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90_SB0443 20 ILCS 105/4.02 from Ch. 23, par. 6104.02 Amends the Illinois Act on the Aging. Designates home-delivered meals to eligible individuals through a nutrition provider and funded by area agencies on aging to be a necessary preventive service. Effective immediately. LRB9002235MWpc LRB9002235MWpc 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. TheseSuchpreventive 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 one 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- LRB9002235MWpc 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 thesesuchservices taking into consideration the unique 5 economic and social needs of the target population for whom 6 they are to be provided. For purposes of this Section, 7 home-delivered meals provided to eligible individuals through 8 a nutrition provider funded by an area agency on aging shall 9 be considered a necessary preventive service. TheSuch10 eligibility standards shall be based on the recipient's 11 ability to pay for services; provided, however, that in 12 determining the amount and nature of services for which a 13 person may qualify, consideration shall not be given to the 14 value of cash, property, or other assets held in the name of 15 the person's spouse pursuant to a written agreement dividing 16 marital property into equal but separate shares or pursuant 17 to a transfer of the person's interest in a home to his 18 spouse, provided that the spouse's share of the marital 19 property is not made available to the person seeking such 20 services. The Department shall, in conjunction with the 21 Department of Public Aid, seek appropriate amendments under 22 Sections 1915 and 1924 of the Social Security Act. The 23 purpose of the amendments shall be to extend eligibility for 24 home and community based services under Sections 1915 and 25 1924 of the Social Security Act to persons who transfer to or 26 for the benefit of a spouse those amounts of income and 27 resources allowed under Section 1924 of the Social Security 28 Act. Subject to the approval of such amendments, the 29 Department shall extend the provisions of Section 5-4 of the 30 Illinois Public Aid Code to persons who, but for the 31 provision of home or community-based services, would require 32 the level of care provided in an institution, as is provided 33 for in federal law. Those persons no longer found to be 34 eligible for receiving noninstitutional services due to -3- LRB9002235MWpc 1 changes in the eligibility criteria shall be given 60 days 2 notice prior to actual termination. Those persons receiving 3 notice of termination may contact the Department and request 4 the determination be appealed at any time during the 60 day 5 notice period. With the exception of the lengthened notice 6 and time frame for the appeal request, the appeal process 7 shall follow the normal procedure. In addition, each person 8 affected regardless of the circumstances for discontinued 9 eligibility shall be given notice and the opportunity to 10 purchase the necessary services through the Community Care 11 Program. If the individual does not elect to purchase 12 services, the Department shall advise the individual of 13 alternative services. The target population identified for 14 the purposes of this Section are persons age 60 and older 15 with an identified service need. Priority shall be given to 16 those who are at imminent risk of institutionalization. The 17 services shall be provided to eligible persons age 60 and 18 older to the extent that the cost of the services together 19 with the other personal maintenance expenses of the persons 20 are reasonably related to the standards established for care 21 in a group facility appropriate to the person's condition. 22 These non-institutional services, pilot projects or 23 experimental facilities may be provided as part of or in 24 addition to those authorized by federal law or those funded 25 and administered by the Department of Rehabilitation 26 Services. The Departments of Rehabilitation Services, Public 27 Aid, Mental Health and Developmental Disabilities, Public 28 Health, Veterans' Affairs, and Commerce and Community Affairs 29 and other appropriate agencies of State, federal and local 30 governments shall cooperate with the Department on Aging in 31 the establishment and development of the non-institutional 32 services. The Department shall require an annual audit from 33 all chore/housekeeping and homemaker vendors contracting with 34 the Department under this Section. The annual audit shall -4- LRB9002235MWpc 1 assure that each audited vendor's procedures are in 2 compliance with Department's financial reporting guidelines 3 requiring a 27% administrative cost split and a 73% employee 4 wages and benefits cost split. The audit is a public record 5 under the Freedom of Information Act. The Department shall 6 execute, relative to the nursing home prescreening project, 7 written inter-agency agreements with the Department of 8 Rehabilitation Services and the Department of Public Aid, to 9 effect the following: (1) intake procedures and common 10 eligibility criteria for those persons who are receiving 11 non-institutional services; and (2) the establishment and 12 development of non-institutional services in areas of the 13 State where they are not currently available or are 14 undeveloped. On and after July 1, 1996, all nursing home 15 prescreenings for individuals 60 years of age or older shall 16 be conducted by the Department. 