HB1237ham001 103RD GENERAL ASSEMBLY

Rep. Kam Buckner

Filed: 2/28/2023

10300HB1237ham001 LRB103 05760 KTG 54728 a

AMENDMENT TO HOUSE BILL 1237

AMENDMENT NO. ______. Amend House Bill 1237 by replacing everything after the enacting clause with the following:

"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 Strategic Action Planning Commission for Aging Equity co-chaired by the Governor's Office and the Department on Aging to research and develop a strategic action plan for aging equity that is comprehensive, cross-sectoral, and long-term. 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, as well as other departments of State government in consideration of sectors outside of the aging network of services. The established Commission will develop a strategic action plan for aging equity for implementation across all of Illinois State Government with support for collaboration across other units of government within the state.

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, a trend occurring in much of the United States and the world. The aging of the population raises significant challenges and opportunities in terms of health, social, financial, care, and public systems, which affect virtually all Illinoisans in varied ways.

(3) The aging of communities has far-reaching effects on all people and all sectors. Many older Illinoisans interact with, and their lives and opportunities are shaped by, multiple systems and aspects of society, including, but not limited to, the availability, cost, and quality of: 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.

(4) Across Illinois, many people suffer hardship from long-standing structural inequities such as racism, class inequity, genderism, sexism, ageism, ableism, xenophobia, homophobia, transphobia, and other forms of oppression. These systemic inequities shape how, and whether or not, individuals reach older adulthood and their quality of life as they age. Health inequities exist both across and within Illinois's 102 counties.

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

(6) 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.

(7) 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 from COVID-19. These health inequities show the effects of structural racism and class inequity intersecting with ageism, which shape the degree of crowdedness and quality of nursing home care.

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

(9) Coordinated action is needed across Illinois' network of aging and disability advocates and providers, across all sectors, policymakers, and units of government to affirm the priority of the health and well-being of older Illinoisans and the need for policies that promote healthy aging throughout all Illinoisans' lives.

(10) 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 to better integrate current and future innovative solutions that improve quality of life 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 2025 through 2037. 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, and resources to support equitable aging across the life course.

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

(3) The Strategic Action Planning Commission for Aging Equity shall 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.

(4) Every 12 years, the Strategic Action Planning Commission for Aging Equity shall develop a new strategic action plan for aging equity.

Section 20. Definitions. As used in this Act:

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

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

"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.

"Aging Equity Commission" or "Commission" means the Strategic Action Planning Commission for Aging Equity.

"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.

"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.

"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.

"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.

"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.

"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.

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

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

"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.

"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.

"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.

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

"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.

"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 designees of the Governor's Office and the Department on Aging. The Aging Equity 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 Aging Equity Commission to ensure the following:

(1) Members across the main Aging Equity Commission and its committees meet the criteria set forth in this subsection. Individual members may fill multiple listed knowledge areas.

(2) The Aging Equity Commission committees reflect the geographic diversity of the State and includes members who represent:

(A) the rural, suburban, and urban areas of the State;

(B) the northern, central, and southern regions of the State; and

(C) the various districts.

(3) The Aging Equity Commission committees are inclusive and consist of members who reflect a diversity of age, gender, ability, race, cultural, socioeconomic, and national background.

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

(5) The Aging Equity Commission consists of the following persons:

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

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

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

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

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

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

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

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

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

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

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

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

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

(N) 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.

(O) 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 Aging Equity Commission consists of the heads of the following agencies, offices, boards, and other entities, or their designees:

(A) Department of Commerce and Economic Opportunity.

(B) Department of Healthcare and Family Services.

(C) Department of Human Services.

(D) Department of Innovation and Technology.

(E) Department of Labor.

(F) Department of Public Health.

(G) Department of Transportation.

(H) Department of Veterans' Affairs.

(I) Department on Aging.

(K) Illinois Housing Development Authority.

(L) Illinois Emergency Management Agency.

(b) The Aging Equity 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 the following topic areas:

(1) Home and community-based care and healthcare.

(2) Transportation.

(3) Housing.

(4) Social participation.

(5) Outdoor spaces and buildings.

(6) Respect and social inclusion.

(7) Civic participation.

(8) Employment.

(9) Communication and information.

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

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

(12) Funding mechanisms for aging-related services.

(13) New economic opportunities for the State.

(14) Ways to better support unpaid family caregivers in Illinois through increased services, programs, policies, and funding of caregiver supports that help people achieve living longer in their homes and communities.

(c) The Aging Equity 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) Commission guidelines.

(1) Anyone interested in becoming a member of one of the Aging Equity Commission's committees, which may be formed at the discretion of the Commission to delve deeper into topics of interest to the Commission, may submit an application to the Office of the Governor through the online application process, to be reviewed and assigned to a committee by the Commission.

