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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| include, but are not limited to, any or all of the following:
|
2 |
| (a) home health services;
|
3 |
| (b) home nursing services;
|
4 |
| (c) home care aide services;
|
5 |
| (d) chore and housekeeping services;
|
6 |
| (e) adult day services;
|
7 |
| (f) home-delivered meals;
|
8 |
| (g) education in self-care;
|
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| (h) personal care services;
|
10 |
| (i) adult day health services;
|
11 |
| (j) habilitation services;
|
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| (k) respite care;
|
13 |
| (k-5) community reintegration services;
|
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| (l) other nonmedical social services that may enable |
15 |
| the person
to become self-supporting; or
|
16 |
| (m) clearinghouse for information provided by senior |
17 |
| citizen home owners
who want to rent rooms to or share |
18 |
| living space with other senior citizens.
|
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| The Department shall establish eligibility standards for |
20 |
| such
services taking into consideration the unique economic and |
21 |
| social needs
of the target population for whom they are to be |
22 |
| provided. Such eligibility
standards shall be based on the |
23 |
| recipient's ability to pay for services;
provided, however, |
24 |
| that in determining the amount and nature of services
for which |
25 |
| a person may qualify, consideration shall not be given to the
|
26 |
| value of cash, property or other assets held in the name of the |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| person's
spouse pursuant to a written agreement dividing |
2 |
| marital property into equal
but separate shares or pursuant to |
3 |
| a transfer of the person's interest in a
home to his spouse, |
4 |
| provided that the spouse's share of the marital
property is not |
5 |
| made available to the person seeking such services.
|
6 |
| Beginning July 1, 2002, the Department shall require as a |
7 |
| condition of
eligibility that all financially eligible |
8 |
| applicants and recipients apply
for medical assistance
under |
9 |
| Article V of the Illinois Public Aid Code in accordance with |
10 |
| rules
promulgated by the Department.
|
11 |
| The Department shall, in conjunction with the Department of |
12 |
| Public Aid (now Department of Healthcare and Family Services),
|
13 |
| seek appropriate amendments under Sections 1915 and 1924 of the |
14 |
| Social
Security Act. The purpose of the amendments shall be to |
15 |
| extend eligibility
for home and community based services under |
16 |
| Sections 1915 and 1924 of the
Social Security Act to persons |
17 |
| who transfer to or for the benefit of a
spouse those amounts of |
18 |
| income and resources allowed under Section 1924 of
the Social |
19 |
| Security Act. Subject to the approval of such amendments, the
|
20 |
| Department shall extend the provisions of Section 5-4 of the |
21 |
| Illinois
Public Aid Code to persons who, but for the provision |
22 |
| of home or
community-based services, would require the level of |
23 |
| care provided in an
institution, as is provided for in federal |
24 |
| law. Those persons no longer
found to be eligible for receiving |
25 |
| noninstitutional services due to changes
in the eligibility |
26 |
| criteria shall be given 60 days notice prior to actual
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| termination. Those persons receiving notice of termination may |
2 |
| contact the
Department and request the determination be |
3 |
| appealed at any time during the
60 day notice period. With the |
4 |
| exception of the lengthened notice and time
frame for the |
5 |
| appeal request, the appeal process shall follow the normal
|
6 |
| procedure. In addition, each person affected regardless of the
|
7 |
| circumstances for discontinued eligibility shall be given |
8 |
| notice and the
opportunity to purchase the necessary services |
9 |
| through the Community Care
Program. If the individual does not |
10 |
| elect to purchase services, the
Department shall advise the |
11 |
| individual of alternative services. The target
population |
12 |
| identified for the purposes of this Section are persons age 60
|
13 |
| and older with an identified service need. Priority shall be |
14 |
| given to those
who are at imminent risk of |
15 |
| institutionalization. The services shall be
provided to |
16 |
| eligible persons age 60 and older to the extent that the cost
|
17 |
| of the services together with the other personal maintenance
|
18 |
| expenses of the persons are reasonably related to the standards
|
19 |
| established for care in a group facility appropriate to the |
20 |
| person's
condition. These non-institutional services, pilot |
21 |
| projects or
experimental facilities may be provided as part of |
22 |
| or in addition to
those authorized by federal law or those |
23 |
| funded and administered by the
Department of Human Services. |
24 |
| The Departments of Human Services, Healthcare and Family |
25 |
| Services,
Public Health, Veterans' Affairs, and Commerce and |
26 |
| Economic Opportunity and
other appropriate agencies of State, |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| federal and local governments shall
cooperate with the |
2 |
| Department on Aging in the establishment and development
of the |
3 |
| non-institutional services. The Department shall require an |
4 |
| annual
audit from all chore/housekeeping and home care aide |
5 |
| vendors contracting with
the Department under this Section. The |
6 |
| annual audit shall assure that each
audited vendor's procedures |
7 |
| are in compliance with Department's financial
reporting |
8 |
| guidelines requiring an administrative and employee wage and |
9 |
| benefits cost split as defined in administrative rules. The |
10 |
| audit is a public record under
the Freedom of Information Act. |
11 |
| The Department shall execute, relative to
the nursing home |
12 |
| prescreening project, written inter-agency
agreements with the |
13 |
| Department of Human Services and the Department
of Healthcare |
14 |
| and Family Services, to effect the following: (1) intake |
15 |
| procedures and common
eligibility criteria for those persons |
16 |
| who are receiving non-institutional
services; and (2) the |
17 |
| establishment and development of non-institutional
services in |
18 |
| areas of the State where they are not currently available or |
19 |
| are
undeveloped. On and after July 1, 1996, all nursing home |
20 |
| prescreenings for
individuals 60 years of age or older shall be |
21 |
| conducted by the Department.
