State of Illinois
92nd General Assembly

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 1        AN ACT concerning services for the aging.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The Illinois Act on the Aging is  amended  by
 5    changing Section 4.02 as follows:

 6        (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
 7        Sec.  4.02.  The  Department shall establish a program of
 8    services  to  prevent  unnecessary  institutionalization   of
 9    persons age 60 and older in need of long term care or who are
10    established as persons who suffer from Alzheimer's disease or
11    a  related  disorder under the Alzheimer's Disease Assistance
12    Act, thereby enabling them to remain in their own homes or in
13    other living arrangements.  Such preventive  services,  which
14    may  be  coordinated  with  other  programs  for the aged and
15    monitored by area agencies on aging in cooperation  with  the
16    Department,  may  include, but are not limited to, any or all
17    of the following:
18             (a)  home health services;
19             (b)  home nursing services;
20             (c)  homemaker services;
21             (d)  chore and housekeeping services;
22             (e)  day care services;
23             (f)  home-delivered meals;
24             (g)  education in self-care;
25             (h)  personal care services;
26             (i)  adult day health services;
27             (j)  habilitation services;
28             (k)  respite care;
29             (l)  other  nonmedical  social  services  that   may
30        enable the person to become self-supporting; or
31             (m)  clearinghouse   for   information  provided  by
                            -2-                LRB9206396TAtm
 1        senior citizen home owners who want to rent rooms  to  or
 2        share living space with other senior citizens.
 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.
17        To be eligible to receive Community  Care  Program  (CCP)
18    services,  an  applicant  or  client may not own interests in
19    non-exempt assets  having  a  combined  value  in  excess  of
20    $15,000, if:
21             (1)  unmarried; or
22             (2)  married and:
23                  (A)  the spouse is receiving CCP services;
24                  (B)  the spouse is in a nursing home;
25                  (C)  the  spouse does not reside on a permanent
26             basis with and does not receive support from or give
27             support to the applicant or client;
28                  (D)  the spouse is abandoned; or
29                  (E)  the  spouse  is  potentially  abusing  the
30             applicant or client.
31        An applicant or client who is married and  has  a  spouse
32    that  does  not receive CCP services may not own interests in
33    non-exempt assets having a total value in excess of 1.5 times
34    the asset disregard amount allowed by the Illinois Department
                            -3-                LRB9206396TAtm
 1    of Public Aid for Medicaid. Non-exempt assets having a  value
 2    over  this  amount  must be transferred to or must be for the
 3    sole benefit of the community  spouse.  If  the  couple  owns
 4    assets  that  exceed  an  amount equal to 1.5 times the asset
 5    disregard and prevention of  spousal  impoverishment  amounts
 6    allowed  by  statute,  the excess (up to $8,000 of non-exempt
 7    assets after transfer or up to $1,800  of  countable  monthly
 8    income  after  diversion) must be designated as a spend down,
 9    to be spent before Medicaid enrollment  is  established.  The
10    value  of non-exempt assets must be considered in determining
11    eligibility for the Community Care Program.  All  assets  not
12    specifically   exempt   are   non-exempt.   When  a  client's
13    non-exempt assets are greater than the  allowable  amount  as
14    specified  above,  consideration  of non-liquid assets may be
15    deferred as follows:
16             (1)  real   property   may    be    deferred    from
17        consideration for 6 months;
18             (2)  the client must sign an agreement to dispose of
19        the  real  property  in  excess  of  the allowable amount
20        within 6 months after the date of the agreement; and
21             (3)  the  6-month  period  for  disposition  may  be
22        extended an additional 6 months if the  client  fails  to
23        dispose of the asset (through no fault of his or her own)
24        despite reasonable and diligent effort.
25        The  Department shall, in conjunction with the Department
26    of Public Aid, seek  appropriate  amendments  under  Sections
27    1915 and 1924 of the Social Security Act.  The purpose of the
28    amendments  shall  be  to  extend  eligibility  for  home and
29    community based services under Sections 1915 and 1924 of  the
30    Social  Security  Act  to  persons who transfer to or for the
31    benefit of a spouse those amounts  of  income  and  resources
32    allowed  under  Section  1924  of  the  Social  Security Act.
