Rep. Gary Hannig
Filed: 5/30/2005
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1 | AMENDMENT TO SENATE BILL 998
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2 | AMENDMENT NO. ______. Amend Senate Bill 998, AS AMENDED, by | ||||||
3 | replacing everything after the enacting clause with the | ||||||
4 | following:
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5 | "Section 1. Short title. This Act may be cited as the | ||||||
6 | FY2006 Budget Implementation (Human Services) Act. | ||||||
7 | Section 5. Purpose. It is the purpose of this Act to | ||||||
8 | implement the Governor's FY2006 budget recommendations | ||||||
9 | concerning human services. | ||||||
10 | Section 10. The Illinois Administrative Procedure Act is | ||||||
11 | amended by changing Section 5-45 as follows:
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12 | (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
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13 | Sec. 5-45. Emergency rulemaking.
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14 | (a) "Emergency" means the existence of any situation that | ||||||
15 | any agency
finds reasonably constitutes a threat to the public | ||||||
16 | interest, safety, or
welfare.
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17 | (b) If any agency finds that an
emergency exists that | ||||||
18 | requires adoption of a rule upon fewer days than
is required by | ||||||
19 | Section 5-40 and states in writing its reasons for that
| ||||||
20 | finding, the agency may adopt an emergency rule without prior | ||||||
21 | notice or
hearing upon filing a notice of emergency rulemaking | ||||||
22 | with the Secretary of
State under Section 5-70. The notice |
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1 | shall include the text of the
emergency rule and shall be | ||||||
2 | published in the Illinois Register. Consent
orders or other | ||||||
3 | court orders adopting settlements negotiated by an agency
may | ||||||
4 | be adopted under this Section. Subject to applicable | ||||||
5 | constitutional or
statutory provisions, an emergency rule | ||||||
6 | becomes effective immediately upon
filing under Section 5-65 or | ||||||
7 | at a stated date less than 10 days
thereafter. The agency's | ||||||
8 | finding and a statement of the specific reasons
for the finding | ||||||
9 | shall be filed with the rule. The agency shall take
reasonable | ||||||
10 | and appropriate measures to make emergency rules known to the
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11 | persons who may be affected by them.
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12 | (c) An emergency rule may be effective for a period of not | ||||||
13 | longer than
150 days, but the agency's authority to adopt an | ||||||
14 | identical rule under Section
5-40 is not precluded. No | ||||||
15 | emergency rule may be adopted more
than once in any 24 month | ||||||
16 | period, except that this limitation on the number
of emergency | ||||||
17 | rules that may be adopted in a 24 month period does not apply
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18 | to (i) emergency rules that make additions to and deletions | ||||||
19 | from the Drug
Manual under Section 5-5.16 of the Illinois | ||||||
20 | Public Aid Code or the
generic drug formulary under Section | ||||||
21 | 3.14 of the Illinois Food, Drug
and Cosmetic Act, (ii) | ||||||
22 | emergency rules adopted by the Pollution Control
Board before | ||||||
23 | July 1, 1997 to implement portions of the Livestock Management
| ||||||
24 | Facilities Act , ; or (iii) emergency rules adopted by the | ||||||
25 | Illinois Department of Public Health under subsections (a) | ||||||
26 | through (i) of Section 2 of the Department of Public Health Act | ||||||
27 | when necessary to protect the public's health. Two or more | ||||||
28 | emergency rules having substantially the same
purpose and | ||||||
29 | effect shall be deemed to be a single rule for purposes of this
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30 | Section.
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31 | (d) In order to provide for the expeditious and timely | ||||||
32 | implementation
of the State's fiscal year 1999 budget, | ||||||
33 | emergency rules to implement any
provision of Public Act 90-587 | ||||||
34 | or 90-588
or any other budget initiative for fiscal year 1999 |
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1 | may be adopted in
accordance with this Section by the agency | ||||||
2 | charged with administering that
provision or initiative, | ||||||
3 | except that the 24-month limitation on the adoption
of | ||||||
4 | emergency rules and the provisions of Sections 5-115 and 5-125 | ||||||
5 | do not apply
to rules adopted under this subsection (d). The | ||||||
6 | adoption of emergency rules
authorized by this subsection (d) | ||||||
7 | shall be deemed to be necessary for the
public interest, | ||||||
8 | safety, and welfare.
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9 | (e) In order to provide for the expeditious and timely | ||||||
10 | implementation
of the State's fiscal year 2000 budget, | ||||||
11 | emergency rules to implement any
provision of this amendatory | ||||||
12 | Act of the 91st General Assembly
or any other budget initiative | ||||||
13 | for fiscal year 2000 may be adopted in
accordance with this | ||||||
14 | Section by the agency charged with administering that
provision | ||||||
15 | or initiative, except that the 24-month limitation on the | ||||||
16 | adoption
of emergency rules and the provisions of Sections | ||||||
17 | 5-115 and 5-125 do not apply
to rules adopted under this | ||||||
18 | subsection (e). The adoption of emergency rules
authorized by | ||||||
19 | this subsection (e) shall be deemed to be necessary for the
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20 | public interest, safety, and welfare.
| ||||||
21 | (f) In order to provide for the expeditious and timely | ||||||
22 | implementation
of the State's fiscal year 2001 budget, | ||||||
23 | emergency rules to implement any
provision of this amendatory | ||||||
24 | Act of the 91st General Assembly
or any other budget initiative | ||||||
25 | for fiscal year 2001 may be adopted in
accordance with this | ||||||
26 | Section by the agency charged with administering that
provision | ||||||
27 | or initiative, except that the 24-month limitation on the | ||||||
28 | adoption
of emergency rules and the provisions of Sections | ||||||
29 | 5-115 and 5-125 do not apply
to rules adopted under this | ||||||
30 | subsection (f). The adoption of emergency rules
authorized by | ||||||
31 | this subsection (f) shall be deemed to be necessary for the
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32 | public interest, safety, and welfare.
| ||||||
33 | (g) In order to provide for the expeditious and timely | ||||||
34 | implementation
of the State's fiscal year 2002 budget, |
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1 | emergency rules to implement any
provision of this amendatory | ||||||
2 | Act of the 92nd General Assembly
or any other budget initiative | ||||||
3 | for fiscal year 2002 may be adopted in
accordance with this | ||||||
4 | Section by the agency charged with administering that
provision | ||||||
5 | or initiative, except that the 24-month limitation on the | ||||||
6 | adoption
of emergency rules and the provisions of Sections | ||||||
7 | 5-115 and 5-125 do not apply
to rules adopted under this | ||||||
8 | subsection (g). The adoption of emergency rules
authorized by | ||||||
9 | this subsection (g) shall be deemed to be necessary for the
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10 | public interest, safety, and welfare.
