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Sen. Iris Y. Martinez
Filed: 4/23/2018
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1 | | AMENDMENT TO SENATE BILL 1628
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2 | | AMENDMENT NO. ______. Amend Senate Bill 1628, AS AMENDED, |
3 | | by replacing everything after the enacting clause with the |
4 | | following:
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5 | | "Section 5. The Illinois Act on the Aging is amended by |
6 | | changing Section 4.02 as follows:
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7 | | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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8 | | Sec. 4.02. Community Care Program. The Department shall |
9 | | establish a program of services to
prevent unnecessary |
10 | | institutionalization of persons age 60 and older in
need of |
11 | | long term care or who are established as persons who suffer |
12 | | from
Alzheimer's disease or a related disorder under the |
13 | | Alzheimer's Disease
Assistance Act, thereby enabling them
to |
14 | | remain in their own homes or in other living arrangements. Such
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15 | | preventive services, which may be coordinated with other |
16 | | programs for the
aged and monitored by area agencies on aging |
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1 | | in cooperation with the
Department, may include, but are not |
2 | | limited to, any or all of the following:
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3 | | (a) (blank);
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4 | | (b) (blank);
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5 | | (c) home care aide services;
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6 | | (d) personal assistant services;
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7 | | (e) adult day services;
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8 | | (f) home-delivered meals;
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9 | | (g) education in self-care;
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10 | | (h) personal care services;
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11 | | (i) adult day health services;
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12 | | (j) habilitation services;
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13 | | (k) respite care;
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14 | | (k-5) community reintegration services;
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15 | | (k-6) flexible senior services; |
16 | | (k-7) medication management; |
17 | | (k-8) emergency home response;
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18 | | (l) other nonmedical social services that may enable |
19 | | the person
to become self-supporting; or
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20 | | (m) clearinghouse for information provided by senior |
21 | | citizen home owners
who want to rent rooms to or share |
22 | | living space with other senior citizens.
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23 | | The Department shall establish eligibility standards for |
24 | | such
services. In determining the amount and nature of services
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25 | | for which a person may qualify, consideration shall not be |
26 | | given to the
value of cash, property or other assets held in |
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1 | | the name of the person's
spouse pursuant to a written agreement |
2 | | dividing marital property into equal
but separate shares or |
3 | | pursuant to a transfer of the person's interest in a
home to |
4 | | his spouse, provided that the spouse's share of the marital
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5 | | property is not made available to the person seeking such |
6 | | services.
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7 | | Beginning January 1, 2008, the Department shall require as |
8 | | a condition of eligibility that all new financially eligible |
9 | | applicants apply for and enroll in medical assistance under |
10 | | Article V of the Illinois Public Aid Code in accordance with |
11 | | rules promulgated by the Department.
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12 | | The Department shall, in conjunction with the Department of |
13 | | Public Aid (now Department of Healthcare and Family Services),
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14 | | seek appropriate amendments under Sections 1915 and 1924 of the |
15 | | Social
Security Act. The purpose of the amendments shall be to |
16 | | extend eligibility
for home and community based services under |
17 | | Sections 1915 and 1924 of the
Social Security Act to persons |
18 | | who transfer to or for the benefit of a
spouse those amounts of |
19 | | income and resources allowed under Section 1924 of
the Social |
20 | | Security Act. Subject to the approval of such amendments, the
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21 | | Department shall extend the provisions of Section 5-4 of the |
22 | | Illinois
Public Aid Code to persons who, but for the provision |
23 | | of home or
community-based services, would require the level of |
24 | | care provided in an
institution, as is provided for in federal |
25 | | law. Those persons no longer
found to be eligible for receiving |
26 | | noninstitutional services due to changes
in the eligibility |
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1 | | criteria shall be given 45 days notice prior to actual
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2 | | termination. Those persons receiving notice of termination may |
3 | | contact the
Department and request the determination be |
4 | | appealed at any time during the
45 day notice period. The |
5 | | target
population identified for the purposes of this Section |
6 | | are persons age 60
and older with an identified service need. |
7 | | Priority shall be given to those
who are at imminent risk of |
8 | | institutionalization. The services shall be
provided to |
9 | | eligible persons age 60 and older to the extent that the cost
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10 | | of the services together with the other personal maintenance
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11 | | expenses of the persons are reasonably related to the standards
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12 | | established for care in a group facility appropriate to the |
13 | | person's
condition. These non-institutional services, pilot |
14 | | projects or
experimental facilities may be provided as part of |
15 | | or in addition to
those authorized by federal law or those |
16 | | funded and administered by the
Department of Human Services. |
17 | | The Departments of Human Services, Healthcare and Family |
18 | | Services,
Public Health, Veterans' Affairs, and Commerce and |
19 | | Economic Opportunity and
other appropriate agencies of State, |
20 | | federal and local governments shall
cooperate with the |
21 | | Department on Aging in the establishment and development
of the |
22 | | non-institutional services. The Department shall require an |
23 | | annual
audit from all personal assistant
and home care aide |
24 | | vendors contracting with
the Department under this Section. The |
25 | | annual audit shall assure that each
audited vendor's procedures |
26 | | are in compliance with Department's financial
reporting |
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1 | | guidelines requiring an administrative and employee wage and |
2 | | benefits cost split as defined in administrative rules. The |
3 | | audit is a public record under
the Freedom of Information Act. |
4 | | The Department shall execute, relative to
the nursing home |
5 | | prescreening project, written inter-agency
agreements with the |
6 | | Department of Human Services and the Department
of Healthcare |
7 | | and Family Services, to effect the following: (1) intake |
8 | | procedures and common
eligibility criteria for those persons |
9 | | who are receiving non-institutional
services; and (2) the |
10 | | establishment and development of non-institutional
services in |
11 | | areas of the State where they are not currently available or |
12 | | are
undeveloped. On and after July 1, 1996, all nursing home |
13 | | prescreenings for
individuals 60 years of age or older shall be |
14 | | conducted by the Department.
