7 | services unavailable, and services refused by the client. Case | ||||||
8 | coordination units shall be reimbursed for care coordination in | ||||||
9 | a manner reflective of the actual cost of providing care | ||||||
10 | coordination. By July 1, 2009, the Department shall develop a | ||||||
11 | rate structure, after collection and review of information from | ||||||
12 | case coordination units and advocates for care recipients, | ||||||
13 | regarding the activities of coordination provided. The | ||||||
14 | Department shall reevaluate the rate structure every other year | ||||||
15 | thereafter. | ||||||
16 | The Department is authorized to establish a system of | ||||||
17 | recipient copayment
for services provided under this Section, | ||||||
18 | such copayment to be based upon
the recipient's ability to pay | ||||||
19 | but in no case to exceed the actual cost of
the services | ||||||
20 | provided. Additionally, any portion of a person's income which
| ||||||
21 | is equal to or less than the federal poverty standard shall not | ||||||
22 | be
considered by the Department in determining the copayment. | ||||||
23 | The level of
such copayment shall be adjusted whenever | ||||||
24 | necessary to reflect any change
in the officially designated | ||||||
25 | federal poverty standard.
| ||||||
26 | The Department, or the Department's authorized |
| |||||||
| |||||||
1 | representative, shall
recover the amount of moneys expended for | ||||||
2 | services provided to or in
behalf of a person under this | ||||||
3 | Section by a claim against the person's
estate or against the | ||||||
4 | estate of the person's surviving spouse, but no
recovery may be | ||||||
5 | had until after the death of the surviving spouse, if
any, and | ||||||
6 | then only at such time when there is no surviving child who
is | ||||||
7 | under age 21, blind, or permanently and totally disabled. This
| ||||||
8 | paragraph, however, shall not bar recovery, at the death of the | ||||||
9 | person, of
moneys for services provided to the person or in | ||||||
10 | behalf of the person under
this Section to which the person was | ||||||
11 | not entitled;
provided that such recovery shall not be enforced | ||||||
12 | against any real estate while
it is occupied as a homestead by | ||||||
13 | the surviving spouse or other dependent, if no
claims by other | ||||||
14 | creditors have been filed against the estate, or, if such
| ||||||
15 | claims have been filed, they remain dormant for failure of | ||||||
16 | prosecution or
failure of the claimant to compel administration | ||||||
17 | of the estate for the purpose
of payment. This paragraph shall | ||||||
18 | not bar recovery from the estate of a spouse,
under Sections | ||||||
19 | 1915 and 1924 of the Social Security Act and Section 5-4 of the
| ||||||
20 | Illinois Public Aid Code, who precedes a person receiving | ||||||
21 | services under this
Section in death. All moneys for services
| ||||||
22 | paid to or in behalf of the person under this Section shall be | ||||||
23 | claimed for
recovery from the deceased spouse's estate. | ||||||
24 | "Homestead", as used
in this paragraph, means the dwelling | ||||||
25 | house and
contiguous real estate occupied by a surviving spouse
| ||||||
26 | or relative, as defined by the rules and regulations of the |
| |||||||
| |||||||
1 | Department of Healthcare and Family Services, regardless of the | ||||||
2 | value of the property.
