HB1237 103RD GENERAL ASSEMBLY

LRB103 05760 KTG 50780 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB1237

Introduced 1/31/2023, by Rep. Kam Buckner, Joyce Mason and Dagmara Avelar

SYNOPSIS AS INTRODUCED:

New Act

Creates the Illinois Strategic Action Plan for Aging Equity Act. Provides that the purpose of the Act is to appoint a planning commission to research and develop a comprehensive, cross-sector, long-term strategic action plan for aging equity that will lead to actionable goals and measurable outcomes for the years 2024 through 2036. Establishes the Strategic Action Planning Commission for Aging Equity. Provides that the planning commission shall be made up of State agency directors and appointed elected officials or their designees as ex officio members, and a group of voting individuals from the general public. Provides that the planning commission shall examine the effects, challenges, opportunities, and needs for planning related to the shifting age demographics toward an increasing portion of the State's and localities' populations being made up of older adults. Requires the planning commission to adopt guiding principles that include, but are not limited to: (i) advancing aging equity across the life course; (ii) developing cultural humility and being culturally responsive with inclusive policies, programs, and services; and (iii) harnessing the power of experience and knowledge of older persons in communities. Requires the Governor to appoint members to the planning commission within 3 months after the effective date of the amendatory Act; and to consult with the President and Minority Leader of the Senate, the Speaker and Minority Leader of the House of Representatives, and the Director of Aging about member appointments to ensure that (1) the planning commission reflects the geographic diversity of the State; (2) the planning commission is inclusive and consists of members who reflect a diversity of age, gender, ability, race, cultural, socioeconomic, and national background; (3) the planning commission includes Illinois residents age 60 or older; and other matters. Contains provisions on the composition of the planning commission; commission meetings; the commission's authority to establish a subcommittee; the establishment of an advisory committee; duties of the planning commission; data analysis; planning commission recommendations and reporting requirements; and other matters. Effective immediately.

A BILL FOR

AN ACT concerning State government.

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

Section 1. Short title. This Act may be cited as the Illinois Strategic Action Plan for Aging Equity Act.

Section 5. Purpose. The purpose of this Act is to direct the appointment of a planning commission co-chaired by the Governor's Office and the Department on Aging to research and develop a comprehensive, cross-sector, long-term strategic action plan for aging equity. A strategic action plan for aging equity could draw upon Illinois' well-developed aging network developed in accordance with the federal Older Americans Act, the Illinois Act on the Aging, and the Older Adult Services Act, all of which help older Illinoisans stay connected and stay in their communities. With decades of support for aging issues from the General Assembly, the Department on Aging and its Aging Network staff, and aging advocates, Illinois will develop, adopt, and implement a strategic action plan for aging equity on a strong foundation.

Section 10. Findings. The General Assembly finds, determines, and declares the following:

(1) This Act is necessary for the immediate preservation of the public peace, health, and safety.

(2) Illinois' population is aging. Like the rest of the United States and the world, Illinois is experiencing a shift in the age demographics of its population. The baby boomer generation is getting older; longevity is increasing for many as well as the health, social, financial, and other needs that come with it. The migration of families and older persons out of Illinois has also increased and the State is experiencing historically low birthrates. All of these social changes have contributed to Illinois' population shrinking.

(3) As Illinois' population shrinks, the State continues to depend more on State or local funding for older adult services as federal funding provided under the Older Americans Act is tied to population numbers.

(4) State taxation leans heavily on income taxes. With a growing percentage of people in older adulthood, new fiscal challenges will likely require changes to how Illinois generates revenue.

(5) The aging of communities has far-reaching effects on all people and all sectors. As of 2019, the 60 and older age group represented 21% of Illinois' total population, with 10% of Illinois' 102 counties having more than 30% of their population aged 60 or older, particularly rural agricultural counties. Statewide, 11% of Illinois' older persons are veterans.

(6) Many older Illinoisans interact with, and their lives and opportunities are shaped by, multiple systems and aspects of society, including, but not limited to, housing development and construction; health and human services; parks and recreation; information technology; arts and communications; public health; hospitality, tourism and travel; workforce development; volunteerism; business and financial planning; legal and human rights; government services; education; transportation; and veterans' affairs.