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15 | | As part of the Department on Aging's routine training of |
16 | | case managers and case manager supervisors, the Department may |
17 | | include information on family futures planning for persons who |
18 | | are age 60 or older and who are caregivers of their adult |
19 | | children with developmental disabilities. The content of the |
20 | | training shall be at the Department's discretion. |
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 pay |
24 | | but in no case to exceed the actual cost of
the services |
25 | | provided. Additionally, any portion of a person's income which
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26 | | is equal to or less than the federal poverty standard shall not |
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1 | | be
considered by the Department in determining the copayment. |
2 | | The level of
such copayment shall be adjusted whenever |
3 | | necessary to reflect any change
in the officially designated |
4 | | federal poverty standard.
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5 | | The Department, or the Department's authorized |
6 | | representative, may
recover the amount of moneys expended for |
7 | | services provided to or in
behalf of a person under this |
8 | | Section by a claim against the person's
estate or against the |
9 | | estate of the person's surviving spouse, but no
recovery may be |
10 | | had until after the death of the surviving spouse, if
any, and |
11 | | then only at such time when there is no surviving child who
is |
12 | | under age 21 or blind or who has a permanent and total |
13 | | disability. This
paragraph, however, shall not bar recovery, at |
14 | | the death of the person, of
moneys for services provided to the |
15 | | person or in behalf of the person under
this Section to which |
16 | | the person was not entitled;
provided that such recovery shall |
17 | | not be enforced against any real estate while
it is occupied as |
18 | | a homestead by the surviving spouse or other dependent, if no
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19 | | claims by other creditors have been filed against the estate, |
20 | | or, if such
claims have been filed, they remain dormant for |
21 | | failure of prosecution or
failure of the claimant to compel |
22 | | administration of the estate for the purpose
of payment. This |
23 | | paragraph shall not bar recovery from the estate of a spouse,
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24 | | under Sections 1915 and 1924 of the Social Security Act and |
25 | | Section 5-4 of the
Illinois Public Aid Code, who precedes a |
26 | | person receiving services under this
Section in death. All |
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1 | | moneys for services
paid to or in behalf of the person under |
2 | | this Section shall be claimed for
recovery from the deceased |
3 | | spouse's estate. "Homestead", as used
in this paragraph, means |
4 | | the dwelling house and
contiguous real estate occupied by a |
5 | | surviving spouse
or relative, as defined by the rules and |
6 | | regulations of the Department of Healthcare and Family |
7 | | Services, regardless of the value of the property.