| ||||||
3 | The Department shall increase the effectiveness of the | ||||||
4 | existing Community Care Program by: | ||||||
5 | (1) ensuring that in-home services included in the care | ||||||
6 | plan are available on evenings and weekends; | ||||||
7 | (2) ensuring that care plans contain the services that | ||||||
8 | eligible participants
participants' need based on the | ||||||
9 | number of days in a month, not limited to specific blocks | ||||||
10 | of time, as identified by the comprehensive assessment tool | ||||||
11 | selected by the Department for use statewide, not to exceed | ||||||
12 | the total monthly service cost maximum allowed for each | ||||||
13 | service ; the . The Department shall develop administrative | ||||||
14 | rules to implement this item (2); | ||||||
15 | (3) ensuring that the participants have the right to | ||||||
16 | choose the services contained in their care plan and to | ||||||
17 | direct how those services are provided, based on | ||||||
18 | administrative rules established by the Department; | ||||||
19 | (4) ensuring that the determination of need tool is | ||||||
20 | accurate in determining the participants' level of need; to | ||||||
21 | achieve this, the Department, in conjunction with the Older | ||||||
22 | Adult Services Advisory Committee, shall institute a study | ||||||
23 | of the relationship between the Determination of Need | ||||||
24 | scores, level of need, service cost maximums , and the | ||||||
25 | development and utilization of service plans no later than | ||||||
26 | May 1, 2008; findings and recommendations shall be |
| |||||||
| |||||||
1 | presented to the Governor and the General Assembly no later | ||||||
2 | than January 1, 2009; recommendations shall include all | ||||||
3 | needed changes to the service cost maximums schedule and | ||||||
4 | additional covered services; | ||||||
5 | (5) ensuring that homemakers can provide personal care | ||||||
6 | services that may or may not involve contact with clients, | ||||||
7 | including but not limited to: | ||||||
8 | (A) bathing; | ||||||
9 | (B) grooming; | ||||||
10 | (C) toileting; | ||||||
11 | (D) nail care; | ||||||
12 | (E) transferring; | ||||||
13 | (F) respiratory services; | ||||||
14 | (G) exercise; or | ||||||
15 | (H) positioning; | ||||||
16 | (6) ensuring that homemaker program vendors are not | ||||||
17 | restricted from hiring homemakers who are family members of | ||||||
18 | clients or recommended by clients; the Department may not, | ||||||
19 | by rule or policy, require homemakers who are family | ||||||
20 | members of clients or recommended by clients to accept | ||||||
21 | assignments in homes other than the client; and | ||||||
22 | (7) ensuring that the State may access maximum federal | ||||||
23 | matching funds by seeking approval for the Centers for | ||||||
24 | Medicare and Medicaid Services for modifications to the | ||||||
25 | State's home and community based services waiver and | ||||||
26 | additional waiver opportunities in order to maximize |
| |||||||
| |||||||
1 | federal matching funds; this shall include, but not be | ||||||
2 | limited to, modification that reflects all changes in the | ||||||
3 | Community Care Program services and all increases in the | ||||||
4 | services cost maximum. | ||||||
5 | By January 1, 2009 or as soon after the end of the Cash and | ||||||
6 | Counseling Demonstration Project as is practicable, the | ||||||
7 | Department may, based on its evaluation of the demonstration | ||||||
8 | project, promulgate rules concerning personal assistant | ||||||
9 | services , to include, but need not be limited to, | ||||||
10 | qualifications, employment screening, rights under fair labor | ||||||
11 | standards, training, fiduciary agent, and supervision | ||||||
12 | requirements. All applicants shall be subject to the provisions | ||||||
13 | of the Health Care Worker Background Check Act.
| ||||||
14 | The Department shall develop procedures to enhance | ||||||
15 | availability of
services on evenings, weekends, and on an | ||||||
16 | emergency basis to meet the
respite needs of caregivers. | ||||||
17 | Procedures shall be developed to permit the
utilization of | ||||||
18 | services in successive blocks of 24 hours up to the monthly
| ||||||
19 | maximum established by the Department. Workers providing these | ||||||
20 | services
shall be appropriately trained.
| ||||||
21 | Beginning on the effective date of this Amendatory Act of | ||||||
22 | 1991, no person
may perform chore/housekeeping and home care | ||||||
23 | aide services under a program
authorized by this Section unless | ||||||
24 | that person has been issued a certificate
of pre-service to do | ||||||
25 | so by his or her employing agency. Information
gathered to | ||||||
26 | effect such certification shall include (i) the person's name,
|
| |||||||
| |||||||
1 | (ii) the date the person was hired by his or her current | ||||||
2 | employer, and
(iii) the training, including dates and levels. | ||||||
3 | Persons engaged in the
program authorized by this Section | ||||||
4 | before the effective date of this
amendatory Act of 1991 shall | ||||||
5 | be issued a certificate of all pre- and
in-service training | ||||||
6 | from his or her employer upon submitting the necessary
| ||||||
7 | information. The employing agency shall be required to retain | ||||||
8 | records of
all staff pre- and in-service training, and shall | ||||||
9 | provide such records to
the Department upon request and upon | ||||||
10 | termination of the employer's contract
with the Department. In | ||||||
11 | addition, the employing agency is responsible for
the issuance | ||||||
12 | of certifications of in-service training completed to their
| ||||||
13 | employees.
