104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
SB3033

 

Introduced 1/28/2026, by Sen. Celina Villanueva

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.02

    Amends the Illinois Act on the Aging. Provides that, subject to federal approval, on and after January 1, 2027, rates for in-home services shall be increased to $33.92 to sustain a minimum wage of $20.75 per hour for direct service workers. Requires rates in subsequent State fiscal years to be no lower than the rates put into effect upon federal approval. Provides that in order for a provider of in-home services to be eligible to receive the $33.92 rate, the provider must pay a minimum wage of $20.75 per hour to all direct service workers employed by the provider. Requires providers of in-home services to certify to the Department on Aging that they remain in compliance with the mandated wage increase for direct service workers. Requires each provider of in-home services to submit cost reports to the Department consistent with a specified administrative rule in order to be eligible for the $33.92 rate for in-home services. Provides that fringe benefits shall not be reduced in relation to the described rate increases. Requires the Department, beginning January 1, 2027, to ensure that each in-home service provider spends a minimum of 79% of the total payments the provider receives for home care aide services it furnishes under the Community Care Program on total compensation for direct service workers who furnish those services. Requires annual direct service worker cost reports from providers; and requires the Department to amend existing rules on financial reporting and minimum direct service worker costs to reflect the increase in the direct service worker spending requirement from 77% to 79%.


LRB104 17826 KTG 31260 b

 

 

A BILL FOR

 

SB3033LRB104 17826 KTG 31260 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.02 as follows:
 
6    (20 ILCS 105/4.02)
7    Sec. 4.02. Community Care Program. The Department shall
8establish a program of services to prevent unnecessary
9institutionalization of persons age 60 and older in need of
10long term care or who are established as persons who suffer
11from Alzheimer's disease or a related disorder under the
12Alzheimer's Disease Assistance Act, thereby enabling them to
13remain in their own homes or in other living arrangements.
14Such preventive services, which may be coordinated with other
15programs for the aged, may include, but are not limited to, any
16or all of the following:
17        (a) (blank);
18        (b) (blank);
19        (c) home care aide services;
20        (d) personal assistant services;
21        (e) adult day services;
22        (f) home-delivered meals;
23        (g) education in self-care;

 

 

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1        (h) personal care services;
2        (i) adult day health services;
3        (j) habilitation services;
4        (k) respite care;
5        (k-5) community reintegration services;
6        (k-6) flexible senior services;
7        (k-7) medication management;
8        (k-8) emergency home response;
9        (l) other nonmedical social services that may enable
10    the person to become self-supporting; or
11        (m) (blank).
12    The Department shall establish eligibility standards for
13such services. In determining the amount and nature of
14services for which a person may qualify, consideration shall
15not be given to the value of cash, property, or other assets
16held in the name of the person's spouse pursuant to a written
17agreement dividing marital property into equal but separate
18shares or pursuant to a transfer of the person's interest in a
19home to his spouse, provided that the spouse's share of the
20marital property is not made available to the person seeking
21such services.
22    The Department shall require as a condition of eligibility
23that all new financially eligible applicants apply for and
24enroll in medical assistance under Article V of the Illinois
25Public Aid Code in accordance with rules promulgated by the
26Department.

 

 

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1    The Department shall, in conjunction with the Department
2of Public Aid (now Department of Healthcare and Family
3Services), seek appropriate amendments under Sections 1915 and
41924 of the Social Security Act. The purpose of the amendments
5shall be to extend eligibility for home and community based
6services under Sections 1915 and 1924 of the Social Security
7Act to persons who transfer to or for the benefit of a spouse
8those amounts of income and resources allowed under Section
91924 of the Social Security Act. Subject to the approval of
10such amendments, the Department shall extend the provisions of
11Section 5-4 of the Illinois Public Aid Code to persons who, but
12for the provision of home or community-based services, would
13require the level of care provided in an institution, as is
14provided for in federal law. Those persons no longer found to
15be eligible for receiving noninstitutional services due to
16changes in the eligibility criteria shall be given 45 days
17notice prior to actual termination. Those persons receiving
18notice of termination may contact the Department and request
19the determination be appealed at any time during the 45 day
20notice period. The target population identified for the
21purposes of this Section are persons age 60 and older with an
22identified service need. Priority shall be given to those who
23are at imminent risk of institutionalization. The services
24shall be provided to eligible persons age 60 and older to the
25extent that the cost of the services together with the other
26personal maintenance expenses of the persons are reasonably