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8 | | The Department shall increase the effectiveness of the |
9 | | existing Community Care Program by: |
10 | | (1) ensuring that in-home services included in the care |
11 | | plan are available on evenings and weekends; |
12 | | (2) ensuring that care plans contain the services that |
13 | | eligible participants
need based on the number of days in a |
14 | | month, not limited to specific blocks of time, as |
15 | | identified by the comprehensive assessment tool selected |
16 | | by the Department for use statewide, not to exceed the |
17 | | total monthly service cost maximum allowed for each |
18 | | service; the Department shall develop administrative rules |
19 | | to implement this item (2); |
20 | | (3) ensuring that the participants have the right to |
21 | | choose the services contained in their care plan and to |
22 | | direct how those services are provided, based on |
23 | | administrative rules established by the Department; |
24 | | (4) ensuring that the determination of need tool is |
25 | | accurate in determining the participants' level of need; to |
26 | | achieve this, the Department, in conjunction with the Older |
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1 | | Adult Services Advisory Committee, shall institute a study |
2 | | of the relationship between the Determination of Need |
3 | | scores, level of need, service cost maximums, and the |
4 | | development and utilization of service plans no later than |
5 | | May 1, 2008; findings and recommendations shall be |
6 | | presented to the Governor and the General Assembly no later |
7 | | than January 1, 2009; recommendations shall include all |
8 | | needed changes to the service cost maximums schedule and |
9 | | additional covered services; |
10 | | (5) ensuring that homemakers can provide personal care |
11 | | services that may or may not involve contact with clients, |
12 | | including but not limited to: |
13 | | (A) bathing; |
14 | | (B) grooming; |
15 | | (C) toileting; |
16 | | (D) nail care; |
17 | | (E) transferring; |
18 | | (F) respiratory services; |
19 | | (G) exercise; or |
20 | | (H) positioning; |
21 | | (6) ensuring that homemaker program vendors are not |
22 | | restricted from hiring homemakers who are family members of |
23 | | clients or recommended by clients; the Department may not, |
24 | | by rule or policy, require homemakers who are family |
25 | | members of clients or recommended by clients to accept |
26 | | assignments in homes other than the client; |
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1 | | (7) ensuring that the State may access maximum federal |
2 | | matching funds by seeking approval for the Centers for |
3 | | Medicare and Medicaid Services for modifications to the |
4 | | State's home and community based services waiver and |
5 | | additional waiver opportunities, including applying for |
6 | | enrollment in the Balance Incentive Payment Program by May |
7 | | 1, 2013, in order to maximize federal matching funds; this |
8 | | shall include, but not be limited to, modification that |
9 | | reflects all changes in the Community Care Program services |
10 | | and all increases in the services cost maximum; |
11 | | (8) ensuring that the determination of need tool |
12 | | accurately reflects the service needs of individuals with |
13 | | Alzheimer's disease and related dementia disorders; |
14 | | (9) ensuring that services are authorized accurately |
15 | | and consistently for the Community Care Program (CCP); the |
16 | | Department shall implement a Service Authorization policy |
17 | | directive; the purpose shall be to ensure that eligibility |
18 | | and services are authorized accurately and consistently in |
19 | | the CCP program; the policy directive shall clarify service |
20 | | authorization guidelines to Care Coordination Units and |
21 | | Community Care Program providers no later than May 1, 2013; |
22 | | (10) working in conjunction with Care Coordination |
23 | | Units, the Department of Healthcare and Family Services, |
24 | | the Department of Human Services, Community Care Program |
25 | | providers, and other stakeholders to make improvements to |
26 | | the Medicaid claiming processes and the Medicaid |
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1 | | enrollment procedures or requirements as needed, |
2 | | including, but not limited to, specific policy changes or |
3 | | rules to improve the up-front enrollment of participants in |
4 | | the Medicaid program and specific policy changes or rules |
5 | | to insure more prompt submission of bills to the federal |
6 | | government to secure maximum federal matching dollars as |
7 | | promptly as possible; the Department on Aging shall have at |
8 | | least 3 meetings with stakeholders by January 1, 2014 in |
9 | | order to address these improvements; |
10 | | (11) requiring home care service providers to comply |
11 | | with the rounding of hours worked provisions under the |
12 | | federal Fair Labor Standards Act (FLSA) and as set forth in |
13 | | 29 CFR 785.48(b) by May 1, 2013; |
14 | | (12) implementing any necessary policy changes or |
15 | | promulgating any rules, no later than January 1, 2014, to |
16 | | assist the Department of Healthcare and Family Services in |
17 | | moving as many participants as possible, consistent with |
18 | | federal regulations, into coordinated care plans if a care |
19 | | coordination plan that covers long term care is available |
20 | | in the recipient's area; and |
21 | | (13) maintaining fiscal year 2014 rates at the same |
22 | | level established on January 1, 2013. |
23 | | By January 1, 2009 or as soon after the end of the Cash and |
24 | | Counseling Demonstration Project as is practicable, the |
25 | | Department may, based on its evaluation of the demonstration |
26 | | project, promulgate rules concerning personal assistant |
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1 | | services, to include, but need not be limited to, |
2 | | qualifications, employment screening, rights under fair labor |
3 | | standards, training, fiduciary agent, and supervision |
4 | | requirements. All applicants shall be subject to the provisions |
5 | | of the Health Care Worker Background Check Act.
