Illinois General Assembly - Full Text of HB4871
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Full Text of HB4871  100th General Assembly




State of Illinois
2017 and 2018


Introduced , by Rep. Lou Lang


20 ILCS 105/4.02  from Ch. 23, par. 6104.02

    Amends the Illinois Act on the Aging. In provisions concerning the Community Care Program, provides that within 30 days after the effective date of the amendatory Act, rates for adult days services shall be increased to $15.02 per hour and rates for each way transportation services for adult day services shall be increased to $10.30 per hour. Effective immediately.

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HB4871LRB100 18979 KTG 34230 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 Section 4.02 as follows:
6    (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
7    Sec. 4.02. Community Care Program. The Department shall
8establish a program of services to prevent unnecessary
9institutionalization of persons age 60 and older in need of
10long term care or who are established as persons who suffer
11from Alzheimer's disease or a related disorder under the
12Alzheimer's Disease Assistance Act, thereby enabling them to
13remain in their own homes or in other living arrangements. Such
14preventive services, which may be coordinated with other
15programs for the aged and monitored by area agencies on aging
16in cooperation with the Department, may include, but are not
17limited to, any or all of the following:
18        (a) (blank);
19        (b) (blank);
20        (c) home care aide services;
21        (d) personal assistant services;
22        (e) adult day services;
23        (f) home-delivered meals;



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1        (g) education in self-care;
2        (h) personal care services;
3        (i) adult day health services;
4        (j) habilitation services;
5        (k) respite care;
6        (k-5) community reintegration services;
7        (k-6) flexible senior services;
8        (k-7) medication management;
9        (k-8) emergency home response;
10        (l) other nonmedical social services that may enable
11    the person to become self-supporting; or
12        (m) clearinghouse for information provided by senior
13    citizen home owners who want to rent rooms to or share
14    living space with other senior citizens.
15    The Department shall establish eligibility standards for
16such services. In determining the amount and nature of services
17for which a person may qualify, consideration shall not be
18given to the value of cash, property or other assets held in
19the name of the person's spouse pursuant to a written agreement
20dividing marital property into equal but separate shares or
21pursuant to a transfer of the person's interest in a home to
22his spouse, provided that the spouse's share of the marital
23property is not made available to the person seeking such
25    Beginning January 1, 2008, the Department shall require as
26a condition of eligibility that all new financially eligible



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1applicants apply for and enroll in medical assistance under
2Article V of the Illinois Public Aid Code in accordance with
3rules promulgated by the Department.
4    The Department shall, in conjunction with the Department of
5Public Aid (now Department of Healthcare and Family Services),
6seek appropriate amendments under Sections 1915 and 1924 of the
7Social Security Act. The purpose of the amendments shall be to
8extend eligibility for home and community based services under
9Sections 1915 and 1924 of the Social Security Act to persons
10who transfer to or for the benefit of a spouse those amounts of
11income and resources allowed under Section 1924 of the Social
12Security Act. Subject to the approval of such amendments, the
13Department shall extend the provisions of Section 5-4 of the
14Illinois Public Aid Code to persons who, but for the provision
15of home or community-based services, would require the level of
16care provided in an institution, as is provided for in federal
17law. Those persons no longer found to be eligible for receiving
18noninstitutional services due to changes in the eligibility
19criteria shall be given 45 days notice prior to actual
20termination. Those persons receiving notice of termination may
21contact the Department and request the determination be
22appealed at any time during the 45 day notice period. The
23target population identified for the purposes of this Section
24are persons age 60 and older with an identified service need.
25Priority shall be given to those who are at imminent risk of
26institutionalization. The services shall be provided to



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1eligible persons age 60 and older to the extent that the cost
2of the services together with the other personal maintenance
3expenses of the persons are reasonably related to the standards
4established for care in a group facility appropriate to the
5person's condition. These non-institutional services, pilot
6projects or experimental facilities may be provided as part of
7or in addition to those authorized by federal law or those
8funded and administered by the Department of Human Services.
9The Departments of Human Services, Healthcare and Family
10Services, Public Health, Veterans' Affairs, and Commerce and
11Economic Opportunity and other appropriate agencies of State,
12federal and local governments shall cooperate with the
13Department on Aging in the establishment and development of the
14non-institutional services. The Department shall require an
15annual audit from all personal assistant and home care aide
16vendors contracting with the Department under this Section. The
17annual audit shall assure that each audited vendor's procedures
18are in compliance with Department's financial reporting
19guidelines requiring an administrative and employee wage and
20benefits cost split as defined in administrative rules. The
21audit is a public record under the Freedom of Information Act.
22The Department shall execute, relative to the nursing home
23prescreening project, written inter-agency agreements with the
24Department of Human Services and the Department of Healthcare
25and Family Services, to effect the following: (1) intake
26procedures and common eligibility criteria for those persons