|
22 |
| As part of the Department on Aging's routine training of |
23 |
| care coordinators and care coordinator supervisors case |
24 |
| managers and case manager supervisors , the Department may |
25 |
| include information on family futures planning for persons who |
26 |
| are age 60 or older and who are caregivers of their adult |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| children with developmental disabilities. The content of the |
2 |
| training shall be at the Department's discretion. |
3 |
| The Department's case management program shall be a fully |
4 |
| integrated care coordination program. The care coordination |
5 |
| program shall incorporate the concepts of client direction and |
6 |
| consumer focus and shall take into account the client's needs |
7 |
| and preferences. Comprehensive care coordination shall include |
8 |
| activities such as: (1) comprehensive assessment of the client; |
9 |
| (2) development and implementation of a service plan with the |
10 |
| client to mobilize the formal and informal resources and |
11 |
| services identified in the assessment to meet the needs of the |
12 |
| client, including coordination of the resources and services |
13 |
| with (A) any other plans that exist for various formal |
14 |
| services, such as hospital discharge plans, and (B) the |
15 |
| information and assistance services; (3) coordination and |
16 |
| monitoring of formal service delivery and monitoring of |
17 |
| informal service delivery, regardless of the funding source, to |
18 |
| ensure that services specified in the plan are being provided; |
19 |
| (4) assistance with the completion of applications for |
20 |
| services, referrals to non-government funded services, health |
21 |
| promotion, and ensuring continuity of care across care |
22 |
| settings; (5) periodic reassessment and revision of the |
23 |
| client's care plan, if necessary, to reflect any changes in the |
24 |
| client's needs; and (6) in accordance with the wishes of the |
25 |
| client, advocacy on behalf of the client for needed services or |
26 |
| resources. |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| A comprehensive assessment shall be performed, using a |
2 |
| holistic tool identified by the Department and supported by an |
3 |
| electronic intake assessment and care planning system linked to |
4 |
| a central location. The comprehensive assessment process shall |
5 |
| include a face to face interview in the client's home or |
6 |
| temporary overnight abode and shall determine the level of |
7 |
| physical, functional, cognitive, psycho-social, financial, and |
8 |
| social needs of the client. Assessment interviews shall |
9 |
| accommodate the scheduling needs of the client and the client's |
10 |
| representative or representatives, who shall participate at |
11 |
| the discretion of the client. The Department shall provide |
12 |
| guidelines for determining the conditions under which a |
13 |
| comprehensive assessment shall be performed and the activities |
14 |
| of care coordination offered to each care recipient. The care |
15 |
| plan shall include the needs identified by the assessment and |
16 |
| incorporate the goals and preferences of the client. Care plans |
17 |
| shall also include all services needed by the client regardless |
18 |
| of the funding source and delineate between services provided, |
19 |
| services unavailable, and services refused by the client. Case |
20 |
| coordination units shall be reimbursed for care coordination in |
21 |
| a manner reflective of the actual cost of providing care |
22 |
| coordination. By July 1, 2009, the Department shall develop a |
23 |
| rate structure, after collection and review of information from |
24 |
| case coordination units and advocates for care recipients, |
25 |
| regarding the activities of coordination provided. The |
26 |
| Department shall reevaluate the rate structure every other year |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| thereafter. |
2 |
| The Department is authorized to establish a system of |
3 |
| recipient copayment
for services provided under this Section, |
4 |
| such copayment to be based upon
the recipient's ability to pay |
5 |
| but in no case to exceed the actual cost of
the services |
6 |
| provided. Additionally, any portion of a person's income which
|
7 |
| is equal to or less than the federal poverty standard shall not |
8 |
| be
considered by the Department in determining the copayment. |
9 |
| The level of
such copayment shall be adjusted whenever |
10 |
| necessary to reflect any change
in the officially designated |
11 |
| federal poverty standard.
|
12 |
| The Department, or the Department's authorized |
13 |
| representative, shall
recover the amount of moneys expended for |
14 |
| services provided to or in
behalf of a person under this |
15 |
| Section by a claim against the person's
estate or against the |
16 |
| estate of the person's surviving spouse, but no
recovery may be |
17 |
| had until after the death of the surviving spouse, if
any, and |
18 |
| then only at such time when there is no surviving child who
is |
19 |
| under age 21, blind, or permanently and totally disabled. This
|
20 |
| paragraph, however, shall not bar recovery, at the death of the |
21 |
| person, of
moneys for services provided to the person or in |
22 |
| behalf of the person under
this Section to which the person was |
23 |
| not entitled;
provided that such recovery shall not be enforced |
24 |
| against any real estate while
it is occupied as a homestead by |
25 |
| the surviving spouse or other dependent, if no
claims by other |
26 |
| creditors have been filed against the estate, or, if such
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| claims have been filed, they remain dormant for failure of |
2 |
| prosecution or
failure of the claimant to compel administration |
3 |
| of the estate for the purpose
of payment. This paragraph shall |
4 |
| not bar recovery from the estate of a spouse,
under Sections |
5 |
| 1915 and 1924 of the Social Security Act and Section 5-4 of the
|
6 |
| Illinois Public Aid Code, who precedes a person receiving |
7 |
| services under this
Section in death. All moneys for services
|
8 |
| paid to or in behalf of the person under this Section shall be |
9 |
| claimed for
recovery from the deceased spouse's estate. |
10 |
| "Homestead", as used
in this paragraph, means the dwelling |
11 |
| house and
contiguous real estate occupied by a surviving spouse
|
12 |
| or relative, as defined by the rules and regulations of the |
13 |
| Department of Healthcare and Family Services, regardless of the |
14 |
| value of the property.
|
15 |
| The Department shall develop procedures to enhance |
16 |
| availability of
services on evenings, weekends, and on an |
17 |
| emergency basis to meet the
respite needs of caregivers. |
18 |
| Procedures shall be developed to permit the
utilization of |
19 |
| services in successive blocks of 24 hours up to the monthly
|
20 |
| maximum established by the Department. Workers providing these |
21 |
| services
shall be appropriately trained.
|
22 |
| Beginning on the effective date of this Amendatory Act of |
23 |
| 1991, no person
may perform chore/housekeeping and home care |
24 |
| aide services under a program
authorized by this Section unless |
25 |
| that person has been issued a certificate
of pre-service to do |
26 |
| so by his or her employing agency. Information
gathered to |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| effect such certification shall include (i) the person's name,
|
2 |
| (ii) the date the person was hired by his or her current |
3 |
| employer, and
(iii) the training, including dates and levels. |
4 |
| Persons engaged in the
program authorized by this Section |
5 |
| before the effective date of this
amendatory Act of 1991 shall |
6 |
| be issued a certificate of all pre- and
in-service training |
7 |
| from his or her employer upon submitting the necessary
|
8 |
| information. The employing agency shall be required to retain |
9 |
| records of
all staff pre- and in-service training, and shall |
10 |
| provide such records to
the Department upon request and upon |
11 |
| termination of the employer's contract
with the Department. In |
12 |
| addition, the employing agency is responsible for
the issuance |
13 |
| of certifications of in-service training completed to their
|
14 |
| employees.
|
15 |
| The Department is required to develop a system to ensure |
16 |
| that persons
working as home care aides and chore housekeepers |
17 |
| receive increases in their
wages when the federal minimum wage |
18 |
| is increased by requiring vendors to
certify that they are |
19 |
| meeting the federal minimum wage statute for home care aides
|
20 |
| and chore housekeepers. An employer that cannot ensure that the |
21 |
| minimum
wage increase is being given to home care aides and |
22 |
| chore housekeepers
shall be denied any increase in |
23 |
| reimbursement costs.