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6 | | The Department shall develop procedures to enhance |
7 | | availability of
services on evenings, weekends, and on an |
8 | | emergency basis to meet the
respite needs of caregivers. |
9 | | Procedures shall be developed to permit the
utilization of |
10 | | services in successive blocks of 24 hours up to the monthly
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11 | | maximum established by the Department. Workers providing these |
12 | | services
shall be appropriately trained.
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13 | | Beginning on the effective date of this amendatory Act of |
14 | | 1991, no person
may perform chore/housekeeping and home care |
15 | | aide services under a program
authorized by this Section unless |
16 | | that person has been issued a certificate
of pre-service to do |
17 | | so by his or her employing agency. Information
gathered to |
18 | | effect such certification shall include (i) the person's name,
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19 | | (ii) the date the person was hired by his or her current |
20 | | employer, and
(iii) the training, including dates and levels. |
21 | | Persons engaged in the
program authorized by this Section |
22 | | before the effective date of this
amendatory Act of 1991 shall |
23 | | be issued a certificate of all pre- and
in-service training |
24 | | from his or her employer upon submitting the necessary
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25 | | information. The employing agency shall be required to retain |
26 | | records of
all staff pre- and in-service training, and shall |
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1 | | provide such records to
the Department upon request and upon |
2 | | termination of the employer's contract
with the Department. In |
3 | | addition, the employing agency is responsible for
the issuance |
4 | | of certifications of in-service training completed to their
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5 | | employees.
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6 | | The Department is required to develop a system to ensure |
7 | | that persons
working as home care aides and personal assistants
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8 | | receive increases in their
wages when the federal minimum wage |
9 | | is increased by requiring vendors to
certify that they are |
10 | | meeting the federal minimum wage statute for home care aides
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11 | | and personal assistants. An employer that cannot ensure that |
12 | | the minimum
wage increase is being given to home care aides and |
13 | | personal assistants
shall be denied any increase in |
14 | | reimbursement costs.
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15 | | The Community Care Program Advisory Committee is created in |
16 | | the Department on Aging. The Director shall appoint individuals |
17 | | to serve in the Committee, who shall serve at their own |
18 | | expense. Members of the Committee must abide by all applicable |
19 | | ethics laws. The Committee shall advise the Department on |
20 | | issues related to the Department's program of services to |
21 | | prevent unnecessary institutionalization. The Committee shall |
22 | | meet on a bi-monthly basis and shall serve to identify and |
23 | | advise the Department on present and potential issues affecting |
24 | | the service delivery network, the program's clients, and the |
25 | | Department and to recommend solution strategies. Persons |
26 | | appointed to the Committee shall be appointed on, but not |
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1 | | limited to, their own and their agency's experience with the |
2 | | program, geographic representation, and willingness to serve. |
3 | | The Director shall appoint members to the Committee to |
4 | | represent provider, advocacy, policy research, and other |
5 | | constituencies committed to the delivery of high quality home |
6 | | and community-based services to older adults. Representatives |
7 | | shall be appointed to ensure representation from community care |
8 | | providers including, but not limited to, adult day service |
9 | | providers, homemaker providers, case coordination and case |
10 | | management units, emergency home response providers, statewide |
11 | | trade or labor unions that represent home care
aides and direct |
12 | | care staff, area agencies on aging, adults over age 60, |
13 | | membership organizations representing older adults, and other |
14 | | organizational entities, providers of care, or individuals |
15 | | with demonstrated interest and expertise in the field of home |
16 | | and community care as determined by the Director. |
17 | | Nominations may be presented from any agency or State |
18 | | association with interest in the program. The Director, or his |
19 | | or her designee, shall serve as the permanent co-chair of the |
20 | | advisory committee. One other co-chair shall be nominated and |
21 | | approved by the members of the committee on an annual basis. |
22 | | Committee members' terms of appointment shall be for 4 years |
23 | | with one-quarter of the appointees' terms expiring each year. A |
24 | | member shall continue to serve until his or her replacement is |
25 | | named. The Department shall fill vacancies that have a |
26 | | remaining term of over one year, and this replacement shall |
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1 | | occur through the annual replacement of expiring terms. The |
2 | | Director shall designate Department staff to provide technical |
3 | | assistance and staff support to the committee. Department |
4 | | representation shall not constitute membership of the |
5 | | committee. All Committee papers, issues, recommendations, |
6 | | reports, and meeting memoranda are advisory only. The Director, |
7 | | or his or her designee, shall make a written report, as |
8 | | requested by the Committee, regarding issues before the |
9 | | Committee.
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10 | | The Department on Aging and the Department of Human |
11 | | Services
shall cooperate in the development and submission of |
12 | | an annual report on
programs and services provided under this |
13 | | Section. Such joint report
shall be filed with the Governor and |
14 | | the General Assembly on or before
September 30 each year.