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1who are receiving non-institutional services; and (2) the
2establishment and development of non-institutional services in
3areas of the State where they are not currently available or
4are undeveloped. On and after July 1, 1996, all nursing home
5prescreenings for individuals 60 years of age or older shall be
6conducted by the Department.
7    As part of the Department on Aging's routine training of
8case managers and case manager supervisors, the Department may
9include information on family futures planning for persons who
10are age 60 or older and who are caregivers of their adult
11children with developmental disabilities. The content of the
12training shall be at the Department's discretion.
13    The Department is authorized to establish a system of
14recipient copayment for services provided under this Section,
15such copayment to be based upon the recipient's ability to pay
16but in no case to exceed the actual cost of the services
17provided. Additionally, any portion of a person's income which
18is equal to or less than the federal poverty standard shall not
19be considered by the Department in determining the copayment.
20The level of such copayment shall be adjusted whenever
21necessary to reflect any change in the officially designated
22federal poverty standard.
23    The Department, or the Department's authorized
24representative, may recover the amount of moneys expended for
25services provided to or in behalf of a person under this
26Section by a claim against the person's estate or against the



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1estate of the person's surviving spouse, but no recovery may be
2had until after the death of the surviving spouse, if any, and
3then only at such time when there is no surviving child who is
4under age 21 or blind or who has a permanent and total
5disability. This paragraph, however, shall not bar recovery, at
6the death of the person, of moneys for services provided to the
7person or in behalf of the person under this Section to which
8the person was not entitled; provided that such recovery shall
9not be enforced against any real estate while it is occupied as
10a homestead by the surviving spouse or other dependent, if no
11claims by other creditors have been filed against the estate,
12or, if such claims have been filed, they remain dormant for
13failure of prosecution or failure of the claimant to compel
14administration of the estate for the purpose of payment. This
15paragraph shall not bar recovery from the estate of a spouse,
16under Sections 1915 and 1924 of the Social Security Act and
17Section 5-4 of the Illinois Public Aid Code, who precedes a
18person receiving services under this Section in death. All
19moneys for services paid to or in behalf of the person under
20this Section shall be claimed for recovery from the deceased
21spouse's estate. "Homestead", as used in this paragraph, means
22the dwelling house and contiguous real estate occupied by a
23surviving spouse or relative, as defined by the rules and
24regulations of the Department of Healthcare and Family
25Services, regardless of the value of the property.
26    The Department shall increase the effectiveness of the



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1existing Community Care Program by:
2        (1) ensuring that in-home services included in the care
3    plan are available on evenings and weekends;
4        (2) ensuring that care plans contain the services that
5    eligible participants need based on the number of days in a
6    month, not limited to specific blocks of time, as
7    identified by the comprehensive assessment tool selected
8    by the Department for use statewide, not to exceed the
9    total monthly service cost maximum allowed for each
10    service; the Department shall develop administrative rules
11    to implement this item (2);
12        (3) ensuring that the participants have the right to
13    choose the services contained in their care plan and to
14    direct how those services are provided, based on
15    administrative rules established by the Department;
16        (4) ensuring that the determination of need tool is
17    accurate in determining the participants' level of need; to
18    achieve this, the Department, in conjunction with the Older
19    Adult Services Advisory Committee, shall institute a study
20    of the relationship between the Determination of Need
21    scores, level of need, service cost maximums, and the
22    development and utilization of service plans no later than
23    May 1, 2008; findings and recommendations shall be
24    presented to the Governor and the General Assembly no later
25    than January 1, 2009; recommendations shall include all
26    needed changes to the service cost maximums schedule and