|
24 |
| The Community Care Program Advisory Committee is created in |
25 |
| the Department on Aging. The Director shall appoint individuals |
26 |
| to serve in the Committee, who shall serve at their own |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| expense. Members of the Committee must abide by all applicable |
2 |
| ethics laws. The Committee shall advise the Department on |
3 |
| issues related to the Department's program of services to |
4 |
| prevent unnecessary institutionalization. The Committee shall |
5 |
| meet on a bi-monthly basis and shall serve to identify and |
6 |
| advise the Department on present and potential issues affecting |
7 |
| the service delivery network, the program's clients, and the |
8 |
| Department and to recommend solution strategies. Persons |
9 |
| appointed to the Committee shall be appointed on, but not |
10 |
| limited to, their own and their agency's experience with the |
11 |
| program, geographic representation, and willingness to serve. |
12 |
| The Director shall appoint members to the Committee to |
13 |
| represent provider, advocacy, policy research, and other |
14 |
| constituencies committed to the delivery of high quality home |
15 |
| and community-based services to older adults. Representatives |
16 |
| shall be appointed to ensure representation from community care |
17 |
| providers including, but not limited to, adult day service |
18 |
| providers, homemaker providers, case coordination and case |
19 |
| management units, emergency home response providers, statewide |
20 |
| trade or labor unions that represent home care
homecare aides |
21 |
| and direct care staff, area agencies on aging, adults over age |
22 |
| 60, membership organizations representing older adults, and |
23 |
| other organizational entities, providers of care, or |
24 |
| individuals with demonstrated interest and expertise in the |
25 |
| field of home and community care as determined by the Director. |
26 |
| Nominations may be presented from any agency or State |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| association with interest in the program. The Director, or his |
2 |
| or her designee, shall serve as the permanent co-chair of the |
3 |
| advisory committee. One other co-chair shall be nominated and |
4 |
| approved by the members of the committee on an annual basis. |
5 |
| Committee members' terms of appointment shall be for 4 years |
6 |
| with one-quarter of the appointees' terms expiring each year. A |
7 |
| member shall continue to serve until his or her replacement is |
8 |
| named. The Department shall fill vacancies that have a |
9 |
| remaining term of over one year, and this replacement shall |
10 |
| occur through the annual replacement of expiring terms. The |
11 |
| Director shall designate Department staff to provide technical |
12 |
| assistance and staff support to the committee. Department |
13 |
| representation shall not constitute membership of the |
14 |
| committee. All Committee papers, issues, recommendations, |
15 |
| reports, and meeting memoranda are advisory only. The Director, |
16 |
| or his or her designee, shall make a written report, as |
17 |
| requested by the Committee, regarding issues before the |
18 |
| Committee.
|
19 |
| The Department on Aging and the Department of Human |
20 |
| Services
shall cooperate in the development and submission of |
21 |
| an annual report on
programs and services provided under this |
22 |
| Section. Such joint report
shall be filed with the Governor and |
23 |
| the General Assembly on or before
September 30 each year.
|
24 |
| The requirement for reporting to the General Assembly shall |
25 |
| be satisfied
by filing copies of the report with the Speaker, |
26 |
| the Minority Leader and
the Clerk of the House of |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| Representatives and the President, the Minority
Leader and the |
2 |
| Secretary of the Senate and the Legislative Research Unit,
as |
3 |
| required by Section 3.1 of the General Assembly Organization |
4 |
| Act and
filing such additional copies with the State Government |
5 |
| Report Distribution
Center for the General Assembly as is |
6 |
| required under paragraph (t) of
Section 7 of the State Library |
7 |
| Act.
|
8 |
| Those persons previously found eligible for receiving |
9 |
| non-institutional
services whose services were discontinued |
10 |
| under the Emergency Budget Act of
Fiscal Year 1992, and who do |
11 |
| not meet the eligibility standards in effect
on or after July |
12 |
| 1, 1992, shall remain ineligible on and after July 1,
1992. |
13 |
| Those persons previously not required to cost-share and who |
14 |
| were
required to cost-share effective March 1, 1992, shall |
15 |
| continue to meet
cost-share requirements on and after July 1, |
16 |
| 1992. Beginning July 1, 1992,
all clients will be required to |
17 |
| meet
eligibility, cost-share, and other requirements and will |
18 |
| have services
discontinued or altered when they fail to meet |
19 |
| these requirements.
|
20 |
| Notwithstanding any other rulemaking authority that may |
21 |
| exist, neither the Governor nor any agency or agency head under |
22 |
| the jurisdiction of the Governor has any authority to make or |
23 |
| promulgate rules to implement or enforce the provisions of this |
24 |
| amendatory Act of the 95th General Assembly. If, however, the |
25 |
| Governor believes that rules are necessary to implement or |
26 |
| enforce the provisions of this amendatory Act of the 95th |
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| General Assembly, the Governor may suggest rules to the General |
2 |
| Assembly by filing them with the Clerk of the House and |
3 |
| Secretary of the Senate and by requesting that the General |
4 |
| Assembly authorize such rulemaking by law, enact those |
5 |
| suggested rules into law, or take any other appropriate action |
6 |
| in the General Assembly's discretion. Nothing contained in this |
7 |
| amendatory Act of the 95th General Assembly shall be |
8 |
| interpreted to grant rulemaking authority under any other |
9 |
| Illinois statute where such authority is not otherwise |
10 |
| explicitly given. For the purposes of this amendatory Act of |
11 |
| the 95th General Assembly, "rules" is given the meaning |
12 |
| contained in Section 1-70 of the Illinois Administrative |
13 |
| Procedure Act, and "agency" and "agency head" are given the |
14 |
| meanings contained in Sections 1-20 and 1-25 of the Illinois |
15 |
| Administrative Procedure Act to the extent that such |
16 |
| definitions apply to agencies or agency heads under the |
17 |
| jurisdiction of the Governor. |
18 |
| (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, |
19 |
| eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; |
20 |
| 95-473, eff. 8-27-07; revised 10-30-07.)
|
21 |
| (Text of Section after amendment by P.A. 95-565 ) |
22 |
| Sec. 4.02. Community Care Program. The Department shall |
23 |
| establish a program of services to
prevent unnecessary |
24 |
| institutionalization of persons age 60 and older in
need of |
25 |
| long term care or who are established as persons who suffer |
|
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| from
Alzheimer's disease or a related disorder under the |
2 |
| Alzheimer's Disease
Assistance Act, thereby enabling them
to |
3 |
| remain in their own homes or in other living arrangements. Such
|
4 |
| preventive services, which may be coordinated with other |
5 |
| programs for the
aged and monitored by area agencies on aging |
6 |
| in cooperation with the
Department, may include, but are not |
7 |
| limited to, any or all of the following:
|
8 |
| (a) (blank);
|
9 |
| (b) (blank);
|
10 |
| (c) home care aide services;
|
11 |
| (d) personal assistant services;
|
12 |
| (e) adult day services;
|
13 |
| (f) home-delivered meals;
|
14 |
| (g) education in self-care;
|
15 |
| (h) personal care services;
|
16 |
| (i) adult day health services;
|
17 |
| (j) habilitation services;
|
18 |
| (k) respite care;
|
19 |
| (k-5) community reintegration services;
|
20 |
| (k-6) flexible senior services; |
21 |
| (k-7) medication management; |
22 |
| (k-8) emergency home response;
|
23 |
| (l) other nonmedical social services that may enable |
24 |
| the person
to become self-supporting; or
|
25 |
| (m) clearinghouse for information provided by senior |
26 |
| citizen home owners
who want to rent rooms to or share |
|
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09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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| living space with other senior citizens.
|
2 |
| The Department shall establish eligibility standards for |
3 |
| such
services taking into consideration the unique economic and |
4 |
| social needs
of the target population for whom they are to be |
5 |
| provided. Such eligibility
standards shall be based on the |
6 |
| recipient's ability to pay for services;
provided, however, |
7 |
| that in determining the amount and nature of services
for which |
8 |
| a person may qualify, consideration shall not be given to the
|
9 |
| value of cash, property or other assets held in the name of the |
10 |
| person's
spouse pursuant to a written agreement dividing |
11 |
| marital property into equal
but separate shares or pursuant to |
12 |
| a transfer of the person's interest in a
home to his spouse, |
13 |
| provided that the spouse's share of the marital
property is not |
14 |
| made available to the person seeking such services.
|
15 |
| Beginning July 1, 2002, the Department shall require as a |
16 |
| condition of
eligibility that all financially eligible |
17 |
| applicants apply
for medical assistance
under Article V of the |
18 |
| Illinois Public Aid Code in accordance with rules
promulgated |
19 |
| by the Department.
