Illinois General Assembly - Full Text of HB4245
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Full Text of HB4245  103rd General Assembly

HB4245 103RD GENERAL ASSEMBLY

 


 
103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB4245

 

Introduced 1/16/2024, by Rep. Bob Morgan

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/3.11
20 ILCS 105/4.01  from Ch. 23, par. 6104.01
20 ILCS 105/4.02
20 ILCS 105/5.03 new

    Amends the Illinois Act on Aging. In provisions concerning the Community Care Program (program), removes from the list of program services clearinghouse information provided by senior citizen home owners who want to rent rooms to or share living space with other senior citizens. In a provision requiring the Department on Aging to perform certain actions to increase the effectiveness of the program, removes a requirement that the Department ensure the determination of need tool is accurate in determining program participants' level of need. In a provision concerning pre-service certification for in-home workers who provide housekeeping or home aide services, requires employing agencies to pay wages to in-home workers for pre-service and in-service training. Provides that the Department may authorize (rather than shall delay) program services until an applicant is determined eligible for medical assistance under the Illinois Public Aid Code. Removes a provision requiring the Department to implement co-payments under the program. Requires the Department to make annual (rather than quarterly) reports on care coordination unit performance and adherence to service guidelines. Removes expired rate levels. Provides that all final administrative decisions of the Department are subject to judicial review. Makes other changes.


LRB103 35331 KTG 65390 b

 

 

A BILL FOR

 

HB4245LRB103 35331 KTG 65390 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Sections 3.11, 4.01, and 4.02 and by adding Section
65.03 as follows:
 
7    (20 ILCS 105/3.11)
8    Sec. 3.11. Greatest social need. "Greatest For the
9purposes of 89 Ill. Adm. Code 210.50, "greatest social need"
10means the need caused by noneconomic factors that restrict an
11individual's ability to perform normal daily tasks or that
12threaten his or her capacity to live independently. These
13factors include, but are not limited to, physical or mental
14disability, language barriers, and cultural or social
15isolation caused by, among other things, racial and ethnic
16status, sexual orientation, gender identity, gender
17expression, or HIV status.
18(Source: P.A. 101-325, eff. 8-9-19.)
 
19    (20 ILCS 105/4.01)  (from Ch. 23, par. 6104.01)
20    Sec. 4.01. Additional powers and duties of the Department.
21In addition to powers and duties otherwise provided by law,
22the Department shall have the following powers and duties:

 

 

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1    (1) To evaluate all programs, services, and facilities for
2the aged and for minority senior citizens within the State and
3determine the extent to which present public or private
4programs, services and facilities meet the needs of the aged.
5    (2) To coordinate and evaluate all programs, services, and
6facilities for the Aging and for minority senior citizens
7presently furnished by State agencies and make appropriate
8recommendations regarding such services, programs and
9facilities to the Governor and/or the General Assembly.
10    (2-a) To request, receive, and share information
11electronically through the use of data-sharing agreements for
12the purpose of (i) establishing and verifying the initial and
13continuing eligibility of older adults to participate in
14programs administered by the Department; (ii) maximizing
15federal financial participation in State assistance
16expenditures; and (iii) investigating allegations of fraud or
17other abuse of publicly funded benefits. Notwithstanding any
18other law to the contrary, but only for the limited purposes
19identified in the preceding sentence, this paragraph (2-a)
20expressly authorizes the exchanges of income, identification,
21and other pertinent eligibility information by and among the
22Department and the Social Security Administration, the
23Department of Employment Security, the Department of
24Healthcare and Family Services, the Department of Human
25Services, the Department of Revenue, the Secretary of State,
26the U.S. Department of Veterans Affairs, and any other

 

 

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1governmental entity. The confidentiality of information
2otherwise shall be maintained as required by law. In addition,
3the Department on Aging shall verify employment information at
4the request of a community care provider for the purpose of
5ensuring program integrity under the Community Care Program.
6    (3) To function as the sole State agency to develop a
7comprehensive plan to meet the needs of the State's senior
8citizens and the State's minority senior citizens.
9    (4) To receive and disburse State and federal funds made
10available directly to the Department including those funds
11made available under the Older Americans Act and the Senior
12Community Service Employment Program for providing services
13for senior citizens and minority senior citizens or for
14purposes related thereto, and shall develop and administer any
15State Plan for the Aging required by federal law.
16    (5) To solicit, accept, hold, and administer in behalf of
17the State any grants or legacies of money, securities, or
18property to the State of Illinois for services to senior
19citizens and minority senior citizens or purposes related
20thereto.
21    (6) To provide consultation and assistance to communities,
22area agencies on aging, and groups developing local services
23for senior citizens and minority senior citizens.
24    (7) To promote community education regarding the problems
25of senior citizens and minority senior citizens through
26institutes, publications, radio, television and the local

 

 

