Full Text of SB0765 95th General Assembly
SB0765enr 95TH GENERAL ASSEMBLY
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| AN ACT concerning State government.
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| Be it enacted by the People of the State of Illinois, | 3 |
| represented in the General Assembly:
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| Section 5. The Disabilities Services Act of 2003 is amended | 5 |
| by adding a heading to Article 1 immediately before Section 1 | 6 |
| of the Act, by adding a heading to Article 2 immediately before | 7 |
| Section 5 of the Act, by adding Article 3 and a heading to | 8 |
| Article 99 immediately before Section 90 of the Act as follows: | 9 |
| (20 ILCS 2407/Art. 1 heading new) | 10 |
| ARTICLE 1. SHORT TITLE | 11 |
| (20 ILCS 2407/Art. 2 heading new) | 12 |
| ARTICLE 2. DISABILITIES SERVICES ACT of 2003 | 13 |
| (20 ILCS 2407/Art. 3 heading new) | 14 |
| ARTICLE 3. MONEY FOLLOWS THE PERSON IMPLEMENTATION ACT | 15 |
| (20 ILCS 2407/51 new) | 16 |
| Sec. 51. Legislative intent. It is the intent of the | 17 |
| General Assembly to promote the civil rights of persons with | 18 |
| disabilities by providing community-based service for persons | 19 |
| with disabilities when such services are determined | 20 |
| appropriate and desired, as required by Title II of the |
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| Americans with Disabilities Act under the United States Supreme | 2 |
| Court's decision in Olmstead v. L.C., 527 U.S. 581 (1999). In | 3 |
| accordance with Section 6071 of the Deficit Reduction Act of | 4 |
| 2005 (P.L. 109-171), the purpose of this Act is (i) to identify | 5 |
| and reduce barriers or mechanisms, whether in State law, the | 6 |
| State Medicaid Plan, the State budget, or otherwise, that | 7 |
| prevent or restrict the flexible use of public funds to enable | 8 |
| individuals with disabilities to receive support for | 9 |
| appropriate and necessary long-term care services in settings | 10 |
| of their choice; (ii) to increase the use of home and | 11 |
| community-based long-term care services, rather than | 12 |
| institutions or long-term care facilities; (iii) to increase | 13 |
| the ability of the State Medicaid program to assure continued | 14 |
| provision of home and community-based long-term care services | 15 |
| to eligible individuals who choose to transition from an | 16 |
| institution or a long-term care facility to a community | 17 |
| setting; and (iv) to ensure that procedures are in place that | 18 |
| are at least comparable to those required under the qualified | 19 |
| home and community-based program to provide quality assurance | 20 |
| for eligible individuals receiving Medicaid home and | 21 |
| community-based long-term care services and to provide for | 22 |
| continuous quality improvement in such services. Utilizing the | 23 |
| framework created by the "Money Follows the Person" | 24 |
| demonstration project, approval received by the State on May | 25 |
| 14, 2007, the purpose of this Act is to codify and reinforce | 26 |
| the State's commitment to promote individual choice and control |
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| and increase utilization of home and community-based services | 2 |
| through: | 3 |
| (a) Increased ability of the State Medicaid program to | 4 |
| ensure continued provision of home and community-based | 5 |
| long-term care services to eligible individuals who choose | 6 |
| to transition from an institution to a community setting. | 7 |
| (b) Assessment and removal of barriers to community | 8 |
| reintegration, including development of a comprehensive | 9 |
| housing strategy. | 10 |
| (c) Expand availability of consumer self-directed | 11 |
| service options. | 12 |
| (d) Increased use of home and community-based | 13 |
| long-term care services, rather than institutions or | 14 |
| long-term care facilities, such that the percentage of the | 15 |
| State long-term care budget expended for community-based | 16 |
| services increases from its current 28.5% to at least 37% | 17 |
| in the next 5 years. | 18 |
| (e) Creation and implementation of interagency | 19 |
| agreements or budgetary mechanisms to allow for the | 20 |
| flexible movement of allocated dollars from institutional | 21 |
| budget appropriations to appropriations supporting home | 22 |
| and community-based services or Medicaid State Plan | 23 |
| options. | 24 |
| (f) Creation of an equitable, clinically sound and | 25 |
| cost-effective system for identification and review of | 26 |
| community transition candidates across all long-term care |
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| systems; including improvement of prescreening, assessment | 2 |
| for rapid reintegration and targeted review of longer stay | 3 |
| residents, training and outreach education for providers | 4 |
| and consumers on community alternatives across all | 5 |
| long-term care systems. | 6 |
| (g) Development and implementation of data and | 7 |
| information systems to track individuals across service | 8 |
| systems and funding streams; support responsive | 9 |
| eligibility determination; facilitate placement and care | 10 |
| decisions; identify individuals with potential for | 11 |
| transition; and drive planning for the development of | 12 |
| community-based alternatives. | 13 |
| (h) Establishment of procedures that are at least | 14 |
| comparable to those required under the qualified home and | 15 |