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1    additional covered services;
2        (5) ensuring that homemakers can provide personal care
3    services that may or may not involve contact with clients,
4    including but not limited to:
5            (A) bathing;
6            (B) grooming;
7            (C) toileting;
8            (D) nail care;
9            (E) transferring;
10            (F) respiratory services;
11            (G) exercise; or
12            (H) positioning;
13        (6) ensuring that homemaker program vendors are not
14    restricted from hiring homemakers who are family members of
15    clients or recommended by clients; the Department may not,
16    by rule or policy, require homemakers who are family
17    members of clients or recommended by clients to accept
18    assignments in homes other than the client;
19        (7) ensuring that the State may access maximum federal
20    matching funds by seeking approval for the Centers for
21    Medicare and Medicaid Services for modifications to the
22    State's home and community based services waiver and
23    additional waiver opportunities, including applying for
24    enrollment in the Balance Incentive Payment Program by May
25    1, 2013, in order to maximize federal matching funds; this
26    shall include, but not be limited to, modification that



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1    reflects all changes in the Community Care Program services
2    and all increases in the services cost maximum;
3        (8) ensuring that the determination of need tool
4    accurately reflects the service needs of individuals with
5    Alzheimer's disease and related dementia disorders;
6        (9) ensuring that services are authorized accurately
7    and consistently for the Community Care Program (CCP); the
8    Department shall implement a Service Authorization policy
9    directive; the purpose shall be to ensure that eligibility
10    and services are authorized accurately and consistently in
11    the CCP program; the policy directive shall clarify service
12    authorization guidelines to Care Coordination Units and
13    Community Care Program providers no later than May 1, 2013;
14        (10) working in conjunction with Care Coordination
15    Units, the Department of Healthcare and Family Services,
16    the Department of Human Services, Community Care Program
17    providers, and other stakeholders to make improvements to
18    the Medicaid claiming processes and the Medicaid
19    enrollment procedures or requirements as needed,
20    including, but not limited to, specific policy changes or
21    rules to improve the up-front enrollment of participants in
22    the Medicaid program and specific policy changes or rules
23    to insure more prompt submission of bills to the federal
24    government to secure maximum federal matching dollars as
25    promptly as possible; the Department on Aging shall have at
26    least 3 meetings with stakeholders by January 1, 2014 in



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1    order to address these improvements;
2        (11) requiring home care service providers to comply
3    with the rounding of hours worked provisions under the
4    federal Fair Labor Standards Act (FLSA) and as set forth in
5    29 CFR 785.48(b) by May 1, 2013;
6        (12) implementing any necessary policy changes or
7    promulgating any rules, no later than January 1, 2014, to
8    assist the Department of Healthcare and Family Services in
9    moving as many participants as possible, consistent with
10    federal regulations, into coordinated care plans if a care
11    coordination plan that covers long term care is available
12    in the recipient's area; and
13        (13) maintaining fiscal year 2014 rates at the same
14    level established on January 1, 2013.
15    By January 1, 2009 or as soon after the end of the Cash and
16Counseling Demonstration Project as is practicable, the
17Department may, based on its evaluation of the demonstration
18project, promulgate rules concerning personal assistant
19services, to include, but need not be limited to,
20qualifications, employment screening, rights under fair labor
21standards, training, fiduciary agent, and supervision
22requirements. All applicants shall be subject to the provisions
23of the Health Care Worker Background Check Act.
24    The Department shall develop procedures to enhance
25availability of services on evenings, weekends, and on an
26emergency basis to meet the respite needs of caregivers.



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1Procedures shall be developed to permit the utilization of
2services in successive blocks of 24 hours up to the monthly
3maximum established by the Department. Workers providing these
4services shall be appropriately trained.
5    Beginning on the effective date of this amendatory Act of
61991, no person may perform chore/housekeeping and home care
7aide services under a program authorized by this Section unless
8that person has been issued a certificate of pre-service to do
9so by his or her employing agency. Information gathered to
10effect such certification shall include (i) the person's name,
11(ii) the date the person was hired by his or her current
12employer, and (iii) the training, including dates and levels.
13Persons engaged in the program authorized by this Section
14before the effective date of this amendatory Act of 1991 shall
15be issued a certificate of all pre- and in-service training
16from his or her employer upon submitting the necessary
17information. The employing agency shall be required to retain
18records of all staff pre- and in-service training, and shall
19provide such records to the Department upon request and upon
20termination of the employer's contract with the Department. In
21addition, the employing agency is responsible for the issuance
22of certifications of in-service training completed to their
24    The Department is required to develop a system to ensure
25that persons working as home care aides and personal assistants
26receive increases in their wages when the federal minimum wage