| ||||||
14 | The Department is required to develop a system to ensure | ||||||
15 | that persons
working as home care aides and
chore housekeepers | ||||||
16 | receive increases in their
wages when the federal minimum wage | ||||||
17 | is increased by requiring vendors to
certify that they are | ||||||
18 | meeting the federal minimum wage statute for home care aides
| ||||||
19 | and
chore housekeepers . An employer that cannot ensure that the | ||||||
20 | minimum
wage increase is being given to home care aides and
| ||||||
21 | chore housekeepers
shall be denied any increase in | ||||||
22 | reimbursement costs.
| ||||||
23 | The Community Care Program Advisory Committee is created in | ||||||
24 | the Department on Aging. The Director shall appoint individuals | ||||||
25 | to serve in the Committee, who shall serve at their own | ||||||
26 | expense. Members of the Committee must abide by all applicable |
| |||||||
| |||||||
1 | ethics laws. The Committee shall advise the Department on | ||||||
2 | issues related to the Department's program of services to | ||||||
3 | prevent unnecessary institutionalization. The Committee shall | ||||||
4 | meet on a bi-monthly basis and shall serve to identify and | ||||||
5 | advise the Department on present and potential issues affecting | ||||||
6 | the service delivery network, the program's clients, and the | ||||||
7 | Department and to recommend solution strategies. Persons | ||||||
8 | appointed to the Committee shall be appointed on, but not | ||||||
9 | limited to, their own and their agency's experience with the | ||||||
10 | program, geographic representation, and willingness to serve. | ||||||
11 | The Director shall appoint members to the Committee to | ||||||
12 | represent provider, advocacy, policy research, and other | ||||||
13 | constituencies committed to the delivery of high quality home | ||||||
14 | and community-based services to older adults. Representatives | ||||||
15 | shall be appointed to ensure representation from community care | ||||||
16 | providers including, but not limited to, adult day service | ||||||
17 | providers, homemaker providers, case coordination and case | ||||||
18 | management units, emergency home response providers, statewide | ||||||
19 | trade or labor unions that represent home care
homecare aides | ||||||
20 | and direct care staff, area agencies on aging, adults over age | ||||||
21 | 60, membership organizations representing older adults, and | ||||||
22 | other organizational entities, providers of care, or | ||||||
23 | individuals with demonstrated interest and expertise in the | ||||||
24 | field of home and community care as determined by the Director. | ||||||
25 | Nominations may be presented from any agency or State | ||||||
26 | association with interest in the program. The Director, or his |
| |||||||
| |||||||
1 | or her designee, shall serve as the permanent co-chair of the | ||||||
2 | advisory committee. One other co-chair shall be nominated and | ||||||
3 | approved by the members of the committee on an annual basis. | ||||||
4 | Committee members' terms of appointment shall be for 4 years | ||||||
5 | with one-quarter of the appointees' terms expiring each year. A | ||||||
6 | member shall continue to serve until his or her replacement is | ||||||
7 | named. The Department shall fill vacancies that have a | ||||||
8 | remaining term of over one year, and this replacement shall | ||||||
9 | occur through the annual replacement of expiring terms. The | ||||||
10 | Director shall designate Department staff to provide technical | ||||||
11 | assistance and staff support to the committee. Department | ||||||
12 | representation shall not constitute membership of the | ||||||
13 | committee. All Committee papers, issues, recommendations, | ||||||
14 | reports, and meeting memoranda are advisory only. The Director, | ||||||
15 | or his or her designee, shall make a written report, as | ||||||
16 | requested by the Committee, regarding issues before the | ||||||
17 | Committee.
| ||||||
18 | The Department on Aging and the Department of Human | ||||||
19 | Services
shall cooperate in the development and submission of | ||||||
20 | an annual report on
programs and services provided under this | ||||||
21 | Section. Such joint report
shall be filed with the Governor and | ||||||
22 | the General Assembly on or before
September 30 each year.