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11 | (h) In order to provide for the expeditious and timely | ||||||
12 | implementation
of the State's fiscal year 2003 budget, | ||||||
13 | emergency rules to implement any
provision of this amendatory | ||||||
14 | Act of the 92nd General Assembly
or any other budget initiative | ||||||
15 | for fiscal year 2003 may be adopted in
accordance with this | ||||||
16 | Section by the agency charged with administering that
provision | ||||||
17 | or initiative, except that the 24-month limitation on the | ||||||
18 | adoption
of emergency rules and the provisions of Sections | ||||||
19 | 5-115 and 5-125 do not apply
to rules adopted under this | ||||||
20 | subsection (h). The adoption of emergency rules
authorized by | ||||||
21 | this subsection (h) shall be deemed to be necessary for the
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22 | public interest, safety, and welfare.
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23 | (i) In order to provide for the expeditious and timely | ||||||
24 | implementation
of the State's fiscal year 2004 budget, | ||||||
25 | emergency rules to implement any
provision of this amendatory | ||||||
26 | Act of the 93rd General Assembly
or any other budget initiative | ||||||
27 | for fiscal year 2004 may be adopted in
accordance with this | ||||||
28 | Section by the agency charged with administering that
provision | ||||||
29 | or initiative, except that the 24-month limitation on the | ||||||
30 | adoption
of emergency rules and the provisions of Sections | ||||||
31 | 5-115 and 5-125 do not apply
to rules adopted under this | ||||||
32 | subsection (i). The adoption of emergency rules
authorized by | ||||||
33 | this subsection (i) shall be deemed to be necessary for the
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34 | public interest, safety, and welfare.
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1 | (j) In order to provide for the expeditious and timely | ||||||
2 | implementation of the provisions of the State's fiscal year | ||||||
3 | 2005 budget as provided under the Fiscal Year 2005 Budget | ||||||
4 | Implementation (Human Services) Act, emergency rules to | ||||||
5 | implement any provision of the Fiscal Year 2005 Budget | ||||||
6 | Implementation (Human Services) Act may be adopted in | ||||||
7 | accordance with this Section by the agency charged with | ||||||
8 | administering that provision, except that the 24-month | ||||||
9 | limitation on the adoption of emergency rules and the | ||||||
10 | provisions of Sections 5-115 and 5-125 do not apply to rules | ||||||
11 | adopted under this subsection (j). The Department of Public Aid | ||||||
12 | may also adopt rules under this subsection (j) necessary to | ||||||
13 | administer the Illinois Public Aid Code and the Children's | ||||||
14 | Health Insurance Program Act. The adoption of emergency rules | ||||||
15 | authorized by this subsection (j) shall be deemed to be | ||||||
16 | necessary for the public interest, safety, and welfare.
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17 | (k) In order to provide for the expeditious and timely | ||||||
18 | implementation of the provisions of the State's fiscal year | ||||||
19 | 2006 budget, emergency rules to implement any provision of this | ||||||
20 | amendatory Act of the 94th General Assembly or any other budget | ||||||
21 | initiative for fiscal year 2006 may be adopted in accordance | ||||||
22 | with this Section by the agency charged with administering that | ||||||
23 | provision or initiative, except that the 24-month limitation on | ||||||
24 | the adoption of emergency rules and the provisions of Sections | ||||||
25 | 5-115 and 5-125 do not apply to rules adopted under this | ||||||
26 | subsection (k). The Department of Public Aid may also adopt | ||||||
27 | rules under this subsection (k) necessary to administer the | ||||||
28 | Illinois Public Aid Code, the Senior Citizens and Disabled | ||||||
29 | Persons Property Tax Relief and Pharmaceutical Assistance Act, | ||||||
30 | the Senior Citizens and Disabled Persons Prescription Drug | ||||||
31 | Discount Program Act, and the Children's Health Insurance | ||||||
32 | Program Act. The adoption of emergency rules authorized by this | ||||||
33 | subsection (k) shall be deemed to be necessary for the public | ||||||
34 | interest, safety, and welfare.
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1 | (Source: P.A. 92-10, eff. 6-11-01; 92-597, eff. 6-28-02; 93-20, | ||||||
2 | eff. 6-20-03; 93-829, eff. 7-28-04; 93-841, eff. 7-30-04; | ||||||
3 | revised 10-25-04.)
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4 | Section 12. The Illinois Act on the Aging is amended by | ||||||
5 | changing Section 4.02 as follows:
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6 | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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7 | Sec. 4.02. The Department shall establish a program of | ||||||
8 | services to
prevent unnecessary institutionalization of | ||||||
9 | persons age 60 and older in
need of long term care or who are | ||||||
10 | established as persons who suffer from
Alzheimer's disease or a | ||||||
11 | related disorder under the Alzheimer's Disease
Assistance Act, | ||||||
12 | thereby enabling them
to remain in their own homes or in other | ||||||
13 | living arrangements. Such
preventive services, which may be | ||||||
14 | coordinated with other programs for the
aged and monitored by | ||||||
15 | area agencies on aging in cooperation with the
Department, may | ||||||
16 | include, but are not limited to, any or all of the following:
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17 | (a) home health services;
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18 | (b) home nursing services;
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19 | (c) homemaker services;
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20 | (d) chore and housekeeping services;
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21 | (e) day care services;
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22 | (f) home-delivered meals;
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23 | (g) education in self-care;
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24 | (h) personal care services;
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25 | (i) adult day health services;
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26 | (j) habilitation services;
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27 | (k) respite care;
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28 | (k-5) community reintegration services;
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29 | (l) other nonmedical social services that may enable | ||||||
30 | the person
to become self-supporting; or
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31 | (m) clearinghouse for information provided by senior | ||||||
32 | citizen home owners
who want to rent rooms to or share |
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1 | living space with other senior citizens.