 

 

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

 

 

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

 

 

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

 

 

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1    care plan are available on evenings and weekends;
2        (2) ensuring that care plans contain the services that
3    eligible participants need based on the number of days in
4    a month, not limited to specific blocks of time, as
5    identified by the comprehensive assessment tool selected
6    by the Department for use statewide, not to exceed the
7    total monthly service cost maximum allowed for each
8    service; the Department shall develop administrative rules
9    to implement this item (2);
10        (3) ensuring that the participants have the right to
11    choose the services contained in their care plan and to
12    direct how those services are provided, based on
13    administrative rules established by the Department;
14        (4)(blank);
15        (5) ensuring that homemakers can provide personal care
16    services that may or may not involve contact with clients,
17    including, but not limited to:
18            (A) bathing;
19            (B) grooming;
20            (C) toileting;
21            (D) nail care;
22            (E) transferring;
23            (F) respiratory services;
24            (G) exercise; or
25            (H) positioning;
26        (6) ensuring that homemaker program vendors are not

 

 

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1    restricted from hiring homemakers who are family members
2    of clients or recommended by clients; the Department may
3    not, by rule or policy, require homemakers who are family
4    members of clients or recommended by clients to accept
5    assignments in homes other than the client;
6        (7) ensuring that the State may access maximum federal
7    matching funds by seeking approval for the Centers for
8    Medicare and Medicaid Services for modifications to the
9    State's home and community based services waiver and
10    additional waiver opportunities, including applying for
11    enrollment in the Balance Incentive Payment Program by May
12    1, 2013, in order to maximize federal matching funds; this
13    shall include, but not be limited to, modification that
14    reflects all changes in the Community Care Program
15    services and all increases in the services cost maximum;
16        (8) ensuring that the determination of need tool
17    accurately reflects the service needs of individuals with
18    Alzheimer's disease and related dementia disorders;
19        (9) ensuring that services are authorized accurately
20    and consistently for the Community Care Program (CCP); the
21    Department shall implement a Service Authorization policy
22    directive; the purpose shall be to ensure that eligibility
23    and services are authorized accurately and consistently in
24    the CCP program; the policy directive shall clarify
25    service authorization guidelines to Care Coordination
26    Units and Community Care Program providers no later than

 

 

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1    May 1, 2013;
2        (10) working in conjunction with Care Coordination
3    Units, the Department of Healthcare and Family Services,
4    the Department of Human Services, Community Care Program
5    providers, and other stakeholders to make improvements to
6    the Medicaid claiming processes and the Medicaid
7    enrollment procedures or requirements as needed,
8    including, but not limited to, specific policy changes or
9    rules to improve the up-front enrollment of participants
10    in the Medicaid program and specific policy changes or
11    rules to insure more prompt submission of bills to the
12    federal government to secure maximum federal matching
13    dollars as promptly as possible; the Department on Aging
14    shall have at least 3 meetings with stakeholders by
15    January 1, 2014 in order to address these improvements;
16        (11) requiring home care service providers to comply
17    with the rounding of hours worked provisions under the
18    federal Fair Labor Standards Act (FLSA) and as set forth
19    in 29 CFR 785.48(b) by May 1, 2013;
20        (12) implementing any necessary policy changes or
21    promulgating any rules, no later than January 1, 2014, to
22    assist the Department of Healthcare and Family Services in
23    moving as many participants as possible, consistent with
24    federal regulations, into coordinated care plans if a care
25    coordination plan that covers long term care is available
26    in the recipient's area; and

 

 

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1        (13) (blank).
2    By January 1, 2009 or as soon after the end of the Cash and
3Counseling Demonstration Project as is practicable, the
4Department may, based on its evaluation of the demonstration
5project, promulgate rules concerning personal assistant
6services, to include, but need not be limited to,
7qualifications, employment screening, rights under fair labor
8standards, training, fiduciary agent, and supervision
9requirements. All applicants shall be subject to the
10provisions of the Health Care Worker Background Check Act.
11    The Department shall develop procedures to enhance
12availability of services on evenings, weekends, and on an
13emergency basis to meet the respite needs of caregivers.
14Procedures shall be developed to permit the utilization of
15services in successive blocks of 24 hours up to the monthly
16maximum established by the Department. Workers providing these
17services shall be appropriately trained.
18    No person may perform chore/housekeeping and home care
19aide services under a program authorized by this Section
20unless that person has been issued a certificate of
21pre-service to do so by his or her employing agency.
22Information gathered to effect such certification shall
23include (i) the person's name, (ii) the date the person was
24hired by his or her current employer, and (iii) the training,
25including dates and levels. Persons engaged in the program
26authorized by this Section before the effective date of this