| ||||||
23 | The requirement for reporting to the General Assembly shall | ||||||
24 | be satisfied
by filing copies of the report with the Speaker, | ||||||
25 | the Minority Leader and
the Clerk of the House of | ||||||
26 | Representatives and the President, the Minority
Leader and the |
| |||||||
| |||||||
1 | Secretary of the Senate and the Legislative Research Unit,
as | ||||||
2 | required by Section 3.1 of the General Assembly Organization | ||||||
3 | Act and
filing such additional copies with the State Government | ||||||
4 | Report Distribution
Center for the General Assembly as is | ||||||
5 | required under paragraph (t) of
Section 7 of the State Library | ||||||
6 | Act.
| ||||||
7 | Those persons previously found eligible for receiving | ||||||
8 | non-institutional
services whose services were discontinued | ||||||
9 | under the Emergency Budget Act of
Fiscal Year 1992, and who do | ||||||
10 | not meet the eligibility standards in effect
on or after July | ||||||
11 | 1, 1992, shall remain ineligible on and after July 1,
1992. | ||||||
12 | Those persons previously not required to cost-share and who | ||||||
13 | were
required to cost-share effective March 1, 1992, shall | ||||||
14 | continue to meet
cost-share requirements on and after July 1, | ||||||
15 | 1992. Beginning July 1, 1992,
all clients will be required to | ||||||
16 | meet
eligibility, cost-share, and other requirements and will | ||||||
17 | have services
discontinued or altered when they fail to meet | ||||||
18 | these requirements. | ||||||
19 | For the purposes of this Section, "flexible senior | ||||||
20 | services" refers to services that require one-time or periodic | ||||||
21 | expenditures including, but not limited to, respite care, home | ||||||
22 | modification, assistive technology, housing assistance, and | ||||||
23 | transportation.
| ||||||
24 | Notwithstanding any other rulemaking authority that may | ||||||
25 | exist, neither the Governor nor any agency or agency head under | ||||||
26 | the jurisdiction of the Governor has any authority to make or |
| |||||||
| |||||||
1 | promulgate rules to implement or enforce the provisions of this | ||||||
2 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
3 | Governor believes that rules are necessary to implement or | ||||||
4 | enforce the provisions of this amendatory Act of the 95th | ||||||
5 | General Assembly, the Governor may suggest rules to the General | ||||||
6 | Assembly by filing them with the Clerk of the House and | ||||||
7 | Secretary of the Senate and by requesting that the General | ||||||
8 | Assembly authorize such rulemaking by law, enact those | ||||||
9 | suggested rules into law, or take any other appropriate action | ||||||
10 | in the General Assembly's discretion. Nothing contained in this | ||||||
11 | amendatory Act of the 95th General Assembly shall be | ||||||
12 | interpreted to grant rulemaking authority under any other | ||||||
13 | Illinois statute where such authority is not otherwise | ||||||
14 | explicitly given. For the purposes of this amendatory Act of | ||||||
15 | the 95th General Assembly, "rules" is given the meaning | ||||||
16 | contained in Section 1-70 of the Illinois Administrative | ||||||
17 | Procedure Act, and "agency" and "agency head" are given the | ||||||
18 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
19 | Administrative Procedure Act to the extent that such | ||||||
20 | definitions apply to agencies or agency heads under the | ||||||
21 | jurisdiction of the Governor. | ||||||
22 | (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, | ||||||
23 | eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; | ||||||
24 | 95-473, eff. 8-27-07; 95-565, eff. 6-1-08; revised 10-30-07.)
| ||||||
25 | (20 ILCS 105/4.12) |
| |||||||
| |||||||
1 | Sec. 4.12. Assistance to nursing home residents. | ||||||
2 | (a) The Department on Aging shall assist eligible nursing | ||||||
3 | home residents and their families to select long-term care | ||||||
4 | options that meet their needs and reflect their preferences. At | ||||||
5 | any time during the process, the resident or his or her | ||||||
6 | representative may decline further assistance. | ||||||
7 | (b) To provide assistance, the Department shall develop a | ||||||
8 | program of transition services with follow-up in selected areas | ||||||
9 | of the State, to be expanded statewide as funding becomes | ||||||
10 | available. The program shall be developed in consultation with | ||||||
11 | nursing homes, care coordinators case managers , Area Agencies | ||||||
12 | on Aging, and others interested in the well-being of frail | ||||||
13 | elderly Illinois residents. The Department shall establish | ||||||
14 | administrative rules pursuant to the Illinois Administrative | ||||||
15 | Procedure Act with respect to resident eligibility, assessment | ||||||
16 | of the resident's health, cognitive, social, and financial | ||||||
17 | needs, development of comprehensive service transition plans, | ||||||
18 | and the level of services that must be available prior to | ||||||
19 | transition of a resident into the community.