(7) Across Illinois, many people are suffering from long-standing structural inequities such as racism, class inequity, genderism, sexism, ageism, ableism, xenophobia, homophobia, transphobia, and other forms of oppression all of which shape how, and whether or not, individuals reach older adulthood and their quality of life as they age. The life expectancy across and within the 102 counties in Illinois varies significantly, with 20% of counties experiencing a life expectancy of less than 70 years. Significant life expectancy and other health inequities exist both within and across counties.

(8) Chronic health conditions impact 85% of older Americans and 70% of persons aged 65 or older will need caregiver support at some point in their older years.

(9) There is a great demand for paid home care workers, direct support workers, and personal aide workers coupled with severe worker shortages, high turnover, difficult work, and often low pay. Older Black and Brown women make up much of this workforce, and the undervaluing and underpaying of this labor is rooted in racism, sexism, and class inequity. Due to worker shortages in all areas of the State, contracted agencies are unable to fulfill the care plans of persons enrolled in the State's Home and Community Based Services Waiver Programs which are designed to prevent the unnecessary institutionalization of persons in need of long-term care services. Worker shortages are also impacting the care management agencies that determine eligibility for these services.

(10) Of the 28,804 Illinoisans who died from COVID-19 as of January 2022, 36.7% were persons of color and 86.2% were persons aged 60 or older. As of August 2021, 43% of all Illinois COVID-19 deaths were nursing home-related, with significant health inequities. With vaccines and boosters in place, as of January 2022, nursing home-related deaths account for 26% of all COVID-19 deaths in Illinois.

(11) A 2021 report by the Department of Healthcare and Family Services found that, overwhelmingly, the understaffed Medicaid facilities with 3-4 persons in a room where the poorest of the poor and mostly Black and Brown persons resided, were the ones that experienced the highest risk of infection and death. These health inequities show the effects of structural racism and class inequity intersecting with ageism, as well as the effect of crowded and low-quality nursing home care.

(12) Health inequities are the systemic patterns of differences that are unfair, unjust, and remediable, meaning that there is something we can do about them, and there is a justice and moral imperative to do so.

(13) There is a need for equitable services across communities with equitable and adequate funding in order for Illinoisans across the State to feel supported across their lifespans, including their older years.

(14) Coordinated action is needed across Illinois' network of aging and disability advocates and providers, cross-sector leaders, policymakers, and units of local government to affirm the priority of the health and well-being of older Illinoisans and the need for policies that promote healthy aging.

(15) There are many opportunities for Illinois to meet the needs of its residents as they get older.

(16) Illinois has the unique opportunity to benefit from comprehensive research, current innovation, and lessons from the pandemic to identify long-term strategic approaches to address current and future challenges and opportunities and better integrate current and future innovative solutions that improve quality across all communities.

Section 15. Legislative intent.

(1) It is the intent of the General Assembly that there is established a multidisciplinary Strategic Action Planning Commission for Aging Equity for the purpose of developing a comprehensive strategic action plan for aging equity in Illinois that will lead to actionable goals and measurable outcomes for the years 2024 through 2036. The purpose of the Strategic Action Planning Commission for Aging Equity is to provide the Governor and the General Assembly with data and specific recommendations regarding public actions by all State agencies so that the General Assembly can address the demographic shift of an aging population. This includes recommended changes in policy, procedures, programs, services, projects, and resources to support equitable aging across the life course.

(2) Recommendations put forth by the Strategic Action Planning Commission for Aging Equity will be presented to the Governor and General Assembly within 2 years from the date of the planning commission's first meeting.

(3) The Strategic Action Planning Commission for Aging Equity will continue to meet regularly to ensure recommended actions are taken and transparent and tangible progress is being made toward initial targeted goals with measurable outcomes as well as establishing new goals as data and research continues to drive equity, innovation, and quality measures.

Section 20. Definitions. As used in this Act:

(1) "Ableism" means discrimination in favor of able-bodied people.

(2) "Ageism" means prejudice or discrimination on the grounds of a person's age.