|
20 |
| Beginning January 1, 2008, the Department shall require as |
21 |
| a condition of eligibility that all new financially eligible |
22 |
| applicants apply for and enroll in medical assistance under |
23 |
| Article V of the Illinois Public Aid Code in accordance with |
24 |
| rules promulgated by the Department.
|
25 |
| The Department shall, in conjunction with the Department of |
26 |
| Public Aid (now Department of Healthcare and Family Services),
|
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| seek appropriate amendments under Sections 1915 and 1924 of the |
2 |
| Social
Security Act. The purpose of the amendments shall be to |
3 |
| extend eligibility
for home and community based services under |
4 |
| Sections 1915 and 1924 of the
Social Security Act to persons |
5 |
| who transfer to or for the benefit of a
spouse those amounts of |
6 |
| income and resources allowed under Section 1924 of
the Social |
7 |
| Security Act. Subject to the approval of such amendments, the
|
8 |
| Department shall extend the provisions of Section 5-4 of the |
9 |
| Illinois
Public Aid Code to persons who, but for the provision |
10 |
| of home or
community-based services, would require the level of |
11 |
| care provided in an
institution, as is provided for in federal |
12 |
| law. Those persons no longer
found to be eligible for receiving |
13 |
| noninstitutional services due to changes
in the eligibility |
14 |
| criteria shall be given 60 days notice prior to actual
|
15 |
| termination. Those persons receiving notice of termination may |
16 |
| contact the
Department and request the determination be |
17 |
| appealed at any time during the
60 day notice period. With the |
18 |
| exception of the lengthened notice and time
frame for the |
19 |
| appeal request, the appeal process shall follow the normal
|
20 |
| procedure. In addition, each person affected regardless of the
|
21 |
| circumstances for discontinued eligibility shall be given |
22 |
| notice and the
opportunity to purchase the necessary services |
23 |
| through the Community Care
Program. If the individual does not |
24 |
| elect to purchase services, the
Department shall advise the |
25 |
| individual of alternative services. The target
population |
26 |
| identified for the purposes of this Section are persons age 60
|
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| and older with an identified service need. Priority shall be |
2 |
| given to those
who are at imminent risk of |
3 |
| institutionalization. The services shall be
provided to |
4 |
| eligible persons age 60 and older to the extent that the cost
|
5 |
| of the services together with the other personal maintenance
|
6 |
| expenses of the persons are reasonably related to the standards
|
7 |
| established for care in a group facility appropriate to the |
8 |
| person's
condition. These non-institutional services, pilot |
9 |
| projects or
experimental facilities may be provided as part of |
10 |
| or in addition to
those authorized by federal law or those |
11 |
| funded and administered by the
Department of Human Services. |
12 |
| The Departments of Human Services, Healthcare and Family |
13 |
| Services,
Public Health, Veterans' Affairs, and Commerce and |
14 |
| Economic Opportunity and
other appropriate agencies of State, |
15 |
| federal and local governments shall
cooperate with the |
16 |
| Department on Aging in the establishment and development
of the |
17 |
| non-institutional services. The Department shall require an |
18 |
| annual
audit from all
chore/housekeeping and home care aide |
19 |
| vendors contracting with
the Department under this Section. The |
20 |
| annual audit shall assure that each
audited vendor's procedures |
21 |
| are in compliance with Department's financial
reporting |
22 |
| guidelines requiring an administrative and employee wage and |
23 |
| benefits cost split as defined in administrative rules. The |
24 |
| audit is a public record under
the Freedom of Information Act. |
25 |
| The Department shall execute, relative to
the nursing home |
26 |
| prescreening project, written inter-agency
agreements with the |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| Department of Human Services and the Department
of Healthcare |
2 |
| and Family Services, to effect the following: (1) intake |
3 |
| procedures and common
eligibility criteria for those persons |
4 |
| who are receiving non-institutional
services; and (2) the |
5 |
| establishment and development of non-institutional
services in |
6 |
| areas of the State where they are not currently available or |
7 |
| are
undeveloped. On and after July 1, 1996, all nursing home |
8 |
| prescreenings for
individuals 60 years of age or older shall be |
9 |
| conducted by the Department.
|
10 |
| As part of the Department on Aging's routine training of |
11 |
| care coordinators and care coordinator supervisors case |
12 |
| managers and case manager supervisors , the Department may |
13 |
| include information on family futures planning for persons who |
14 |
| are age 60 or older and who are caregivers of their adult |
15 |
| children with developmental disabilities. The content of the |
16 |
| training shall be at the Department's discretion. |
17 |
| The Department's case management program shall be a fully |
18 |
| integrated care coordination program. The care coordination |
19 |
| program shall incorporate the concepts of client direction and |
20 |
| consumer focus and shall take into account the client's needs |
21 |
| and preferences. Comprehensive care coordination shall include |
22 |
| activities such as: (1) comprehensive assessment of the client; |
23 |
| (2) development and implementation of a service plan with the |
24 |
| client to mobilize the formal and informal resources and |
25 |
| services identified in the assessment to meet the needs of the |
26 |
| client, including coordination of the resources and services |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| with (A) any other plans that exist for various formal |
2 |
| services, such as hospital discharge plans, and (B) the |
3 |
| information and assistance services; (3) coordination and |
4 |
| monitoring of formal service delivery and monitoring of |
5 |
| informal service delivery, regardless of the funding source, to |
6 |
| ensure that services specified in the plan are being provided; |
7 |
| (4) assistance with the completion of applications for |
8 |
| services, referrals to non-government funded services, health |
9 |
| promotion, and ensuring continuity of care across care |
10 |
| settings; (5) periodic reassessment and revision of the |
11 |
| client's care plan, if necessary, to reflect any changes in the |
12 |
| client's needs; and (6) in accordance with the wishes of the |
13 |
| client, advocacy on behalf of the client for needed services or |
14 |
| resources. |
15 |
| A comprehensive assessment shall be performed, using a |
16 |
| holistic tool identified by the Department and supported by an |
17 |
| electronic intake assessment and care planning system linked to |
18 |
| a central location. The comprehensive assessment process shall |
19 |
| include a face to face interview in the client's home or |
20 |
| temporary overnight abode and shall determine the level of |
21 |
| physical, functional, cognitive, psycho-social, financial, and |
22 |
| social needs of the client. Assessment interviews shall |
23 |
| accommodate the scheduling needs of the client and the client's |
24 |
| representative or representatives, who shall participate at |
25 |
| the discretion of the client. The Department shall provide |
26 |
| guidelines for determining the conditions under which a |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| comprehensive assessment shall be performed and the activities |
2 |
| of care coordination offered to each care recipient. The care |
3 |
| plan shall include the needs identified by the assessment and |
4 |
| incorporate the goals and preferences of the client. Care plans |
5 |
| shall also include all services needed by the client regardless |
6 |
| of the funding source and delineate between services provided, |
7 |
| services unavailable, and services refused by the client. Case |
8 |
| coordination units shall be reimbursed for care coordination in |
9 |
| a manner reflective of the actual cost of providing care |
10 |
| coordination. By July 1, 2009, the Department shall develop a |
11 |
| rate structure, after collection and review of information from |
12 |
| case coordination units and advocates for care recipients, |
13 |
| regarding the activities of coordination provided. The |
14 |
| Department shall reevaluate the rate structure every other year |
15 |
| thereafter. |
16 |
| The Department is authorized to establish a system of |
17 |
| recipient copayment
for services provided under this Section, |
18 |
| such copayment to be based upon
the recipient's ability to pay |
19 |
| but in no case to exceed the actual cost of
the services |
20 |
| provided. Additionally, any portion of a person's income which
|
21 |
| is equal to or less than the federal poverty standard shall not |
22 |
| be
considered by the Department in determining the copayment. |
23 |
| The level of
such copayment shall be adjusted whenever |
24 |
| necessary to reflect any change
in the officially designated |
25 |
| federal poverty standard.