| ||||||
20 | (c) Notwithstanding any other rulemaking authority that | ||||||
21 | may exist, neither the Governor nor any agency or agency head | ||||||
22 | under the jurisdiction of the Governor has any authority to | ||||||
23 | make or promulgate rules to implement or enforce the provisions | ||||||
24 | of this amendatory Act of the 95th General Assembly. If, | ||||||
25 | however, the Governor believes that rules are necessary to | ||||||
26 | implement or enforce the provisions of this amendatory Act of |
| |||||||
| |||||||
1 | the 95th General Assembly, the Governor may suggest rules to | ||||||
2 | the General Assembly by filing them with the Clerk of the House | ||||||
3 | and Secretary of the Senate and by requesting that the General | ||||||
4 | Assembly authorize such rulemaking by law, enact those | ||||||
5 | suggested rules into law, or take any other appropriate action | ||||||
6 | in the General Assembly's discretion. Nothing contained in this | ||||||
7 | amendatory Act of the 95th General Assembly shall be | ||||||
8 | interpreted to grant rulemaking authority under any other | ||||||
9 | Illinois statute where such authority is not otherwise | ||||||
10 | explicitly given. For the purposes of this amendatory Act of | ||||||
11 | the 95th General Assembly, "rules" is given the meaning | ||||||
12 | contained in Section 1-70 of the Illinois Administrative | ||||||
13 | Procedure Act, and "agency" and "agency head" are given the | ||||||
14 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
15 | Administrative Procedure Act to the extent that such | ||||||
16 | definitions apply to agencies or agency heads under the | ||||||
17 | jurisdiction of the Governor. | ||||||
18 | (Source: P.A. 95-331, eff. 8-21-07.)
| ||||||
19 | Section 10. The Older Adult Services Act is amended by | ||||||
20 | changing Section 25 as follows: | ||||||
21 | (320 ILCS 42/25)
| ||||||
22 | Sec. 25. Older adult services restructuring. No later than | ||||||
23 | January 1, 2005, the Department shall commence the process of | ||||||
24 | restructuring the older adult services delivery system. |
| |||||||
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1 | Priority shall be given to both the expansion of services and | ||||||
2 | the development of new services in priority service areas. | ||||||
3 | Subject to the availability of funding, the restructuring shall | ||||||
4 | include, but not be limited to, the following:
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5 | (1) Planning. The Department shall develop a plan to | ||||||
6 | restructure the State's service delivery system for older | ||||||
7 | adults. The plan shall include a schedule for the | ||||||
8 | implementation of the initiatives outlined in this Act and all | ||||||
9 | other initiatives identified by the participating agencies to | ||||||
10 | fulfill the purposes of this Act. Financing for older adult | ||||||
11 | services shall be based on the principle that "money follows | ||||||
12 | the individual". The plan shall also identify potential | ||||||
13 | impediments to delivery system restructuring and include any | ||||||
14 | known regulatory or statutory barriers. | ||||||
15 | (2) Comprehensive care coordination case management . The | ||||||
16 | Department shall implement a statewide system of holistic | ||||||
17 | comprehensive case management. The system shall include the | ||||||
18 | identification and implementation of a universal, | ||||||
19 | comprehensive assessment tool to be used statewide to determine | ||||||
20 | the level of physical, functional, cognitive, psycho-social, | ||||||
21 | social socialization , and financial needs of older adults. This | ||||||
22 | tool shall be supported by an electronic intake, assessment, | ||||||
23 | and care planning system linked to a central location. | ||||||
24 | "Comprehensive care coordination case management " shall | ||||||
25 | include activities such includes services and coordination | ||||||
26 | such as (i) comprehensive assessment of the older adult |
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1 | (including the physical, functional, cognitive, psycho-social, | ||||||