(3) "Aging equity" is both an outcome and a process. As an outcome it means, aging equity is achieved when every person can attain their full potential across the life course without disadvantage because of social position or other socially and structurally determined circumstances. As a process, aging equity is a process of assurance of the conditions of optimal aging for all people which requires at least 3 things: (i) valuing all individuals and populations equally; (ii) recognizing and rectifying historical injustices; and (iii) providing resources according to need. Aging inequities will be eliminated when aging equity is achieved.

(4) "Caregiver" means someone caring for a spouse or parent, an extended family member, or even a friend or neighbor. A caregiver provides help with transportation to medical appointments, purchasing or organizing medications, monitoring a person's medical condition, communicating with health care professionals, advocating on a person's behalf with providers or agencies, and assisting a person with getting in and out of bed or a chair, getting dressed, bathing or showering, grocery or other shopping, housework, preparing meals, and managing finances.

(5) "Class inequity" means relations of power among networked and organized social groups that direct society's major institutions (such as corporations and government authorities), material resources, and investments. "Class inequity" or "classism" is the systematic oppression of subordinated class groups, held in place by attitudes that rank people according to economic status, family lineage, job status, level of education, and other divisions.

(6) "Cultural humility" means an approach to healthcare and other services that incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances between the providers and institutions and their patients or clients and to developing mutually beneficial and non-paternalistic clinical, service-based, and advocacy partnerships with communities on behalf of individuals and defined populations.

(7) "Cultural responsiveness" means a strengths-based approach to serving others rooted in respect and appreciation for the role of culture in a person's understanding and development, taking into account each person's strengths, abilities, experiences, and interests as developed within the person's family and culture.

(8) "Genderism" means the systematic belief that people need to conform to their gender assigned at birth in a gender-binary system that includes only female and male.

(9) "Historical and contemporary racism" means a system of structuring opportunity and assigning value based on phenotype ("race"), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.

(10) "Homophobia" means dislike of or prejudice against people who are LGBTQ+.

(11) "Older adults" or "older persons" means persons 60 years of age or older.

(12) "Planning commission" means the Strategic Action Planning Commission for Aging Equity.

(13) "Sexism" means prejudice or discrimination based on sex, especially discrimination against women, behavior, conditions, or attitudes that foster stereotypes of social roles based on sex.

(14) "Social determinants of health" means the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources.

(15) "Structural inequities" means the personal, interpersonal, institutional, and systemic drivers, such as, racism, sexism, classism, ableism, xenophobia, and homophobia, that make people's various identities (race and ethnicity, gender, employment status, socioeconomic status, disability status, immigration status, geography, and more) salient to the fair distribution of health opportunities and outcomes.

(16) "Transphobia" means dislike of or prejudice against transgender or transsexual people.

(17) "Trauma-informed systems" means systems that: (i) realize the widespread impact of trauma and understand potential paths for recovery; (ii) recognize signs and symptoms of trauma in clients, families, staff, and others involved with the system; (iii) respond by fully integrating knowledge about trauma into policies, procedures, and practices; and (iv) seek to actively resist re-traumatization.

(18) "Xenophobia" means dislike of or prejudice against people from other countries.

Section 25. Strategic Action Planning Commission for Aging Equity.

(a) The Strategic Action Planning Commission for Aging Equity is established and shall be co-chaired by the Governor's Office and the Department on Aging. The planning commission shall be made up of State agency directors and appointed elected officials or their designees as ex officio members, and a group of voting individuals from the general public, as outlined in subsection (d), and shall host a monthly open meeting with an aging equity advisory committee.

(b) The planning commission shall examine the effects, challenges, opportunities, and needs for planning related to the shifting age demographics toward an increasing portion of the State's and localities' populations being made up of older adults, including at least:

(1) Community and healthcare.

(2) Transportation.

(3) Housing.

(4) Social participation.

(5) Outdoor spaces and buildings.

(6) Respect and social inclusion.

(7) Civic participation and employment.

(8) Communication and information.

(9) The public sector as well as the broader economy, workforce, community systems, businesses, and services.

(10) Changes in federal, State, and local tax bases, revenues, budgets, fiscal policies, programs, and workforce.

(11) Funding mechanisms for aging-related services.