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15 | | The requirement for reporting to the General Assembly shall |
16 | | be satisfied
by filing copies of the report with the Speaker, |
17 | | the Minority Leader and
the Clerk of the House of |
18 | | Representatives and the President, the Minority
Leader and the |
19 | | Secretary of the Senate and the Legislative Research Unit,
as |
20 | | required by Section 3.1 of the General Assembly Organization |
21 | | Act and
filing such additional copies with the State Government |
22 | | Report Distribution
Center for the General Assembly as is |
23 | | required under paragraph (t) of
Section 7 of the State Library |
24 | | Act.
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25 | | Those persons previously found eligible for receiving |
26 | | non-institutional
services whose services were discontinued |
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1 | | under the Emergency Budget Act of
Fiscal Year 1992, and who do |
2 | | not meet the eligibility standards in effect
on or after July |
3 | | 1, 1992, shall remain ineligible on and after July 1,
1992. |
4 | | Those persons previously not required to cost-share and who |
5 | | were
required to cost-share effective March 1, 1992, shall |
6 | | continue to meet
cost-share requirements on and after July 1, |
7 | | 1992. Beginning July 1, 1992,
all clients will be required to |
8 | | meet
eligibility, cost-share, and other requirements and will |
9 | | have services
discontinued or altered when they fail to meet |
10 | | these requirements. |
11 | | For the purposes of this Section, "flexible senior |
12 | | services" refers to services that require one-time or periodic |
13 | | expenditures including, but not limited to, respite care, home |
14 | | modification, assistive technology, housing assistance, and |
15 | | transportation.
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16 | | The Department shall implement an electronic service |
17 | | verification based on global positioning systems or other |
18 | | cost-effective technology for the Community Care Program no |
19 | | later than January 1, 2014. |
20 | | The Department shall require, as a condition of |
21 | | eligibility, enrollment in the medical assistance program |
22 | | under Article V of the Illinois Public Aid Code (i) beginning |
23 | | August 1, 2013, if the Auditor General has reported that the |
24 | | Department has failed
to comply with the reporting requirements |
25 | | of Section 2-27 of
the Illinois State Auditing Act; or (ii) |
26 | | beginning June 1, 2014, if the Auditor General has reported |
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1 | | that the
Department has not undertaken the required actions |
2 | | listed in
the report required by subsection (a) of Section 2-27 |
3 | | of the
Illinois State Auditing Act. |
4 | | The Department shall delay Community Care Program services |
5 | | until an applicant is determined eligible for medical |
6 | | assistance under Article V of the Illinois Public Aid Code (i) |
7 | | beginning August 1, 2013, if the Auditor General has reported |
8 | | that the Department has failed
to comply with the reporting |
9 | | requirements of Section 2-27 of
the Illinois State Auditing |
10 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has |
11 | | reported that the
Department has not undertaken the required |
12 | | actions listed in
the report required by subsection (a) of |
13 | | Section 2-27 of the
Illinois State Auditing Act. |
14 | | The Department shall implement co-payments for the |
15 | | Community Care Program at the federally allowable maximum level |
16 | | (i) beginning August 1, 2013, if the Auditor General has |
17 | | reported that the Department has failed
to comply with the |
18 | | reporting requirements of Section 2-27 of
the Illinois State |
19 | | Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
20 | | General has reported that the
Department has not undertaken the |
21 | | required actions listed in
the report required by subsection |
22 | | (a) of Section 2-27 of the
Illinois State Auditing Act. |
23 | | The Department shall provide a bi-monthly report on the |
24 | | progress of the Community Care Program reforms set forth in |
25 | | this amendatory Act of the 98th General Assembly to the |
26 | | Governor, the Speaker of the House of Representatives, the |
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1 | | Minority Leader of the House of Representatives, the
President |
2 | | of the
Senate, and the Minority Leader of the Senate. |
3 | | The Department shall conduct a quarterly review of Care |
4 | | Coordination Unit performance and adherence to service |
5 | | guidelines. The quarterly review shall be reported to the |
6 | | Speaker of the House of Representatives, the Minority Leader of |
7 | | the House of Representatives, the
President of the
Senate, and |
8 | | the Minority Leader of the Senate. The Department shall collect |
9 | | and report longitudinal data on the performance of each care |
10 | | coordination unit. Nothing in this paragraph shall be construed |
11 | | to require the Department to identify specific care |
12 | | coordination units. |
13 | | In regard to community care providers, failure to comply |
14 | | with Department on Aging policies shall be cause for |
15 | | disciplinary action, including, but not limited to, |
16 | | disqualification from serving Community Care Program clients. |
17 | | Each provider, upon submission of any bill or invoice to the |
18 | | Department for payment for services rendered, shall include a |