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2 | The Department shall establish eligibility standards for | ||||||
3 | such
services taking into consideration the unique economic and | ||||||
4 | social needs
of the target population for whom they are to be | ||||||
5 | provided. Such eligibility
standards shall be based on the | ||||||
6 | recipient's ability to pay for services;
provided, however, | ||||||
7 | that in determining the amount and nature of services
for which | ||||||
8 | a person may qualify, consideration shall not be given to the
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9 | value of cash, property or other assets held in the name of the | ||||||
10 | person's
spouse pursuant to a written agreement dividing | ||||||
11 | marital property into equal
but separate shares or pursuant to | ||||||
12 | a transfer of the person's interest in a
home to his spouse, | ||||||
13 | provided that the spouse's share of the marital
property is not | ||||||
14 | made available to the person seeking such services.
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15 | Beginning July 1, 2002, the Department shall require as a | ||||||
16 | condition of
eligibility that all financially eligible | ||||||
17 | applicants and recipients apply
for medical assistance
under | ||||||
18 | Article V of the Illinois Public Aid Code in accordance with | ||||||
19 | rules
promulgated by the Department.
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20 | The Department shall, in conjunction with the Department of | ||||||
21 | Public Aid,
seek appropriate amendments under Sections 1915 and | ||||||
22 | 1924 of the Social
Security Act. The purpose of the amendments | ||||||
23 | shall be to extend eligibility
for home and community based | ||||||
24 | services under Sections 1915 and 1924 of the
Social Security | ||||||
25 | Act to persons who transfer to or for the benefit of a
spouse | ||||||
26 | those amounts of income and resources allowed under Section | ||||||
27 | 1924 of
the Social Security Act. Subject to the approval of | ||||||
28 | such amendments, the
Department shall extend the provisions of | ||||||
29 | Section 5-4 of the Illinois
Public Aid Code to persons who, but | ||||||
30 | for the provision of home or
community-based services, would | ||||||
31 | require the level of care provided in an
institution, as is | ||||||
32 | provided for in federal law. Those persons no longer
found to | ||||||
33 | be eligible for receiving noninstitutional services due to | ||||||
34 | changes
in the eligibility criteria shall be given 60 days |
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1 | notice prior to actual
termination. Those persons receiving | ||||||
2 | notice of termination may contact the
Department and request | ||||||
3 | the determination be appealed at any time during the
60 day | ||||||
4 | notice period. With the exception of the lengthened notice and | ||||||
5 | time
frame for the appeal request, the appeal process shall | ||||||
6 | follow the normal
procedure. In addition, each person affected | ||||||
7 | regardless of the
circumstances for discontinued eligibility | ||||||
8 | shall be given notice and the
opportunity to purchase the | ||||||
9 | necessary services through the Community Care
Program. If the | ||||||
10 | individual does not elect to purchase services, the
Department | ||||||
11 | shall advise the individual of alternative services. The target
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12 | population identified for the purposes of this Section are | ||||||
13 | persons age 60
and older with an identified service need. | ||||||
14 | Priority shall be given to those
who are at imminent risk of | ||||||
15 | institutionalization. The services shall be
provided to | ||||||
16 | eligible persons age 60 and older to the extent that the cost
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17 | of the services together with the other personal maintenance
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18 | expenses of the persons are reasonably related to the standards
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19 | established for care in a group facility appropriate to the | ||||||
20 | person's
condition. These non-institutional services, pilot | ||||||
21 | projects or
experimental facilities may be provided as part of | ||||||
22 | or in addition to
those authorized by federal law or those | ||||||
23 | funded and administered by the
Department of Human Services. | ||||||
24 | The Departments of Human Services, Public Aid,
Public Health, | ||||||
25 | Veterans' Affairs, and Commerce and Economic Opportunity and
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26 | other appropriate agencies of State, federal and local | ||||||
27 | governments shall
cooperate with the Department on Aging in the | ||||||
28 | establishment and development
of the non-institutional | ||||||
29 | services. The Department shall require an annual
audit from all | ||||||
30 | chore/housekeeping and homemaker vendors contracting with
the | ||||||
31 | Department under this Section. The annual audit shall assure | ||||||
32 | that each
audited vendor's procedures are in compliance with | ||||||
33 | Department's financial
reporting guidelines requiring an | ||||||
34 | administrative and employee wage and benefits cost split as |
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1 | defined in administrative rules
a 27% administrative cost split | ||||||
2 | and a 73%
employee wages and benefits cost split . The audit is | ||||||
3 | a public record under
the Freedom of Information Act. The | ||||||
4 | Department shall execute, relative to
the nursing home | ||||||
5 | prescreening project, written inter-agency
agreements with the | ||||||
6 | Department of Human Services and the Department
of Public Aid, | ||||||
7 | to effect the following: (1) intake procedures and common
| ||||||
8 | eligibility criteria for those persons who are receiving | ||||||
9 | non-institutional
services; and (2) the establishment and | ||||||
10 | development of non-institutional
services in areas of the State | ||||||
11 | where they are not currently available or are
undeveloped. On | ||||||
12 | and after July 1, 1996, all nursing home prescreenings for
| ||||||
13 | individuals 60 years of age or older shall be conducted by the | ||||||
14 | Department.