17 The Department is authorized to establish a system of 18 recipient copayment for services provided under this Section, 19 such copayment to be based upon the recipient's ability to 20 pay but in no case to exceed the actual cost of the services 21 provided. Additionally, any portion of a person's income 22 which is equal to or less than the federal poverty standard 23 shall not be considered by the Department in determining the 24 copayment. The level of such copayment shall be adjusted 25 whenever necessary to reflect any change in the officially 26 designated federal poverty standard. 27 The Department, or the Department's authorized 28 representative, shall recover the amount of moneys expended 29 for services provided to or in behalf of a person under this 30 Section by a claim against the person's estate or against the 31 estate of the person's surviving spouse, but no recovery may 32 be had until after the death of the surviving spouse, if any, 33 and then only at such time when there is no surviving child 34 who is under age 21, blind, or permanently and totally -5- LRB9002235MWpc 1 disabled. This paragraph, however, shall not bar recovery, 2 at the death of the person, of moneys for services provided 3 to the person or in behalf of the person under this Section 4 to which the person was not entitled; provided that such 5 recovery shall not be enforced against any real estate while 6 it is occupied as a homestead by the surviving spouse or 7 other dependent, if no claims by other creditors have been 8 filed against the estate, or, if such claims have been filed, 9 they remain dormant for failure of prosecution or failure of 10 the claimant to compel administration of the estate for the 11 purpose of payment. This paragraph shall not bar recovery 12 from the estate of a spouse, under Sections 1915 and 1924 of 13 the Social Security Act and Section 5-4 of the Illinois 14 Public Aid Code, who precedes a person receiving services 15 under this Section in death. All moneys for services paid to 16 or in behalf of the person under this Section shall be 17 claimed for recovery from the deceased spouse's estate. 18 "Homestead", as used in this paragraph, means the dwelling 19 house and contiguous real estate occupied by a surviving 20 spouse or relative, as defined by the rules and regulations 21 of the Illinois Department of Public Aid, regardless of the 22 value of the property. 23 The Department shall develop procedures to enhance 24 availability of services on evenings, weekends, and on an 25 emergency basis to meet the respite needs of caregivers. 26 Procedures shall be developed to permit the utilization of 27 services in successive blocks of 24 hours up to the monthly 28 maximum established by the Department. Workers providing 29 these services shall be appropriately trained. 30 The Department shall work in conjunction with the 31 Alzheimer's Task Force and members of the Alzheimer's 32 Association and other senior citizens' organizations in 33 developing these procedures by December 30, 1991. 34 Beginning on the effective date of this Amendatory Act of -6- LRB9002235MWpc 1 1991, no person may perform chore/housekeeping and homemaker 2 services under a program authorized by this Section unless 3 that person has been issued a certificate of pre-service to 4 do so by his or her employing agency. Information gathered 5 to effect such certification shall include (i) the person's 6 name, (ii) the date the person was hired by his or her 7 current employer, and (iii) the training, including dates and 8 levels. Persons engaged in the program authorized by this 9 Section before the effective date of this Amendatory Act of 10 1991 shall be issued a certificate of all pre- and in-service 11 training from his or her employer upon submitting the 12 necessary information. The employing agency shall be 13 required to retain records of all staff pre- and in-service 14 training, and shall provide such records to the Department 15 upon request and upon termination of the employer's contract 16 with the Department. In addition, the employing agency is 17 responsible for the issuance of certifications of in-service 18 training completed to their employees. 