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90_HB1320 20 ILCS 105/4.02 from Ch. 23, par. 6104.02 Amends the Illinois Act on the Aging. Provides that the Department on Aging may provide recipients of non-institutional services with personal care attendants when certain conditions are met. Provides that the Department shall pay personal care attendants an hourly wage that is the greater of the federal minimum wage or the wage paid to personal care attendants by the Department of Human Services. LRB9003723MWpc LRB9003723MWpc 1 AN ACT to amend the Illinois Act on the Aging by changing 2 Section 4.02. 3 Be it enacted by the People of the State of Illinois, 4 represented in the General Assembly: 5 Section 5. The Illinois Act on the Aging is amended by 6 changing Section 4.02 as follows: 7 (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02) 8 (Text of Section before amendment by P.A. 89-507) 9 Sec. 4.02. The Department shall establish a program of 10 services to prevent unnecessary institutionalization of 11 persons age 60 and older in need of long term care or who are 12 established as persons who suffer from Alzheimer's disease or 13 a related disorder under the Alzheimer's Disease Assistance 14 Act, enacted by the 84th General Assembly, thereby enabling 15 them to remain in their own homes or in other living 16 arrangements. Such preventive services, which may be 17 coordinated with other programs for the aged and monitored by 18 area agencies on aging in cooperation with the Department, 19 may include, but are not limited to, any or all of the 20 following: 21 (a) home health services; 22 (b) home nursing services; 23 (c) homemaker services; 24 (d) chore and housekeeping services; 25 (e) day care services; 26 (f) home-delivered meals; 27 (g) education in self-care; 28 (h) personal care services; 29 (i) adult day health services; 30 (j) habilitation services; 31 (k) respite care; or -2- LRB9003723MWpc 1 (l) other nonmedical social services that may enable the 2 person to become self-supporting. 3 The Department shall establish eligibility standards for 4 such services taking into consideration the unique economic 5 and social needs of the target population for whom they are 6 to be provided. Such eligibility standards shall be based on 7 the recipient's ability to pay for services; provided, 8 however, that in determining the amount and nature of 9 services for which a person may qualify, consideration shall 10 not be given to the value of cash, property or other assets 11 held in the name of the person's spouse pursuant to a written 12 agreement dividing marital property into equal but separate 13 shares or pursuant to a transfer of the person's interest in 14 a home to his spouse, provided that the spouse's share of the 15 marital property is not made available to the person seeking 16 such services. The Department shall, in conjunction with the 17 Department of Public Aid, seek appropriate amendments under 18 Sections 1915 and 1924 of the Social Security Act. The 19 purpose of the amendments shall be to extend eligibility for 20 home and community based services under Sections 1915 and 21 1924 of the Social Security Act to persons who transfer to or 22 for the benefit of a spouse those amounts of income and 23 resources allowed under Section 1924 of the Social Security 24 Act. Subject to the approval of such amendments, the 25 Department shall extend the provisions of Section 5-4 of the 26 Illinois Public Aid Code to persons who, but for the 27 provision of home or community-based services, would require 28 the level of care provided in an institution, as is provided 29 for in federal law. Those persons no longer found to be 30 eligible for receiving noninstitutional services due to 31 changes in the eligibility criteria shall be given 60 days 32 notice prior to actual termination. Those persons receiving 33 notice of termination may contact the Department and request 34 the determination be appealed at any time during the 60 day -3- LRB9003723MWpc 1 notice period. With the exception of the lengthened notice 2 and time frame for the appeal request, the appeal process 3 shall follow the normal procedure. In addition, each person 4 affected regardless of the circumstances for discontinued 5 eligibility shall be given notice and the opportunity to 6 purchase the necessary services through the Community Care 7 Program. If the individual does not elect to purchase 8 services, the Department shall advise the individual of 9 alternative services. The target population identified for 10 the purposes of this Section are persons age 60 and older 11 with an identified service need. Priority shall be given to 12 those who are at imminent risk of institutionalization. The 13 services shall be provided to eligible persons age 60 and 14 older to the extent that the cost of the services together 15 with the other personal maintenance expenses of the persons 16 are reasonably related to the standards established for care 17 in a group facility appropriate to the person's condition. 