 

 

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1amendatory Act of 1991 shall be issued a certificate of all
2pre-service and in-service training from his or her employer
3upon submitting the necessary information. The employing
4agency shall be required to retain records of all staff
5pre-service and in-service training, and shall provide such
6records to the Department upon request and upon termination of
7the employer's contract with the Department. In addition, the
8employing agency is responsible for the issuance of
9certifications of in-service training completed to their
10employees.
11    The Department is required to develop a system to ensure
12that persons working as home care aides and personal
13assistants receive increases in their wages when the federal
14minimum wage is increased by requiring vendors to certify that
15they are meeting the federal minimum wage statute for home
16care aides and personal assistants. An employer that cannot
17ensure that the minimum wage increase is being given to home
18care aides and personal assistants shall be denied any
19increase in reimbursement costs.
20    The Community Care Program Advisory Committee is created
21in the Department on Aging. The Director shall appoint
22individuals to serve in the Committee, who shall serve at
23their own expense. Members of the Committee must abide by all
24applicable ethics laws. The Committee shall advise the
25Department on issues related to the Department's program of
26services to prevent unnecessary institutionalization. The

 

 

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1Committee shall meet on a bi-monthly basis and shall serve to
2identify and advise the Department on present and potential
3issues affecting the service delivery network, the program's
4clients, and the Department and to recommend solution
5strategies. Persons appointed to the Committee shall be
6appointed on, but not limited to, their own and their agency's
7experience with the program, geographic representation, and
8willingness to serve. The Director shall appoint members to
9the Committee to represent provider, advocacy, policy
10research, and other constituencies committed to the delivery
11of high quality home and community-based services to older
12adults. Representatives shall be appointed to ensure
13representation from community care providers, including, but
14not limited to, adult day service providers, homemaker
15providers, case coordination and case management units,
16emergency home response providers, statewide trade or labor
17unions that represent home care aides and direct care staff,
18area agencies on aging, adults over age 60, membership
19organizations representing older adults, and other
20organizational entities, providers of care, or individuals
21with demonstrated interest and expertise in the field of home
22and community care as determined by the Director.
23    Nominations may be presented from any agency or State
24association with interest in the program. The Director, or his
25or her designee, shall serve as the permanent co-chair of the
26advisory committee. One other co-chair shall be nominated and

 

 

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1approved by the members of the committee on an annual basis.
2Committee members' terms of appointment shall be for 4 years
3with one-quarter of the appointees' terms expiring each year.
4A member shall continue to serve until his or her replacement
5is named. The Department shall fill vacancies that have a
6remaining term of over one year, and this replacement shall
7occur through the annual replacement of expiring terms. The
8Director shall designate Department staff to provide technical
9assistance and staff support to the committee. Department
10representation shall not constitute membership of the
11committee. All Committee papers, issues, recommendations,
12reports, and meeting memoranda are advisory only. The
13Director, or his or her designee, shall make a written report,
14as requested by the Committee, regarding issues before the
15Committee.
16    The Department on Aging and the Department of Human
17Services shall cooperate in the development and submission of
18an annual report on programs and services provided under this
19Section. Such joint report shall be filed with the Governor
20and the General Assembly on or before March 31 of the following
21fiscal year.
22    The requirement for reporting to the General Assembly
23shall be satisfied by filing copies of the report as required
24by Section 3.1 of the General Assembly Organization Act and
25filing such additional copies with the State Government Report
26Distribution Center for the General Assembly as is required

 

 