|
26 |
| The Department, or the Department's authorized |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| representative, shall
recover the amount of moneys expended for |
2 |
| services provided to or in
behalf of a person under this |
3 |
| Section by a claim against the person's
estate or against the |
4 |
| estate of the person's surviving spouse, but no
recovery may be |
5 |
| had until after the death of the surviving spouse, if
any, and |
6 |
| then only at such time when there is no surviving child who
is |
7 |
| under age 21, blind, or permanently and totally disabled. This
|
8 |
| paragraph, however, shall not bar recovery, at the death of the |
9 |
| person, of
moneys for services provided to the person or in |
10 |
| behalf of the person under
this Section to which the person was |
11 |
| not entitled;
provided that such recovery shall not be enforced |
12 |
| against any real estate while
it is occupied as a homestead by |
13 |
| the surviving spouse or other dependent, if no
claims by other |
14 |
| creditors have been filed against the estate, or, if such
|
15 |
| claims have been filed, they remain dormant for failure of |
16 |
| prosecution or
failure of the claimant to compel administration |
17 |
| of the estate for the purpose
of payment. This paragraph shall |
18 |
| not bar recovery from the estate of a spouse,
under Sections |
19 |
| 1915 and 1924 of the Social Security Act and Section 5-4 of the
|
20 |
| Illinois Public Aid Code, who precedes a person receiving |
21 |
| services under this
Section in death. All moneys for services
|
22 |
| paid to or in behalf of the person under this Section shall be |
23 |
| claimed for
recovery from the deceased spouse's estate. |
24 |
| "Homestead", as used
in this paragraph, means the dwelling |
25 |
| house and
contiguous real estate occupied by a surviving spouse
|
26 |
| or relative, as defined by the rules and regulations of the |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| Department of Healthcare and Family Services, regardless of the |
2 |
| value of the property.
|
3 |
| The Department shall increase the effectiveness of the |
4 |
| existing Community Care Program by: |
5 |
| (1) ensuring that in-home services included in the care |
6 |
| plan are available on evenings and weekends; |
7 |
| (2) ensuring that care plans contain the services that |
8 |
| eligible participants
participants' need based on the |
9 |
| number of days in a month, not limited to specific blocks |
10 |
| of time, as identified by the comprehensive assessment tool |
11 |
| selected by the Department for use statewide, not to exceed |
12 |
| the total monthly service cost maximum allowed for each |
13 |
| service ; the . The Department shall develop administrative |
14 |
| rules to implement this item (2); |
15 |
| (3) ensuring that the participants have the right to |
16 |
| choose the services contained in their care plan and to |
17 |
| direct how those services are provided, based on |
18 |
| administrative rules established by the Department; |
19 |
| (4) ensuring that the determination of need tool is |
20 |
| accurate in determining the participants' level of need; to |
21 |
| achieve this, the Department, in conjunction with the Older |
22 |
| Adult Services Advisory Committee, shall institute a study |
23 |
| of the relationship between the Determination of Need |
24 |
| scores, level of need, service cost maximums , and the |
25 |
| development and utilization of service plans no later than |
26 |
| May 1, 2008; findings and recommendations shall be |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| presented to the Governor and the General Assembly no later |
2 |
| than January 1, 2009; recommendations shall include all |
3 |
| needed changes to the service cost maximums schedule and |
4 |
| additional covered services; |
5 |
| (5) ensuring that homemakers can provide personal care |
6 |
| services that may or may not involve contact with clients, |
7 |
| including but not limited to: |
8 |
| (A) bathing; |
9 |
| (B) grooming; |
10 |
| (C) toileting; |
11 |
| (D) nail care; |
12 |
| (E) transferring; |
13 |
| (F) respiratory services; |
14 |
| (G) exercise; or |
15 |
| (H) positioning; |
16 |
| (6) ensuring that homemaker program vendors are not |
17 |
| restricted from hiring homemakers who are family members of |
18 |
| clients or recommended by clients; the Department may not, |
19 |
| by rule or policy, require homemakers who are family |
20 |
| members of clients or recommended by clients to accept |
21 |
| assignments in homes other than the client; and |
22 |
| (7) ensuring that the State may access maximum federal |
23 |
| matching funds by seeking approval for the Centers for |
24 |
| Medicare and Medicaid Services for modifications to the |
25 |
| State's home and community based services waiver and |
26 |
| additional waiver opportunities in order to maximize |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| federal matching funds; this shall include, but not be |
2 |
| limited to, modification that reflects all changes in the |
3 |
| Community Care Program services and all increases in the |
4 |
| services cost maximum. |
5 |
| By January 1, 2009 or as soon after the end of the Cash and |
6 |
| Counseling Demonstration Project as is practicable, the |
7 |
| Department may, based on its evaluation of the demonstration |
8 |
| project, promulgate rules concerning personal assistant |
9 |
| services , to include, but need not be limited to, |
10 |
| qualifications, employment screening, rights under fair labor |
11 |
| standards, training, fiduciary agent, and supervision |
12 |
| requirements. All applicants shall be subject to the provisions |
13 |
| of the Health Care Worker Background Check Act.
|
14 |
| The Department shall develop procedures to enhance |
15 |
| availability of
services on evenings, weekends, and on an |
16 |
| emergency basis to meet the
respite needs of caregivers. |
17 |
| Procedures shall be developed to permit the
utilization of |
18 |
| services in successive blocks of 24 hours up to the monthly
|
19 |
| maximum established by the Department. Workers providing these |
20 |
| services
shall be appropriately trained.
|
21 |
| Beginning on the effective date of this Amendatory Act of |
22 |
| 1991, no person
may perform chore/housekeeping and home care |
23 |
| aide services under a program
authorized by this Section unless |
24 |
| that person has been issued a certificate
of pre-service to do |
25 |
| so by his or her employing agency. Information
gathered to |
26 |
| effect such certification shall include (i) the person's name,
|
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| (ii) the date the person was hired by his or her current |
2 |
| employer, and
(iii) the training, including dates and levels. |
3 |
| Persons engaged in the
program authorized by this Section |
4 |
| before the effective date of this
amendatory Act of 1991 shall |
5 |
| be issued a certificate of all pre- and
in-service training |
6 |
| from his or her employer upon submitting the necessary
|
7 |
| information. The employing agency shall be required to retain |
8 |
| records of
all staff pre- and in-service training, and shall |
9 |
| provide such records to
the Department upon request and upon |
10 |
| termination of the employer's contract
with the Department. In |
11 |
| addition, the employing agency is responsible for
the issuance |
12 |
| of certifications of in-service training completed to their
|
13 |
| employees.