18 These non-institutional services, pilot projects or 19 experimental facilities may be provided as part of or in 20 addition to those authorized by federal law or those funded 21 and administered by the Department of Rehabilitation 22 Services. The Departments of Rehabilitation Services, Public 23 Aid, Mental Health and Developmental Disabilities, Public 24 Health, Veterans' Affairs, and Commerce and Community Affairs 25 and other appropriate agencies of State, federal and local 26 governments shall cooperate with the Department on Aging in 27 the establishment and development of the non-institutional 28 services. The Department shall require an annual audit from 29 all chore/housekeeping and homemaker vendors contracting with 30 the Department under this Section. The annual audit shall 31 assure that each audited vendor's procedures are in 32 compliance with Department's financial reporting guidelines 33 requiring a 27% administrative cost split and a 73% employee 34 wages and benefits cost split. The audit is a public record -4- LRB9003723MWpc 1 under the Freedom of Information Act. The Department shall 2 execute, relative to the nursing home prescreening project, 3 written inter-agency agreements with the Department of 4 Rehabilitation Services and the Department of Public Aid, to 5 effect the following: (1) intake procedures and common 6 eligibility criteria for those persons who are receiving 7 non-institutional services; and (2) the establishment and 8 development of non-institutional services in areas of the 9 State where they are not currently available or are 10 undeveloped. On and after July 1, 1996, all nursing home 11 prescreenings for individuals 60 years of age or older shall 12 be conducted by the Department. 13 The Department is authorized to establish a system of 14 recipient copayment for services provided under this Section, 15 such copayment to be based upon the recipient's ability to 16 pay but in no case to exceed the actual cost of the services 17 provided. Additionally, any portion of a person's income 18 which is equal to or less than the federal poverty standard 19 shall not be considered by the Department in determining the 20 copayment. The level of such copayment shall be adjusted 21 whenever necessary to reflect any change in the officially 22 designated federal poverty standard. 23 The Department, or the Department's authorized 24 representative, shall recover the amount of moneys expended 25 for services provided to or in behalf of a person under this 26 Section by a claim against the person's estate or against the 27 estate of the person's surviving spouse, but no recovery may 28 be had until after the death of the surviving spouse, if any, 29 and then only at such time when there is no surviving child 30 who is under age 21, blind, or permanently and totally 31 disabled. This paragraph, however, shall not bar recovery, 32 at the death of the person, of moneys for services provided 33 to the person or in behalf of the person under this Section 34 to which the person was not entitled; provided that such -5- LRB9003723MWpc 1 recovery shall not be enforced against any real estate while 2 it is occupied as a homestead by the surviving spouse or 3 other dependent, if no claims by other creditors have been 4 filed against the estate, or, if such claims have been filed, 5 they remain dormant for failure of prosecution or failure of 6 the claimant to compel administration of the estate for the 7 purpose of payment. This paragraph shall not bar recovery 8 from the estate of a spouse, under Sections 1915 and 1924 of 9 the Social Security Act and Section 5-4 of the Illinois 10 Public Aid Code, who precedes a person receiving services 11 under this Section in death. All moneys for services paid to 12 or in behalf of the person under this Section shall be 13 claimed for recovery from the deceased spouse's estate. 14 "Homestead", as used in this paragraph, means the dwelling 15 house and contiguous real estate occupied by a surviving 16 spouse or relative, as defined by the rules and regulations 17 of the Illinois Department of Public Aid, regardless of the 18 value of the property. 19 The Department shall develop procedures to enhance 20 availability of services on evenings, weekends, and on an 21 emergency basis to meet the respite needs of caregivers. 22 Procedures shall be developed to permit the utilization of 23 services in successive blocks of 24 hours up to the monthly 24 maximum established by the Department. Workers providing 25 these services shall be appropriately trained. 26 The Department shall work in conjunction with the 27 Alzheimer's Task Force and members of the Alzheimer's 28 Association and other senior citizens' organizations in 29 developing these procedures by December 30, 1991. 30 Beginning on the effective date of this Amendatory Act of 31 1991, no person may perform chore/housekeeping and homemaker 32 services under a program authorized by this Section unless 33 that person has been issued a certificate of pre-service to 34 do so by his or her employing agency. Information gathered -6- LRB9003723MWpc 1 to effect such certification shall include (i) the person's 2 name, (ii) the date the person was hired by his or her 3 current employer, and (iii) the training, including dates and 4 levels. Persons engaged in the program authorized by this 5 Section before the effective date of this Amendatory Act of 6 1991 shall be issued a certificate of all pre- and in-service 7 training from his or her employer upon submitting the 8 necessary information. The employing agency shall be 9 required to retain records of all staff pre- and in-service 10 training, and shall provide such records to the Department 11 upon request and upon termination of the employer's contract 12 with the Department. In addition, the employing agency is 13 responsible for the issuance of certifications of in-service 14 training completed to their employees. 