19 | | notarized statement, under penalty of perjury pursuant to |
20 | | Section 1-109 of the Code of Civil Procedure, that the provider |
21 | | has complied with all Department policies. |
22 | | The Director of the Department on Aging shall make |
23 | | information available to the State Board of Elections as may be |
24 | | required by an agreement the State Board of Elections has |
25 | | entered into with a multi-state voter registration list |
26 | | maintenance system. |
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1 | | Within 30 days after the effective date of this amendatory |
2 | | Act of the 100th General Assembly, rates shall be increased to |
3 | | $18.29 per hour, for the purpose of increasing, by at least |
4 | | $.72 per hour, the wages paid by those vendors to their |
5 | | employees who provide homemaker services. The Department shall |
6 | | pay an enhanced rate under the Community Care Program to those |
7 | | in-home service provider agencies that offer health insurance |
8 | | coverage as a benefit to their direct service worker employees |
9 | | consistent with the mandates of Public Act 95-713. For State |
10 | | fiscal year 2018, the enhanced rate shall be $1.77 per hour. |
11 | | The rate shall be adjusted using actuarial analysis based on |
12 | | the cost of care, but shall not be set below $1.77 per hour. |
13 | | The Department shall adopt rules, including emergency rules |
14 | | under subsection (y) of Section 5-45 of the Illinois |
15 | | Administrative Procedure Act, to implement the provisions of |
16 | | this paragraph. |
17 | | The General Assembly finds it necessary to authorize an |
18 | | aggressive Medicaid enrollment initiative designed to maximize |
19 | | federal Medicaid funding for the Community Care Program which |
20 | | produces significant savings for the State of Illinois. The |
21 | | Department on Aging shall establish and implement a Community |
22 | | Care Program Medicaid Initiative. Under the Initiative, the
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23 | | Department on Aging shall, at a minimum: (i) provide an |
24 | | enhanced rate to adequately compensate care coordination units |
25 | | to enroll eligible Community Care Program clients into |
26 | | Medicaid; (ii) use recommendations from a stakeholder |
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1 | | committee on how best to implement the Initiative; and (iii) |
2 | | establish requirements for State agencies to make enrollment in |
3 | | the State's Medical Assistance program easier for seniors. |
4 | | The Community Care Program Medicaid Enrollment Oversight |
5 | | Subcommittee is created as a subcommittee of the Older Adult |
6 | | Services Advisory Committee established in Section 35 of the |
7 | | Older Adult Services Act to make recommendations on how best to |
8 | | increase the number of medical assistance recipients who are |
9 | | enrolled in the Community Care Program. The Subcommittee shall |
10 | | consist of all of the following persons who must be appointed |
11 | | within 30 days after the effective date of this amendatory Act |
12 | | of the 100th General Assembly: |
13 | | (1) The Director of Aging, or his or her designee, who |
14 | | shall serve as the chairperson of the Subcommittee. |
15 | | (2) One representative of the Department of Healthcare |
16 | | and Family Services, appointed by the Director of |
17 | | Healthcare and Family Services. |
18 | | (3) One representative of the Department of Human |
19 | | Services, appointed by the Secretary of Human Services. |
20 | | (4) One individual representing a care coordination |
21 | | unit, appointed by the Director of Aging. |
22 | | (5) One individual from a non-governmental statewide |
23 | | organization that advocates for seniors, appointed by the |
24 | | Director of Aging. |
25 | | (6) One individual representing Area Agencies on |
26 | | Aging, appointed by the Director of Aging. |
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1 | | (7) One individual from a statewide association |
2 | | dedicated to Alzheimer's care, support, and research, |
3 | | appointed by the Director of Aging. |
4 | | (8) One individual from an organization that employs |
5 | | persons who provide services under the Community Care |
6 | | Program, appointed by the Director of Aging. |
7 | | (9) One member of a trade or labor union representing |
8 | | persons who provide services under the Community Care |
9 | | Program, appointed by the Director of Aging. |
10 | | (10) One member of the Senate, who shall serve as |
11 | | co-chairperson, appointed by the President of the Senate. |
12 | | (11) One member of the Senate, who shall serve as |
13 | | co-chairperson, appointed by the Minority Leader of the |
14 | | Senate. |
15 | | (12) One member of the House of
Representatives, who |
16 | | shall serve as co-chairperson, appointed by the Speaker of |
17 | | the House of Representatives. |
18 | | (13) One member of the House of Representatives, who |
19 | | shall serve as co-chairperson, appointed by the Minority |
20 | | Leader of the House of Representatives. |
21 | | (14) One individual appointed by a labor organization |
22 | | representing front line employees at the Department of |
23 | | Human Services. |
24 | | The Subcommittee shall provide oversight to the Community |
25 | | Care Program Medicaid Initiative and shall meet quarterly. At |
26 | | each Subcommittee meeting the Department on Aging shall provide |
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1 | | the following data sets to the Subcommittee: (A) the number of |