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1press.
2    (8) To cooperate with agencies of the federal government
3in studies and conferences designed to examine the needs of
4senior citizens and minority senior citizens and to prepare
5programs and facilities to meet those needs.
6    (9) To establish and maintain information and referral
7sources throughout the State when not provided by other
8agencies.
9    (10) To provide the staff support that may reasonably be
10required by the Council.
11    (11) To make and enforce rules and regulations necessary
12and proper to the performance of its duties.
13    (12) To establish and fund programs or projects or
14experimental facilities that are specially designed as
15alternatives to institutional care.
16    (13) To develop a training program to train the counselors
17presently employed by the Department's aging network to
18provide Medicare beneficiaries with counseling and advocacy in
19Medicare, private health insurance, and related health care
20coverage plans. The Department shall report to the General
21Assembly on the implementation of the training program on or
22before December 1, 1986.
23    (14) To make a grant to an institution of higher learning
24to study the feasibility of establishing and implementing an
25affirmative action employment plan for the recruitment,
26hiring, training and retraining of persons 60 or more years

 

 

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1old for jobs for which their employment would not be precluded
2by law.
3    (15) To present one award annually in each of the
4categories of community service, education, the performance
5and graphic arts, and the labor force to outstanding Illinois
6senior citizens and minority senior citizens in recognition of
7their individual contributions to either community service,
8education, the performance and graphic arts, or the labor
9force. The awards shall be presented to 4 senior citizens and
10minority senior citizens selected from a list of 44 nominees
11compiled annually by the Department. Nominations shall be
12solicited from senior citizens' service providers, area
13agencies on aging, senior citizens' centers, and senior
14citizens' organizations. If there are no nominations in a
15category, the Department may award a second person in one of
16the remaining categories. The Department shall establish a
17central location within the State to be designated as the
18Senior Illinoisans Hall of Fame for the public display of all
19the annual awards, or replicas thereof.
20    (16) To establish multipurpose senior centers through area
21agencies on aging and to fund those new and existing
22multipurpose senior centers through area agencies on aging,
23the establishment and funding to begin in such areas of the
24State as the Department shall designate by rule and as
25specifically appropriated funds become available.
26    (17) (Blank).

 

 

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1    (18) To develop a pamphlet in English and Spanish which
2may be used by physicians licensed to practice medicine in all
3of its branches pursuant to the Medical Practice Act of 1987,
4pharmacists licensed pursuant to the Pharmacy Practice Act,
5and Illinois residents 65 years of age or older for the purpose
6of assisting physicians, pharmacists, and patients in
7monitoring prescriptions provided by various physicians and to
8aid persons 65 years of age or older in complying with
9directions for proper use of pharmaceutical prescriptions. The
10pamphlet may provide space for recording information including
11but not limited to the following:
12        (a) name and telephone number of the patient;
13        (b) name and telephone number of the prescribing
14    physician;
15        (c) date of prescription;
16        (d) name of drug prescribed;
17        (e) directions for patient compliance; and
18        (f) name and telephone number of dispensing pharmacy.
19    In developing the pamphlet, the Department shall consult
20with the Illinois State Medical Society, the Center for
21Minority Health Services, the Illinois Pharmacists Association
22and senior citizens organizations. The Department shall
23distribute the pamphlets to physicians, pharmacists and
24persons 65 years of age or older or various senior citizen
25organizations throughout the State.
26    (19) To conduct a study of the feasibility of implementing

 

 

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1the Senior Companion Program throughout the State.
2    (20) The reimbursement rates paid through the community
3care program for chore housekeeping services and home care
4aides shall be the same.
5    (21) From funds appropriated to the Department from the
6Meals on Wheels Fund, a special fund in the State treasury that
7is hereby created, and in accordance with State and federal
8guidelines and the intrastate funding formula, to make grants
9to area agencies on aging, designated by the Department, for
10the sole purpose of delivering meals to homebound persons 60
11years of age and older.
12    (22) To distribute, through its area agencies on aging,
13information alerting seniors on safety issues regarding
14emergency weather conditions, including extreme heat and cold,
15flooding, tornadoes, electrical storms, and other severe storm
16weather. The information shall include all necessary
17instructions for safety and all emergency telephone numbers of
18organizations that will provide additional information and
19assistance.
20    (23) To develop guidelines for the organization and
21implementation of Volunteer Services Credit Programs to be
22administered by Area Agencies on Aging or community based
23senior service organizations. The Department shall hold public
24hearings on the proposed guidelines for public comment,
25suggestion, and determination of public interest. The
26guidelines shall be based on the findings of other states and

 

 