15 The Department is required to develop a system to ensure 16 that persons working as homemakers and chore housekeepers 17 receive increases in their wages when the federal minimum 18 wage is increased by requiring vendors to certify that they 19 are meeting the federal minimum wage statute for homemakers 20 and chore housekeepers. An employer that cannot ensure that 21 the minimum wage increase is being given to homemakers and 22 chore housekeepers shall be denied any increase in 23 reimbursement costs. 24 The Department on Aging and the Department of 25 Rehabilitation Services shall cooperate in the development 26 and submission of an annual report on programs and services 27 provided under this Section. Such joint report shall be filed 28 with the Governor and the General Assembly on or before 29 September 30 each year. 30 The requirement for reporting to the General Assembly 31 shall be satisfied by filing copies of the report with the 32 Speaker, the Minority Leader and the Clerk of the House of 33 Representatives and the President, the Minority Leader and 34 the Secretary of the Senate and the Legislative Research -7- LRB9003723MWpc 1 Unit, as required by Section 3.1 of the General Assembly 2 Organization Act and filing such additional copies with the 3 State Government Report Distribution Center for the General 4 Assembly as is required under paragraph (t) of Section 7 of 5 the State Library Act. 6 Those persons previously found eligible for receiving 7 non-institutional services whose services were discontinued 8 under the Emergency Budget Act of Fiscal Year 1992, and who 9 do not meet the eligibility standards in effect on or after 10 July 1, 1992, shall remain ineligible on and after July 1, 11 1992. Those persons previously not required to cost-share 12 and who were required to cost-share effective March 1, 1992, 13 shall continue to meet cost-share requirements on and after 14 July 1, 1992. Beginning July 1, 1992, all clients will be 15 required to meet eligibility, cost-share, and other 16 requirements and will have services discontinued or altered 17 when they fail to meet these requirements. 18 (Source: P.A. 89-21, eff. 7-1-95.) 19 (Text of Section after amendment by P.A. 89-507) 20 Sec. 4.02. Unnecessary institutionalization; services; 21 annual report. The Department shall establish a program of 22 services to prevent unnecessary institutionalization of 23 persons age 60 and older in need of long term care or who are 24 established as persons who suffer from Alzheimer's disease or 25 a related disorder under the Alzheimer's Disease Assistance 26 Act, thereby enabling them to remain in their own homes or in 27 other living arrangements. Such preventive services, which 28 may be coordinated with other programs for the aged and 29 monitored by area agencies on aging in cooperation with the 30 Department, may include, but are not limited to, any or all 31 of the following: 32 (a) home health services; 33 (b) home nursing services; 34 (c) homemaker services; -8- LRB9003723MWpc 1 (d) chore and housekeeping services; 2 (e) day care services; 3 (f) home-delivered meals; 4 (g) education in self-care; 5 (h) personal care services; 6 (i) adult day health services; 7 (j) habilitation services; 8 (k) respite care; or 9 (l) other nonmedical social services that may enable the 10 person to become self-supporting. 11 The Department shall establish eligibility standards for 12 such services taking into consideration the unique economic 13 and social needs of the target population for whom they are 14 to be provided. Such eligibility standards shall be based on 15 the recipient's ability to pay for services; provided, 16 however, that in determining the amount and nature of 17 services for which a person may qualify, consideration shall 18 not be given to the value of cash, property or other assets 19 held in the name of the person's spouse pursuant to a written 20 agreement dividing marital property into equal but separate 21 shares or pursuant to a transfer of the person's interest in 22 a home to his spouse, provided that the spouse's share of the 23 marital property is not made available to the person seeking 24 such services. The Department shall, in conjunction with the 25 Department of Public Aid, seek appropriate amendments under 26 Sections 1915 and 1924 of the Social Security Act. The 27 purpose of the amendments shall be to extend eligibility for 28 home and community based services under Sections 1915 and 29 1924 of the Social Security Act to persons who transfer to or 30 for the benefit of a spouse those amounts of income and 31 resources allowed under Section 1924 of the Social Security 32 Act. Subject to the approval of such amendments, the 33 Department shall extend the provisions of Section 5-4 of the 34 Illinois Public Aid Code to persons who, but for the -9- LRB9003723MWpc 1 provision of home or community-based services, would require 2 the level of care provided in an institution, as is provided 3 for in federal law. Those persons no longer found to be 4 eligible for receiving noninstitutional services due to 5 changes in the eligibility criteria shall be given 