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15 | The Department is authorized to establish a system of | ||||||
16 | recipient copayment
for services provided under this Section, | ||||||
17 | such copayment to be based upon
the recipient's ability to pay | ||||||
18 | but in no case to exceed the actual cost of
the services | ||||||
19 | provided. Additionally, any portion of a person's income which
| ||||||
20 | is equal to or less than the federal poverty standard shall not | ||||||
21 | be
considered by the Department in determining the copayment. | ||||||
22 | The level of
such copayment shall be adjusted whenever | ||||||
23 | necessary to reflect any change
in the officially designated | ||||||
24 | federal poverty standard.
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25 | The Department, or the Department's authorized | ||||||
26 | representative, shall
recover the amount of moneys expended for | ||||||
27 | services provided to or in
behalf of a person under this | ||||||
28 | Section by a claim against the person's
estate or against the | ||||||
29 | estate of the person's surviving spouse, but no
recovery may be | ||||||
30 | had until after the death of the surviving spouse, if
any, and | ||||||
31 | then only at such time when there is no surviving child who
is | ||||||
32 | under age 21, blind, or permanently and totally disabled. This
| ||||||
33 | paragraph, however, shall not bar recovery, at the death of the | ||||||
34 | person, of
moneys for services provided to the person or in |
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1 | behalf of the person under
this Section to which the person was | ||||||
2 | not entitled;
provided that such recovery shall not be enforced | ||||||
3 | against any real estate while
it is occupied as a homestead by | ||||||
4 | the surviving spouse or other dependent, if no
claims by other | ||||||
5 | creditors have been filed against the estate, or, if such
| ||||||
6 | claims have been filed, they remain dormant for failure of | ||||||
7 | prosecution or
failure of the claimant to compel administration | ||||||
8 | of the estate for the purpose
of payment. This paragraph shall | ||||||
9 | not bar recovery from the estate of a spouse,
under Sections | ||||||
10 | 1915 and 1924 of the Social Security Act and Section 5-4 of the
| ||||||
11 | Illinois Public Aid Code, who precedes a person receiving | ||||||
12 | services under this
Section in death. All moneys for services
| ||||||
13 | paid to or in behalf of the person under this Section shall be | ||||||
14 | claimed for
recovery from the deceased spouse's estate. | ||||||
15 | "Homestead", as used
in this paragraph, means the dwelling | ||||||
16 | house and
contiguous real estate occupied by a surviving spouse
| ||||||
17 | or relative, as defined by the rules and regulations of the | ||||||
18 | Illinois Department
of Public Aid, regardless of the value of | ||||||
19 | the property.
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20 | The Department shall develop procedures to enhance | ||||||
21 | availability of
services on evenings, weekends, and on an | ||||||
22 | emergency basis to meet the
respite needs of caregivers. | ||||||
23 | Procedures shall be developed to permit the
utilization of | ||||||
24 | services in successive blocks of 24 hours up to the monthly
| ||||||
25 | maximum established by the Department. Workers providing these | ||||||
26 | services
shall be appropriately trained.
| ||||||
27 | Beginning on the effective date of this Amendatory Act of | ||||||
28 | 1991, no person
may perform chore/housekeeping and homemaker | ||||||
29 | services under a program
authorized by this Section unless that | ||||||
30 | person has been issued a certificate
of pre-service to do so by | ||||||
31 | his or her employing agency. Information
gathered to effect | ||||||
32 | such certification shall include (i) the person's name,
(ii) | ||||||
33 | the date the person was hired by his or her current employer, | ||||||
34 | and
(iii) the training, including dates and levels. Persons |
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1 | engaged in the
program authorized by this Section before the | ||||||
2 | effective date of this
amendatory Act of 1991 shall be issued a | ||||||
3 | certificate of all pre- and
in-service training from his or her | ||||||
4 | employer upon submitting the necessary
information. The | ||||||
5 | employing agency shall be required to retain records of
all | ||||||
6 | staff pre- and in-service training, and shall provide such | ||||||
7 | records to
the Department upon request and upon termination of | ||||||
8 | the employer's contract
with the Department. In addition, the | ||||||
9 | employing agency is responsible for
the issuance of | ||||||
10 | certifications of in-service training completed to their
| ||||||
11 | employees.
| ||||||
12 | The Department is required to develop a system to ensure | ||||||
13 | that persons
working as homemakers and chore housekeepers | ||||||
14 | receive increases in their
wages when the federal minimum wage | ||||||
15 | is increased by requiring vendors to
certify that they are | ||||||
16 | meeting the federal minimum wage statute for homemakers
and | ||||||
17 | chore housekeepers. An employer that cannot ensure that the | ||||||
18 | minimum
wage increase is being given to homemakers and chore | ||||||
19 | housekeepers
shall be denied any increase in reimbursement | ||||||
20 | costs.
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21 | The Department on Aging and the Department of Human | ||||||
22 | Services
shall cooperate in the development and submission of | ||||||
23 | an annual report on
programs and services provided under this | ||||||
24 | Section. Such joint report
shall be filed with the Governor and | ||||||
25 | the General Assembly on or before
September 30 each year.
| ||||||
26 | The requirement for reporting to the General Assembly shall | ||||||
27 | be satisfied
by filing copies of the report with the Speaker, | ||||||
28 | the Minority Leader and
the Clerk of the House of | ||||||
29 | Representatives and the President, the Minority
Leader and the | ||||||
30 | Secretary of the Senate and the Legislative Research Unit,
as | ||||||
31 | required by Section 3.1 of the General Assembly Organization | ||||||
32 | Act and
filing such additional copies with the State Government | ||||||
33 | Report Distribution
Center for the General Assembly as is | ||||||
34 | required under paragraph (t) of
Section 7 of the State Library |
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1 | Act.