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1of community organizations in Illinois that are currently
2operating volunteer services credit programs or demonstration
3volunteer services credit programs. The Department shall offer
4guidelines for all aspects of the programs including, but not
5limited to, the following:
6        (a) types of services to be offered by volunteers;
7        (b) types of services to be received upon the
8    redemption of service credits;
9        (c) issues of liability for the volunteers and the
10    administering organizations;
11        (d) methods of tracking service credits earned and
12    service credits redeemed;
13        (e) issues of time limits for redemption of service
14    credits;
15        (f) methods of recruitment of volunteers;
16        (g) utilization of community volunteers, community
17    service groups, and other resources for delivering
18    services to be received by service credit program clients;
19        (h) accountability and assurance that services will be
20    available to individuals who have earned service credits;
21    and
22        (i) volunteer screening and qualifications.
23The Department shall submit a written copy of the guidelines
24to the General Assembly by July 1, 1998.
25    (24) To function as the sole State agency to receive and
26disburse State and federal funds for providing adult

 

 

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1protective services in a domestic living situation in
2accordance with the Adult Protective Services Act.
3    (25) To hold conferences, trainings, and other programs
4for which the Department shall determine by rule a reasonable
5fee to cover related administrative costs. Rules to implement
6the fee authority granted by this paragraph (25) must be
7adopted in accordance with all provisions of the Illinois
8Administrative Procedure Act and all rules and procedures of
9the Joint Committee on Administrative Rules; any purported
10rule not so adopted, for whatever reason, is unauthorized.
11(Source: P.A. 98-8, eff. 5-3-13; 98-49, eff. 7-1-13; 98-380,
12eff. 8-16-13; 98-756, eff. 7-16-14; 99-331, eff. 1-1-16.)
 
13    (20 ILCS 105/4.02)
14    (Text of Section after amendment by P.A. 103-102)
15    Sec. 4.02. Community Care Program. The Department shall
16establish a program of services to prevent unnecessary
17institutionalization of persons age 60 and older in need of
18long term care or who are established as persons who suffer
19from Alzheimer's disease or a related disorder under the
20Alzheimer's Disease Assistance Act, thereby enabling them to
21remain in their own homes or in other living arrangements.
22Such preventive services, which may be coordinated with other
23programs for the aged and monitored by area agencies on aging
24in cooperation with the Department, may include, but are not
25limited to, any or all of the following:

 

 

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1        (a) (blank);
2        (b) (blank);
3        (c) home care aide services;
4        (d) personal assistant 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        (k-6) flexible senior services;
14        (k-7) medication management;
15        (k-8) emergency home response;
16        (l) other nonmedical social services that may enable
17    the person to become self-supporting; or
18        (m) (blank). clearinghouse for information provided by
19    senior citizen home owners who want to rent rooms to or
20    share living space with other senior citizens.
21    The Department shall establish eligibility standards for
22such services. In determining the amount and nature of
23services for which a person may qualify, consideration shall
24not be given to the value of cash, property, or other assets
25held in the name of the person's spouse pursuant to a written
26agreement dividing marital property into equal but separate

 

 

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1shares or pursuant to a transfer of the person's interest in a
2home to his spouse, provided that the spouse's share of the
3marital property is not made available to the person seeking
4such services.
5    The Beginning January 1, 2008, the Department shall
6require as a condition of eligibility that all new financially
7eligible applicants apply for and enroll in medical assistance
8under Article V of the Illinois Public Aid Code in accordance
9with rules promulgated by the Department.
10    The Department shall, in conjunction with the Department
11of Public Aid (now Department of Healthcare and Family
12Services), seek appropriate amendments under Sections 1915 and
131924 of the Social Security Act. The purpose of the amendments
14shall be to extend eligibility for home and community based
15services under Sections 1915 and 1924 of the Social Security
16Act to persons who transfer to or for the benefit of a spouse
17those amounts of income and resources allowed under Section
181924 of the Social Security Act. Subject to the approval of
19such amendments, the Department shall extend the provisions of
20Section 5-4 of the Illinois Public Aid Code to persons who, but
21for the provision of home or community-based services, would
22require the level of care provided in an institution, as is
23provided for in federal law. Those persons no longer found to
24be eligible for receiving noninstitutional services due to
25changes in the eligibility criteria shall be given 45 days
26notice prior to actual termination. Those persons receiving

 

 

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1notice of termination may contact the Department and request
2the determination be appealed at any time during the 45 day
3notice period. The target population identified for the
4purposes of this Section are persons age 60 and older with an
5identified service need. Priority shall be given to those who
6are at imminent risk of institutionalization. The services
7shall be provided to eligible persons age 60 and older to the
8extent that the cost of the services together with the other
9personal maintenance expenses of the persons are reasonably
10related to the standards established for care in a group
11facility appropriate to the person's condition. These
12non-institutional services, pilot projects, or experimental
13facilities may be provided as part of or in addition to those
14authorized by federal law or those funded and administered by
15the Department of Human Services. The Departments of Human
16Services, Healthcare and Family Services, Public Health,
17Veterans' Affairs, and Commerce and Economic Opportunity and
18other appropriate agencies of State, federal, and local
19governments shall cooperate with the Department on Aging in
20the establishment and development of the non-institutional
21services. The Department shall require an annual audit from
22all personal assistant and home care aide vendors contracting
23with the Department under this Section. The annual audit shall
24assure that each audited vendor's procedures are in compliance
25with Department's financial reporting guidelines requiring an
26administrative and employee wage and benefits cost split as

