103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3952

 

Introduced 5/14/2024, by Sen. Doris Turner

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.02

    Amends the Illinois Act on the Aging. Provides that by January 1, 2025, the Department on Aging shall seek federal approval from the Centers for Medicare and Medicaid Services for any waiver or State Plan amendment necessary to provide monthly monitoring payments to care coordination units for each active participant enrolled in the Community Care Program who is receiving any allowable service and has not utilized services authorized by the care coordination unit or managed care organization for the month preceding the last month of services. Requires managed care organizations to remediate the full monthly monitoring payment to care coordination units that are providing services in accordance with the Act. Defines "active participant" to mean a person 60 years of age or older who has been found eligible to receive Community Care Program services. Provides that to receive administrative payments, a care coordination unit must provide documentation demonstrating that an effort has been made to contact the individual and confirm that the individual no longer needs services provided by the care coordination unit. Requires the Department to secure federal financial participation for expenditures made by the Department for State Fiscal Year 2025 and every State fiscal year thereafter. Effective immediately.


LRB103 39999 KTG 71302 b

 

 

A BILL FOR

 

SB3952LRB103 39999 KTG 71302 b

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

 

 

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1        (g) education in self-care;
2        (h) personal care services;
3        (i) adult day health services;
4        (j) habilitation services;
5        (k) respite care;
6        (k-5) community reintegration services;
7        (k-6) flexible senior services;
8        (k-7) medication management;
9        (k-8) emergency home response;
10        (l) other nonmedical social services that may enable
11    the person to become self-supporting; or
12        (m) clearinghouse for information provided by senior
13    citizen home owners who want to rent rooms to or share
14    living space with other senior citizens.
15    The Department shall establish eligibility standards for
16such services. In determining the amount and nature of
17services for which a person may qualify, consideration shall
18not be given to the value of cash, property, or other assets
19held in the name of the person's spouse pursuant to a written
20agreement dividing marital property into equal but separate
21shares or pursuant to a transfer of the person's interest in a
22home to his spouse, provided that the spouse's share of the
23marital property is not made available to the person seeking
24such services.
25    Beginning January 1, 2008, the Department shall require as
26a condition of eligibility that all new financially eligible

 

 

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1applicants apply for and enroll in medical assistance under
2Article V of the Illinois Public Aid Code in accordance with
3rules promulgated by the Department.
4    The Department shall, in conjunction with the Department
5of Public Aid (now Department of Healthcare and Family
6Services), seek appropriate amendments under Sections 1915 and
71924 of the Social Security Act. The purpose of the amendments
8shall be to extend eligibility for home and community based
9services under Sections 1915 and 1924 of the Social Security
10Act to persons who transfer to or for the benefit of a spouse
11those amounts of income and resources allowed under Section
121924 of the Social Security Act. Subject to the approval of
13such amendments, the Department shall extend the provisions of
14Section 5-4 of the Illinois Public Aid Code to persons who, but
15for the provision of home or community-based services, would
16require the level of care provided in an institution, as is
17provided for in federal law. Those persons no longer found to
18be eligible for receiving noninstitutional services due to
19changes in the eligibility criteria shall be given 45 days
20notice prior to actual termination. Those persons receiving
21notice of termination may contact the Department and request
22the determination be appealed at any time during the 45 day
23notice period. The target population identified for the
24purposes of this Section are persons age 60 and older with an
25identified service need. Priority shall be given to those who
26are at imminent risk of institutionalization. The services

 

 

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1shall be provided to eligible persons age 60 and older to the
2extent that the cost of the services together with the other
3personal maintenance expenses of the persons are reasonably
4related to the standards established for care in a group
5facility appropriate to the person's condition. These
6non-institutional services, pilot projects, or experimental
7facilities may be provided as part of or in addition to those
8authorized by federal law or those funded and administered by
9the Department of Human Services. The Departments of Human
10Services, Healthcare and Family Services, Public Health,
11Veterans' Affairs, and Commerce and Economic Opportunity and
12other appropriate agencies of State, federal, and local
13governments shall cooperate with the Department on Aging in
14the establishment and development of the non-institutional
15services. The Department shall require an annual audit from
16all personal assistant and home care aide vendors contracting
17with the Department under this Section. The annual audit shall
18assure that each audited vendor's procedures are in compliance
19with Department's financial reporting guidelines requiring an
20administrative and employee wage and benefits cost split as
21defined in administrative rules. The audit is a public record
22under the Freedom of Information Act. The Department shall
23execute, relative to the nursing home prescreening project,
24written inter-agency agreements with the Department of Human
25Services and the Department of Healthcare and Family Services,
26to effect the following: (1) intake procedures and common