(12) New economic opportunities for the State.

(c) The planning commission shall adopt guiding principles that include:

(1) Advancing aging equity across the life course.

(2) Developing cultural humility and being culturally responsive with inclusive policies, programs, and services.

(3) Being language inclusive to reach and support older persons and caregivers who primarily read and speak languages other than English.

(4) Supporting trauma-informed systems.

(5) Understanding the experiences of older Illinoisans, caregivers, and future older Illinoisans of diverse backgrounds.

(6) Recognizing the impact of historical and contemporary racism, class inequity, ableism, genderism, sexism, homophobia, transphobia, xenophobia, and other structural inequities on systems, communities, families, and individual Illinoisans of all ages.

(7) Equity and accessibility of policies, programs, services, and resources for Illinoisans statewide.

(8) Harnessing the power of experience and knowledge of older persons in communities.

(9) Opportunities for improved policies, programs, and services that better reflect supporting the needs of current and future older Illinoisans and caregivers.

(d) The planning commission shall be a public body consisting of members appointed by the Governor within 3 months after the effective date of this Act. The Governor shall consult with the President and Minority Leader of the Senate, the Speaker and Minority Leader of the House of Representatives, and the Director of Aging about appointments to the planning commission to ensure the following:

(1) Members meet the criteria set forth in this subsection. Members may fill multiple roles.

(2) The planning commission reflects the geographic diversity of the State and includes members who represent (i) the rural, suburban, and urban areas of the State, (ii) the northern, central, and southern regions of the State, and (iii) the various districts.

(3) The planning commission is inclusive and consists of members who reflect a diversity of age, gender, ability, race, cultural, socioeconomic, and national background.

(4) The planning commission includes Illinois residents aged 60 or older who represent urban, suburban, and rural areas of the State.

(5) The planning commission consists of the following persons:

(i) One member with extensive professional knowledge about aging.

(ii) One member with extensive professional knowledge of home and community-based services for older Illinoisans.

(iii) One member with extensive professional knowledge of community-based services provided under the Older Americans Act.

(iv) One member with extensive professional knowledge of health policy.

(v) One member with extensive professional knowledge of geriatric or palliative medicine.

(vi) Two members with extensive professional knowledge of health systems.

(vii) Two members with extensive professional knowledge of affordable accessible housing.

(viii) One member with extensive professional knowledge of public transportation, active transportation, and private transportation systems.

(ix) One member with extensive professional knowledge of urban planning, community walkability, and age-friendly principles.

(x) One member with extensive professional knowledge about nursing homes.

(xi) One member who is a health insurance policy advocate with extensive professional knowledge of Medicare.

(xii) One member with extensive professional knowledge about labor advocacy.

(xiii) One member with extensive professional knowledge about the criminal-legal system and aging.

(xiv) One member with extensive professional knowledge about caregiving.

(xv) One member with extensive professional knowledge of dementia.

(xvi) One member with extensive professional knowledge about disabilities.

(xvii) One member with extensive professional knowledge in partnering education and labor needs.

(xviii) One member with extensive professional knowledge in volunteerism, community connecting, and civic engagement of older persons.

(xix) One member representing park districts.

(xx) One member representing school systems.

(xxi) One member representing chambers of commerce.

(xxii) One member with extensive professional knowledge of electronic communications technology.

(xxiii) One member representing travel and hospitality.

(xxiv) One member representing a philanthropic foundation.

(xxv) Two members from the Senate, both major parties represented, one appointed by the President of the Senate and one appointed by the Minority Leader of the Senate.

(xxvi) Two members from the House of Representatives, both major parties represented, one appointed by the Speaker of the House of Representatives and one appointed by the Minority Leader of the House of Representatives.

(6) The planning commission consists of the heads of the following agencies, offices, boards, and other entities, or their designees:

(i) Department of Agriculture.

(ii) Department of Commerce and Economic Opportunity.

(iii) Department of Healthcare and Family Services.

(iv) Department of Human Rights.

(v) Department of Human Services.

(vi) Department of Innovation and Technology.

(vii) Department of Insurance.

(viii) Department of Labor.

(ix) Department of Natural Resources.