19 The Department is required to develop a system to ensure 20 that persons working as homemakers and chore housekeepers 21 receive increases in their wages when the federal minimum 22 wage is increased by requiring vendors to certify that they 23 are meeting the federal minimum wage statute for homemakers 24 and chore housekeepers. An employer that cannot ensure that 25 the minimum wage increase is being given to homemakers and 26 chore housekeepers shall be denied any increase in 27 reimbursement costs. 28 The Department on Aging and the Department of 29 Rehabilitation Services shall cooperate in the development 30 and submission of an annual report on programs and services 31 provided under this Section. Such joint report shall be filed 32 with the Governor and the General Assembly on or before 33 September 30 each year. 34 The requirement for reporting to the General Assembly -7- LRB9002235MWpc 1 shall be satisfied by filing copies of the report with the 2 Speaker, the Minority Leader and the Clerk of the House of 3 Representatives and the President, the Minority Leader and 4 the Secretary of the Senate and the Legislative Research 5 Unit, as required by Section 3.1 of the General Assembly 6 Organization Act and filing such additional copies with the 7 State Government Report Distribution Center for the General 8 Assembly as is required under paragraph (t) of Section 7 of 9 the State Library Act. 10 Those persons previously found eligible for receiving 11 non-institutional services whose services were discontinued 12 under the Emergency Budget Act of Fiscal Year 1992, and who 13 do not meet the eligibility standards in effect on or after 14 July 1, 1992, shall remain ineligible on and after July 1, 15 1992. Those persons previously not required to cost-share 16 and who were required to cost-share effective March 1, 1992, 17 shall continue to meet cost-share requirements on and after 18 July 1, 1992. Beginning July 1, 1992, all clients will be 19 required to meet eligibility, cost-share, and other 20 requirements and will have services discontinued or altered 21 when they fail to meet these requirements. 22 (Source: P.A. 89-21, eff. 7-1-95.) 23 (Text of Section after amendment by P.A. 89-507) 24 Sec. 4.02. The Department shall establish a program of 25 services to prevent unnecessary institutionalization of 26 persons age 60 and older in need of long term care or who are 27 established as persons who suffer from Alzheimer's disease or 28 a related disorder under the Alzheimer's Disease Assistance 29 Act, thereby enabling them to remain in their own homes or in 30 other living arrangements. TheseSuchpreventive services, 31 which may be coordinated with other programs for the aged and 32 monitored by area agencies on aging in cooperation with the 33 Department, may include, but are not limited to, any one or 34 all of the following: -8- LRB9002235MWpc 1 (a) home health services.;2 (b) home nursing services.;3 (c) homemaker services.;4 (d) chore and housekeeping services.;5 (e) day care 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.; or12 (l) other nonmedical social services that may enable the 13 person to become self-supporting. 14 The Department shall establish eligibility standards for 15 thesesuchservices taking into consideration the unique 16 economic and social needs of the target population for whom 17 they are to be provided. For purposes of this Section, 18 home-delivered meals provided to eligible individuals through 19 a nutrition provider funded by an area agency on aging shall 20 be considered a necessary preventive service. TheSuch21 eligibility standards shall be based on the recipient's 22 ability to pay for services; provided, however, that in 23 determining the amount and nature of services for which a 24 person may qualify, consideration shall not be given to the 25 value of cash, property, or other assets held in the name of 26 the person's spouse pursuant to a written agreement dividing 27 marital property into equal but separate shares or pursuant 28 to a transfer of the person's interest in a home to his 29 spouse, provided that the spouse's share of the marital 30 property is not made available to the person seeking such 31 services. The Department shall, in conjunction with the 32 Department of Public Aid, seek appropriate amendments under 33 Sections 1915 and 1924 of the Social Security Act. The 34 purpose of the amendments shall be to extend eligibility for -9- LRB9002235MWpc 1 home and community based services under Sections 1915 and 2 1924 of the Social Security Act to persons who transfer to or 3 for the benefit of a spouse those amounts of income and 4 resources allowed under Section 1924 of the Social Security 5 Act. Subject to the approval of such amendments, the 6 Department shall extend the provisions of Section 5-4 of the 7 Illinois Public Aid Code to persons who, but for the 8 provision of home or community-based services, would require 9 the level of care provided in an institution, as is provided 10 for in federal law. Those persons no longer found to be 11 eligible