| ||||||
2 | Those persons previously found eligible for receiving | ||||||
3 | non-institutional
services whose services were discontinued | ||||||
4 | under the Emergency Budget Act of
Fiscal Year 1992, and who do | ||||||
5 | not meet the eligibility standards in effect
on or after July | ||||||
6 | 1, 1992, shall remain ineligible on and after July 1,
1992. | ||||||
7 | Those persons previously not required to cost-share and who | ||||||
8 | were
required to cost-share effective March 1, 1992, shall | ||||||
9 | continue to meet
cost-share requirements on and after July 1, | ||||||
10 | 1992. Beginning July 1, 1992,
all clients will be required to | ||||||
11 | meet
eligibility, cost-share, and other requirements and will | ||||||
12 | have services
discontinued or altered when they fail to meet | ||||||
13 | these requirements.
| ||||||
14 | (Source: P.A. 92-597, eff. 6-28-02; 93-85, eff. 1-1-04; 93-902, | ||||||
15 | eff. 8-10-04.)
| ||||||
16 | Section 15. The Children's Health Insurance Program Act is | ||||||
17 | amended by changing Section 30 as follows:
| ||||||
18 | (215 ILCS 106/30)
| ||||||
19 | Sec. 30. Cost sharing.
| ||||||
20 | (a) Children enrolled in a health benefits program pursuant | ||||||
21 | to subdivision
(a)(2) of Section 25 and persons enrolled in a | ||||||
22 | health benefits waiver program pursuant to Section 40 shall be | ||||||
23 | subject to the following cost sharing
requirements:
| ||||||
24 | (1) There shall be no co-payment required for well-baby | ||||||
25 | or well-child
care, including age-appropriate | ||||||
26 | immunizations as required under
federal law.
| ||||||
27 | (2) Health insurance premiums for family members, | ||||||
28 | either children or adults, in families whose household
| ||||||
29 | income is above 150% of the federal poverty level shall be | ||||||
30 | payable
monthly, subject to rules promulgated by the | ||||||
31 | Department for grace periods and
advance payments, and | ||||||
32 | shall be as follows:
|
| |||||||
| |||||||
1 | (A) $15 per month for one family member
child .
| ||||||
2 | (B) $25 per month for 2 family members
children .
| ||||||
3 | (C) $30 per month for 3 family members
or more | ||||||
4 | children . | ||||||
5 | (D) $35 per month for 4 family members. | ||||||
6 | (E) $40 per month for 5 or more family members.
| ||||||
7 | (3) Co-payments for children or adults in families | ||||||
8 | whose income is at or below
150% of the federal poverty | ||||||
9 | level, at a minimum and to the extent permitted
under | ||||||
10 | federal law, shall be $2 for all medical visits and | ||||||
11 | prescriptions
provided under this Act.
| ||||||
12 | (4) Co-payments for children or adults in families | ||||||
13 | whose income is above 150%
of the federal poverty level, at | ||||||
14 | a minimum and to the extent permitted under
federal law | ||||||
15 | shall be as follows:
| ||||||
16 | (A) $5 for medical visits.
| ||||||
17 | (B) $3 for generic prescriptions and $5 for brand | ||||||
18 | name
prescriptions.
| ||||||
19 | (C) $25 for emergency room use for a non-emergency
| ||||||
20 | situation as defined by the Department by rule.
| ||||||
21 | (5) The maximum amount of out-of-pocket expenses for | ||||||
22 | co-payments shall be
$100 per family per year.
| ||||||
23 | (b) Individuals enrolled in a privately sponsored health | ||||||
24 | insurance plan
pursuant to subdivision (a)(1) of Section 25 | ||||||
25 | shall be subject to the cost
sharing provisions as stated in | ||||||
26 | the privately sponsored health insurance plan.
| ||||||
27 | (Source: P.A. 90-736, eff. 8-12-98; 91-266, eff. 7-23-99 .)
| ||||||
28 | Section 20. The Illinois Public Aid Code is amended by | ||||||
29 | changing Sections 5-5.4, 5-5.12, and 12-4.35 as follows: | ||||||
30 | (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
| ||||||
31 | Sec. 5-5.4. Standards of Payment - Department of Public | ||||||
32 | Aid.
The Department of Public Aid shall develop standards of |
| |||||||
| |||||||
1 | payment of skilled
nursing and intermediate care services in | ||||||
2 | facilities providing such services
under this Article which:
| ||||||
3 | (1) Provide for the determination of a facility's payment
| ||||||
4 | for skilled nursing and intermediate care services on a | ||||||
5 | prospective basis.
The amount of the payment rate for all | ||||||
6 | nursing facilities certified by the
Department of Public Health | ||||||
7 | under the Nursing Home Care Act as Intermediate
Care for the | ||||||
8 | Developmentally Disabled facilities, Long Term Care for Under | ||||||
9 | Age
22 facilities, Skilled Nursing facilities, or Intermediate | ||||||
10 | Care facilities
under the
medical assistance program shall be | ||||||
11 | prospectively established annually on the
basis of historical, | ||||||
12 | financial, and statistical data reflecting actual costs
from | ||||||
13 | prior years, which shall be applied to the current rate year | ||||||
14 | and updated
for inflation, except that the capital cost element | ||||||
15 | for newly constructed
facilities shall be based upon projected | ||||||
16 | budgets. The annually established
payment rate shall take | ||||||
17 | effect on July 1 in 1984 and subsequent years. No rate
increase | ||||||
18 | and no
update for inflation shall be provided on or after July | ||||||
19 | 1, 1994 and before
July 1, 2006
2005 , unless specifically | ||||||
20 | provided for in this
Section.