|
14 |
| The Department is required to develop a system to ensure |
15 |
| that persons
working as home care aides and
chore housekeepers |
16 |
| receive increases in their
wages when the federal minimum wage |
17 |
| is increased by requiring vendors to
certify that they are |
18 |
| meeting the federal minimum wage statute for home care aides
|
19 |
| and
chore housekeepers . An employer that cannot ensure that the |
20 |
| minimum
wage increase is being given to home care aides and
|
21 |
| chore housekeepers
shall be denied any increase in |
22 |
| reimbursement costs.
|
23 |
| The Community Care Program Advisory Committee is created in |
24 |
| the Department on Aging. The Director shall appoint individuals |
25 |
| to serve in the Committee, who shall serve at their own |
26 |
| expense. Members of the Committee must abide by all applicable |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| ethics laws. The Committee shall advise the Department on |
2 |
| issues related to the Department's program of services to |
3 |
| prevent unnecessary institutionalization. The Committee shall |
4 |
| meet on a bi-monthly basis and shall serve to identify and |
5 |
| advise the Department on present and potential issues affecting |
6 |
| the service delivery network, the program's clients, and the |
7 |
| Department and to recommend solution strategies. Persons |
8 |
| appointed to the Committee shall be appointed on, but not |
9 |
| limited to, their own and their agency's experience with the |
10 |
| program, geographic representation, and willingness to serve. |
11 |
| The Director shall appoint members to the Committee to |
12 |
| represent provider, advocacy, policy research, and other |
13 |
| constituencies committed to the delivery of high quality home |
14 |
| and community-based services to older adults. Representatives |
15 |
| shall be appointed to ensure representation from community care |
16 |
| providers including, but not limited to, adult day service |
17 |
| providers, homemaker providers, case coordination and case |
18 |
| management units, emergency home response providers, statewide |
19 |
| trade or labor unions that represent home care
homecare aides |
20 |
| and direct care staff, area agencies on aging, adults over age |
21 |
| 60, membership organizations representing older adults, and |
22 |
| other organizational entities, providers of care, or |
23 |
| individuals with demonstrated interest and expertise in the |
24 |
| field of home and community care as determined by the Director. |
25 |
| Nominations may be presented from any agency or State |
26 |
| association with interest in the program. The Director, or his |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| or her designee, shall serve as the permanent co-chair of the |
2 |
| advisory committee. One other co-chair shall be nominated and |
3 |
| approved by the members of the committee on an annual basis. |
4 |
| Committee members' terms of appointment shall be for 4 years |
5 |
| with one-quarter of the appointees' terms expiring each year. A |
6 |
| member shall continue to serve until his or her replacement is |
7 |
| named. The Department shall fill vacancies that have a |
8 |
| remaining term of over one year, and this replacement shall |
9 |
| occur through the annual replacement of expiring terms. The |
10 |
| Director shall designate Department staff to provide technical |
11 |
| assistance and staff support to the committee. Department |
12 |
| representation shall not constitute membership of the |
13 |
| committee. All Committee papers, issues, recommendations, |
14 |
| reports, and meeting memoranda are advisory only. The Director, |
15 |
| or his or her designee, shall make a written report, as |
16 |
| requested by the Committee, regarding issues before the |
17 |
| Committee.
|
18 |
| The Department on Aging and the Department of Human |
19 |
| Services
shall cooperate in the development and submission of |
20 |
| an annual report on
programs and services provided under this |
21 |
| Section. Such joint report
shall be filed with the Governor and |
22 |
| the General Assembly on or before
September 30 each year.
|
23 |
| The requirement for reporting to the General Assembly shall |
24 |
| be satisfied
by filing copies of the report with the Speaker, |
25 |
| the Minority Leader and
the Clerk of the House of |
26 |
| Representatives and the President, the Minority
Leader and the |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| Secretary of the Senate and the Legislative Research Unit,
as |
2 |
| required by Section 3.1 of the General Assembly Organization |
3 |
| Act and
filing such additional copies with the State Government |
4 |
| Report Distribution
Center for the General Assembly as is |
5 |
| required under paragraph (t) of
Section 7 of the State Library |
6 |
| Act.
|
7 |
| Those persons previously found eligible for receiving |
8 |
| non-institutional
services whose services were discontinued |
9 |
| under the Emergency Budget Act of
Fiscal Year 1992, and who do |
10 |
| not meet the eligibility standards in effect
on or after July |
11 |
| 1, 1992, shall remain ineligible on and after July 1,
1992. |
12 |
| Those persons previously not required to cost-share and who |
13 |
| were
required to cost-share effective March 1, 1992, shall |
14 |
| continue to meet
cost-share requirements on and after July 1, |
15 |
| 1992. Beginning July 1, 1992,
all clients will be required to |
16 |
| meet
eligibility, cost-share, and other requirements and will |
17 |
| have services
discontinued or altered when they fail to meet |
18 |
| these requirements. |
19 |
| For the purposes of this Section, "flexible senior |
20 |
| services" refers to services that require one-time or periodic |
21 |
| expenditures including, but not limited to, respite care, home |
22 |
| modification, assistive technology, housing assistance, and |
23 |
| transportation.
|
24 |
| Notwithstanding any other rulemaking authority that may |
25 |
| exist, neither the Governor nor any agency or agency head under |
26 |
| the jurisdiction of the Governor has any authority to make or |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
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|
1 |
| promulgate rules to implement or enforce the provisions of this |
2 |
| amendatory Act of the 95th General Assembly. If, however, the |
3 |
| Governor believes that rules are necessary to implement or |
4 |
| enforce the provisions of this amendatory Act of the 95th |
5 |
| General Assembly, the Governor may suggest rules to the General |
6 |
| Assembly by filing them with the Clerk of the House and |
7 |
| Secretary of the Senate and by requesting that the General |
8 |
| Assembly authorize such rulemaking by law, enact those |
9 |
| suggested rules into law, or take any other appropriate action |
10 |
| in the General Assembly's discretion. Nothing contained in this |
11 |
| amendatory Act of the 95th General Assembly shall be |
12 |
| interpreted to grant rulemaking authority under any other |
13 |
| Illinois statute where such authority is not otherwise |
14 |
| explicitly given. For the purposes of this amendatory Act of |
15 |
| the 95th General Assembly, "rules" is given the meaning |
16 |
| contained in Section 1-70 of the Illinois Administrative |
17 |
| Procedure Act, and "agency" and "agency head" are given the |
18 |
| meanings contained in Sections 1-20 and 1-25 of the Illinois |
19 |
| Administrative Procedure Act to the extent that such |
20 |
| definitions apply to agencies or agency heads under the |
21 |
| jurisdiction of the Governor. |
22 |
| (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, |
23 |
| eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; |
24 |
| 95-473, eff. 8-27-07; 95-565, eff. 6-1-08; revised 10-30-07.)
