Sen. Louis S. Viverito

Filed: 3/13/2007

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 591

2     AMENDMENT NO. ______. Amend Senate Bill 591 by replacing
3 everything after the enacting clause with the following:
 
4     "Section 5. The Illinois Act on the Aging is amended by
5 changing Sections 4.02 and 4.12 as follows:
 
6     (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
7     Sec. 4.02. The Department shall establish a program of
8 services to prevent unnecessary institutionalization of
9 persons age 60 and older in need of long term care or who are
10 established as persons who suffer from Alzheimer's disease or a
11 related disorder under the Alzheimer's Disease Assistance Act,
12 thereby enabling them to remain in their own homes or in other
13 living arrangements. Such preventive services, which may be
14 coordinated with other programs for the aged and monitored by
15 area agencies on aging in cooperation with the Department, may
16 include, but are not limited to, any or all of the following:

 

 

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1         (a) home health services;
2         (b) home nursing services;
3         (c) homemaker services;
4         (d) chore and housekeeping services;
5         (e) adult day services;
6         (f) home-delivered meals;
7         (g) education in self-care;
8         (h) personal care services;
9         (i) adult day health services;
10         (j) habilitation services;
11         (k) respite care;
12         (k-5) community reintegration services;
13         (l) other nonmedical social services that may enable
14     the person to become self-supporting; or
15         (m) clearinghouse for information provided by senior
16     citizen home owners who want to rent rooms to or share
17     living space with other senior citizens.
18     The Department shall establish eligibility standards for
19 such services taking into consideration the unique economic and
20 social needs of the target population for whom they are to be
21 provided. Such eligibility standards shall be based on the
22 recipient's ability to pay for services; provided, however,
23 that in determining the amount and nature of services for which
24 a person may qualify, consideration shall not be given to the
25 value of cash, property or other assets held in the name of the
26 person's spouse pursuant to a written agreement dividing

 

 

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1 marital property into equal but separate shares or pursuant to
2 a transfer of the person's interest in a home to his spouse,
3 provided that the spouse's share of the marital property is not
4 made available to the person seeking such services.
5     Beginning July 1, 2002, the Department shall require as a
6 condition of eligibility that all financially eligible
7 applicants and recipients apply for medical assistance under
8 Article V of the Illinois Public Aid Code in accordance with
9 rules promulgated by the Department.
10     The Department shall, in conjunction with the Department of
11 Public Aid (now Department of Healthcare and Family Services),
12 seek appropriate amendments under Sections 1915 and 1924 of the
13 Social Security Act. The purpose of the amendments shall be to
14 extend eligibility for home and community based services under
15 Sections 1915 and 1924 of the Social Security Act to persons
16 who transfer to or for the benefit of a spouse those amounts of
17 income and resources allowed under Section 1924 of the Social
18 Security Act. Subject to the approval of such amendments, the
19 Department shall extend the provisions of Section 5-4 of the
20 Illinois Public Aid Code to persons who, but for the provision
21 of home or community-based services, would require the level of
22 care provided in an institution, as is provided for in federal
23 law. Those persons no longer found to be eligible for receiving
24 noninstitutional services due to changes in the eligibility
25 criteria shall be given 60 days notice prior to actual
26 termination. Those persons receiving notice of termination may

 

 

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1 contact the Department and request the determination be
2 appealed at any time during the 60 day notice period. With the
3 exception of the lengthened notice and time frame for the
4 appeal request, the appeal process shall follow the normal
5 procedure. In addition, each person affected regardless of the
6 circumstances for discontinued eligibility shall be given
7 notice and the opportunity to purchase the necessary services
8 through the Community Care Program. If the individual does not
9 elect to purchase services, the Department shall advise the
10 individual of alternative services. The target population
11 identified for the purposes of this Section are persons age 60
12 and older with an identified service need. Priority shall be
13 given to those who are at imminent risk of
14 institutionalization. The services shall be provided to
15 eligible persons age 60 and older to the extent that the cost
16 of the services together with the other personal maintenance
17 expenses of the persons are reasonably related to the standards
18 established for care in a group facility appropriate to the
19 person's condition. These non-institutional services, pilot
20 projects or experimental facilities may be provided as part of
21 or in addition to those authorized by federal law or those
22 funded and administered by the Department of Human Services.
23 The Departments of Human Services, Healthcare and Family
24 Services, Public Health, Veterans' Affairs, and Commerce and
25 Economic Opportunity and other appropriate agencies of State,
26 federal and local governments shall cooperate with the