 

 

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1defined in administrative rules. The audit is a public record
2under the Freedom of Information Act. The Department shall
3execute, relative to the nursing home prescreening project,
4written inter-agency agreements with the Department of Human
5Services and the Department of Healthcare and Family Services,
6to effect the following: (1) intake procedures and common
7eligibility criteria for those persons who are receiving
8non-institutional services; and (2) the establishment and
9development of non-institutional services in areas of the
10State where they are not currently available or are
11undeveloped. On and after July 1, 1996, all nursing home
12prescreenings for individuals 60 years of age or older shall
13be conducted by the Department.
14    As part of the Department on Aging's routine training of
15case managers and case manager supervisors, the Department may
16include information on family futures planning for persons who
17are age 60 or older and who are caregivers of their adult
18children with developmental disabilities. The content of the
19training shall be at the Department's discretion.
20    The Department is authorized to establish a system of
21recipient copayment for services provided under this Section,
22such copayment to be based upon the recipient's ability to pay
23but in no case to exceed the actual cost of the services
24provided. Additionally, any portion of a person's income which
25is equal to or less than the federal poverty standard shall not
26be considered by the Department in determining the copayment.

 

 

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1The level of such copayment shall be adjusted whenever
2necessary to reflect any change in the officially designated
3federal poverty standard.
4    The Department, or the Department's authorized
5representative, may recover the amount of moneys expended for
6services provided to or in behalf of a person under this
7Section by a claim against the person's estate or against the
8estate of the person's surviving spouse, but no recovery may
9be had until after the death of the surviving spouse, if any,
10and then only at such time when there is no surviving child who
11is under age 21 or blind or who has a permanent and total
12disability. This paragraph, however, shall not bar recovery,
13at the death of the person, of moneys for services provided to
14the person or in behalf of the person under this Section to
15which the person was not entitled; provided that such recovery
16shall not be enforced against any real estate while it is
17occupied as a homestead by the surviving spouse or other
18dependent, if no claims by other creditors have been filed
19against the estate, or, if such claims have been filed, they
20remain dormant for failure of prosecution or failure of the
21claimant to compel administration of the estate for the
22purpose of payment. This paragraph shall not bar recovery from
23the estate of a spouse, under Sections 1915 and 1924 of the
24Social Security Act and Section 5-4 of the Illinois Public Aid
25Code, who precedes a person receiving services under this
26Section in death. All moneys for services paid to or in behalf

 

 

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1of the person under this Section shall be claimed for recovery
2from the deceased spouse's estate. "Homestead", as used in
3this paragraph, means the dwelling house and contiguous real
4estate occupied by a surviving spouse or relative, as defined
5by the rules and regulations of the Department of Healthcare
6and Family Services, regardless of the value of the property.
7    The Department shall increase the effectiveness of the
8existing Community Care Program by:
9        (1) ensuring that in-home services included in the
10    care plan are available on evenings and weekends;
11        (2) ensuring that care plans contain the services that
12    eligible participants need based on the number of days in
13    a month, not limited to specific blocks of time, as
14    identified by the comprehensive assessment tool selected
15    by the Department for use statewide, not to exceed the
16    total monthly service cost maximum allowed for each
17    service; the Department shall develop administrative rules
18    to implement this item (2);
19        (3) ensuring that the participants have the right to
20    choose the services contained in their care plan and to
21    direct how those services are provided, based on
22    administrative rules established by the Department;
23        (4) (blank); ensuring that the determination of need
24    tool is accurate in determining the participants' level of
25    need; to achieve this, the Department, in conjunction with
26    the Older Adult Services Advisory Committee, shall

 

 

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1    institute a study of the relationship between the
2    Determination of Need scores, level of need, service cost
3    maximums, and the development and utilization of service
4    plans no later than May 1, 2008; findings and
5    recommendations shall be presented to the Governor and the
6    General Assembly no later than January 1, 2009;
7    recommendations shall include all needed changes to the
8    service cost maximums schedule and additional covered
9    services;
10        (5) ensuring that homemakers can provide personal care
11    services that may or may not involve contact with clients,
12    including, but not limited to:
13            (A) bathing;
14            (B) grooming;
15            (C) toileting;
16            (D) nail care;
17            (E) transferring;
18            (F) respiratory services;
19            (G) exercise; or
20            (H) positioning;
21        (6) ensuring that homemaker program vendors are not
22    restricted from hiring homemakers who are family members
23    of clients or recommended by clients; the Department may
24    not, by rule or policy, require homemakers who are family
25    members of clients or recommended by clients to accept
26    assignments in homes other than the client;