|
25 |
| (20 ILCS 105/4.12) |
|
|
|
09500HB5703ham003 |
- 31 - |
LRB095 17678 DRJ 49735 a |
|
|
1 |
| Sec. 4.12. Assistance to nursing home residents. |
2 |
| (a) The Department on Aging shall assist eligible nursing |
3 |
| home residents and their families to select long-term care |
4 |
| options that meet their needs and reflect their preferences. At |
5 |
| any time during the process, the resident or his or her |
6 |
| representative may decline further assistance. |
7 |
| (b) To provide assistance, the Department shall develop a |
8 |
| program of transition services with follow-up in selected areas |
9 |
| of the State, to be expanded statewide as funding becomes |
10 |
| available. The program shall be developed in consultation with |
11 |
| nursing homes, care coordinators case managers , Area Agencies |
12 |
| on Aging, and others interested in the well-being of frail |
13 |
| elderly Illinois residents. The Department shall establish |
14 |
| administrative rules pursuant to the Illinois Administrative |
15 |
| Procedure Act with respect to resident eligibility, assessment |
16 |
| of the resident's health, cognitive, social, and financial |
17 |
| needs, development of comprehensive service transition plans, |
18 |
| and the level of services that must be available prior to |
19 |
| transition of a resident into the community.
|
20 |
| (c) Notwithstanding any other rulemaking authority that |
21 |
| may exist, neither the Governor nor any agency or agency head |
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| under the jurisdiction of the Governor has any authority to |
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| make or promulgate rules to implement or enforce the provisions |
24 |
| of this amendatory Act of the 95th General Assembly. If, |
25 |
| however, the Governor believes that rules are necessary to |
26 |
| implement or enforce the provisions of this amendatory Act of |
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| the 95th General Assembly, the Governor may suggest rules to |
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| the General Assembly by filing them with the Clerk of the House |
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| and Secretary of the Senate and by requesting that the General |
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| Assembly authorize such rulemaking by law, enact those |
5 |
| suggested rules into law, or take any other appropriate action |
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| in the General Assembly's discretion. Nothing contained in this |
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| amendatory Act of the 95th General Assembly shall be |
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| interpreted to grant rulemaking authority under any other |
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| Illinois statute where such authority is not otherwise |
10 |
| explicitly given. For the purposes of this amendatory Act of |
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| the 95th General Assembly, "rules" is given the meaning |
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| contained in Section 1-70 of the Illinois Administrative |
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| Procedure Act, and "agency" and "agency head" are given the |
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| meanings contained in Sections 1-20 and 1-25 of the Illinois |
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| Administrative Procedure Act to the extent that such |
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| definitions apply to agencies or agency heads under the |
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| jurisdiction of the Governor. |
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| (Source: P.A. 95-331, eff. 8-21-07.)
|
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| Section 10. The Older Adult Services Act is amended by |
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| changing Section 25 as follows: |
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| (320 ILCS 42/25)
|
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| Sec. 25. Older adult services restructuring. No later than |
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| January 1, 2005, the Department shall commence the process of |
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| restructuring the older adult services delivery system. |
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| Priority shall be given to both the expansion of services and |
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| the development of new services in priority service areas. |
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| Subject to the availability of funding, the restructuring shall |
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| include, but not be limited to, the following:
|
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| (1) Planning. The Department shall develop a plan to |
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| restructure the State's service delivery system for older |
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| adults. The plan shall include a schedule for the |
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| implementation of the initiatives outlined in this Act and all |
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| other initiatives identified by the participating agencies to |
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| fulfill the purposes of this Act. Financing for older adult |
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| services shall be based on the principle that "money follows |
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| the individual". The plan shall also identify potential |
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| impediments to delivery system restructuring and include any |
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| known regulatory or statutory barriers. |
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| (2) Comprehensive care coordination case management . The |
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| Department shall implement a statewide system of holistic |
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| comprehensive case management. The system shall include the |
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| identification and implementation of a universal, |
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| comprehensive assessment tool to be used statewide to determine |
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| the level of physical, functional, cognitive, psycho-social, |
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| social socialization , and financial needs of older adults. This |
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| tool shall be supported by an electronic intake, assessment, |
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| and care planning system linked to a central location. |
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| "Comprehensive care coordination case management " shall |
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| include activities such includes services and coordination |
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| such as (i) comprehensive assessment of the older adult |
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| (including the physical, functional, cognitive, psycho-social, |
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| and social needs of the individual) ; (ii) development and |
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| implementation of a service plan with the older adult to |
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| mobilize the formal and family resources and services |
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| identified in the assessment to meet the needs of the older |
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| adult, including coordination of the resources and services |
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| with any other plans that exist for various formal services, |
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| such as hospital discharge plans, and with the information and |
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| assistance services; (iii) coordination and monitoring of |
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| formal and informal family service delivery, regardless of the |
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| funding source, including coordination and monitoring to |
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| ensure that services specified in the plan are being provided; |
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| (iv) assistance with completion of applications for services, |
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| referrals to non-government funded services, health promotion, |
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| and ensuring continuity of care across care settings; (v) |
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| periodic reassessment and revision of the status of the older |
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| adult with the older adult or, if necessary, the older adult's |
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| designated representative; and (vi) (v) in accordance with the |
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| wishes of the older adult, advocacy on behalf of the older |
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| adult for needed services or resources. |
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| (3) Coordinated point of entry. The Department shall |
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| implement and publicize a statewide coordinated point of entry |
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| using a uniform name, identity, logo, and toll-free number. |
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| (4) Public web site. The Department shall develop a public |
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| web site that provides links to available services, resources, |
26 |
| and reference materials concerning caregiving, diseases, and |
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| best practices for use by professionals, older adults, and |
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| family caregivers. |
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| (5) Expansion of older adult services. The Department shall |
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| expand older adult services that promote independence and |
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| permit older adults to remain in their own homes and |
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| communities. |
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| (6) Consumer-directed home and community-based services. |
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| The Department shall expand the range of service options |
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| available to permit older adults to exercise maximum choice and |
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| control over their care. |
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| (7) Comprehensive delivery system. The Department shall |
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| expand opportunities for older adults to receive services in |
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| systems that integrate acute and chronic care. |
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| (8) Enhanced transition and follow-up services. The |
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| Department shall implement a program of transition from one |
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| residential setting to another and follow-up services, |
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| regardless of residential setting, pursuant to rules with |
18 |
| respect to (i) resident eligibility, (ii) assessment of the |
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| resident's health, cognitive, social, and financial needs, |
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| (iii) development of transition plans, and (iv) the level of |
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| services that must be available before transitioning a resident |
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| from one setting to another. |
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| (9) Family caregiver support. The Department shall develop |
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| strategies for public and private financing of services that |
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| supplement and support family caregivers.
|
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| (10) Quality standards and quality improvement. The |
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| Department shall establish a core set of uniform quality |
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| standards for all providers that focus on outcomes and take |
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| into consideration consumer choice and satisfaction, and the |
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| Department shall require each provider to implement a |
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| continuous quality improvement process to address consumer |
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| issues. The continuous quality improvement process must |
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| benchmark performance, be person-centered and data-driven, and |
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| focus on consumer satisfaction.