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1under paragraph (t) of Section 7 of the State Library Act.
2    Those persons previously found eligible for receiving
3noninstitutional services whose services were discontinued
4under the Emergency Budget Act of Fiscal Year 1992, and who do
5not meet the eligibility standards in effect on or after July
61, 1992, shall remain ineligible on and after July 1, 1992.
7Those persons previously not required to cost-share and who
8were required to cost-share effective March 1, 1992, shall
9continue to meet cost-share requirements on and after July 1,
101992. Beginning July 1, 1992, all clients will be required to
11meet eligibility, cost-share, and other requirements and will
12have services discontinued or altered when they fail to meet
13these requirements.
14    For the purposes of this Section, "flexible senior
15services" refers to services that require one-time or periodic
16expenditures, including, but not limited to, respite care,
17home modification, assistive technology, housing assistance,
18and transportation.
19    The Department shall implement an electronic service
20verification based on global positioning systems or other
21cost-effective technology for the Community Care Program no
22later than January 1, 2014.
23    The Department shall require, as a condition of
24eligibility, application for the medical assistance program
25under Article V of the Illinois Public Aid Code.
26    The Department may authorize Community Care Program

 

 

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1services until an applicant is determined eligible for medical
2assistance under Article V of the Illinois Public Aid Code.
3    The Department shall continue to provide Community Care
4Program reports as required by statute, which shall include an
5annual report on Care Coordination Unit performance and
6adherence to service guidelines and a 6-month supplemental
7report.
8    In regard to community care providers, failure to comply
9with Department on Aging policies shall be cause for
10disciplinary action, including, but not limited to,
11disqualification from serving Community Care Program clients.
12Each provider, upon submission of any bill or invoice to the
13Department for payment for services rendered, shall include a
14notarized statement, under penalty of perjury pursuant to
15Section 1-109 of the Code of Civil Procedure, that the
16provider has complied with all Department policies.
17    The Director of the Department on Aging shall make
18information available to the State Board of Elections as may
19be required by an agreement the State Board of Elections has
20entered into with a multi-state voter registration list
21maintenance system.
22    The Department shall pay an enhanced rate of at least
23$1.77 per unit under the Community Care Program to those
24in-home service provider agencies that offer health insurance
25coverage as a benefit to their direct service worker employees
26pursuant to rules adopted by the Department. The Department

 

 

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1shall review the enhanced rate as part of its process to rebase
2in-home service provider reimbursement rates pursuant to
3federal waiver requirements. Subject to federal approval,
4beginning on January 1, 2024, rates for adult day services
5shall be increased to $16.84 per hour and rates for each way
6transportation services for adult day services shall be
7increased to $12.44 per unit transportation.
8    Subject to federal approval, on and after January 1, 2024,
9rates for homemaker services shall be increased to $28.07 to
10sustain a minimum wage of $17 per hour for direct service
11workers. Rates in subsequent State fiscal years shall be no
12lower than the rates put into effect upon federal approval.
13Providers of in-home services shall be required to certify to
14the Department that they remain in compliance with the
15mandated wage increase for direct service workers. Fringe
16benefits, including, but not limited to, paid time off and
17payment for training, health insurance, travel, or
18transportation, shall not be reduced in relation to the rate
19increases described in this paragraph.
20    Subject to and upon federal approval, on and after January
211, 2025, rates for homemaker services shall be increased to
22$29.63 to sustain a minimum wage of $18 per hour for direct
23service workers. Rates in subsequent State fiscal years shall
24be no lower than the rates put into effect upon federal
25approval. Providers of in-home services shall be required to
26certify to the Department that they remain in compliance with

 

 

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1the mandated wage increase for direct service workers. Fringe
2benefits, including, but not limited to, paid time off and
3payment for training, health insurance, travel, or
4transportation, shall not be reduced in relation to the rate
5increases described in this paragraph.
6    Subject to and upon federal approval, on and after January
71, 2026, rates for homemaker services shall be increased to
8$30.80 to sustain a minimum wage of $18.75 per hour for direct
9service workers. Rates in subsequent State fiscal years shall
10be no lower than the rates put into effect upon federal
11approval. Providers of in-home services shall be required to
12certify to the Department that they remain in compliance with
13the mandated wage increase for direct service workers. Fringe
14benefits, including, but not limited to, paid time off and
15payment for training, health insurance, travel, or
16transportation, shall not be reduced in relation to the rate
17increases described in this paragraph.
18    Subject to federal approval, on and after January 1, 2027,
19rates for in-home services shall be increased to $33.92 to
20sustain a minimum wage of $20.75 per hour for direct service
21workers. Rates in subsequent State fiscal years shall be no
22lower than the rates put into effect upon federal approval. In
23order for a provider of in-home services to be eligible to
24receive the $33.92 rate, the provider must pay a minimum wage
25of $20.75 per hour to all direct service workers employed by
26the provider. Providers of in-home services shall be required