33    Subject to the approval of such  amendments,  the  Department
34    shall  extend  the  provisions of Section 5-4 of the Illinois
                            -4-                LRB9206396TAtm
 1    Public Aid Code to persons who, but for the provision of home
 2    or community-based services, would require the level of  care
 3    provided  in  an  institution,  as is provided for in federal
 4    law. Those  persons  no  longer  found  to  be  eligible  for
 5    receiving  noninstitutional  services  due  to changes in the
 6    eligibility criteria shall be given 60 days notice  prior  to
 7    actual   termination.   Those  persons  receiving  notice  of
 8    termination  may  contact  the  Department  and  request  the
 9    determination be appealed at  any  time  during  the  60  day
10    notice  period.  With  the exception of the lengthened notice
11    and time frame for the appeal  request,  the  appeal  process
12    shall  follow  the normal procedure. In addition, each person
13    affected regardless of  the  circumstances  for  discontinued
14    eligibility  shall  be  given  notice  and the opportunity to
15    purchase the necessary services through  the  Community  Care
16    Program.   If  the  individual  does  not  elect  to purchase
17    services, the  Department  shall  advise  the  individual  of
18    alternative  services.  The  target population identified for
19    the purposes of this Section are persons  age  60  and  older
20    with  an identified service need.  Priority shall be given to
21    those who are at imminent risk of institutionalization.   The
22    services  shall  be  provided  to eligible persons age 60 and
23    older to the extent that the cost of  the  services  together
24    with  the  other personal maintenance expenses of the persons
25    are reasonably related to the standards established for  care
26    in  a  group  facility appropriate to the person's condition.
27    These   non-institutional   services,   pilot   projects   or
28    experimental facilities may be provided  as  part  of  or  in
29    addition  to  those authorized by federal law or those funded
30    and administered by the Department of  Human  Services.   The
31    Departments  of  Human  Services,  Public Aid, Public Health,
32    Veterans' Affairs, and Commerce  and  Community  Affairs  and
33    other  appropriate  agencies  of  State,  federal  and  local
34    governments  shall  cooperate with the Department on Aging in
                            -5-                LRB9206396TAtm
 1    the establishment and development  of  the  non-institutional
 2    services.   The Department shall require an annual audit from
 3    all chore/housekeeping and homemaker vendors contracting with
 4    the Department under this Section.  The  annual  audit  shall
 5    assure   that   each   audited  vendor's  procedures  are  in
 6    compliance with Department's financial  reporting  guidelines
 7    requiring  a 27% administrative cost split and a 73% employee
 8    wages and benefits cost split.  The audit is a public  record
 9    under  the  Freedom of Information Act.  The Department shall
10    execute, relative to the nursing home  prescreening  project,
11    written  inter-agency agreements with the Department of Human
12    Services and the Department of  Public  Aid,  to  effect  the
13    following:   (1)  intake  procedures  and  common eligibility
14    criteria   for    those    persons    who    are    receiving
15    non-institutional  services;  and  (2)  the establishment and
16    development of non-institutional services  in  areas  of  the
17    State   where   they  are  not  currently  available  or  are
18    undeveloped. On and after July  1,  1996,  all  nursing  home
19    prescreenings  for individuals 60 years of age or older shall
20    be conducted by the Department.
21        The Department is authorized to  establish  a  system  of
22    recipient copayment for services provided under this Section,
23    such  copayment  to  be based upon the recipient's ability to
24    pay but in no case to exceed the actual cost of the  services
25    provided.  Additionally,  any  portion  of  a person's income
26    which is equal to or less than the federal  poverty  standard
27    shall  not be considered by the Department in determining the
28    copayment. The level of  such  copayment  shall  be  adjusted
29    whenever  necessary  to  reflect any change in the officially
30    designated federal poverty standard.