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1is increased by requiring vendors to certify that they are
2meeting the federal minimum wage statute for home care aides
3and personal assistants. An employer that cannot ensure that
4the minimum wage increase is being given to home care aides and
5personal assistants shall be denied any increase in
6reimbursement costs.
7    The Community Care Program Advisory Committee is created in
8the Department on Aging. The Director shall appoint individuals
9to serve in the Committee, who shall serve at their own
10expense. Members of the Committee must abide by all applicable
11ethics laws. The Committee shall advise the Department on
12issues related to the Department's program of services to
13prevent unnecessary institutionalization. The Committee shall
14meet on a bi-monthly basis and shall serve to identify and
15advise the Department on present and potential issues affecting
16the service delivery network, the program's clients, and the
17Department and to recommend solution strategies. Persons
18appointed to the Committee shall be appointed on, but not
19limited to, their own and their agency's experience with the
20program, geographic representation, and willingness to serve.
21The Director shall appoint members to the Committee to
22represent provider, advocacy, policy research, and other
23constituencies committed to the delivery of high quality home
24and community-based services to older adults. Representatives
25shall be appointed to ensure representation from community care
26providers including, but not limited to, adult day service



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1providers, homemaker providers, case coordination and case
2management units, emergency home response providers, statewide
3trade or labor unions that represent home care aides and direct
4care staff, area agencies on aging, adults over age 60,
5membership organizations representing older adults, and other
6organizational entities, providers of care, or individuals
7with demonstrated interest and expertise in the field of home
8and community care as determined by the Director.
9    Nominations may be presented from any agency or State
10association with interest in the program. The Director, or his
11or her designee, shall serve as the permanent co-chair of the
12advisory committee. One other co-chair shall be nominated and
13approved by the members of the committee on an annual basis.
14Committee members' terms of appointment shall be for 4 years
15with one-quarter of the appointees' terms expiring each year. A
16member shall continue to serve until his or her replacement is
17named. The Department shall fill vacancies that have a
18remaining term of over one year, and this replacement shall
19occur through the annual replacement of expiring terms. The
20Director shall designate Department staff to provide technical
21assistance and staff support to the committee. Department
22representation shall not constitute membership of the
23committee. All Committee papers, issues, recommendations,
24reports, and meeting memoranda are advisory only. The Director,
25or his or her designee, shall make a written report, as
26requested by the Committee, regarding issues before the



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2    The Department on Aging and the Department of Human
3Services shall cooperate in the development and submission of
4an annual report on programs and services provided under this
5Section. Such joint report shall be filed with the Governor and
6the General Assembly on or before September 30 each year.
7    The requirement for reporting to the General Assembly shall
8be satisfied by filing copies of the report with the Speaker,
9the Minority Leader and the Clerk of the House of
10Representatives and the President, the Minority Leader and the
11Secretary of the Senate and the Legislative Research Unit, as
12required by Section 3.1 of the General Assembly Organization
13Act and filing such additional copies with the State Government
14Report Distribution Center for the General Assembly as is
15required under paragraph (t) of Section 7 of the State Library
17    Those persons previously found eligible for receiving
18non-institutional services whose services were discontinued
19under the Emergency Budget Act of Fiscal Year 1992, and who do
20not meet the eligibility standards in effect on or after July
211, 1992, shall remain ineligible on and after July 1, 1992.
22Those persons previously not required to cost-share and who
23were required to cost-share effective March 1, 1992, shall
24continue to meet cost-share requirements on and after July 1,
251992. Beginning July 1, 1992, all clients will be required to
26meet eligibility, cost-share, and other requirements and will