 

 

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

 

 

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

 

 

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1    The Department shall increase the effectiveness of the
2existing Community Care Program by:
3        (1) ensuring that in-home services included in the
4    care plan are available on evenings and weekends;
5        (2) ensuring that care plans contain the services that
6    eligible participants need based on the number of days in
7    a month, not limited to specific blocks of time, as
8    identified by the comprehensive assessment tool selected
9    by the Department for use statewide, not to exceed the
10    total monthly service cost maximum allowed for each
11    service; the Department shall develop administrative rules
12    to implement this item (2);
13        (3) ensuring that the participants have the right to
14    choose the services contained in their care plan and to
15    direct how those services are provided, based on
16    administrative rules established by the Department;
17        (4) ensuring that the determination of need tool is
18    accurate in determining the participants' level of need;
19    to achieve this, the Department, in conjunction with the
20    Older Adult Services Advisory Committee, shall institute a
21    study of the relationship between the Determination of
22    Need scores, level of need, service cost maximums, and the
23    development and utilization of service plans no later than
24    May 1, 2008; findings and recommendations shall be
25    presented to the Governor and the General Assembly no
26    later than January 1, 2009; recommendations shall include

 

 

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1    all needed changes to the service cost maximums schedule
2    and additional covered services;
3        (5) ensuring that homemakers can provide personal care
4    services that may or may not involve contact with clients,
5    including, but not limited to:
6            (A) bathing;
7            (B) grooming;
8            (C) toileting;
9            (D) nail care;
10            (E) transferring;
11            (F) respiratory services;
12            (G) exercise; or
13            (H) positioning;
14        (6) ensuring that homemaker program vendors are not
15    restricted from hiring homemakers who are family members
16    of clients or recommended by clients; the Department may
17    not, by rule or policy, require homemakers who are family
18    members of clients or recommended by clients to accept
19    assignments in homes other than the client;
20        (7) ensuring that the State may access maximum federal
21    matching funds by seeking approval for the Centers for
22    Medicare and Medicaid Services for modifications to the
23    State's home and community based services waiver and
24    additional waiver opportunities, including applying for
25    enrollment in the Balance Incentive Payment Program by May
26    1, 2013, in order to maximize federal matching funds; this

 

 

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1    shall include, but not be limited to, modification that
2    reflects all changes in the Community Care Program
3    services and all increases in the services cost maximum;
4        (8) ensuring that the determination of need tool
5    accurately reflects the service needs of individuals with
6    Alzheimer's disease and related dementia disorders;
7        (9) ensuring that services are authorized accurately
8    and consistently for the Community Care Program (CCP); the
9    Department shall implement a Service Authorization policy
10    directive; the purpose shall be to ensure that eligibility
11    and services are authorized accurately and consistently in
12    the CCP program; the policy directive shall clarify
13    service authorization guidelines to Care Coordination
14    Units and Community Care Program providers no later than
15    May 1, 2013;
16        (10) working in conjunction with Care Coordination
17    Units, the Department of Healthcare and Family Services,
18    the Department of Human Services, Community Care Program
19    providers, and other stakeholders to make improvements to
20    the Medicaid claiming processes and the Medicaid
21    enrollment procedures or requirements as needed,
22    including, but not limited to, specific policy changes or
23    rules to improve the up-front enrollment of participants
24    in the Medicaid program and specific policy changes or
25    rules to insure more prompt submission of bills to the
26    federal government to secure maximum federal matching

 

 

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1    dollars as promptly as possible; the Department on Aging
2    shall have at least 3 meetings with stakeholders by
3    January 1, 2014 in order to address these improvements;
4        (11) requiring home care service providers to comply
5    with the rounding of hours worked provisions under the
6    federal Fair Labor Standards Act (FLSA) and as set forth
7    in 29 CFR 785.48(b) by May 1, 2013;
8        (12) implementing any necessary policy changes or
9    promulgating any rules, no later than January 1, 2014, to
10    assist the Department of Healthcare and Family Services in
11    moving as many participants as possible, consistent with
12    federal regulations, into coordinated care plans if a care
13    coordination plan that covers long term care is available
14    in the recipient's area; and
15        (13) maintaining fiscal year 2014 rates at the same
16    level established on January 1, 2013.
17    By January 1, 2009 or as soon after the end of the Cash and
18Counseling Demonstration Project as is practicable, the
19Department may, based on its evaluation of the demonstration
20project, promulgate rules concerning personal assistant
21services, to include, but need not be limited to,
22qualifications, employment screening, rights under fair labor
23standards, training, fiduciary agent, and supervision
24requirements. All applicants shall be subject to the
25provisions of the Health Care Worker Background Check Act.
26    The Department shall develop procedures to enhance