 

 

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1 Department on Aging in the establishment and development of the
2 non-institutional services. The Department shall require an
3 annual audit from all chore/housekeeping and homemaker vendors
4 contracting with the Department under this Section. The annual
5 audit shall assure that each audited vendor's procedures are in
6 compliance with Department's financial reporting guidelines
7 requiring an administrative and employee wage and benefits cost
8 split as defined in administrative rules. The audit is a public
9 record under the Freedom of Information Act. The Department
10 shall execute, relative to the nursing home prescreening
11 project, written inter-agency agreements with the Department
12 of Human Services and the Department of Healthcare and Family
13 Services, to effect the following: (1) intake procedures and
14 common eligibility criteria for those persons who are receiving
15 non-institutional services; and (2) the establishment and
16 development of non-institutional services in areas of the State
17 where they are not currently available or are undeveloped. On
18 and after July 1, 1996, all nursing home prescreenings for
19 individuals 60 years of age or older shall be conducted by the
20 Department.
21     As part of the Department on Aging's routine training of
22 care coordinators case managers and care coordinator case
23 manager supervisors, the Department may include information on
24 family futures planning for persons who are age 60 or older and
25 who are caregivers of their adult children with developmental
26 disabilities. The content of the training shall be at the

 

 

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1 Department's discretion.
2     No later than July 1, 2008, the Department's case
3 management program shall be transitioned to a fully integrated
4 care coordination program. The care coordination program shall
5 incorporate the concepts of client direction and consumer focus
6 and shall take into account the client's needs and preferences.
7 On an individual client basis, duties of the care coordinators
8 may include any combination of the following:
9         (A) intake;
10         (B) assessment;
11         (C) eligibility determination;
12         (D) care plan development;
13         (E) case work to implement care plan;
14         (F) follow-up;
15         (G) assistance with completion of applications for
16     services;
17         (H) re-evaluation;
18         (I) referrals to non-government funded services;
19         (J) resource development;
20         (K) prevention;
21         (L) case closure;
22         (M) ensuring continuity of care across care settings;
23         (N) identification of gaps in services;
24         (O) monitoring; and
25         (P) other tasks as needed.
26     At the discretion of the care coordinators, a comprehensive

 

 

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1 assessment shall be performed, using a tool identified by the
2 Department. The comprehensive assessment process shall include
3 a face to face interview in the client's home or temporary
4 abode. Assessment interviews shall accommodate the scheduling
5 needs of the client and the client's representative or
6 representatives, who shall participate at the discretion of the
7 client. The Department shall provide, by administrative rule,
8 guidelines for determining the intensity of care coordination
9 offered to each care recipient. Services contained in the care
10 plan shall be menu driven and the client shall be given, to the
11 extent practicable, the ability to choose, in collaboration
12 with his or her care coordinator, the services that best
13 reflect his or her needs and preferences. Care plans shall
14 include all services needed by the recipient regardless of his
15 or her funding source and delineate between services provided,
16 services unavailable, and services refused by the client. The
17 Department shall develop a process for the collection of unmet
18 needs and the identification of priority service areas, as
19 directed by the Older Adult Services Act. Case coordination
20 units shall be reimbursed for care coordination in a just and
21 equitable manner reflective of the actual cost of providing
22 care coordination. By January 1, 2008, the Department shall
23 develop a rate structure, in collaboration with case
24 coordination units and advocates for care recipients, that
25 reflects the intensity of coordination provided. The
26 Department shall reevaluate the rate structure, each January

 

 