The changes made by this | ||||||
21 | amendatory Act of the 93rd General Assembly extending the | ||||||
22 | duration of the prohibition against a rate increase or update | ||||||
23 | for inflation are effective retroactive to July 1, 2004.
| ||||||
24 | For facilities licensed by the Department of Public Health | ||||||
25 | under the Nursing
Home Care Act as Intermediate Care for the | ||||||
26 | Developmentally Disabled facilities
or Long Term Care for Under | ||||||
27 | Age 22 facilities, the rates taking effect on July
1, 1998 | ||||||
28 | shall include an increase of 3%. For facilities licensed by the
| ||||||
29 | Department of Public Health under the Nursing Home Care Act as | ||||||
30 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
31 | the rates taking effect on July 1,
1998 shall include an | ||||||
32 | increase of 3% plus $1.10 per resident-day, as defined by
the | ||||||
33 | Department.
| ||||||
34 | For facilities licensed by the Department of Public Health |
| |||||||
| |||||||
1 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
2 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
3 | Age 22 facilities, the rates taking
effect on July 1, 1999 | ||||||
4 | shall include an increase of 1.6% plus $3.00 per
resident-day, | ||||||
5 | as defined by the Department. For facilities licensed by the
| ||||||
6 | Department of Public Health under the Nursing Home Care Act as | ||||||
7 | Skilled Nursing
facilities or Intermediate Care facilities, | ||||||
8 | the rates taking effect on July 1,
1999 shall include an | ||||||
9 | increase of 1.6% and, for services provided on or after
October | ||||||
10 | 1, 1999, shall be increased by $4.00 per resident-day, as | ||||||
11 | defined by
the Department.
| ||||||
12 | For facilities licensed by the Department of Public Health | ||||||
13 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
14 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
15 | Age 22 facilities, the rates taking
effect on July 1, 2000 | ||||||
16 | shall include an increase of 2.5% per resident-day,
as defined | ||||||
17 | by the Department. For facilities licensed by the Department of
| ||||||
18 | Public Health under the Nursing Home Care Act as Skilled | ||||||
19 | Nursing facilities or
Intermediate Care facilities, the rates | ||||||
20 | taking effect on July 1, 2000 shall
include an increase of 2.5% | ||||||
21 | per resident-day, as defined by the Department.
| ||||||
22 | For facilities licensed by the Department of Public Health | ||||||
23 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
24 | or intermediate care
facilities, a new payment methodology must | ||||||
25 | be implemented for the nursing
component of the rate effective | ||||||
26 | July 1, 2003. The Department of Public Aid
shall develop the | ||||||
27 | new payment methodology using the Minimum Data Set
(MDS) as the | ||||||
28 | instrument to collect information concerning nursing home
| ||||||
29 | resident condition necessary to compute the rate. The | ||||||
30 | Department of Public Aid
shall develop the new payment | ||||||
31 | methodology to meet the unique needs of
Illinois nursing home | ||||||
32 | residents while remaining subject to the appropriations
| ||||||
33 | provided by the General Assembly.
A transition period from the | ||||||
34 | payment methodology in effect on June 30, 2003
to the payment |
| |||||||
| |||||||
1 | methodology in effect on July 1, 2003 shall be provided for a
| ||||||
2 | period not exceeding 2 years after implementation of the new | ||||||
3 | payment
methodology as follows:
| ||||||
4 | (A) For a facility that would receive a lower
nursing | ||||||
5 | component rate per patient day under the new system than | ||||||
6 | the facility
received
effective on the date immediately | ||||||
7 | preceding the date that the Department
implements the new | ||||||
8 | payment methodology, the nursing component rate per | ||||||
9 | patient
day for the facility
shall be held at
the level in | ||||||
10 | effect on the date immediately preceding the date that the
| ||||||
11 | Department implements the new payment methodology until a | ||||||
12 | higher nursing
component rate of
reimbursement is achieved | ||||||
13 | by that
facility.
| ||||||
14 | (B) For a facility that would receive a higher nursing | ||||||
15 | component rate per
patient day under the payment | ||||||
16 | methodology in effect on July 1, 2003 than the
facility | ||||||
17 | received effective on the date immediately preceding the | ||||||
18 | date that the
Department implements the new payment | ||||||
19 | methodology, the nursing component rate
per patient day for | ||||||
20 | the facility shall be adjusted.
| ||||||
21 | (C) Notwithstanding paragraphs (A) and (B), the | ||||||
22 | nursing component rate per
patient day for the facility | ||||||
23 | shall be adjusted subject to appropriations
provided by the | ||||||
24 | General Assembly.
| ||||||
25 | For facilities licensed by the Department of Public Health | ||||||
26 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
27 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
28 | Age 22 facilities, the rates taking
effect on March 1, 2001 | ||||||
29 | shall include a statewide increase of 7.85%, as
defined by the | ||||||
30 | Department.
| ||||||
31 | For facilities licensed by the Department of Public Health | ||||||
32 | under the
Nursing Home Care Act as Intermediate Care for the | ||||||
33 | Developmentally Disabled
facilities or Long Term Care for Under | ||||||
34 | Age 22 facilities, the rates taking
effect on April 1, 2002 |
| |||||||
| |||||||
1 | shall include a statewide increase of 2.0%, as
defined by the | ||||||
2 | Department.
This increase terminates on July 1, 2002;
beginning | ||||||
3 | July 1, 2002 these rates are reduced to the level of the rates
| ||||||
4 | in effect on March 31, 2002, as defined by the Department.
| ||||||
5 | For facilities licensed by the Department of Public Health | ||||||
6 | under the
Nursing Home Care Act as skilled nursing facilities | ||||||
7 | or intermediate care
facilities, the rates taking effect on | ||||||
8 | July 1, 2001 shall be computed using the most recent cost | ||||||
9 | reports
on file with the Department of Public Aid no later than | ||||||
10 | April 1, 2000,
updated for inflation to January 1, 2001. For | ||||||
11 | rates effective July 1, 2001
only, rates shall be the greater | ||||||
12 | of the rate computed for July 1, 2001
or the rate effective on | ||||||
13 | June 30, 2001.
| ||||||
14 | Notwithstanding any other provision of this Section, for | ||||||
15 | facilities
licensed by the Department of Public Health under | ||||||
16 | the Nursing Home Care Act
as skilled nursing facilities or | ||||||
17 | intermediate care facilities, the Illinois
Department shall | ||||||
18 | determine by rule the rates taking effect on July 1, 2002,
| ||||||
19 | which shall be 5.9% less than the rates in effect on June 30, | ||||||
20 | 2002.