 

 

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1availability of services on evenings, weekends, and on an
2emergency basis to meet the respite needs of caregivers.
3Procedures shall be developed to permit the utilization of
4services in successive blocks of 24 hours up to the monthly
5maximum established by the Department. Workers providing these
6services shall be appropriately trained.
7    Beginning on September 23, 1991 (the effective date of
8Public Act 87-729) this amendatory Act of 1991, no person may
9perform chore/housekeeping and home care aide services under a
10program authorized by this Section unless that person has been
11issued a certificate of pre-service to do so by his or her
12employing agency. Information gathered to effect such
13certification shall include (i) the person's name, (ii) the
14date the person was hired by his or her current employer, and
15(iii) the training, including dates and levels. Persons
16engaged in the program authorized by this Section before the
17effective date of this amendatory Act of 1991 shall be issued a
18certificate of all pre-service pre- and in-service training
19from his or her employer upon submitting the necessary
20information. The employing agency shall be required to retain
21records of all staff pre-service pre- and in-service training,
22and shall provide such records to the Department upon request
23and upon termination of the employer's contract with the
24Department. In addition, the employing agency is responsible
25for the issuance of certifications of in-service training
26completed to their employees.

 

 

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1    The Department is required to develop a system to ensure
2that persons working as home care aides and personal
3assistants receive increases in their wages when the federal
4minimum wage is increased by requiring vendors to certify that
5they are meeting the federal minimum wage statute for home
6care aides and personal assistants. An employer that cannot
7ensure that the minimum wage increase is being given to home
8care aides and personal assistants shall be denied any
9increase in reimbursement costs.
10    The Community Care Program Advisory Committee is created
11in the Department on Aging. The Director shall appoint
12individuals to serve in the Committee, who shall serve at
13their own expense. Members of the Committee must abide by all
14applicable ethics laws. The Committee shall advise the
15Department on issues related to the Department's program of
16services to prevent unnecessary institutionalization. The
17Committee shall meet on a bi-monthly basis and shall serve to
18identify and advise the Department on present and potential
19issues affecting the service delivery network, the program's
20clients, and the Department and to recommend solution
21strategies. Persons appointed to the Committee shall be
22appointed on, but not limited to, their own and their agency's
23experience with the program, geographic representation, and
24willingness to serve. The Director shall appoint members to
25the Committee to represent provider, advocacy, policy
26research, and other constituencies committed to the delivery

 

 

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1of high quality home and community-based services to older
2adults. Representatives shall be appointed to ensure
3representation from community care providers, including, but
4not limited to, adult day service providers, homemaker
5providers, case coordination and case management units,
6emergency home response providers, statewide trade or labor
7unions that represent home care aides and direct care staff,
8area agencies on aging, adults over age 60, membership
9organizations representing older adults, and other
10organizational entities, providers of care, or individuals
11with demonstrated interest and expertise in the field of home
12and community care as determined by the Director.
13    Nominations may be presented from any agency or State
14association with interest in the program. The Director, or his
15or her designee, shall serve as the permanent co-chair of the
16advisory committee. One other co-chair shall be nominated and
17approved by the members of the committee on an annual basis.
18Committee members' terms of appointment shall be for 4 years
19with one-quarter of the appointees' terms expiring each year.
20A member shall continue to serve until his or her replacement
21is named. The Department shall fill vacancies that have a
22remaining term of over one year, and this replacement shall
23occur through the annual replacement of expiring terms. The
24Director shall designate Department staff to provide technical
25assistance and staff support to the committee. Department
26representation shall not constitute membership of the

 

 