2 | and social needs of the individual) ; (ii) development and | ||||||
3 | implementation of a service plan with the older adult to | ||||||
4 | mobilize the formal and family resources and services | ||||||
5 | identified in the assessment to meet the needs of the older | ||||||
6 | adult, including coordination of the resources and services | ||||||
7 | with any other plans that exist for various formal services, | ||||||
8 | such as hospital discharge plans, and with the information and | ||||||
9 | assistance services; (iii) coordination and monitoring of | ||||||
10 | formal and informal family service delivery, regardless of the | ||||||
11 | funding source, including coordination and monitoring to | ||||||
12 | ensure that services specified in the plan are being provided; | ||||||
13 | (iv) assistance with completion of applications for services, | ||||||
14 | referrals to non-government funded services, health promotion, | ||||||
15 | and ensuring continuity of care across care settings; (v) | ||||||
16 | periodic reassessment and revision of the status of the older | ||||||
17 | adult with the older adult or, if necessary, the older adult's | ||||||
18 | designated representative; and (vi) (v) in accordance with the | ||||||
19 | wishes of the older adult, advocacy on behalf of the older | ||||||
20 | adult for needed services or resources. | ||||||
21 | (3) Coordinated point of entry. The Department shall | ||||||
22 | implement and publicize a statewide coordinated point of entry | ||||||
23 | using a uniform name, identity, logo, and toll-free number. | ||||||
24 | (4) Public web site. The Department shall develop a public | ||||||
25 | web site that provides links to available services, resources, | ||||||
26 | and reference materials concerning caregiving, diseases, and |
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1 | best practices for use by professionals, older adults, and | ||||||
2 | family caregivers. | ||||||
3 | (5) Expansion of older adult services. The Department shall | ||||||
4 | expand older adult services that promote independence and | ||||||
5 | permit older adults to remain in their own homes and | ||||||
6 | communities. | ||||||
7 | (6) Consumer-directed home and community-based services. | ||||||
8 | The Department shall expand the range of service options | ||||||
9 | available to permit older adults to exercise maximum choice and | ||||||
10 | control over their care. | ||||||
11 | (7) Comprehensive delivery system. The Department shall | ||||||
12 | expand opportunities for older adults to receive services in | ||||||
13 | systems that integrate acute and chronic care. | ||||||
14 | (8) Enhanced transition and follow-up services. The | ||||||
15 | Department shall implement a program of transition from one | ||||||
16 | residential setting to another and follow-up services, | ||||||
17 | regardless of residential setting, pursuant to rules with | ||||||
18 | respect to (i) resident eligibility, (ii) assessment of the | ||||||
19 | resident's health, cognitive, social, and financial needs, | ||||||
20 | (iii) development of transition plans, and (iv) the level of | ||||||
21 | services that must be available before transitioning a resident | ||||||
22 | from one setting to another. | ||||||
23 | (9) Family caregiver support. The Department shall develop | ||||||
24 | strategies for public and private financing of services that | ||||||
25 | supplement and support family caregivers.
| ||||||
26 | (10) Quality standards and quality improvement. The |
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1 | Department shall establish a core set of uniform quality | ||||||
2 | standards for all providers that focus on outcomes and take | ||||||
3 | into consideration consumer choice and satisfaction, and the | ||||||
4 | Department shall require each provider to implement a | ||||||
5 | continuous quality improvement process to address consumer | ||||||
6 | issues. The continuous quality improvement process must | ||||||
7 | benchmark performance, be person-centered and data-driven, and | ||||||
8 | focus on consumer satisfaction.