|
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| (11) Workforce. The Department shall develop strategies to |
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| attract and retain a qualified and stable worker pool, provide |
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| living wages and benefits, and create a work environment that |
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| is conducive to long-term employment and career development. |
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| Resources such as grants, education, and promotion of career |
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| opportunities may be used. |
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| (12) Coordination of services. The Department shall |
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| identify methods to better coordinate service networks to |
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| maximize resources and minimize duplication of services and |
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| ease of application. |
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| (13) Barriers to services. The Department shall identify |
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| barriers to the provision, availability, and accessibility of |
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| services and shall implement a plan to address those barriers. |
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| The plan shall: (i) identify barriers, including but not |
23 |
| limited to, statutory and regulatory complexity, reimbursement |
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| issues, payment issues, and labor force issues; (ii) recommend |
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| changes to State or federal laws or administrative rules or |
26 |
| regulations; (iii) recommend application for federal waivers |
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| to improve efficiency and reduce cost and paperwork; (iv) |
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| develop innovative service delivery models; and (v) recommend |
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| application for federal or private service grants. |
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| (14) Reimbursement and funding. The Department shall |
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| investigate and evaluate costs and payments by defining costs |
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| to implement a uniform, audited provider cost reporting system |
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| to be considered by all Departments in establishing payments. |
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| To the extent possible, multiple cost reporting mandates shall |
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| not be imposed. |
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| (15) Medicaid nursing home cost containment and Medicare |
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| utilization. The Department of Healthcare and Family Services |
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| (formerly Department of Public Aid), in collaboration with the |
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| Department on Aging and the Department of Public Health and in |
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| consultation with the Advisory Committee, shall propose a plan |
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| to contain Medicaid nursing home costs and maximize Medicare |
16 |
| utilization. The plan must not impair the ability of an older |
17 |
| adult to choose among available services. The plan shall |
18 |
| include, but not be limited to, (i) techniques to maximize the |
19 |
| use of the most cost-effective services without sacrificing |
20 |
| quality and (ii) methods to identify and serve older adults in |
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| need of minimal services to remain independent, but who are |
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| likely to develop a need for more extensive services in the |
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| absence of those minimal services. |
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| (16) Bed reduction. The Department of Public Health shall |
25 |
| implement a nursing home conversion program to reduce the |
26 |
| number of Medicaid-certified nursing home beds in areas with |
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| excess beds. The Department of Healthcare and Family Services |
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| shall investigate changes to the Medicaid nursing facility |
3 |
| reimbursement system in order to reduce beds. Such changes may |
4 |
| include, but are not limited to, incentive payments that will |
5 |
| enable facilities to adjust to the restructuring and expansion |
6 |
| of services required by the Older Adult Services Act, including |
7 |
| adjustments for the voluntary closure or layaway of nursing |
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| home beds certified under Title XIX of the federal Social |
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| Security Act. Any savings shall be reallocated to fund |
10 |
| home-based or community-based older adult services pursuant to |
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| Section 20. |
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| (17) Financing. The Department shall investigate and |
13 |
| evaluate financing options for older adult services and shall |
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| make recommendations in the report required by Section 15 |
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| concerning the feasibility of these financing arrangements. |
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| These arrangements shall include, but are not limited to: |
17 |
| (A) private long-term care insurance coverage for |
18 |
| older adult services; |
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| (B) enhancement of federal long-term care financing |
20 |
| initiatives; |
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| (C) employer benefit programs such as medical savings |
22 |
| accounts for long-term care; |
23 |
| (D) individual and family cost-sharing options; |
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| (E) strategies to reduce reliance on government |
25 |
| programs; |
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| (F) fraudulent asset divestiture and financial |
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| planning prevention; and |
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| (G) methods to supplement and support family and |
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| community caregiving. |
4 |
| (18) Older Adult Services Demonstration Grants. The |
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| Department shall implement a program of demonstration grants |
6 |
| that will assist in the restructuring of the older adult |
7 |
| services delivery system, and shall provide funding for |
8 |
| innovative service delivery models and system change and |
9 |
| integration initiatives pursuant to subsection (g) of Section |
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| 20. |
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| (19) Bed need methodology update. For the purposes of |
12 |
| determining areas with excess beds, the Departments shall |
13 |
| provide information and assistance to the Health Facilities |
14 |
| Planning Board to update the Bed Need Methodology for Long-Term |
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| Care to update the assumptions used to establish the |
16 |
| methodology to make them consistent with modern older adult |
17 |
| services.
|
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| (20) Affordable housing. The Departments shall utilize the |
19 |
| recommendations of Illinois' Annual Comprehensive Housing |
20 |
| Plan, as developed by the Affordable Housing Task Force through |
21 |
| the Governor's Executive Order 2003-18, in their efforts to |
22 |
| address the affordable housing needs of older adults.
|
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| The Older Adult Services Advisory Committee shall |
24 |
| investigate innovative and promising practices operating as |
25 |
| demonstration or pilot projects in Illinois and in other |
26 |
| states. The Department on Aging shall provide the Older Adult |
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| Services Advisory Committee with a list of all demonstration or |
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| pilot projects funded by the Department on Aging, including |
3 |
| those specified by rule, law, policy memorandum, or funding |
4 |
| arrangement. The Committee shall work with the Department on |
5 |
| Aging to evaluate the viability of expanding these programs |
6 |
| into other areas of the State.
|
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| Notwithstanding any other rulemaking authority that may |
8 |
| exist, neither the Governor nor any agency or agency head under |
9 |
| the jurisdiction of the Governor has any authority to make or |
10 |
| promulgate rules to implement or enforce the provisions of this |
11 |
| amendatory Act of the 95th General Assembly. If, however, the |
12 |
| Governor believes that rules are necessary to implement or |
13 |
| enforce the provisions of this amendatory Act of the 95th |
14 |
| General Assembly, the Governor may suggest rules to the General |
15 |
| Assembly by filing them with the Clerk of the House and |
16 |
| Secretary of the Senate and by requesting that the General |
17 |
| Assembly authorize such rulemaking by law, enact those |
18 |
| suggested rules into law, or take any other appropriate action |
19 |
| in the General Assembly's discretion. Nothing contained in this |
20 |
| amendatory Act of the 95th General Assembly shall be |
21 |
| interpreted to grant rulemaking authority under any other |
22 |
| Illinois statute where such authority is not otherwise |
23 |
| explicitly given. For the purposes of this amendatory Act of |
24 |
| the 95th General Assembly, "rules" is given the meaning |
25 |
| contained in Section 1-70 of the Illinois Administrative |
26 |
| Procedure Act, and "agency" and "agency head" are given the |
|
|
|
09500HB5703ham003 |
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LRB095 17678 DRJ 49735 a |
|
|
1 |
| meanings contained in Sections 1-20 and 1-25 of the Illinois |
2 |
| Administrative Procedure Act to the extent that such |
3 |
| definitions apply to agencies or agency heads under the |
4 |
| jurisdiction of the Governor. |
5 |
| (Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05; |
6 |
| 94-766, eff. 1-1-07.)
|
7 |
| (320 ILCS 60/Act rep.)
|
8 |
| Section 15. The Community Senior Services and Resources Act |
9 |
| is repealed. |
10 |
| (320 ILCS 65/16 rep.) |
11 |
| Section 20. The Family Caregiver Act is amended by |
12 |
| repealing Section 16. |
13 |
| Section 95. No acceleration or delay. Where this Act makes |
14 |
| changes in a statute that is represented in this Act by text |
15 |
| that is not yet or no longer in effect (for example, a Section |
16 |
| represented by multiple versions), the use of that text does |
17 |
| not accelerate or delay the taking effect of (i) the changes |
18 |
| made by this Act or (ii) provisions derived from any other |
19 |
| Public Act. |
20 |
| Section 99. Effective date. This Act takes effect upon |
21 |
| becoming law.".
|