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1committee. All Committee papers, issues, recommendations,
2reports, and meeting memoranda are advisory only. The
3Director, or his or her designee, shall make a written report,
4as requested by the Committee, regarding issues before the
5Committee.
6    The Department on Aging and the Department of Human
7Services shall cooperate in the development and submission of
8an annual report on programs and services provided under this
9Section. Such joint report shall be filed with the Governor
10and the General Assembly on or before March 31 of the following
11fiscal year.
12    The requirement for reporting to the General Assembly
13shall be satisfied by filing copies of the report as required
14by Section 3.1 of the General Assembly Organization Act and
15filing such additional copies with the State Government Report
16Distribution Center for the General Assembly as is required
17under paragraph (t) of Section 7 of the State Library Act.
18    Those persons previously found eligible for receiving
19non-institutional services whose services were discontinued
20under the Emergency Budget Act of Fiscal Year 1992, and who do
21not meet the eligibility standards in effect on or after July
221, 1992, shall remain ineligible on and after July 1, 1992.
23Those persons previously not required to cost-share and who
24were required to cost-share effective March 1, 1992, shall
25continue to meet cost-share requirements on and after July 1,
261992. Beginning July 1, 1992, all clients will be required to

 

 

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1meet eligibility, cost-share, and other requirements and will
2have services discontinued or altered when they fail to meet
3these requirements.
4    For the purposes of this Section, "flexible senior
5services" refers to services that require one-time or periodic
6expenditures, including, but not limited to, respite care,
7home modification, assistive technology, housing assistance,
8and transportation.
9    The Department shall implement an electronic service
10verification based on global positioning systems or other
11cost-effective technology for the Community Care Program no
12later than January 1, 2014.
13    The Department shall require, as a condition of
14eligibility, enrollment in the medical assistance program
15under Article V of the Illinois Public Aid Code (i) beginning
16August 1, 2013, if the Auditor General has reported that the
17Department has failed to comply with the reporting
18requirements of Section 2-27 of the Illinois State Auditing
19Act; or (ii) beginning June 1, 2014, if the Auditor General has
20reported that the Department has not undertaken the required
21actions listed in the report required by subsection (a) of
22Section 2-27 of the Illinois State Auditing Act.
23    The Department shall delay Community Care Program services
24until an applicant is determined eligible for medical
25assistance under Article V of the Illinois Public Aid Code (i)
26beginning August 1, 2013, if the Auditor General has reported

 

 

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1that the Department has failed to comply with the reporting
2requirements of Section 2-27 of the Illinois State Auditing
3Act; or (ii) beginning June 1, 2014, if the Auditor General has
4reported that the Department has not undertaken the required
5actions listed in the report required by subsection (a) of
6Section 2-27 of the Illinois State Auditing Act.
7    The Department shall implement co-payments for the
8Community Care Program at the federally allowable maximum
9level (i) beginning August 1, 2013, if the Auditor General has
10reported that the Department has failed to comply with the
11reporting requirements of Section 2-27 of the Illinois State
12Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
13General has reported that the Department has not undertaken
14the required actions listed in the report required by
15subsection (a) of Section 2-27 of the Illinois State Auditing
16Act.
17    The Department shall continue to provide other Community
18Care Program reports as required by statute.
19    The Department shall conduct a quarterly review of Care
20Coordination Unit performance and adherence to service
21guidelines. The quarterly review shall be reported to the
22Speaker of the House of Representatives, the Minority Leader
23of the House of Representatives, the President of the Senate,
24and the Minority Leader of the Senate. The Department shall
25collect and report longitudinal data on the performance of
26each care coordination unit. Nothing in this paragraph shall

 

 

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1be construed to require the Department to identify specific
2care coordination units.
3    In regard to community care providers, failure to comply
4with Department on Aging policies shall be cause for
5disciplinary action, including, but not limited to,
6disqualification from serving Community Care Program clients.
7Each provider, upon submission of any bill or invoice to the
8Department for payment for services rendered, shall include a
9notarized statement, under penalty of perjury pursuant to
10Section 1-109 of the Code of Civil Procedure, that the
11provider has complied with all Department policies.
12    The Director of the Department on Aging shall make
13information available to the State Board of Elections as may
14be required by an agreement the State Board of Elections has
15entered into with a multi-state voter registration list
16maintenance system.
17    Within 30 days after July 6, 2017 (the effective date of
18Public Act 100-23), rates shall be increased to $18.29 per
19hour, for the purpose of increasing, by at least $.72 per hour,
20the wages paid by those vendors to their employees who provide
21homemaker services. The Department shall pay an enhanced rate
22under the Community Care Program to those in-home service
23provider agencies that offer health insurance coverage as a
24benefit to their direct service worker employees consistent
25with the mandates of Public Act 95-713. For State fiscal years
262018 and 2019, the enhanced rate shall be $1.77 per hour. The