 

 

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1        (7) ensuring that the State may access maximum federal
2    matching funds by seeking approval for the Centers for
3    Medicare and Medicaid Services for modifications to the
4    State's home and community based services waiver and
5    additional waiver opportunities, including applying for
6    enrollment in the Balance Incentive Payment Program by May
7    1, 2013, in order to maximize federal matching funds; this
8    shall include, but not be limited to, modification that
9    reflects all changes in the Community Care Program
10    services and all increases in the services cost maximum;
11        (8) ensuring that the determination of need tool
12    accurately reflects the service needs of individuals with
13    Alzheimer's disease and related dementia disorders;
14        (9) ensuring that services are authorized accurately
15    and consistently for the Community Care Program (CCP); the
16    Department shall implement a Service Authorization policy
17    directive; the purpose shall be to ensure that eligibility
18    and services are authorized accurately and consistently in
19    the CCP program; the policy directive shall clarify
20    service authorization guidelines to Care Coordination
21    Units and Community Care Program providers no later than
22    May 1, 2013;
23        (10) working in conjunction with Care Coordination
24    Units, the Department of Healthcare and Family Services,
25    the Department of Human Services, Community Care Program
26    providers, and other stakeholders to make improvements to

 

 

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1    the Medicaid claiming processes and the Medicaid
2    enrollment procedures or requirements as needed,
3    including, but not limited to, specific policy changes or
4    rules to improve the up-front enrollment of participants
5    in the Medicaid program and specific policy changes or
6    rules to insure more prompt submission of bills to the
7    federal government to secure maximum federal matching
8    dollars as promptly as possible; the Department on Aging
9    shall have at least 3 meetings with stakeholders by
10    January 1, 2014 in order to address these improvements;
11        (11) requiring home care service providers to comply
12    with the rounding of hours worked provisions under the
13    federal Fair Labor Standards Act (FLSA) and as set forth
14    in 29 CFR 785.48(b) by May 1, 2013;
15        (12) implementing any necessary policy changes or
16    promulgating any rules, no later than January 1, 2014, to
17    assist the Department of Healthcare and Family Services in
18    moving as many participants as possible, consistent with
19    federal regulations, into coordinated care plans if a care
20    coordination plan that covers long term care is available
21    in the recipient's area; and
22        (13) (blank). maintaining fiscal year 2014 rates at
23    the same level established on January 1, 2013.
24    By January 1, 2009 or as soon after the end of the Cash and
25Counseling Demonstration Project as is practicable, the
26Department may, based on its evaluation of the demonstration

 

 

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1project, promulgate rules concerning personal assistant
2services, to include, but need not be limited to,
3qualifications, employment screening, rights under fair labor
4standards, training, fiduciary agent, and supervision
5requirements. All applicants shall be subject to the
6provisions of the Health Care Worker Background Check Act.
7    The Department shall develop procedures to enhance
8availability of services on evenings, weekends, and on an
9emergency basis to meet the respite needs of caregivers.
10Procedures shall be developed to permit the utilization of
11services in successive blocks of 24 hours up to the monthly
12maximum established by the Department. Workers providing these
13services shall be appropriately trained.
14    No Beginning on the effective date of this amendatory Act
15of 1991, no person may perform chore/housekeeping and home
16care aide services under a program authorized by this Section
17unless that person has been issued a certificate of
18pre-service to do so by his or her employing agency.
19Information gathered to effect such certification shall
20include (i) the person's name, (ii) the date the person was
21hired by his or her current employer, and (iii) the training,
22including dates and levels. Persons engaged in the program
23authorized by this Section before the effective date of this
24amendatory Act of 1991 shall be issued a certificate of all
25pre-service pre- and in-service training from his or her
26employer upon submitting the necessary information. The

 

 

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1employing agency shall be required to retain records of all
2staff pre-service pre- and in-service training, and shall
3provide such records to the Department upon request and upon
4termination of the employer's contract with the Department. In
5addition, the employing agency is responsible for the issuance
6of certifications of in-service training completed to their
7employees as well as paying wages to the in-home workers for
8pre-service and in-service training.
9    The Department is required to develop a system to ensure
10that persons working as home care aides and personal
11assistants receive increases in their wages when the federal
12minimum wage is increased by requiring vendors to certify that
13they are meeting the federal minimum wage statute for home
14care aides and personal assistants. An employer that cannot
15ensure that the minimum wage increase is being given to home
16care aides and personal assistants shall be denied any
17increase in reimbursement costs.
18    The Community Care Program Advisory Committee is created
19in the Department on Aging. The Director shall appoint
20individuals to serve in the Committee, who shall serve at
21their own expense. Members of the Committee must abide by all
22applicable ethics laws. The Committee shall advise the
23Department on issues related to the Department's program of
24services to prevent unnecessary institutionalization. The
25Committee shall meet on a bi-monthly basis and shall serve to
26identify and advise the Department on present and potential