2 | | Illinois residents, categorized by planning and service area, |
3 | | who are receiving services under the Community Care Program and |
4 | | are enrolled in the State's Medical Assistance Program; (B) the |
5 | | number of Illinois residents, categorized by planning and |
6 | | service area, who are receiving services under the Community |
7 | | Care Program, but are not enrolled in the State's Medical |
8 | | Assistance Program; and (C) the number of Illinois residents, |
9 | | categorized by planning and service area, who are receiving |
10 | | services under the Community Care Program and are eligible for |
11 | | benefits under the State's Medical Assistance Program, but are |
12 | | not enrolled in the State's Medical Assistance Program. In |
13 | | addition to this data, the Department on Aging shall provide |
14 | | the Subcommittee with plans on how the Department on Aging will |
15 | | reduce the number of Illinois residents who are not enrolled in |
16 | | the State's Medical Assistance Program but who are eligible for |
17 | | medical assistance benefits. The Department on Aging shall |
18 | | enroll in the State's Medical Assistance Program those Illinois |
19 | | residents who receive services under the Community Care Program |
20 | | and are eligible for medical assistance benefits but are not |
21 | | enrolled in the State's Medicaid Assistance Program. The data |
22 | | provided to the Subcommittee shall be made available to the |
23 | | public via the Department on Aging's website. |
24 | | The Department on Aging, with the involvement of the |
25 | | Subcommittee, shall collaborate with the Department of Human |
26 | | Services and the Department of Healthcare and Family Services |
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1 | | on how best to achieve the responsibilities of the Community |
2 | | Care Program Medicaid Initiative. |
3 | | The Department on Aging, the Department of Human Services, |
4 | | and the Department of Healthcare and Family Services shall |
5 | | coordinate and implement a streamlined process for seniors to |
6 | | access benefits under the State's Medical Assistance Program. |
7 | | The Subcommittee shall collaborate with the Department of |
8 | | Human Services on the adoption of a uniform application |
9 | | submission process. The Department of Human Services and any |
10 | | other State agency involved with processing the medical |
11 | | assistance application of any person enrolled in the Community |
12 | | Care Program shall include the appropriate care coordination |
13 | | unit in all communications related to the determination or |
14 | | status of the application. |
15 | | The Community Care Program Medicaid Initiative shall |
16 | | provide targeted funding to care coordination units to help |
17 | | seniors complete their applications for medical assistance |
18 | | benefits. Care coordination units shall receive payment for |
19 | | each completed application for those months in which the total |
20 | | statewide number of medical assistance applications all care |
21 | | coordination units helped seniors complete is at or above the |
22 | | total statewide number of medical assistance applications |
23 | | completed during the same month during calendar year 2017. The |
24 | | rate of payment shall be no less than $240 per completed |
25 | | application. |
26 | | The Community Care Program Medicaid Initiative shall cease |
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1 | | operation 5 years after the effective date of this amendatory |
2 | | Act of the 100th General Assembly, after which the Subcommittee |
3 | | shall dissolve. |
4 | | (Source: P.A. 99-143, eff. 7-27-15; 100-23, eff. 7-6-17.) |
5 | | Section 10. The Older Adult Services Act is amended by |
6 | | changing Section 35 as follows: |
7 | | (320 ILCS 42/35) |
8 | | Sec. 35. Older Adult Services Advisory Committee. |
9 | | (a) The Older Adult Services Advisory Committee is created |
10 | | to advise the directors of Aging, Healthcare and Family |
11 | | Services, and Public Health on all matters related to this Act |
12 | | and the delivery of services to older adults in general.
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13 | | (b) The Advisory Committee shall be comprised of the |
14 | | following:
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15 | | (1) The Director of Aging or his or her designee, who |
16 | | shall serve as chair and shall be an ex officio and |
17 | | nonvoting member.
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18 | | (2) The Director of Healthcare and Family Services and |
19 | | the Director of Public Health or their designees, who shall |
20 | | serve as vice-chairs and shall be ex officio and nonvoting |
21 | | members.
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22 | | (3) One representative each of the Governor's Office, |
23 | | the Department of Healthcare and Family Services, the |
24 | | Department of Public Health, the Department of Veterans' |
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1 | | Affairs, the Department of Human Services, the Department |
2 | | of Insurance, the Department of Commerce and Economic |
3 | | Opportunity, the Department on Aging, the Department on |
4 | | Aging's State Long Term Care Ombudsman, the Illinois |
5 | | Housing Finance Authority, and the Illinois Housing |
6 | | Development Authority, each of whom shall be selected by |
7 | | his or her respective director and shall be an ex officio |
8 | | and nonvoting member.