(x) Department of Public Health.

(xi) Department of Human Services' Division of Rehabilitative Services.

(xii) Department of Revenue.

(xiii) Department of Transportation.

(xiv) Department of Veterans' Affairs.

(xv) Department on Aging.

(xvi) Department of Corrections.

(xvii) Department of Children and Family Services.

(xviii) Department of Financial and Professional Regulation.

(xix) Illinois Housing Development Authority.

(xx) Office of the Illinois State Fire Marshal.

(xxi) Illinois Emergency Management Agency.

(xxii) Illinois State Board of Education.

(xxiii) Illinois Community College Board.

(xxiv) Illinois Board of Higher Education.

(xxv) Illinois State Police.

(xxvi) Illinois Cognitive Support Network.

(xxvii) Illinois Council on Developmental Disabilities.

(xxviii) Illinois Finance Authority.

(xxix) The Governor's Office of Management and Budget.

(xxx) Department of Central Management Services.

(xxxi) Office of the Attorney General.

(xxxii) Office of the Secretary of State.

(xxxiii) Office of the State Treasurer.

(e) Anyone interested in becoming a member of the planning commission may submit an application to the Office of the Governor through the online application process.

(f) The planning commission shall elect a chair and vice-chair from among its members to coordinate the planning commission's meetings along with State agency staff or contractors. Members of the planning commission shall serve without compensation. Members shall serve 4-year terms. The planning commission shall establish staggered end of term dates of initial members. The Governor may reappoint a member for only one additional 4-year term after a member's initial term has expired. In case of a vacancy, the Governor shall appoint a new member in the same manner as the initial appointment.

(g) Members of the planning commission may remove a member for cause as determined by the planning commission, if approved by a two-thirds majority of all members. The planning commission shall meet 6 times each calendar year, at a minimum, with dates determined by the members of the planning commission as soon as practicable after all members have been appointed to the planning commission.

(h) The planning commission may establish subcommittees. Each subcommittee shall consider and evaluate issues related to guiding principles listed under subsection (c). The subcommittees may include persons who are not members of the planning commission yet represent relevant expertise not otherwise represented on the planning commission. Members of the specialized subcommittee shall serve without compensation.

(i) The planning commission shall establish an aging equity advisory committee which shall consist of the State demographer and subject matter experts from local governmental and nongovernmental organizations to advise and assist the planning commission.

(j) The planning commission shall exercise its powers and perform its duties and functions as specified under this Act independently of the State agencies. The planning commission may establish bylaws as appropriate for its effective operation. The chair of the planning commission shall establish a schedule for planning commission meetings. Members of the planning commission, staff, and consultants are not liable for an act or omission in their official capacity performed in good faith in accordance with this Act.

Section 30. Duties of the Strategic Action Planning Commission for Aging Equity.

(a) The planning commission shall develop a preliminary comprehensive strategic action plan for aging in Illinois through the year 2036 to be completed within 18 months of commencement of the planning commission. A 2-month comment period shall be included and then a final strategic action plan for aging shall be developed within 2 years from the commencement of the planning commission.

(b) In developing the strategic action plan, the planning commission shall review and incorporate past recommendations and findings from previous studies and commissions, task forces, departments, and area agencies on aging that the planning commission considers relevant and necessary to its duties. Previous recommendations must be reviewed in conjunction with the latest demographic and economic projections specified in the analysis conducted in accordance with Section 30.

(c) The strategic action plan must address at least the following 3 areas:

(1) Demographic, economic, fiscal, and budget data analysis through the year 2041.

(2) Actionable recommendations.

(3) Plans for periodic updates to the strategic action plan.

Section 35. Data analysis. The Strategic Action Planning Commission for Aging Equity shall include data analysis that is inclusive of, but not limited to, the following areas:

(1) Community and healthcare.

(2) Transportation.

(3) Housing.

(4) Social participation.

(5) Outdoor spaces and buildings.

(6) Respect and social inclusion.

(7) Civic participation and employment.

(8) Communication and information.

(9) Retirement savings gaps and retirement security for the State's current and future older adult populations.