| ||||||
21 | Notwithstanding any other provision of this Section, for | ||||||
22 | facilities
licensed by the Department of Public Health under | ||||||
23 | the Nursing Home Care Act as
skilled nursing
facilities or | ||||||
24 | intermediate care facilities, if the payment methodologies | ||||||
25 | required under Section 5A-12 and the waiver granted under 42 | ||||||
26 | CFR 433.68 are approved by the United States Centers for | ||||||
27 | Medicare and Medicaid Services, the rates taking effect on July | ||||||
28 | 1, 2004 shall be 3.0% greater than the rates in effect on June | ||||||
29 | 30, 2004. These rates shall take
effect only upon approval and
| ||||||
30 | implementation of the payment methodologies required under | ||||||
31 | Section 5A-12.
| ||||||
32 | Notwithstanding any other provisions of this Section, for | ||||||
33 | facilities licensed by the Department of Public Health under | ||||||
34 | the Nursing Home Care Act as skilled nursing facilities or |
| |||||||
| |||||||
1 | intermediate care facilities, the rates taking effect on | ||||||
2 | January 1, 2005 shall be 3% more than the rates in effect on | ||||||
3 | December 31, 2004.
| ||||||
4 | For facilities
licensed
by the
Department of Public Health | ||||||
5 | under the Nursing Home Care Act as Intermediate
Care for
the | ||||||
6 | Developmentally Disabled facilities or as long-term care | ||||||
7 | facilities for
residents under 22 years of age, the rates | ||||||
8 | taking effect on July 1,
2003 shall
include a statewide | ||||||
9 | increase of 4%, as defined by the Department.
| ||||||
10 | Notwithstanding any other provision of this Section, for | ||||||
11 | facilities licensed by the Department of Public Health under | ||||||
12 | the Nursing Home Care Act as skilled nursing facilities or | ||||||
13 | intermediate care facilities, effective January 1, 2005, | ||||||
14 | facility rates shall be increased by the difference between (i) | ||||||
15 | a facility's per diem property, liability, and malpractice | ||||||
16 | insurance costs as reported in the cost report filed with the | ||||||
17 | Department of Public Aid and used to establish rates effective | ||||||
18 | July 1, 2001 and (ii) those same costs as reported in the | ||||||
19 | facility's 2002 cost report. These costs shall be passed | ||||||
20 | through to the facility without caps or limitations, except for | ||||||
21 | adjustments required under normal auditing procedures.
| ||||||
22 | Rates established effective each July 1 shall govern | ||||||
23 | payment
for services rendered throughout that fiscal year, | ||||||
24 | except that rates
established on July 1, 1996 shall be | ||||||
25 | increased by 6.8% for services
provided on or after January 1, | ||||||
26 | 1997. Such rates will be based
upon the rates calculated for | ||||||
27 | the year beginning July 1, 1990, and for
subsequent years | ||||||
28 | thereafter until June 30, 2001 shall be based on the
facility | ||||||
29 | cost reports
for the facility fiscal year ending at any point | ||||||
30 | in time during the previous
calendar year, updated to the | ||||||
31 | midpoint of the rate year. The cost report
shall be on file | ||||||
32 | with the Department no later than April 1 of the current
rate | ||||||
33 | year. Should the cost report not be on file by April 1, the | ||||||
34 | Department
shall base the rate on the latest cost report filed |
| |||||||
| |||||||
1 | by each skilled care
facility and intermediate care facility, | ||||||
2 | updated to the midpoint of the
current rate year. In | ||||||
3 | determining rates for services rendered on and after
July 1, | ||||||
4 | 1985, fixed time shall not be computed at less than zero. The
| ||||||
5 | Department shall not make any alterations of regulations which | ||||||
6 | would reduce
any component of the Medicaid rate to a level | ||||||
7 | below what that component would
have been utilizing in the rate | ||||||
8 | effective on July 1, 1984.
| ||||||
9 | (2) Shall take into account the actual costs incurred by | ||||||
10 | facilities
in providing services for recipients of skilled | ||||||
11 | nursing and intermediate
care services under the medical | ||||||
12 | assistance program.
| ||||||
13 | (3) Shall take into account the medical and psycho-social
| ||||||
14 | characteristics and needs of the patients.
| ||||||
15 | (4) Shall take into account the actual costs incurred by | ||||||
16 | facilities in
meeting licensing and certification standards | ||||||
17 | imposed and prescribed by the
State of Illinois, any of its | ||||||
18 | political subdivisions or municipalities and by
the U.S. | ||||||
19 | Department of Health and Human Services pursuant to Title XIX | ||||||
20 | of the
Social Security Act.
| ||||||
21 | The Department of Public Aid shall develop precise | ||||||
22 | standards for
payments to reimburse nursing facilities for any | ||||||
23 | utilization of
appropriate rehabilitative personnel for the | ||||||
24 | provision of rehabilitative
services which is authorized by | ||||||
25 | federal regulations, including
reimbursement for services | ||||||
26 | provided by qualified therapists or qualified
assistants, and | ||||||
27 | which is in accordance with accepted professional
practices. | ||||||
28 | Reimbursement also may be made for utilization of other
| ||||||
29 | supportive personnel under appropriate supervision.
| ||||||
30 | (Source: P.A. 92-10, eff. 6-11-01; 92-31, eff. 6-28-01; 92-597, | ||||||
31 | eff. 6-28-02; 92-651, eff. 7-11-02; 92-848, eff. 1-1-03; 93-20, | ||||||
32 | eff. 6-20-03; 93-649, eff. 1-8-04; 93-659, eff. 2-3-04; 93-841, | ||||||
33 | eff. 7-30-04; 93-1087, eff. 2-28-05.)
|
| |||||||
| |||||||
1 | (305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)
| ||||||
2 | Sec. 5-5.12. Pharmacy payments.
| ||||||
3 | (a) Every request submitted by a pharmacy for reimbursement | ||||||
4 | under this
Article for prescription drugs provided to a | ||||||
5 | recipient of aid under this
Article shall include the name of | ||||||
6 | the prescriber or an acceptable
identification number as | ||||||
7 | established by the Department.
| ||||||
8 | (b) Pharmacies providing prescription drugs under
this | ||||||
9 | Article shall be reimbursed at a rate which shall include
a | ||||||
10 | professional dispensing fee as determined by the Illinois
| ||||||
11 | Department, plus the current acquisition cost of the | ||||||
12 | prescription
drug dispensed. The Illinois Department shall | ||||||
13 | update its
information on the acquisition costs of all | ||||||
14 | prescription drugs
no less frequently than every 30 days. | ||||||
15 | However, the Illinois
Department may set the rate of | ||||||
16 | reimbursement for the acquisition
cost, by rule, at a | ||||||
17 | percentage of the current average wholesale
acquisition cost.
| ||||||
18 | (c) (Blank).