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9 | | (4) Thirty members appointed by the Director of Aging |
10 | | in collaboration with the directors of Public Health and |
11 | | Healthcare and Family Services, and selected from the |
12 | | recommendations of statewide associations and |
13 | | organizations, as follows:
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14 | | (A) One member representing the Area Agencies on |
15 | | Aging;
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16 | | (B) Four members representing nursing homes or |
17 | | licensed assisted living establishments;
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18 | | (C) One member representing home health agencies;
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19 | | (D) One member representing case management |
20 | | services;
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21 | | (E) One member representing statewide senior |
22 | | center associations;
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23 | | (F) One member representing Community Care Program |
24 | | homemaker services;
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25 | | (G) One member representing Community Care Program |
26 | | adult day services;
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1 | | (H) One member representing nutrition project |
2 | | directors;
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3 | | (I) One member representing hospice programs;
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4 | | (J) One member representing individuals with |
5 | | Alzheimer's disease and related dementias;
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6 | | (K) Two members representing statewide trade or |
7 | | labor unions;
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8 | | (L) One advanced practice registered nurse with |
9 | | experience in gerontological nursing;
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10 | | (M) One physician specializing in gerontology;
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11 | | (N) One member representing regional long-term |
12 | | care ombudsmen;
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13 | | (O) One member representing municipal, township, |
14 | | or county officials;
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15 | | (P) (Blank);
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16 | | (Q) (Blank);
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17 | | (R) One member representing the parish nurse |
18 | | movement;
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19 | | (S) One member representing pharmacists;
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20 | | (T) Two members representing statewide |
21 | | organizations engaging in advocacy or legal |
22 | | representation on behalf of the senior population;
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23 | | (U) Two family caregivers;
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24 | | (V) Two citizen members over the age of 60;
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25 | | (W) One citizen with knowledge in the area of |
26 | | gerontology research or health care law;
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1 | | (X) One representative of health care facilities |
2 | | licensed under the Hospital Licensing Act; and
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3 | | (Y) One representative of primary care service |
4 | | providers. |
5 | | The Director of Aging, in collaboration with the Directors |
6 | | of Public Health and Healthcare and Family Services, may |
7 | | appoint additional citizen members to the Older Adult Services |
8 | | Advisory Committee. Each such additional member must be either |
9 | | an individual age 60 or older or an uncompensated caregiver for |
10 | | a family member or friend who is age 60 or older.
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11 | | (c) Voting members of the Advisory Committee shall serve |
12 | | for a term of 3 years or until a replacement is named. All |
13 | | members shall be appointed no later than January 1, 2005. Of |
14 | | the initial appointees, as determined by lot, 10 members shall |
15 | | serve a term of one year; 10 shall serve for a term of 2 years; |
16 | | and 12 shall serve for a term of 3 years. Any member appointed |
17 | | to fill a vacancy occurring prior to the expiration of the term |
18 | | for which his or her predecessor was appointed shall be |
19 | | appointed for the remainder of that term. The Advisory |
20 | | Committee shall meet at least quarterly and may meet more |
21 | | frequently at the call of the Chair. A simple majority of those |
22 | | appointed shall constitute a quorum. The affirmative vote of a |
23 | | majority of those present and voting shall be necessary for |
24 | | Advisory Committee action. Members of the Advisory Committee |
25 | | shall receive no compensation for their services.
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26 | | (d) The Advisory Committee shall have an Executive |
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1 | | Committee comprised of the Chair, the Vice Chairs, and up to 15 |
2 | | members of the Advisory Committee appointed by the Chair who |
3 | | have demonstrated expertise in developing, implementing, or |
4 | | coordinating the system restructuring initiatives defined in |
5 | | Section 25. The Executive Committee shall have responsibility |
6 | | to oversee and structure the operations of the Advisory |
7 | | Committee and to create and appoint necessary subcommittees and |
8 | | subcommittee members.
The Advisory Committee's Community Care |
9 | | Program Medicaid Enrollment Oversight Subcommittee shall have |
10 | | the membership and powers and duties set forth in Section 4.02 |
11 | | of the Illinois Act on the Aging. |
12 | | (e) The Advisory Committee shall study and make |
13 | | recommendations related to the implementation of this Act, |
14 | | including but not limited to system restructuring initiatives |
15 | | as defined in Section 25 or otherwise related to this Act.
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16 | | (Source: P.A. 100-513, eff. 1-1-18 .)".
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