for receiving noninstitutional services due to 12 changes in the eligibility criteria shall be given 60 days 13 notice prior to actual termination. Those persons receiving 14 notice of termination may contact the Department and request 15 the determination be appealed at any time during the 60 day 16 notice period. With the exception of the lengthened notice 17 and time frame for the appeal request, the appeal process 18 shall follow the normal procedure. In addition, each person 19 affected regardless of the circumstances for discontinued 20 eligibility shall be given notice and the opportunity to 21 purchase the necessary services through the Community Care 22 Program. If the individual does not elect to purchase 23 services, the Department shall advise the individual of 24 alternative services. The target population identified for 25 the purposes of this Section are persons age 60 and older 26 with an identified service need. Priority shall be given to 27 those who are at imminent risk of institutionalization. The 28 services shall be provided to eligible persons age 60 and 29 older to the extent that the cost of the services together 30 with the other personal maintenance expenses of the persons 31 are reasonably related to the standards established for care 32 in a group facility appropriate to the person's condition. 33 These non-institutional services, pilot projects or 34 experimental facilities may be provided as part of or in -10- LRB9002235MWpc 1 addition to those authorized by federal law or those funded 2 and administered by the Department of Human Services. The 3 Departments of Human Services, Public Aid, Public Health, 4 Veterans' Affairs, and Commerce and Community Affairs and 5 other appropriate agencies of State, federal and local 6 governments shall cooperate with the Department on Aging in 7 the establishment and development of the non-institutional 8 services. The Department shall require an annual audit from 9 all chore/housekeeping and homemaker vendors contracting with 10 the Department under this Section. The annual audit shall 11 assure that each audited vendor's procedures are in 12 compliance with Department's financial reporting guidelines 13 requiring a 27% administrative cost split and a 73% employee 14 wages and benefits cost split. The audit is a public record 15 under the Freedom of Information Act. The Department shall 16 execute, relative to the nursing home prescreening project, 17 written inter-agency agreements with the Department of Human 18 Services and the Department of Public Aid, to effect the 19 following: (1) intake procedures and common eligibility 20 criteria for those persons who are receiving 21 non-institutional services; and (2) the establishment and 22 development of non-institutional services in areas of the 23 State where they are not currently available or are 24 undeveloped. On and after July 1, 1996, all nursing home 25 prescreenings for individuals 60 years of age or older shall 26 be conducted by the Department. 27 The Department is authorized to establish a system of 28 recipient copayment for services provided under this Section, 29 such copayment to be based upon the recipient's ability to 30 pay but in no case to exceed the actual cost of the services 31 provided. Additionally, any portion of a person's income 32 which is equal to or less than the federal poverty standard 33 shall not be considered by the Department in determining the 34 copayment. The level of such copayment shall be adjusted -11- LRB9002235MWpc 1 whenever necessary to reflect any change in the officially 2 designated federal poverty standard. 3 The Department, or the Department's authorized 4 representative, shall recover the amount of moneys expended 5 for services provided to or in behalf of a person under this 6 Section by a claim against the person's estate or against the 7 estate of the person's surviving spouse, but no recovery may 8 be had until after the death of the surviving spouse, if any, 9 and then only at such time when there is no surviving child 10 who is under age 21, blind, or permanently and totally 11 disabled. This paragraph, however, shall not bar recovery, 12 at the death of the person, of moneys for services provided 13 to the person or in behalf of the person under this Section 14 to which the person was not entitled; provided that such 15 recovery shall not be enforced against any real estate while 16 it is occupied as a homestead by the surviving spouse or 17 other dependent, if no claims by other creditors have been 18 filed against the estate, or, if such claims have been filed, 19 they remain dormant for failure of prosecution or failure of 20 the claimant to compel administration of the estate for the 21 purpose of payment. This paragraph shall not bar recovery 22 from the estate of a spouse, under Sections 1915 and 1924 of 23 the Social Security Act and Section 5-4 of the Illinois 24 Public Aid Code, who precedes a person receiving services 25 under this Section in death. All moneys for services paid to 26 or in behalf of the person under this Section shall be 27 claimed for recovery from the deceased spouse's estate. 