| community-based program to provide quality assurance for | 16 |
| eligible individuals receiving Medicaid home and | 17 |
| community-based long-term care services and to provide for | 18 |
| continuous quality improvement in such services. | 19 |
| (i) Nothing in this amendatory Act of the 95th General | 20 |
| Assembly shall diminish or restrict the choice of an | 21 |
| individual to reside in an institution or the quality of | 22 |
| care they receive. | 23 |
| (20 ILCS 2407/52 new) | 24 |
| Sec. 52. Applicability; definitions. In accordance with | 25 |
| Section 6071 of the Deficit Reduction Act of 2005 (P.L. |
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| 109-171), as used in this Article: | 2 |
| "Departments". The term "Departments" means for the | 3 |
| purposes of this Act, the Department of Human Services, the | 4 |
| Department on Aging, Department of Healthcare and Family | 5 |
| Services and Department of Public Health, unless otherwise | 6 |
| noted. | 7 |
| "Home and community-based long-term care services". The | 8 |
| term "home and community-based long-term care services" means, | 9 |
| with respect to the State Medicaid program, a service aid, or | 10 |
| benefit, home and community-based services, including but not | 11 |
| limited to home health and personal care services, that are | 12 |
| provided to a person with a disability, and are voluntarily | 13 |
| accepted, as part of his or her long-term care that: (i) is | 14 |
| provided under the State's qualified home and community-based | 15 |
| program or that could be provided under such a program but is | 16 |
| otherwise provided under the Medicaid program; (ii) is | 17 |
| delivered in a qualified residence; and (iii) is necessary for | 18 |
| the person with a disability to live in the community. | 19 |
| "Long-term care facility". The term "long-term care | 20 |
| facility", for the purposes of this Article, means a skilled | 21 |
| nursing or intermediate long-term care facility subject to | 22 |
| licensure by the Department of Public Health under the Nursing | 23 |
| Home Care Act, an intermediate care facility for the | 24 |
| developmentally disabled (ICF-DDs), and a State-operated | 25 |
| developmental center or mental health center, whether publicly | 26 |
| or privately owned. |
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| "Money Follows the Person" Demonstration. Enacted by the | 2 |
| Deficit Reduction Act of 2005, the Money Follows the Person | 3 |
| (MFP) Rebalancing Demonstration is part of a comprehensive, | 4 |
| coordinated strategy to assist states, in collaboration with | 5 |
| stakeholders, to make widespread changes to their long-term | 6 |
| care support systems. This initiative will assist states in | 7 |
| their efforts to reduce their reliance on institutional care | 8 |
| while developing community-based long-term care opportunities, | 9 |
| enabling the elderly and people with disabilities to fully | 10 |
| participate in their communities. | 11 |
| "Public funds" mean any funds appropriated by the General | 12 |
| Assembly to the Departments of Human Services, on Aging, of | 13 |
| Healthcare and Family Services and of Public Health for | 14 |
| settings and services as defined in this Article. | 15 |
| "Qualified residence". The term "qualified residence" | 16 |
| means, with respect to an eligible individual: (i) a home owned | 17 |
| or leased by the individual or the individual's authorized | 18 |
| representative (as defined by P.L. 109-171); (ii) an apartment | 19 |
| with an individual lease, with lockable access and egress, and | 20 |
| which includes living, sleeping, bathing, and cooking areas | 21 |
| over which the individual or the individual's family has domain | 22 |
| and control; or (iii) a residence, in a community-based | 23 |
| residential setting, in which no more than 4 unrelated | 24 |
| individuals reside. Where qualified residences are not | 25 |
| sufficient to meet the demand of eligible individuals, | 26 |
| time-limited exceptions to this definition may be developed |
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SB0765 Enrolled |
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| through administrative rule. | 2 |
| "Self-directed services". The term "self-directed | 3 |
| services" means, with respect to home and community-based | 4 |
| long-term services for an eligible individual, those services | 5 |
| for the individual that are planned and purchased under the | 6 |
| direction and control of the individual or the individual's | 7 |
| authorized representative, including the amount, duration, | 8 |
| scope, provider, and location of such services, under the State | 9 |
| Medicaid program consistent with the following requirements: | 10 |
| (a) Assessment: there is an assessment of the needs, | 11 |
| capabilities, and preference of the individual with | 12 |
| respect to such services. | 13 |
| (b) Individual service care or treatment plan: based on | 14 |
| the assessment, there is development jointly with such | 15 |
| individual or individual's authorized representative, a | 16 |
| plan for such services for the individual that (i) | 17 |
| specifies those services, if any, that the individual or | 18 |
| the individual's authorized representative would be | 19 |
| responsible for directing; (ii) identifies the methods by | 20 |
| which the individual or the individual's authorized | 21 |
| representative or an agency designated by an individual or | 22 |