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1 thereafter, to determine if the rate structure reflects the
2 current costs of doing business.
3     The Department is authorized to establish a system of
4 recipient copayment for services provided under this Section,
5 such copayment to be based upon the recipient's ability to pay
6 but in no case to exceed the actual cost of the services
7 provided. Additionally, any portion of a person's income which
8 is equal to or less than the federal poverty standard shall not
9 be considered by the Department in determining the copayment.
10 The level of such copayment shall be adjusted whenever
11 necessary to reflect any change in the officially designated
12 federal poverty standard.
13     The Department, or the Department's authorized
14 representative, shall recover the amount of moneys expended for
15 services provided to or in behalf of a person under this
16 Section by a claim against the person's estate or against the
17 estate of the person's surviving spouse, but no recovery may be
18 had until after the death of the surviving spouse, if any, and
19 then only at such time when there is no surviving child who is
20 under age 21, blind, or permanently and totally disabled. This
21 paragraph, however, shall not bar recovery, at the death of the
22 person, of moneys for services provided to the person or in
23 behalf of the person under this Section to which the person was
24 not entitled; provided that such recovery shall not be enforced
25 against any real estate while it is occupied as a homestead by
26 the surviving spouse or other dependent, if no claims by other

 

 

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1 creditors have been filed against the estate, or, if such
2 claims have been filed, they remain dormant for failure of
3 prosecution or failure of the claimant to compel administration
4 of the estate for the purpose of payment. This paragraph shall
5 not bar recovery from the estate of a spouse, under Sections
6 1915 and 1924 of the Social Security Act and Section 5-4 of the
7 Illinois Public Aid Code, who precedes a person receiving
8 services under this Section in death. All moneys for services
9 paid to or in behalf of the person under this Section shall be
10 claimed for recovery from the deceased spouse's estate.
11 "Homestead", as used in this paragraph, means the dwelling
12 house and contiguous real estate occupied by a surviving spouse
13 or relative, as defined by the rules and regulations of the
14 Department of Healthcare and Family Services, regardless of the
15 value of the property.
16     The Department shall develop procedures to enhance
17 availability of services on evenings, weekends, and on an
18 emergency basis to meet the respite needs of caregivers.
19 Procedures shall be developed to permit the utilization of
20 services in successive blocks of 24 hours up to the monthly
21 maximum established by the Department. Workers providing these
22 services shall be appropriately trained.
23     Beginning on the effective date of this Amendatory Act of
24 1991, no person may perform chore/housekeeping and homemaker
25 services under a program authorized by this Section unless that
26 person has been issued a certificate of pre-service to do so by

 

 

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1 his or her employing agency. Information gathered to effect
2 such certification shall include (i) the person's name, (ii)
3 the date the person was hired by his or her current employer,
4 and (iii) the training, including dates and levels. Persons
5 engaged in the program authorized by this Section before the
6 effective date of this amendatory Act of 1991 shall be issued a
7 certificate of all pre- and in-service training from his or her
8 employer upon submitting the necessary information. The
9 employing agency shall be required to retain records of all
10 staff pre- and in-service training, and shall provide such
11 records to the Department upon request and upon termination of
12 the employer's contract with the Department. In addition, the
13 employing agency is responsible for the issuance of
14 certifications of in-service training completed to their
15 employees.
16     The Department is required to develop a system to ensure
17 that persons working as homemakers and chore housekeepers
18 receive increases in their wages when the federal minimum wage
19 is increased by requiring vendors to certify that they are
20 meeting the federal minimum wage statute for homemakers and
21 chore housekeepers. An employer that cannot ensure that the
22 minimum wage increase is being given to homemakers and chore
23 housekeepers shall be denied any increase in reimbursement
24 costs.
25     The Community Care Program Advisory Committee is created in
26 the Department on Aging. The Director shall appoint individuals

 

 

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1 to serve in the Committee, who shall serve at their own
2 expense. Members of the Committee must abide by all applicable
3 ethics laws. The Committee shall advise the Department on
4 issues related to the Department's program of services to
5 prevent unnecessary institutionalization. The Committee shall
6 meet on a bi-monthly basis and shall serve to identify and
7 advise the Department on present and potential issues affecting
8 the service delivery network, the program's clients, and the
9 Department and to recommend solution strategies. Persons
10 appointed to the Committee shall be appointed on, but not
11 limited to, their own and their agency's experience with the
12 program, geographic representation, and willingness to serve.
13 The Committee shall include, but not be limited to,
14 representatives from the following agencies and organizations:
15         (a) at least 4 adult day service representatives;
16         (b) at least 4 care case coordination unit
17     representatives;
18         (c) at least 4 representatives from in-home direct care
19     service agencies;
20         (d) at least 2 representatives of statewide trade or
21     labor unions that represent in-home direct care service
22     staff;
23         (e) at least 2 representatives of Area Agencies on
24     Aging;
25         (f) at least 2 non-provider representatives from a
26     policy, advocacy, research, or other service organization;