60 days 6 notice prior to actual termination. Those persons receiving 7 notice of termination may contact the Department and request 8 the determination be appealed at any time during the 60 day 9 notice period. With the exception of the lengthened notice 10 and time frame for the appeal request, the appeal process 11 shall follow the normal procedure. In addition, each person 12 affected regardless of the circumstances for discontinued 13 eligibility shall be given notice and the opportunity to 14 purchase the necessary services through the Community Care 15 Program. If the individual does not elect to purchase 16 services, the Department shall advise the individual of 17 alternative services. The target population identified for 18 the purposes of this Section are persons age 60 and older 19 with an identified service need. Priority shall be given to 20 those who are at imminent risk of institutionalization. The 21 services shall be provided to eligible persons age 60 and 22 older to the extent that the cost of the services together 23 with the other personal maintenance expenses of the persons 24 are reasonably related to the standards established for care 25 in a group facility appropriate to the person's condition. 26 These non-institutional services, pilot projects or 27 experimental facilities may be provided as part of or in 28 addition to those authorized by federal law or those funded 29 and administered by the Department of Human Services. The 30 Departments of Human Services, Public Aid, Public Health, 31 Veterans' Affairs, and Commerce and Community Affairs and 32 other appropriate agencies of State, federal and local 33 governments shall cooperate with the Department on Aging in 34 the establishment and development of the non-institutional -10- LRB9003723MWpc 1 services. Beginning on the effective date of this amendatory 2 Act of 1997, when preferred by the recipient of the services, 3 non-institutional services may include a personal care 4 attendant chosen by the recipient. A personal care attendant 5 is permitted only when, and so long as, the coordinator 6 assigned to the case determines that the services provided by 7 the attendant are appropriate; the attendant chosen is 8 appropriate; the recipient of the services is able to make a 9 rational choice of an attendant; and the recipient is able to 10 direct and supervise the attendant. The Department shall 11 establish a system of vouchers for the payment of new 12 providers of personal care attendant services by the State. 13 The vouchers shall be submitted twice during the first month 14 of employment and once during each month of employment 15 thereafter. The Department shall pay personal care 16 attendants an hourly wage that is the greater of the federal 17 minimum wage or the wage paid to personal care attendants by 18 the Department of Human Services. The Department shall 19 require an annual audit from all chore/housekeeping and 20 homemaker vendors contracting with the Department under this 21 Section. The annual audit shall assure that each audited 22 vendor's procedures are in compliance with Department's 23 financial reporting guidelines requiring a 27% administrative 24 cost split and a 73% employee wages and benefits cost split. 25 The audit is a public record under the Freedom of Information 26 Act. The Department shall execute, relative to the nursing 27 home prescreening project, written inter-agency agreements 28 with the Department of Human Services and the Department of 29 Public Aid, to effect the following: (1) intake procedures 30 and common eligibility criteria for those persons who are 31 receiving non-institutional services; and (2) the 32 establishment and development of non-institutional services 33 in areas of the State where they are not currently available 34 or are undeveloped. On and after July 1, 1996, all nursing -11- LRB9003723MWpc 1 home prescreenings for individuals 60 years of age or older 2 shall be conducted by the Department. 3 The Department is authorized to establish a system of 4 recipient copayment for services provided under this Section, 5 such copayment to be based upon the recipient's ability to 6 pay but in no case to exceed the actual cost of the services 7 provided. Additionally, any portion of a person's income 8 which is equal to or less than the federal poverty standard 9 shall not be considered by the Department in determining the 10 copayment. The level of such copayment shall be adjusted 11 whenever necessary to reflect any change in the officially 12 designated federal poverty standard. 13 The Department, or the Department's authorized 14 representative, shall recover the amount of moneys expended 15 for services provided to or in behalf of a person under this 16 Section by a claim against the person's estate or against the 17 estate of the person's surviving spouse, but no recovery may 18 be had until after the death of the surviving spouse, if any, 19 and then only at such time when there is no surviving child 20 who is under age 21, blind, or permanently and totally 21 disabled. This paragraph, however, shall not bar recovery, 22 at the death of the person, of moneys for services provided 23 to the person or in behalf of the person under this Section 24 to which the person was not entitled; provided that such 25 recovery shall not be enforced against any real estate while 26 it is occupied as a homestead by the surviving spouse or 27 other dependent, if no claims by other creditors have been 28 filed against the estate, or, if such claims have been filed, 29 they remain dormant for failure of prosecution or failure of 30 the claimant to compel administration of the estate for the 31 purpose of payment. This paragraph shall not bar recovery 32 from the estate of a spouse, under Sections 1915 and 1924 of 33 the Social Security Act and Section 5-4 of the Illinois 34 Public Aid Code, who precedes a person receiving services -12- LRB9003723MWpc 1 under this Section in death. All moneys for services paid to 2 or in behalf of the person under this Section shall be 3 claimed for recovery from the deceased spouse's estate. 