 

 

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1to certify to the Department that they remain in compliance
2with the mandated wage increase for direct service workers. By
3no more than 60 days after issuing notification of the rate
4increase, the Department shall require providers of in-home
5services to submit such certification to the Department in
6order for the provider to be eligible for the $33.92 rate for
7in-home services. The Department shall also require each
8provider of in-home services to submit cost reports to the
9Department consistent with Section 240.2023 of Title 89 of the
10Illinois Administrative Code in order for the provider to be
11eligible for the $33.92 rate for in-home services. Fringe
12benefits, including, but not limited to, paid time off and
13payment for training, health insurance, travel, or
14transportation, shall not be reduced in relation to the rate
15increases described in this paragraph.
16    To ensure that in-home service payment rates are adequate
17to maintain a sufficient direct care workforce to meet the
18needs of Community Care Program beneficiaries and provide
19access to services in the amount, duration, and scope
20specified in beneficiaries' person-centered service plans,
21beginning January 1, 2027, the Department shall ensure that
22each in-home service provider spends a minimum of 79% of the
23total payments the provider receives for home care aide
24services it furnishes under the Community Care Program on
25total compensation for direct service workers who furnish
26those services. The Department shall require each provider

 

 

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1annually to submit a direct service worker cost report
2certifying that the provider has met the minimum spending
3requirement. The report must be based upon actual, documented
4expenditures, attested to by an authorized representative of
5the provider, and submitted within 6 months after the end of
6the reporting period. The Department shall amend current rules
7on financial reporting and minimum direct service worker costs
8at Sections 240.2020 and 240.2040 of Title 89 of the Illinois
9Administrative Code to reflect the increase in the direct
10service worker spending requirement from 77% to 79%.
11    The General Assembly finds it necessary to authorize an
12aggressive Medicaid enrollment initiative designed to maximize
13federal Medicaid funding for the Community Care Program which
14produces significant savings for the State of Illinois. The
15Department on Aging shall establish and implement a Community
16Care Program Medicaid Initiative. Under the Initiative, the
17Department on Aging shall, at a minimum: (i) provide an
18enhanced rate to adequately compensate care coordination units
19to enroll eligible Community Care Program clients into
20Medicaid; (ii) use recommendations from a stakeholder
21committee on how best to implement the Initiative; and (iii)
22establish requirements for State agencies to make enrollment
23in the State's Medical Assistance program easier for seniors.
24    The Community Care Program Medicaid Enrollment Oversight
25Subcommittee is created as a subcommittee of the Older Adult
26Services Advisory Committee established in Section 35 of the

 

 

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1Older Adult Services Act to make recommendations on how best
2to increase the number of medical assistance recipients who
3are enrolled in the Community Care Program. The Subcommittee
4shall consist of all of the following persons who must be
5appointed within 30 days after June 4, 2018 (the effective
6date of Public Act 100-587):
7        (1) The Director of Aging, or his or her designee, who
8    shall serve as the chairperson of the Subcommittee.
9        (2) One representative of the Department of Healthcare
10    and Family Services, appointed by the Director of
11    Healthcare and Family Services.
12        (3) One representative of the Department of Human
13    Services, appointed by the Secretary of Human Services.
14        (4) One individual representing a care coordination
15    unit, appointed by the Director of Aging.
16        (5) One individual from a non-governmental statewide
17    organization that advocates for seniors, appointed by the
18    Director of Aging.
19        (6) One individual representing Area Agencies on
20    Aging, appointed by the Director of Aging.
21        (7) One individual from a statewide association
22    dedicated to Alzheimer's care, support, and research,
23    appointed by the Director of Aging.
24        (8) One individual from an organization that employs
25    persons who provide services under the Community Care
26    Program, appointed by the Director of Aging.