 

 

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1issues affecting the service delivery network, the program's
2clients, and the Department and to recommend solution
3strategies. Persons appointed to the Committee shall be
4appointed on, but not limited to, their own and their agency's
5experience with the program, geographic representation, and
6willingness to serve. The Director shall appoint members to
7the Committee to represent provider, advocacy, policy
8research, and other constituencies committed to the delivery
9of high quality home and community-based services to older
10adults. Representatives shall be appointed to ensure
11representation from community care providers, including, but
12not limited to, adult day service providers, homemaker
13providers, case coordination and case management units,
14emergency home response providers, statewide trade or labor
15unions that represent home care aides and direct care staff,
16area agencies on aging, adults over age 60, membership
17organizations representing older adults, and other
18organizational entities, providers of care, or individuals
19with demonstrated interest and expertise in the field of home
20and community care as determined by the Director.
21    Nominations may be presented from any agency or State
22association with interest in the program. The Director, or his
23or her designee, shall serve as the permanent co-chair of the
24advisory committee. One other co-chair shall be nominated and
25approved by the members of the committee on an annual basis.
26Committee members' terms of appointment shall be for 4 years

 

 

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1with one-quarter of the appointees' terms expiring each year.
2A member shall continue to serve until his or her replacement
3is named. The Department shall fill vacancies that have a
4remaining term of over one year, and this replacement shall
5occur through the annual replacement of expiring terms. The
6Director shall designate Department staff to provide technical
7assistance and staff support to the committee. Department
8representation shall not constitute membership of the
9committee. All Committee papers, issues, recommendations,
10reports, and meeting memoranda are advisory only. The
11Director, or his or her designee, shall make a written report,
12as requested by the Committee, regarding issues before the
13Committee.
14    The Department on Aging and the Department of Human
15Services shall cooperate in the development and submission of
16an annual report on programs and services provided under this
17Section. Such joint report shall be filed with the Governor
18and the General Assembly on or before March 31 of the following
19fiscal year.
20    The requirement for reporting to the General Assembly
21shall be satisfied by filing copies of the report as required
22by Section 3.1 of the General Assembly Organization Act and
23filing such additional copies with the State Government Report
24Distribution Center for the General Assembly as is required
25under paragraph (t) of Section 7 of the State Library Act.
26    Those persons previously found eligible for receiving

 

 

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1non-institutional services whose services were discontinued
2under the Emergency Budget Act of Fiscal Year 1992, and who do
3not meet the eligibility standards in effect on or after July
41, 1992, shall remain ineligible on and after July 1, 1992.
5Those persons previously not required to cost-share and who
6were required to cost-share effective March 1, 1992, shall
7continue to meet cost-share requirements on and after July 1,
81992. Beginning July 1, 1992, all clients will be required to
9meet eligibility, cost-share, and other requirements and will
10have services discontinued or altered when they fail to meet
11these requirements.
12    For the purposes of this Section, "flexible senior
13services" refers to services that require one-time or periodic
14expenditures, including, but not limited to, respite care,
15home modification, assistive technology, housing assistance,
16and transportation.
17    The Department shall implement an electronic service
18verification based on global positioning systems or other
19cost-effective technology for the Community Care Program no
20later than January 1, 2014.
21    The Department shall require, as a condition of
22eligibility, application for enrollment in the medical
23assistance program under Article V of the Illinois Public Aid
24Code (i) beginning August 1, 2013, if the Auditor General has
25reported that the Department has failed to comply with the
26reporting requirements of Section 2-27 of the Illinois State

 

 

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1Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
2General has reported that the Department has not undertaken
3the required actions listed in the report required by
4subsection (a) of Section 2-27 of the Illinois State Auditing
5Act.
6    The Department may authorize shall delay Community Care
7Program services until an applicant is determined eligible for
8medical assistance under Article V of the Illinois Public Aid
9Code (i) beginning August 1, 2013, if the Auditor General has
10reported that the Department has failed to comply with the
11reporting requirements of Section 2-27 of the Illinois State
12Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
13General has reported that the Department has not undertaken
14the required actions listed in the report required by
15subsection (a) of Section 2-27 of the Illinois State Auditing
16Act.
17    The Department shall implement co-payments for the
18Community Care Program at the federally allowable maximum
19level (i) beginning August 1, 2013, if the Auditor General has
20reported that the Department has failed to comply with the
21reporting requirements of Section 2-27 of the Illinois State
22Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
23General has reported that the Department has not undertaken
24the required actions listed in the report required by
25subsection (a) of Section 2-27 of the Illinois State Auditing
26Act.