4 "Homestead", as used in this paragraph, means the dwelling 5 house and contiguous real estate occupied by a surviving 6 spouse or relative, as defined by the rules and regulations 7 of the Illinois Department of Public Aid, regardless of the 8 value of the property. 9 The Department shall develop procedures to enhance 10 availability of services on evenings, weekends, and on an 11 emergency basis to meet the respite needs of caregivers. 12 Procedures shall be developed to permit the utilization of 13 services in successive blocks of 24 hours up to the monthly 14 maximum established by the Department. Workers providing 15 these services shall be appropriately trained. 16 The Department shall work in conjunction with the 17 Alzheimer's Task Force and members of the Alzheimer's 18 Association and other senior citizens' organizations in 19 developing these procedures by December 30, 1991. 20 Beginning on the effective date of this Amendatory Act of 21 1991, no person may perform chore/housekeeping and homemaker 22 services under a program authorized by this Section unless 23 that person has been issued a certificate of pre-service to 24 do so by his or her employing agency. Information gathered 25 to effect such certification shall include (i) the person's 26 name, (ii) the date the person was hired by his or her 27 current employer, and (iii) the training, including dates and 28 levels. Persons engaged in the program authorized by this 29 Section before the effective date of this amendatory Act of 30 1991 shall be issued a certificate of all pre- and in-service 31 training from his or her employer upon submitting the 32 necessary information. The employing agency shall be 33 required to retain records of all staff pre- and in-service 34 training, and shall provide such records to the Department -13- LRB9003723MWpc 1 upon request and upon termination of the employer's contract 2 with the Department. In addition, the employing agency is 3 responsible for the issuance of certifications of in-service 4 training completed to their employees. 5 The Department is required to develop a system to ensure 6 that persons working as homemakers and chore housekeepers 7 receive increases in their wages when the federal minimum 8 wage is increased by requiring vendors to certify that they 9 are meeting the federal minimum wage statute for homemakers 10 and chore housekeepers. An employer that cannot ensure that 11 the minimum wage increase is being given to homemakers and 12 chore housekeepers shall be denied any increase in 13 reimbursement costs. 14 The Department on Aging and the Department of Human 15 Services shall cooperate in the development and submission of 16 an annual report on programs and services provided under this 17 Section. Such joint report shall be filed with the Governor 18 and the General Assembly on or before September 30 each year. 19 The requirement for reporting to the General Assembly 20 shall be satisfied by filing copies of the report with the 21 Speaker, the Minority Leader and the Clerk of the House of 22 Representatives and the President, the Minority Leader and 23 the Secretary of the Senate and the Legislative Research 24 Unit, as required by Section 3.1 of the General Assembly 25 Organization Act and filing such additional copies with the 26 State Government Report Distribution Center for the General 27 Assembly as is required under paragraph (t) of Section 7 of 28 the State Library Act. 29 Those persons previously found eligible for receiving 30 non-institutional services whose services were discontinued 31 under the Emergency Budget Act of Fiscal Year 1992, and who 32 do not meet the eligibility standards in effect on or after 33 July 1, 1992, shall remain ineligible on and after July 1, 34 1992. Those persons previously not required to cost-share -14- LRB9003723MWpc 1 and who were required to cost-share effective March 1, 1992, 2 shall continue to meet cost-share requirements on and after 3 July 1, 1992. Beginning July 1, 1992, all clients will be 4 required to meet eligibility, cost-share, and other 5 requirements and will have services discontinued or altered 6 when they fail to meet these requirements. 7 (Source: P.A. 89-21, eff. 7-1-95; 89-507, eff. 7-1-97.) 8 Section 95. No acceleration or delay. Where this Act 9 makes changes in a statute that is represented in this Act by 10 text that is not yet or no longer in effect (for example, a 11 Section represented by multiple versions), the use of that 12 text does not accelerate or delay the taking effect of (i) 13 the changes made by this Act or (ii) provisions derived from 14 any other Public Act.