 

 

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1         (g) at least 2 representatives from a statewide
2     membership organization for senior citizens; and
3         (h) at least 2 citizen members 60 years of age or
4     older.
5     Nominations may be presented from any agency or State
6 association with interest in the program. The Director, or his
7 or her designee, shall serve as the permanent co-chair of the
8 advisory committee. One other co-chair shall be nominated and
9 approved by the members of the committee on an annual basis.
10 Committee members' terms of appointment shall be for 4 years
11 with one-quarter of the appointees' terms expiring each year.
12 At no time may a member serve more than one consecutive term in
13 any capacity on the committee. The Department shall fill
14 vacancies that have a remaining term of over one year, and this
15 replacement shall occur through the annual replacement of
16 expiring terms. The Director shall designate Department staff
17 to provide technical assistance and staff support to the
18 committee. Department representation shall not constitute
19 membership of the committee. All Committee papers, issues,
20 recommendations, reports, and meeting memoranda are advisory
21 only. The Director, or his or her designee, shall make a
22 written report, as requested by the Committee, regarding issues
23 before the Committee.
24     The Department on Aging and the Department of Human
25 Services shall cooperate in the development and submission of
26 an annual report on programs and services provided under this

 

 

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1 Section. Such joint report shall be filed with the Governor and
2 the General Assembly on or before September 30 each year.
3     The requirement for reporting to the General Assembly shall
4 be satisfied by filing copies of the report with the Speaker,
5 the Minority Leader and the Clerk of the House of
6 Representatives and the President, the Minority Leader and the
7 Secretary of the Senate and the Legislative Research Unit, as
8 required by Section 3.1 of the General Assembly Organization
9 Act and filing such additional copies with the State Government
10 Report Distribution Center for the General Assembly as is
11 required under paragraph (t) of Section 7 of the State Library
12 Act.
13     Those persons previously found eligible for receiving
14 non-institutional services whose services were discontinued
15 under the Emergency Budget Act of Fiscal Year 1992, and who do
16 not meet the eligibility standards in effect on or after July
17 1, 1992, shall remain ineligible on and after July 1, 1992.
18 Those persons previously not required to cost-share and who
19 were required to cost-share effective March 1, 1992, shall
20 continue to meet cost-share requirements on and after July 1,
21 1992. Beginning July 1, 1992, all clients will be required to
22 meet eligibility, cost-share, and other requirements and will
23 have services discontinued or altered when they fail to meet
24 these requirements.
25 (Source: P.A. 93-85, eff. 1-1-04; 93-902, eff. 8-10-04; 94-48,
26 eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, eff. 7-26-05;

 

 

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1 94-954, eff. 6-27-06.)
 
2     (20 ILCS 105/4.12)
3     Sec. 4.12. Assistance to nursing home residents.
4     (a) The Department on Aging shall assist eligible nursing
5 home residents and their families to select long-term care
6 options that meet their needs and reflect their preferences. At
7 any time during the process, the resident or his or her
8 representative may decline further assistance.
9     (b) To provide assistance, the Department shall develop a
10 program of transition services with follow-up in selected areas
11 of the State, to be expanded statewide as funding becomes
12 available. The program shall be developed in consultation with
13 nursing homes, care coordinators case managers, Area Agencies
14 on Aging, and others interested in the well-being of frail
15 elderly Illinois residents. The Department shall establish
16 administrative rules pursuant to the Illinois Administrative
17 Procedure Act with respect to resident eligibility, assessment
18 of the resident's health, cognitive, social, and financial
19 needs, development of comprehensive service transition plans,
20 and the level of services that must be available prior to
21 transition of a resident into the community.
22 (Source: P.A. 93-902, eff. 8-10-04.)
 
23     Section 99. Effective date. This Act takes effect upon
24 becoming law.".