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    AN ACT concerning public aid.

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



 
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    Section 5. The Illinois Public Aid Code is amended  by 
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adding Section 5-2.08 as follows:
 
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    (305 ILCS 5/5-2.08  new)
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    Sec. 5-2.08. Spousal caregiver demonstration.
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    (a) The Department of Human Services, in consultation with 
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the Department of Healthcare and Family Services, shall develop 
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a demonstration project within the Home Services Program under 
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which a spouse may be reimbursed for providing care to his or 
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her spouse, who is eligible for services through the Home 
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Services Program and who meets the criteria for this 
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demonstration project. The demonstration project shall operate 
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in selected counties and be limited to serving no more than 100 
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unduplicated persons in a State fiscal year.
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    The components of the demonstration project shall include 
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the following:
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        (1) Authorization for a spouse to be reimbursed for 
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    care provided to his or her otherwise eligible spouse 
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    through the Home Services Program.
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        (2) The development of specific criteria for the 
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    provision of services under the demonstration project. 
 


 






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    Criteria applicable to a spousal caregiver shall include, 
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    but need not be limited to, (i) a limitation on the total 
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    hours of a spousal caregiver's outside employment plus 
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    hours of providing care to his or her eligible spouse to 
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    ensure that the complete plan of care is delivered to the 
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    eligible spouse and (ii) limitations on a spousal 
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    caregiver's participation in the demonstration project if 
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    the caregiver has a known history of spousal abuse, 
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    neglect, or exploitation.
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        (3) The determination of the personal care or similar 
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    services for which payment may be made. Spousal caregivers 
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    shall be paid at the Personal Assistant level of care and 
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    pay rate. In those instances in which the eligible spouse 
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    requires specialized services (for example, services 
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    provided by a certified nursing assistant (CNA), licensed 
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    practical nurse (LPN), or registered nurse (RN)) and the 
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    spousal caregiver has the corresponding certification or 
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    licensure, the spousal caregiver shall be paid the higher 
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    rate for the specialized services only. The specialized 
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    services the eligible spouse is authorized to receive shall 
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    be defined and approved in the services plan.
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        (4) The method for determining that the amount of 
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    personal care or similar services provided by the spouse is 
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    "extraordinary care" that exceeds the ordinary care that 
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    would be provided to a spouse without a disability.
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        (5) Limitations on the number of hours of personal 
 


 






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    services that will be reimbursed.
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        (6) Utilization of the Determination of Need 
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    evaluation and other comprehensive assessment tools as 
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    criteria for determining eligibility and developing 
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    service plans under the demonstration project.
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        (7) Determination of how or whether the provision of 
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    personal care by the spouse is in the best interest of his 
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    or her spouse, who is an eligible participant in the 
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    demonstration project.
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        (8) Use of procedures that ensure that payments are 
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    made for services rendered.
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        (9) Assurances that all other criteria of the 
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    demonstration project are met.
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        (10) Measurement of participant experiences.
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        (11) Monthly in-home monitoring of the health and 
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    safety of the eligible spouse.
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        (12) Documentation of the marital relationship for 
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    participation in the demonstration project.
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        (13) Assurances that the eligible spouse is capable of 
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    communicating his or her needs.
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        (14) Enrollment of an alternative care provider to 
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    ensure that there is no disruption of care to the eligible 
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    spouse.
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        (15) Assurances that the spousal caregiver is 
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    emotionally, physically, and cognitively able to provide 
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    the necessary care to the eligible spouse.
 


 






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    (b) By July 1, 2009, the Department of Human Services, in 
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consultation with the Department of Healthcare and Family 
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Services, shall begin development of the demonstration 
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project.  The Department of Human Services shall provide an 
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interim report on or before March 1, 2010 to the Governor and 
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the General Assembly that includes the progress on the 
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development of the demonstration project and implementation 
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timelines of the demonstration project and the criteria for the 
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demonstration project.
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    (c) The Department of Human Services shall report findings 
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and recommendations by March 1, 2011 to the Governor and the 
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General Assembly.  The report shall include an explanation of 
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the manner in which each demonstration project component listed 
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in paragraphs (1) through (10) of subsection (a) is addressed.  
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In addition, the report shall include (i) the estimated number 
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of clients statewide who could utilize services and (ii) an 
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analysis of the fiscal impact per client on the Department's 
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new and existing costs under the Home Services Program.
 

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    Section 99. Effective date. This Act takes effect upon 
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becoming law.