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1have services discontinued or altered when they fail to meet
2these requirements.
3    For the purposes of this Section, "flexible senior
4services" refers to services that require one-time or periodic
5expenditures including, but not limited to, respite care, home
6modification, assistive technology, housing assistance, and
8    The Department shall implement an electronic service
9verification based on global positioning systems or other
10cost-effective technology for the Community Care Program no
11later than January 1, 2014.
12    The Department shall require, as a condition of
13eligibility, enrollment in the medical assistance program
14under Article V of the Illinois Public Aid Code (i) beginning
15August 1, 2013, if the Auditor General has reported that the
16Department has failed to comply with the reporting requirements
17of Section 2-27 of the Illinois State Auditing Act; or (ii)
18beginning June 1, 2014, if the Auditor General has reported
19that the Department has not undertaken the required actions
20listed in the report required by subsection (a) of Section 2-27
21of the Illinois State Auditing Act.
22    The Department shall delay Community Care Program services
23until an applicant is determined eligible for medical
24assistance under Article V of the Illinois Public Aid Code (i)
25beginning August 1, 2013, if the Auditor General has reported
26that the Department has failed to comply with the reporting



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1requirements of Section 2-27 of the Illinois State Auditing
2Act; or (ii) beginning June 1, 2014, if the Auditor General has
3reported that the Department has not undertaken the required
4actions listed in the report required by subsection (a) of
5Section 2-27 of the Illinois State Auditing Act.
6    The Department shall implement co-payments for the
7Community Care Program at the federally allowable maximum level
8(i) beginning August 1, 2013, if the Auditor General has
9reported that the Department has failed to comply with the
10reporting requirements of Section 2-27 of the Illinois State
11Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
12General has reported that the Department has not undertaken the
13required actions listed in the report required by subsection
14(a) of Section 2-27 of the Illinois State Auditing Act.
15    The Department shall provide a bi-monthly report on the
16progress of the Community Care Program reforms set forth in
17this amendatory Act of the 98th General Assembly to the
18Governor, the Speaker of the House of Representatives, the
19Minority Leader of the House of Representatives, the President
20of the Senate, and the Minority Leader of the Senate.
21    The Department shall conduct a quarterly review of Care
22Coordination Unit performance and adherence to service
23guidelines. The quarterly review shall be reported to the
24Speaker of the House of Representatives, the Minority Leader of
25the House of Representatives, the President of the Senate, and
26the Minority Leader of the Senate. The Department shall collect



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1and report longitudinal data on the performance of each care
2coordination unit. Nothing in this paragraph shall be construed
3to require the Department to identify specific care
4coordination units.
5    In regard to community care providers, failure to comply
6with Department on Aging policies shall be cause for
7disciplinary action, including, but not limited to,
8disqualification from serving Community Care Program clients.
9Each provider, upon submission of any bill or invoice to the
10Department for payment for services rendered, shall include a
11notarized statement, under penalty of perjury pursuant to
12Section 1-109 of the Code of Civil Procedure, that the provider
13has complied with all Department policies.
14    The Director of the Department on Aging shall make
15information available to the State Board of Elections as may be
16required by an agreement the State Board of Elections has
17entered into with a multi-state voter registration list
18maintenance system.
19    Within 30 days after the effective date of this amendatory
20Act of the 100th General Assembly, rates shall be increased to
21$18.29 per hour, for the purpose of increasing, by at least
22$.72 per hour, the wages paid by those vendors to their
23employees who provide homemaker services. The Department shall
24pay an enhanced rate under the Community Care Program to those
25in-home service provider agencies that offer health insurance
26coverage as a benefit to their direct service worker employees



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1consistent with the mandates of Public Act 95-713. For State
2fiscal year 2018, the enhanced rate shall be $1.77 per hour.
3The rate shall be adjusted using actuarial analysis based on
4the cost of care, but shall not be set below $1.77 per hour.
5The Department shall adopt rules, including emergency rules
6under subsection (y) of Section 5-45 of the Illinois
7Administrative Procedure Act, to implement the provisions of
8this paragraph.
9    Within 30 days after the effective date of this amendatory
10Act of the 100th General Assembly, rates shall be increased to
11$15.02 per hour for adult day services and rates shall be
12increased to $10.30 per hour for each way transportation
13services for adult day services.
14(Source: P.A. 99-143, eff. 7-27-15; 100-23, eff. 7-6-17.)
15    Section 99. Effective date. This Act takes effect upon
16becoming law.