 

 

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1        (9) One member of a trade or labor union representing
2    persons who provide services under the Community Care
3    Program, appointed by the Director of Aging.
4        (10) One member of the Senate, who shall serve as
5    co-chairperson, appointed by the President of the Senate.
6        (11) One member of the Senate, who shall serve as
7    co-chairperson, appointed by the Minority Leader of the
8    Senate.
9        (12) One member of the House of Representatives, who
10    shall serve as co-chairperson, appointed by the Speaker of
11    the House of Representatives.
12        (13) One member of the House of Representatives, who
13    shall serve as co-chairperson, appointed by the Minority
14    Leader of the House of Representatives.
15        (14) One individual appointed by a labor organization
16    representing frontline employees at the Department of
17    Human Services.
18    The Subcommittee shall provide oversight to the Community
19Care Program Medicaid Initiative and shall meet quarterly. At
20each Subcommittee meeting the Department on Aging shall
21provide the following data sets to the Subcommittee: (A) the
22number of Illinois residents, categorized by planning and
23service area, who are receiving services under the Community
24Care Program and are enrolled in the State's Medical
25Assistance Program; (B) the number of Illinois residents,
26categorized by planning and service area, who are receiving

 

 

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1services under the Community Care Program, but are not
2enrolled in the State's Medical Assistance Program; and (C)
3the number of Illinois residents, categorized by planning and
4service area, who are receiving services under the Community
5Care Program and are eligible for benefits under the State's
6Medical Assistance Program, but are not enrolled in the
7State's Medical Assistance Program. In addition to this data,
8the Department on Aging shall provide the Subcommittee with
9plans on how the Department on Aging will reduce the number of
10Illinois residents who are not enrolled in the State's Medical
11Assistance Program but who are eligible for medical assistance
12benefits. The Department on Aging shall enroll in the State's
13Medical Assistance Program those Illinois residents who
14receive services under the Community Care Program and are
15eligible for medical assistance benefits but are not enrolled
16in the State's Medicaid Assistance Program. The data provided
17to the Subcommittee shall be made available to the public via
18the Department on Aging's website.
19    The Department on Aging, with the involvement of the
20Subcommittee, shall collaborate with the Department of Human
21Services and the Department of Healthcare and Family Services
22on how best to achieve the responsibilities of the Community
23Care Program Medicaid Initiative.
24    The Department on Aging, the Department of Human Services,
25and the Department of Healthcare and Family Services shall
26coordinate and implement a streamlined process for seniors to

 

 

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1access benefits under the State's Medical Assistance Program.
2    The Subcommittee shall collaborate with the Department of
3Human Services on the adoption of a uniform application
4submission process. The Department of Human Services and any
5other State agency involved with processing the medical
6assistance application of any person enrolled in the Community
7Care Program shall include the appropriate care coordination
8unit in all communications related to the determination or
9status of the application.
10    The Community Care Program Medicaid Initiative shall
11provide targeted funding to care coordination units to help
12seniors complete their applications for medical assistance
13benefits. On and after July 1, 2019, care coordination units
14shall receive no less than $200 per completed application,
15which rate may be included in a bundled rate for initial intake
16services when Medicaid application assistance is provided in
17conjunction with the initial intake process for new program
18participants.
19    The Community Care Program Medicaid Initiative shall cease
20operation 5 years after June 4, 2018 (the effective date of
21Public Act 100-587), after which the Subcommittee shall
22dissolve.
23    Effective July 1, 2023, subject to federal approval, the
24Department on Aging shall reimburse Care Coordination Units at
25the following rates for case management services: $252.40 for
26each initial assessment; $366.40 for each initial assessment

 

 

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1with translation; $229.68 for each redetermination assessment;
2$313.68 for each redetermination assessment with translation;
3$200.00 for each completed application for medical assistance
4benefits; $132.26 for each face-to-face, choices-for-care
5screening; $168.26 for each face-to-face, choices-for-care
6screening with translation; $124.56 for each 6-month,
7face-to-face visit; $132.00 for each MCO participant
8eligibility determination; and $157.00 for each MCO
9participant eligibility determination with translation.
10(Source: P.A. 103-8, eff. 6-7-23; 103-102, Article 45, Section
1145-5, eff. 1-1-24; 103-102, Article 85, Section 85-5, eff.
121-1-24; 103-102, Article 90, Section 90-5, eff. 1-1-24;
13103-588, eff. 6-5-24; 103-605, eff. 7-1-24; 103-670, eff.
141-1-25; 104-2, eff. 6-16-25; 104-417, eff. 8-15-25.)