| representative will select, manage, and dismiss providers | 23 |
| of such services. | 24 |
| (20 ILCS 2407/53 new) | 25 |
| Sec. 53. Rebalancing benchmarks. |
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| (a) Illinois' long-term care system is in a state of | 2 |
| transformation, as evidenced by the creation and subsequent | 3 |
| work products of the Disability Services Advisory Committee, | 4 |
| Older Adult Services Advisory Committee, Housing Task Force and | 5 |
| other executive and legislative branch initiatives. | 6 |
| (b) Illinois' Money Follows the Person demonstration | 7 |
| approval capitalizes on this progress and commits the State to | 8 |
| transition approximately 3,357 older persons and persons with | 9 |
| developmental, physical or psychiatric disabilities from | 10 |
| institutional to home and community-based settings, resulting | 11 |
| in an increased percentage of long-term care community spending | 12 |
| over the next 5 years. | 13 |
| (c) The State will endeavor to increase the percentage of | 14 |
| community-based long-term care spending over the next 5 years | 15 |
| according to the following timeline: | 16 |
| Estimated baseline: 28.5% | 17 |
| Year 1: 30% | 18 |
| Year 2: 31% | 19 |
| Year 3: 32% | 20 |
| Year 4: 35% | 21 |
| Year 5: 37% | 22 |
| (d) The Departments will utilize interagency agreements | 23 |
| and will seek legislative authority to implement a Money | 24 |
| Follows the Person budgetary mechanism to allocate or | 25 |
| reallocate funds for the purpose of expanding the availability, | 26 |
| quality or stability of home and community-based long-term care |
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| services and supports for persons with disabilities. | 2 |
| (e) The allocation of public funds for home and | 3 |
| community-based long-term care services shall not have the | 4 |
| effect of: (i) diminishing or reducing the quality of services | 5 |
| available to residents of long-term care facilities; (ii) | 6 |
| forcing any residents of long-term care facilities to | 7 |
| involuntarily accept home and community-based long-term care | 8 |
| services, or causing any residents of long-term care facilities | 9 |
| to be involuntarily transferred or discharged; (iii) causing | 10 |
| reductions in long-term care facility reimbursement rates in | 11 |
| effect as of July 1, 2008; or (iv) diminishing access to a full | 12 |
| array of long-term care options. | 13 |
| (20 ILCS 2407/54 new) | 14 |
| Sec. 54. Quality assurance and quality improvement. | 15 |
| (a) In accordance with subsection (11) of Section 6071 of | 16 |
| the Deficit Reduction Act of 2005 (P.L. 109-171), the | 17 |
| Departments shall develop a plan for quality assurance and | 18 |
| quality improvement for home and community-based long-term | 19 |
| care services under the State Medicaid program, including a | 20 |
| plan to assure the health and welfare of eligible individuals | 21 |
| under this Act. | 22 |
| (b) This plan shall require the Departments to apply for | 23 |
| any available funding to support the intent of this | 24 |
| legislation, and to seek any appropriate federal Medicaid | 25 |
| approval. |
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SB0765 Enrolled |
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| (20 ILCS 2407/55 new) | 2 |
| Sec. 55. Dissemination of reports. | 3 |
| (a) On or before April 1 of each year, in conjunction with | 4 |
| their annual report, the Department of Healthcare and Family | 5 |
| Services, in cooperation with the other involved agencies, | 6 |
| shall report to the Governor and the General Assembly on the | 7 |
| implementation of this Act and include, at a minimum, the | 8 |
| following data: (i) a description of any interagency | 9 |
| agreements, fiscal payment mechanisms or methodologies | 10 |
| developed under this Act that effectively support choice; (ii) | 11 |
| information concerning the dollar amounts of State Medicaid | 12 |
| long-term care expenditures and the percentage of such | 13 |
| expenditures that were for institutional long-term care | 14 |
| services or were for home and community-based long-term care | 15 |
| services; and (iii) documentation that the Departments have met | 16 |
| the requirements under Section 54(a) to assure the health and | 17 |
| welfare of eligible individuals receiving home and | 18 |
| community-based long-term care services. This report must be | 19 |
| made available to the general public, including via the | 20 |
| Departmental websites. | 21 |
| (20 ILCS 2407/56 new) | 22 |
| Sec. 56. Effect on existing rights. | 23 |
| (a) This Article does not alter or affect the manner in | 24 |
| which persons with disabilities are determined eligible or |
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| appropriate for home and community-based long-term care | 2 |
| services. | 3 |
| (b) This Article shall not be read to limit in any way the | 4 |
| rights of persons with disabilities under the U.S. | 5 |
| Constitution, the Americans with Disabilities Act, Section 504 | 6 |
| of the Rehabilitation Act, the Social Security Act, or any | 7 |
| other federal or State law. | 8 |
| (20 ILCS 2407/57 new) | 9 |
| Sec. 57. Rules. The Departments of Human Services, on | 10 |
| Aging, of Healthcare and Family Services and of Public Health | 11 |
| shall adopt any rules necessary for the implementation and | 12 |
| administration of this Act. |
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