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9 | (11) Workforce. The Department shall develop strategies to | ||||||
10 | attract and retain a qualified and stable worker pool, provide | ||||||
11 | living wages and benefits, and create a work environment that | ||||||
12 | is conducive to long-term employment and career development. | ||||||
13 | Resources such as grants, education, and promotion of career | ||||||
14 | opportunities may be used. | ||||||
15 | (12) Coordination of services. The Department shall | ||||||
16 | identify methods to better coordinate service networks to | ||||||
17 | maximize resources and minimize duplication of services and | ||||||
18 | ease of application. | ||||||
19 | (13) Barriers to services. The Department shall identify | ||||||
20 | barriers to the provision, availability, and accessibility of | ||||||
21 | services and shall implement a plan to address those barriers. | ||||||
22 | The plan shall: (i) identify barriers, including but not | ||||||
23 | limited to, statutory and regulatory complexity, reimbursement | ||||||
24 | issues, payment issues, and labor force issues; (ii) recommend | ||||||
25 | changes to State or federal laws or administrative rules or | ||||||
26 | regulations; (iii) recommend application for federal waivers |
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1 | to improve efficiency and reduce cost and paperwork; (iv) | ||||||
2 | develop innovative service delivery models; and (v) recommend | ||||||
3 | application for federal or private service grants. | ||||||
4 | (14) Reimbursement and funding. The Department shall | ||||||
5 | investigate and evaluate costs and payments by defining costs | ||||||
6 | to implement a uniform, audited provider cost reporting system | ||||||
7 | to be considered by all Departments in establishing payments. | ||||||
8 | To the extent possible, multiple cost reporting mandates shall | ||||||
9 | not be imposed. | ||||||
10 | (15) Medicaid nursing home cost containment and Medicare | ||||||
11 | utilization. The Department of Healthcare and Family Services | ||||||
12 | (formerly Department of Public Aid), in collaboration with the | ||||||
13 | Department on Aging and the Department of Public Health and in | ||||||
14 | consultation with the Advisory Committee, shall propose a plan | ||||||
15 | to contain Medicaid nursing home costs and maximize Medicare | ||||||
16 | utilization. The plan must not impair the ability of an older | ||||||
17 | adult to choose among available services. The plan shall | ||||||
18 | include, but not be limited to, (i) techniques to maximize the | ||||||
19 | use of the most cost-effective services without sacrificing | ||||||
20 | quality and (ii) methods to identify and serve older adults in | ||||||
21 | need of minimal services to remain independent, but who are | ||||||
22 | likely to develop a need for more extensive services in the | ||||||
23 | absence of those minimal services. | ||||||
24 | (16) Bed reduction. The Department of Public Health shall | ||||||
25 | implement a nursing home conversion program to reduce the | ||||||
26 | number of Medicaid-certified nursing home beds in areas with |
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| |||||||
1 | excess beds. The Department of Healthcare and Family Services | ||||||
2 | shall investigate changes to the Medicaid nursing facility | ||||||
3 | reimbursement system in order to reduce beds. Such changes may | ||||||
4 | include, but are not limited to, incentive payments that will | ||||||
5 | enable facilities to adjust to the restructuring and expansion | ||||||
6 | of services required by the Older Adult Services Act, including | ||||||
7 | adjustments for the voluntary closure or layaway of nursing | ||||||
8 | home beds certified under Title XIX of the federal Social | ||||||
9 | Security Act. Any savings shall be reallocated to fund | ||||||
10 | home-based or community-based older adult services pursuant to | ||||||
11 | Section 20. | ||||||
12 | (17) Financing. The Department shall investigate and | ||||||
13 | evaluate financing options for older adult services and shall | ||||||
14 | make recommendations in the report required by Section 15 | ||||||
15 | concerning the feasibility of these financing arrangements. | ||||||
16 | These arrangements shall include, but are not limited to: | ||||||
17 | (A) private long-term care insurance coverage for | ||||||
18 | older adult services; | ||||||
19 | (B) enhancement of federal long-term care financing | ||||||
20 | initiatives; | ||||||
21 | (C) employer benefit programs such as medical savings | ||||||
22 | accounts for long-term care; | ||||||
23 | (D) individual and family cost-sharing options; | ||||||
24 | (E) strategies to reduce reliance on government | ||||||
25 | programs; | ||||||
26 | (F) fraudulent asset divestiture and financial |
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| |||||||
1 | planning prevention; and | ||||||
2 | (G) methods to supplement and support family and | ||||||
3 | community caregiving. | ||||||
4 | (18) Older Adult Services Demonstration Grants. The | ||||||
5 | Department shall implement a program of demonstration grants | ||||||
6 | that will assist in the restructuring of the older adult | ||||||
7 | services delivery system, and shall provide funding for | ||||||
8 | innovative service delivery models and system change and | ||||||
9 | integration initiatives pursuant to subsection (g) of Section | ||||||
10 | 20. | ||||||
11 | (19) Bed need methodology update. For the purposes of | ||||||
12 | determining areas with excess beds, the Departments shall | ||||||
13 | provide information and assistance to the Health Facilities | ||||||
14 | Planning Board to update the Bed Need Methodology for Long-Term | ||||||
15 | Care to update the assumptions used to establish the | ||||||
16 | methodology to make them consistent with modern older adult | ||||||
17 | services.