 

 

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1rate shall be adjusted using actuarial analysis based on the
2cost of care, but shall not be set below $1.77 per hour. The
3Department shall adopt rules, including emergency rules under
4subsections (y) and (bb) of Section 5-45 of the Illinois
5Administrative Procedure Act, to implement the provisions of
6this paragraph.
7    Subject to federal approval, beginning on January 1, 2024,
8rates for adult day services shall be increased to $16.84 per
9hour and rates for each way transportation services for adult
10day services shall be increased to $12.44 per unit
11transportation.
12    Subject to federal approval, on and after January 1, 2024,
13rates for homemaker services shall be increased to $28.07 to
14sustain a minimum wage of $17 per hour for direct service
15workers. Rates in subsequent State fiscal years shall be no
16lower than the rates put into effect upon federal approval.
17Providers of in-home services shall be required to certify to
18the Department that they remain in compliance with the
19mandated wage increase for direct service workers. Fringe
20benefits, including, but not limited to, paid time off and
21payment for training, health insurance, travel, or
22transportation, shall not be reduced in relation to the rate
23increases described in this paragraph.
24    The General Assembly finds it necessary to authorize an
25aggressive Medicaid enrollment initiative designed to maximize
26federal Medicaid funding for the Community Care Program which

 

 

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1produces significant savings for the State of Illinois. The
2Department on Aging shall establish and implement a Community
3Care Program Medicaid Initiative. Under the Initiative, the
4Department on Aging shall, at a minimum: (i) provide an
5enhanced rate to adequately compensate care coordination units
6to enroll eligible Community Care Program clients into
7Medicaid; (ii) use recommendations from a stakeholder
8committee on how best to implement the Initiative; and (iii)
9establish requirements for State agencies to make enrollment
10in the State's Medical Assistance program easier for seniors.
11    The Community Care Program Medicaid Enrollment Oversight
12Subcommittee is created as a subcommittee of the Older Adult
13Services Advisory Committee established in Section 35 of the
14Older Adult Services Act to make recommendations on how best
15to increase the number of medical assistance recipients who
16are enrolled in the Community Care Program. The Subcommittee
17shall consist of all of the following persons who must be
18appointed within 30 days after June 4, 2018 (the effective
19date of Public Act 100-587) this amendatory Act of the 100th
20General Assembly:
21        (1) The Director of Aging, or his or her designee, who
22    shall serve as the chairperson of the Subcommittee.
23        (2) One representative of the Department of Healthcare
24    and Family Services, appointed by the Director of
25    Healthcare and Family Services.
26        (3) One representative of the Department of Human

 

 

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1    Services, appointed by the Secretary of Human Services.
2        (4) One individual representing a care coordination
3    unit, appointed by the Director of Aging.
4        (5) One individual from a non-governmental statewide
5    organization that advocates for seniors, appointed by the
6    Director of Aging.
7        (6) One individual representing Area Agencies on
8    Aging, appointed by the Director of Aging.
9        (7) One individual from a statewide association
10    dedicated to Alzheimer's care, support, and research,
11    appointed by the Director of Aging.
12        (8) One individual from an organization that employs
13    persons who provide services under the Community Care
14    Program, appointed by the Director of Aging.
15        (9) One member of a trade or labor union representing
16    persons who provide services under the Community Care
17    Program, appointed by the Director of Aging.
18        (10) One member of the Senate, who shall serve as
19    co-chairperson, appointed by the President of the Senate.
20        (11) One member of the Senate, who shall serve as
21    co-chairperson, appointed by the Minority Leader of the
22    Senate.
23        (12) One member of the House of Representatives, who
24    shall serve as co-chairperson, appointed by the Speaker of
25    the House of Representatives.
26        (13) One member of the House of Representatives, who

 

 