28 "Homestead", as used in this paragraph, means the dwelling 29 house and contiguous real estate occupied by a surviving 30 spouse or relative, as defined by the rules and regulations 31 of the Illinois Department of Public Aid, regardless of the 32 value of the property. 33 The Department shall develop procedures to enhance 34 availability of services on evenings, weekends, and on an -12- LRB9002235MWpc 1 emergency basis to meet the respite needs of caregivers. 2 Procedures shall be developed to permit the utilization of 3 services in successive blocks of 24 hours up to the monthly 4 maximum established by the Department. Workers providing 5 these services shall be appropriately trained. 6 The Department shall work in conjunction with the 7 Alzheimer's Task Force and members of the Alzheimer's 8 Association and other senior citizens' organizations in 9 developing these procedures by December 30, 1991. 10 Beginning on the effective date of this Amendatory Act of 11 1991, no person may perform chore/housekeeping and homemaker 12 services under a program authorized by this Section unless 13 that person has been issued a certificate of pre-service to 14 do so by his or her employing agency. Information gathered 15 to effect such certification shall include (i) the person's 16 name, (ii) the date the person was hired by his or her 17 current employer, and (iii) the training, including dates and 18 levels. Persons engaged in the program authorized by this 19 Section before the effective date of this amendatory Act of 20 1991 shall be issued a certificate of all pre- and in-service 21 training from his or her employer upon submitting the 22 necessary information. The employing agency shall be 23 required to retain records of all staff pre- and in-service 24 training, and shall provide such records to the Department 25 upon request and upon termination of the employer's contract 26 with the Department. In addition, the employing agency is 27 responsible for the issuance of certifications of in-service 28 training completed to their employees. 29 The Department is required to develop a system to ensure 30 that persons working as homemakers and chore housekeepers 31 receive increases in their wages when the federal minimum 32 wage is increased by requiring vendors to certify that they 33 are meeting the federal minimum wage statute for homemakers 34 and chore housekeepers. An employer that cannot ensure that -13- LRB9002235MWpc 1 the minimum wage increase is being given to homemakers and 2 chore housekeepers shall be denied any increase in 3 reimbursement costs. 4 The Department on Aging and the Department of Human 5 Services shall cooperate in the development and submission of 6 an annual report on programs and services provided under this 7 Section. Such joint report shall be filed with the Governor 8 and the General Assembly on or before September 30 each year. 9 The requirement for reporting to the General Assembly 10 shall be satisfied by filing copies of the report with the 11 Speaker, the Minority Leader and the Clerk of the House of 12 Representatives and the President, the Minority Leader and 13 the Secretary of the Senate and the Legislative Research 14 Unit, as required by Section 3.1 of the General Assembly 15 Organization Act and filing such additional copies with the 16 State Government Report Distribution Center for the General 17 Assembly as is required under paragraph (t) of Section 7 of 18 the State Library Act. 19 Those persons previously found eligible for receiving 20 non-institutional services whose services were discontinued 21 under the Emergency Budget Act of Fiscal Year 1992, and who 22 do not meet the eligibility standards in effect on or after 23 July 1, 1992, shall remain ineligible on and after July 1, 24 1992. Those persons previously not required to cost-share 25 and who were required to cost-share effective March 1, 1992, 26 shall continue to meet cost-share requirements on and after 27 July 1, 1992. Beginning July 1, 1992, all clients will be 28 required to meet eligibility, cost-share, and other 29 requirements and will have services discontinued or altered 30 when they fail to meet these requirements. 31 (Source: P.A. 89-21, eff. 7-1-95; 89-507, eff. 7-1-97.) 32 Section 95. No acceleration or delay. Where this Act 33 makes changes in a statute that is represented in this Act by -14- LRB9002235MWpc 1 text that is not yet or no longer in effect (for example, a 2 Section represented by multiple versions), the use of that 3 text does not accelerate or delay the taking effect of (i) 4 the changes made by this Act or (ii) provisions derived from 5 any other Public Act. 6 Section 99. Effective date. This Act takes effect upon 7 becoming law.