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18 | (20) Affordable housing. The Departments shall utilize the | ||||||
19 | recommendations of Illinois' Annual Comprehensive Housing | ||||||
20 | Plan, as developed by the Affordable Housing Task Force through | ||||||
21 | the Governor's Executive Order 2003-18, in their efforts to | ||||||
22 | address the affordable housing needs of older adults.
| ||||||
23 | The Older Adult Services Advisory Committee shall | ||||||
24 | investigate innovative and promising practices operating as | ||||||
25 | demonstration or pilot projects in Illinois and in other | ||||||
26 | states. The Department on Aging shall provide the Older Adult |
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| |||||||
1 | Services Advisory Committee with a list of all demonstration or | ||||||
2 | pilot projects funded by the Department on Aging, including | ||||||
3 | those specified by rule, law, policy memorandum, or funding | ||||||
4 | arrangement. The Committee shall work with the Department on | ||||||
5 | Aging to evaluate the viability of expanding these programs | ||||||
6 | into other areas of the State.
| ||||||
7 | Notwithstanding any other rulemaking authority that may | ||||||
8 | exist, neither the Governor nor any agency or agency head under | ||||||
9 | the jurisdiction of the Governor has any authority to make or | ||||||
10 | promulgate rules to implement or enforce the provisions of this | ||||||
11 | amendatory Act of the 95th General Assembly. If, however, the | ||||||
12 | Governor believes that rules are necessary to implement or | ||||||
13 | enforce the provisions of this amendatory Act of the 95th | ||||||
14 | General Assembly, the Governor may suggest rules to the General | ||||||
15 | Assembly by filing them with the Clerk of the House and | ||||||
16 | Secretary of the Senate and by requesting that the General | ||||||
17 | Assembly authorize such rulemaking by law, enact those | ||||||
18 | suggested rules into law, or take any other appropriate action | ||||||
19 | in the General Assembly's discretion. Nothing contained in this | ||||||
20 | amendatory Act of the 95th General Assembly shall be | ||||||
21 | interpreted to grant rulemaking authority under any other | ||||||
22 | Illinois statute where such authority is not otherwise | ||||||
23 | explicitly given. For the purposes of this amendatory Act of | ||||||
24 | the 95th General Assembly, "rules" is given the meaning | ||||||
25 | contained in Section 1-70 of the Illinois Administrative | ||||||
26 | Procedure Act, and "agency" and "agency head" are given the |
| |||||||
| |||||||
1 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
2 | Administrative Procedure Act to the extent that such | ||||||
3 | definitions apply to agencies or agency heads under the | ||||||
4 | jurisdiction of the Governor. | ||||||
5 | (Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05; | ||||||
6 | 94-766, eff. 1-1-07.)
| ||||||
7 | (320 ILCS 60/Act rep.)
| ||||||
8 | Section 15. The Community Senior Services and Resources Act | ||||||
9 | is repealed. | ||||||
10 | (320 ILCS 65/16 rep.) | ||||||
11 | Section 20. The Family Caregiver Act is amended by | ||||||
12 | repealing Section 16. | ||||||
13 | Section 95. No acceleration or delay. Where this Act makes | ||||||
14 | changes in a statute that is represented in this Act by text | ||||||
15 | that is not yet or no longer in effect (for example, a Section | ||||||
16 | represented by multiple versions), the use of that text does | ||||||
17 | not accelerate or delay the taking effect of (i) the changes | ||||||
18 | made by this Act or (ii) provisions derived from any other | ||||||
19 | Public Act. | ||||||
20 | Section 99. Effective date. This Act takes effect upon | ||||||
21 | becoming law.".
|