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1    shall serve as co-chairperson, appointed by the Minority
2    Leader of the House of Representatives.
3        (14) One individual appointed by a labor organization
4    representing frontline employees at the Department of
5    Human Services.
6    The Subcommittee shall provide oversight to the Community
7Care Program Medicaid Initiative and shall meet quarterly. At
8each Subcommittee meeting the Department on Aging shall
9provide the following data sets to the Subcommittee: (A) the
10number of Illinois residents, categorized by planning and
11service area, who are receiving services under the Community
12Care Program and are enrolled in the State's Medical
13Assistance Program; (B) the number of Illinois residents,
14categorized by planning and service area, who are receiving
15services under the Community Care Program, but are not
16enrolled in the State's Medical Assistance Program; and (C)
17the number of Illinois residents, categorized by planning and
18service area, who are receiving services under the Community
19Care Program and are eligible for benefits under the State's
20Medical Assistance Program, but are not enrolled in the
21State's Medical Assistance Program. In addition to this data,
22the Department on Aging shall provide the Subcommittee with
23plans on how the Department on Aging will reduce the number of
24Illinois residents who are not enrolled in the State's Medical
25Assistance Program but who are eligible for medical assistance
26benefits. The Department on Aging shall enroll in the State's

 

 

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1Medical Assistance Program those Illinois residents who
2receive services under the Community Care Program and are
3eligible for medical assistance benefits but are not enrolled
4in the State's Medicaid Assistance Program. The data provided
5to the Subcommittee shall be made available to the public via
6the Department on Aging's website.
7    The Department on Aging, with the involvement of the
8Subcommittee, shall collaborate with the Department of Human
9Services and the Department of Healthcare and Family Services
10on how best to achieve the responsibilities of the Community
11Care Program Medicaid Initiative.
12    The Department on Aging, the Department of Human Services,
13and the Department of Healthcare and Family Services shall
14coordinate and implement a streamlined process for seniors to
15access benefits under the State's Medical Assistance Program.
16    The Subcommittee shall collaborate with the Department of
17Human Services on the adoption of a uniform application
18submission process. The Department of Human Services and any
19other State agency involved with processing the medical
20assistance application of any person enrolled in the Community
21Care Program shall include the appropriate care coordination
22unit in all communications related to the determination or
23status of the application.
24    The Community Care Program Medicaid Initiative shall
25provide targeted funding to care coordination units to help
26seniors complete their applications for medical assistance

 

 

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1benefits. On and after July 1, 2019, care coordination units
2shall receive no less than $200 per completed application,
3which rate may be included in a bundled rate for initial intake
4services when Medicaid application assistance is provided in
5conjunction with the initial intake process for new program
6participants.
7    The Community Care Program Medicaid Initiative shall cease
8operation 5 years after June 4, 2018 (the effective date of
9Public Act 100-587) this amendatory Act of the 100th General
10Assembly, after which the Subcommittee shall dissolve.
11    Effective July 1, 2023, subject to federal approval, the
12Department on Aging shall reimburse Care Coordination Units at
13the following rates for case management services: $252.40 for
14each initial assessment; $366.40 for each initial assessment
15with translation; $229.68 for each redetermination assessment;
16$313.68 for each redetermination assessment with translation;
17$200.00 for each completed application for medical assistance
18benefits; $132.26 for each face-to-face, choices-for-care
19screening; $168.26 for each face-to-face, choices-for-care
20screening with translation; $124.56 for each 6-month,
21face-to-face visit; $132.00 for each MCO participant
22eligibility determination; and $157.00 for each MCO
23participant eligibility determination with translation.
24    By January 1, 2025, the Department shall seek federal
25approval from the Centers for Medicare and Medicaid Services
26for any waiver or State Plan amendment necessary to provide

 

 

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1monthly monitoring payments to care coordination units for
2each active participant enrolled in the Community Care Program
3who is receiving any allowable service under this Section and
4has not utilized services authorized by the care coordination
5unit or managed care organization for the month preceding the
6last month of services. Managed care organizations shall
7remediate the full monthly monitoring payment to care
8coordination units that are providing services in accordance
9with this Section. As used in this paragraph, "active
10participant" means a person 60 years of age or older who has
11been found eligible to receive Community Care Program
12services. To receive administrative payments under this
13paragraph, a care coordination unit must provide documentation
14demonstrating that an effort has been made to contact the
15individual and confirm that the individual no longer needs
16services provided by the care coordination unit. The
17Department shall secure federal financial participation for
18expenditures made by the Department in accordance with this
19paragraph for State Fiscal Year 2025 and every State fiscal
20year thereafter.
21(Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23;
22103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102,
23Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90,
24Section 90-5, eff. 1-1-24; revised 12-12-23.)
 
25    Section 99. Effective date. This Act takes effect upon
26becoming law.