Section 40. Actionable recommendations. Planning commission recommendations shall include the following at a minimum:

(1) Potential and recommended actions to address the long-term effects of the demographic shift on Illinois residents, State government, and the private sector, including disproportional regional demographic shifts in older adult populations.

(2) Potential and recommended actions to strengthen and improve service infrastructure for and the quality, staffing, accessibility, and availability of long-term services and supports to better enable the services and supports to meet future demand.

(3) Potential and recommended actions to enhance access to services and public education on opportunities, challenges, resources, and topics for older Illinoisans and caregivers.

(4) Potential and recommended actions to improve caregiver supports and mitigate both the financial and nonfinancial impacts of caregiving on patients, caregivers, businesses, and the State.

(5) Potential and recommended actions to improve financial security and retirement preparation for the older adult population.

(6) Potential and recommended actions to improve the accessibility and sustainability of healthy, safe, affordable, accessible, and non-segregated housing.

(7) Potential and recommended actions to improve the accessibility and sustainability of affordable transportation services.

(8) Potential and recommended actions to reduce administrative and service delivery costs of public and private long-term services and supports while improving service quality.

(9) Administrative and regulatory reforms needed to more cost-effectively organize State agencies to implement statewide programs and services.

(10) Possible legislation for consideration by the General Assembly in order to implement the planning commission's recommendations and achieve its stated goals.

(11) Possible regulatory and administrative changes to be offered to State departments in order to implement the planning commission's recommendations and achieve its stated goals.

(12) Private sector potential and recommended actions for quality long-term care, services, and supports that are accessible, equitable, and meet cultural and linguistic needs.

(13) Potential and recommended actions to extend and improve other services and supports that would allow individuals to remain in their residences and communities for as long as possible.

(14) Potential and recommended actions to improve migration of college students, professionals, families, and retirees from outside of the State to communities across Illinois.

(15) Potential and recommended actions to make Illinois an age-friendly State.

(16) Potential and recommended actions to support health equity as it relates to advancing aging equity.

(17) Projections on the economic, fiscal, and personal impacts of implementing or not implementing the recommendations.

Section 45. Reporting.

(a) During the 2024 and 2025 legislative sessions, the planning commission shall submit an oral and written report summarizing its work and any preliminary findings or recommendations to the joint budget committee and the General Assembly.

(b) Within 2 years of commencement, the planning commission shall submit to the Governor, the General Assembly, and any affected State agency its strategic action plan detailing the work of the planning commission and its final recommendations.

(c) If the strategic action plan identifies programs, services, projects, policies, or procedures that would result in cost savings, without adversely affecting the quality of care and services, and do not require legislation, the Governor and the associated State agencies must pursue the necessary actions to implement the recommendations, including, as necessary, requesting adequate funding through the State budget process.

(d) If the strategic action plan identifies programs, services, projects, policies, or procedures that would result in cost savings, without adversely affecting the quality of care and services, that require legislation, the planning commission shall recommend legislation to implement the changes to the General Assembly. In its plan, the planning commission shall specify the laws and the policies and procedures of the relevant State agencies that need to be created, amended, or repealed to implement the recommendations.

Section 50. Strategic plan updates and oversight.

(a) The planning commission shall submit updates to the strategic action plan every 4 years, to update the planning commission's analysis and recommendations.

(1) These updates shall include new economic and demographic data as well as respond to new State and national public and private initiatives and must address a time period for analysis and recommendation that extends 15 years after the delivery of the update.

(2) The process for creating these updates shall be determined by the planning commission as part of its strategic action plan.

(3) New legislative or regulatory recommendations may be offered in order to address new or changing circumstances.

(b) The planning commission shall take measures to ensure transparency to the public, the General Assembly, and to stakeholders in planning, goal setting, action steps, and reporting on successful implementation and outcomes such as by adhering to the Open Meetings Act and ensuring documents regarding proceedings are posted, organized, and maintained on an appropriate State website.

(c) After the initial development of the plan, the planning commission's plan updates shall list areas in which the plan is not being implemented or followed.

(d) The initial planning commission shall determine the staffing and process for updating the initial strategic action plan. The planning commission shall only undertake the plan updates if sufficient funding is secured through appropriations, gifts, grants, or donations.

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