31        The   Department,   or   the   Department's    authorized
32    representative,  shall  recover the amount of moneys expended
33    for services provided to or in behalf of a person under  this
34    Section by a claim against the person's estate or against the
                            -6-                LRB9206396TAtm
 1    estate  of the person's surviving spouse, but no recovery may
 2    be had until after the death of the surviving spouse, if any,
 3    and then only at such time when there is no  surviving  child
 4    who  is  under  age  21,  blind,  or  permanently and totally
 5    disabled.  This paragraph, however, shall not  bar  recovery,
 6    at  the  death of the person, of moneys for services provided
 7    to the person or in behalf of the person under  this  Section
 8    to  which  the  person  was  not entitled; provided that such
 9    recovery shall not be enforced against any real estate  while
10    it  is  occupied  as  a  homestead by the surviving spouse or
11    other dependent, if no claims by other  creditors  have  been
12    filed against the estate, or, if such claims have been filed,
13    they  remain dormant for failure of prosecution or failure of
14    the claimant to compel administration of the estate  for  the
15    purpose  of  payment.   This paragraph shall not bar recovery
16    from the estate of a spouse, under Sections 1915 and 1924  of
17    the  Social  Security  Act  and  Section  5-4 of the Illinois
18    Public Aid Code, who precedes  a  person  receiving  services
19    under this Section in death.  All moneys for services paid to
20    or  in  behalf  of  the  person  under  this Section shall be
21    claimed for  recovery  from  the  deceased  spouse's  estate.
22    "Homestead",  as  used  in this paragraph, means the dwelling
23    house and contiguous real  estate  occupied  by  a  surviving
24    spouse  or  relative, as defined by the rules and regulations
25    of the Illinois Department of Public Aid, regardless  of  the
26    value of the property.
27        The   Department  shall  develop  procedures  to  enhance
28    availability of services on evenings,  weekends,  and  on  an
29    emergency  basis  to  meet  the  respite needs of caregivers.
30    Procedures shall be developed to permit  the  utilization  of
31    services  in  successive blocks of 24 hours up to the monthly
32    maximum established by the  Department.    Workers  providing
33    these services shall be appropriately trained.
34        Beginning on the effective date of this Amendatory Act of
                            -7-                LRB9206396TAtm
 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 Human
29    Services shall cooperate in the development and submission of
30    an annual report on programs and services provided under this
31    Section.  Such joint report shall be filed with the  Governor
32    and the General Assembly on or before September 30 each year.
33        The  requirement  for  reporting  to the General Assembly
34    shall be satisfied by filing copies of the  report  with  the
                            -8-                LRB9206396TAtm
 1    Speaker,  the  Minority  Leader and the Clerk of the House of
 2    Representatives and the President, the  Minority  Leader  and
 3    the  Secretary  of  the  Senate  and the Legislative Research
 4    Unit, as required by Section  3.1  of  the  General  Assembly
 5    Organization  Act  and filing such additional copies with the
 6    State Government Report Distribution Center for  the  General
 7    Assembly  as  is required under paragraph (t) of Section 7 of
 8    the State Library Act.
 9        Those persons previously  found  eligible  for  receiving
10    non-institutional  services  whose services were discontinued
11    under the Emergency Budget Act of Fiscal Year 1992,  and  who
12    do  not  meet the eligibility standards in effect on or after
13    July 1, 1992, shall remain ineligible on and  after  July  1,
14    1992.   Those  persons  previously not required to cost-share
15    and who were required to cost-share effective March 1,  1992,
16    shall  continue  to meet cost-share requirements on and after
17    July 1, 1992.  Beginning July 1, 1992, all  clients  will  be
18    required   to   meet   eligibility,   cost-share,  and  other
19    requirements and will have services discontinued  or  altered
20    when they fail to meet these requirements.
21    (Source: P.A. 91-303, eff. 1-1-00; 91-798, eff. 7-9-00.)

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