(2) The Aging Equity Commission shall elect a chair and vice-chair from among its members to coordinate the Aging Equity Commission's meetings along with State agency staff or contractors. Members of the Aging Equity Commission shall serve without compensation. Members shall serve 4-year terms. The Aging Equity Commission shall establish staggered end of term dates for 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.

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

(4) The Aging Equity Commission shall establish a minimum of 5 committees to conduct planning on substantive issues listed in subsection (b) for the Strategic Action Plan for Aging Equity. Each committee shall consider and evaluate issues related to guiding principles listed under subsection (c). The committees shall include members of the Aging Equity Commission and may include persons who are not members of the Aging Equity Commission yet represent relevant expertise. Members of the specialized committees shall serve without compensation.

(5) Members of the committees shall include heads of the following agencies, offices, boards, and other entities, or their designees to ensure an all-of-government approach for the strategic action plan for aging equity:

(A) Department of Agriculture.

(B) Department of Commerce and Economic Opportunity.

(C) Department of Healthcare and Family Services.

(D) Department of Human Rights.

(E) Department of Human Services.

(F) Department of Innovation and Technology.

(G) Department of Insurance.

(H) Department of Labor.

(I) Department of Natural Resources.

(J) Department of Public Health.

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

(L) Department of Revenue.

(M) Department of Transportation.

(N) Department of Veterans' Affairs.

(O) Department on Aging.

(P) Department of Corrections.

(Q) Department of Children and Family Services.

(R) Department of Financial and Professional Regulation.

(S) Illinois Housing Development Authority.

(T) Office of the Illinois State Fire Marshal.

(U) Illinois Emergency Management Agency.

(V) Illinois State Board of Education.

(W) Illinois Board of Higher Education.

(X) Illinois Cognitive Support Network.

(Y) Illinois Council on Developmental Disabilities.

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

(AA) Department of Central Management Services.

(BB) Office of the Attorney General.

(CC) Office of the Secretary of State.

(DD) Office of the State Treasurer.

(6) Additionally, committees shall seek to include individuals with the following described backgrounds and expertise to engage a wide array of expertise:

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

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

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

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

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

(F) One member representing park districts.

(G) One member representing K-12 school systems.

(H) One member representing chambers of commerce.

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

(J) One member representing travel and hospitality.

(K) One member representing a philanthropic foundation.

(L) one member with extensive background in advocacy for unpaid family caregivers in both long-term care facilities and home services.

(7) The Aging Equity Commission shall establish and regularly engage with an Aging Equity Advisory Committee which consists of the State demographer and subject matter experts from local governmental and nongovernmental organizations to advise, inform, and assist the Aging Equity Commission.

(8) The Aging Equity Commission shall exercise its powers and perform its duties and functions as specified under this Act independently of the State agencies. The Aging Equity Commission may establish bylaws as appropriate for its effective operation. The chair of the Aging Equity Commission shall establish a schedule for Aging Equity Commission meetings. Members of the Aging Equity 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 Aging Equity Commission for Aging Equity.

(a) The Aging Equity Commission shall develop a preliminary comprehensive strategic action plan for aging equity in Illinois through the year 2035 to be completed within 18 months of commencement of the Aging Equity Commission. A 2-month public comment period shall be included and the strategic action plan for aging equity shall be finalized within 2 years from the commencement of the Aging Equity Commission.

(b) In developing the strategic action plan for aging equity, the Aging Equity Commission shall review and incorporate past recommendations and findings from previous studies and commissions, task forces, departments, and area agencies on aging that the Aging Equity 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. The strategic action plan must address at least the following 3 areas:

(1) Demographic, economic, fiscal, and budget data analysis through the year 2040.

(2) Actionable recommendations.

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

Section 35. Actionable recommendations. Aging Equity Commission recommendations shall be responsive to 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.

(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 older persons to remain in their homes and communities according to their wishes (to age-in-place).

(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 needed to implement the Aging Equity Commission's recommendations and achieve its stated goals.

(11) Possible regulatory and administrative changes to be offered to State departments needed to implement the Aging Equity 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 support individuals' abilities to remain in their homes and communities for as long as possible.

(14) Potential and recommended actions to make Illinois an age-friendly state.

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

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

Section 40. Reporting.

(a) During the 2024 and 2025 legislative sessions, the Aging Equity 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 Aging Equity Commission shall submit to the Governor, the General Assembly, and any affected State agency its strategic action plan detailing the work of the Aging Equity 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 Aging Equity Commission shall recommend legislation to implement the changes to the General Assembly. In its plan, the Aging Equity 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 45. Strategic plan updates and oversight.

(a) The Aging Equity Commission shall submit updates to the strategic action plan every 4 years, to update the Aging Equity 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 Aging Equity 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 Aging Equity Commission shall be subject to the Open Meetings Act and 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. The Commission shall ensure documents regarding proceedings are available on an appropriate State website.

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

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

Section 50. Repeal. The Aging Equity Commission is dissolved, and this Act is repealed, on December 31, 2043.

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