 

 

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1    The Department shall continue to provide other Community
2Care Program reports as required by statute, which shall
3include an annual report on Care Coordination Unit performance
4and adherence to service guidelines.
5    The Department shall conduct a quarterly review of Care
6Coordination Unit performance and adherence to service
7guidelines. The quarterly review shall be reported to the
8Speaker of the House of Representatives, the Minority Leader
9of the House of Representatives, the President of the Senate,
10and the Minority Leader of the Senate. The Department shall
11collect and report longitudinal data on the performance of
12each care coordination unit. Nothing in this paragraph shall
13be construed to require the Department to identify specific
14care coordination units.
15    In regard to community care providers, failure to comply
16with Department on Aging policies shall be cause for
17disciplinary action, including, but not limited to,
18disqualification from serving Community Care Program clients.
19Each provider, upon submission of any bill or invoice to the
20Department for payment for services rendered, shall include a
21notarized statement, under penalty of perjury pursuant to
22Section 1-109 of the Code of Civil Procedure, that the
23provider has complied with all Department policies.
24    The Director of the Department on Aging shall make
25information available to the State Board of Elections as may
26be required by an agreement the State Board of Elections has

 

 

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1entered into with a multi-state voter registration list
2maintenance system.
3    Within 30 days after July 6, 2017 (the effective date of
4Public Act 100-23), rates shall be increased to $18.29 per
5hour, for the purpose of increasing, by at least $.72 per hour,
6the wages paid by those vendors to their employees who provide
7homemaker services. The Department shall pay an enhanced rate
8under the Community Care Program to those in-home service
9provider agencies that offer health insurance coverage as a
10benefit to their direct service worker employees consistent
11with the mandates of Public Act 95-713. For State fiscal years
122018 and 2019, the enhanced rate shall be $1.77 per hour. The
13rate shall be adjusted using actuarial analysis based on the
14cost of care, but shall not be set below $1.77 per hour. The
15Department shall adopt rules, including emergency rules under
16subsections (y) and (bb) of Section 5-45 of the Illinois
17Administrative Procedure Act, to implement the provisions of
18this paragraph.
19    Subject to federal approval, beginning on January 1, 2024,
20rates for adult day services shall be increased to $16.84 per
21hour and rates for each way transportation services for adult
22day services shall be increased to $12.44 per unit
23transportation.
24    Subject to federal approval, on and after January 1, 2024,
25rates for homemaker services shall be increased to $28.07 to
26sustain a minimum wage of $17 per hour for direct service

 

 

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1workers. Rates in subsequent State fiscal years shall be no
2lower than the rates put into effect upon federal approval.
3Providers of in-home services shall be required to certify to
4the Department that they remain in compliance with the
5mandated wage increase for direct service workers. Fringe
6benefits, including, but not limited to, paid time off and
7payment for training, health insurance, travel, or
8transportation, shall not be reduced in relation to the rate
9increases described in this paragraph.
10    The General Assembly finds it necessary to authorize an
11aggressive Medicaid enrollment initiative designed to maximize
12federal Medicaid funding for the Community Care Program which
13produces significant savings for the State of Illinois. The
14Department on Aging shall establish and implement a Community
15Care Program Medicaid Initiative. Under the Initiative, the
16Department on Aging shall, at a minimum: (i) provide an
17enhanced rate to adequately compensate care coordination units
18to enroll eligible Community Care Program clients into
19Medicaid; (ii) use recommendations from a stakeholder
20committee on how best to implement the Initiative; and (iii)
21establish requirements for State agencies to make enrollment
22in the State's Medical Assistance program easier for seniors.
23    The Community Care Program Medicaid Enrollment Oversight
24Subcommittee is created as a subcommittee of the Older Adult
25Services Advisory Committee established in Section 35 of the
26Older Adult Services Act to make recommendations on how best

 

 

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1to increase the number of medical assistance recipients who
2are enrolled in the Community Care Program. The Subcommittee
3shall consist of all of the following persons who must be
4appointed within 30 days after June 4, 2018 (the effective
5date of Public Act 100-587) this amendatory Act of the 100th
6General Assembly:
7        (1) The Director of Aging, or his or her designee, who
8    shall serve as the chairperson of the Subcommittee.
9        (2) One representative of the Department of Healthcare
10    and Family Services, appointed by the Director of
11    Healthcare and Family Services.
12        (3) One representative of the Department of Human
13    Services, appointed by the Secretary of Human Services.
14        (4) One individual representing a care coordination
15    unit, appointed by the Director of Aging.
16        (5) One individual from a non-governmental statewide
17    organization that advocates for seniors, appointed by the
18    Director of Aging.
19        (6) One individual representing Area Agencies on
20    Aging, appointed by the Director of Aging.
21        (7) One individual from a statewide association
22    dedicated to Alzheimer's care, support, and research,
23    appointed by the Director of Aging.
24        (8) One individual from an organization that employs
25    persons who provide services under the Community Care
26    Program, appointed by the Director of Aging.

 

 

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1        (9) One member of a trade or labor union representing
2    persons who provide services under the Community Care
3    Program, appointed by the Director of Aging.
4        (10) One member of the Senate, who shall serve as
5    co-chairperson, appointed by the President of the Senate.
6        (11) One member of the Senate, who shall serve as
7    co-chairperson, appointed by the Minority Leader of the
8    Senate.
9        (12) One member of the House of Representatives, who
10    shall serve as co-chairperson, appointed by the Speaker of
11    the House of Representatives.
12        (13) One member of the House of Representatives, who
13    shall serve as co-chairperson, appointed by the Minority
14    Leader of the House of Representatives.
15        (14) One individual appointed by a labor organization
16    representing frontline employees at the Department of
17    Human Services.
18    The Subcommittee shall provide oversight to the Community
19Care Program Medicaid Initiative and shall meet quarterly. At
20each Subcommittee meeting the Department on Aging shall
21provide the following data sets to the Subcommittee: (A) the
22number of Illinois residents, categorized by planning and
23service area, who are receiving services under the Community
24Care Program and are enrolled in the State's Medical
25Assistance Program; (B) the number of Illinois residents,
26categorized by planning and service area, who are receiving

 

 

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1services under the Community Care Program, but are not
2enrolled in the State's Medical Assistance Program; and (C)
3the number of Illinois residents, categorized by planning and
4service area, who are receiving services under the Community
5Care Program and are eligible for benefits under the State's
6Medical Assistance Program, but are not enrolled in the
7State's Medical Assistance Program. In addition to this data,
8the Department on Aging shall provide the Subcommittee with
9plans on how the Department on Aging will reduce the number of
10Illinois residents who are not enrolled in the State's Medical
11Assistance Program but who are eligible for medical assistance
12benefits. The Department on Aging shall enroll in the State's
13Medical Assistance Program those Illinois residents who
14receive services under the Community Care Program and are
15eligible for medical assistance benefits but are not enrolled
16in the State's Medicaid Assistance Program. The data provided
17to the Subcommittee shall be made available to the public via
18the Department on Aging's website.
19    The Department on Aging, with the involvement of the
20Subcommittee, shall collaborate with the Department of Human
21Services and the Department of Healthcare and Family Services
22on how best to achieve the responsibilities of the Community
23Care Program Medicaid Initiative.
24    The Department on Aging, the Department of Human Services,
25and the Department of Healthcare and Family Services shall
26coordinate and implement a streamlined process for seniors to

 

 

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1access benefits under the State's Medical Assistance Program.
2    The Subcommittee shall collaborate with the Department of
3Human Services on the adoption of a uniform application
4submission process. The Department of Human Services and any
5other State agency involved with processing the medical
6assistance application of any person enrolled in the Community
7Care Program shall include the appropriate care coordination
8unit in all communications related to the determination or
9status of the application.
10    The Community Care Program Medicaid Initiative shall
11provide targeted funding to care coordination units to help
12seniors complete their applications for medical assistance
13benefits. On and after July 1, 2019, care coordination units
14shall receive no less than $200 per completed application,
15which rate may be included in a bundled rate for initial intake
16services when Medicaid application assistance is provided in
17conjunction with the initial intake process for new program
18participants.
19    The Community Care Program Medicaid Initiative shall cease
20operation 5 years after June 4, 2018 (the effective date of
21Public Act 100-587) this amendatory Act of the 100th General
22Assembly, after which the Subcommittee shall dissolve.
23    Effective July 1, 2023, subject to federal approval, the
24Department on Aging shall reimburse Care Coordination Units at
25the following rates for case management services: $252.40 for
26each initial assessment; $366.40 for each initial assessment

 

 

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1with translation; $229.68 for each redetermination assessment;
2$313.68 for each redetermination assessment with translation;
3$200.00 for each completed application for medical assistance
4benefits; $132.26 for each face-to-face, choices-for-care
5screening; $168.26 for each face-to-face, choices-for-care
6screening with translation; $124.56 for each 6-month,
7face-to-face visit; $132.00 for each MCO participant
8eligibility determination; and $157.00 for each MCO
9participant eligibility determination with translation.
10(Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23;
11103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102,
12Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90,
13Section 90-5, eff. 1-1-24; revised 9-25-23.)
 
14    (20 ILCS 105/5.03 new)
15    Sec. 5.03. Judicial review. All final administrative
16decisions of the Department are subject to judicial review in
17accordance with the provisions of the Administrative Review
18Law, and all rules adopted under the Administrative Review
19Law. The term "administrative decision" is defined as in
20Section 3-101 of the Code of Civil Procedure.
21    Proceedings for judicial review shall be commenced in the
22circuit court of the county in which the party applying for
23review resides; however, if the party is not a resident of this
24State, the venue shall be Sangamon County.