Reimbursement under this Article for | ||||||
19 | prescription drugs shall be
limited to reimbursement for 4 | ||||||
20 | brand-name prescription drugs per patient per
month. This | ||||||
21 | subsection applies only if (i) the brand-name drug was not
| ||||||
22 | prescribed for an acute or urgent condition, (ii) the | ||||||
23 | brand-name drug was not
prescribed for Alzheimer's disease, | ||||||
24 | arthritis, diabetes, HIV/AIDS, a mental
health condition, or | ||||||
25 | respiratory disease, and (iii) a therapeutically
equivalent | ||||||
26 | generic medication has been approved by the federal Food and | ||||||
27 | Drug
Administration.
| ||||||
28 | (d) The Department shall not impose requirements for prior | ||||||
29 | approval
based on a preferred drug list for anti-retroviral, | ||||||
30 | anti-hemophilic factor
concentrates,
or
any atypical | ||||||
31 | antipsychotics, conventional antipsychotics,
or | ||||||
32 | anticonvulsants used for the treatment of serious mental
| ||||||
33 | illnesses
until 30 days after it has conducted a study of the | ||||||
34 | impact of such
requirements on patient care and submitted a |
| |||||||
| |||||||
1 | report to the Speaker of the
House of Representatives and the | ||||||
2 | President of the Senate.
| ||||||
3 | (Source: P.A. 92-597, eff. 6-28-02; 92-825, eff. 8-21-02; | ||||||
4 | 93-106, eff.
7-8-03.)
| ||||||
5 | (305 ILCS 5/12-4.35)
| ||||||
6 | Sec. 12-4.35. Medical services for certain noncitizens.
| ||||||
7 | (a) Notwithstanding
Subject to specific appropriation for | ||||||
8 | this purpose, and notwithstanding
Section 1-11 of this Code or | ||||||
9 | Section 20(a) of the Children's Health Insurance
Program Act, | ||||||
10 | the Department of Public Aid may provide medical services to
| ||||||
11 | noncitizens who have not yet attained 19 years of age and who | ||||||
12 | are not eligible
for medical assistance under Article V of this | ||||||
13 | Code or under the Children's
Health Insurance Program created | ||||||
14 | by the Children's Health Insurance Program Act
due to their not | ||||||
15 | meeting the otherwise applicable provisions of Section 1-11
of | ||||||
16 | this Code or Section 20(a) of the Children's Health Insurance | ||||||
17 | Program Act.
The medical services available, standards for | ||||||
18 | eligibility, and other conditions
of participation under this | ||||||
19 | Section shall be established by rule by the
Department; | ||||||
20 | however, any such rule shall be at least as restrictive as the
| ||||||
21 | rules for medical assistance under Article V of this Code or | ||||||
22 | the Children's
Health Insurance Program created by the | ||||||
23 | Children's Health Insurance Program
Act.
| ||||||
24 | (b) The Department is authorized to take any action, | ||||||
25 | including without
limitation cessation of enrollment, | ||||||
26 | reduction of available medical services,
and changing | ||||||
27 | standards for eligibility, that is deemed necessary by the
| ||||||
28 | Department during a State fiscal year to assure that payments | ||||||
29 | under this
Section do not exceed available funds
the amounts | ||||||
30 | appropriated for this purpose .
| ||||||
31 | (c) Continued
In the event that the appropriation in any | ||||||
32 | fiscal year for the
Children's Health Insurance Program created | ||||||
33 | by the Children's Health Insurance
Program Act is determined by |
| |||||||
| |||||||
1 | the Department to be insufficient to continue
enrollment of | ||||||
2 | otherwise eligible children under that Program during that | ||||||
3 | fiscal
year, the Department is authorized to use funds | ||||||
4 | appropriated for the purposes
of this Section to fund that | ||||||
5 | Program and to take any other action necessary to
continue the | ||||||
6 | operation of that Program. Furthermore, continued enrollment | ||||||
7 | of
individuals into the program created under this Section in | ||||||
8 | any fiscal year is
contingent upon continued enrollment of | ||||||
9 | individuals into the Children's Health
Insurance Program | ||||||
10 | during that fiscal year.
| ||||||
11 | (d) (Blank).
The General Assembly finds that the adoption | ||||||
12 | of rules to meet the
purposes of subsections (a), (b), and (c) | ||||||
13 | is an emergency and necessary for
the public interest, safety, | ||||||
14 | and welfare. The Department may adopt such rules
through the | ||||||
15 | use of emergency rulemaking in accordance with Section 5-45 of | ||||||
16 | the
Illinois Administrative Procedure Act, except that the | ||||||
17 | limitation on the number
of emergency rules that may be adopted | ||||||
18 | in a 24-month period shall not apply.
| ||||||
19 | (Source: P.A. 90-588, eff. 7-1-98.)
| ||||||
20 | Section 25. The All-Inclusive Care for the Elderly Act is | ||||||
21 | amended by changing Sections 10 and 15 as follows:
| ||||||
22 | (320 ILCS 40/10) (from Ch. 23, par. 6910)
| ||||||
23 | Sec. 10. Services for eligible persons. Within the context | ||||||
24 | of the
PACE program established under this Act, the Illinois | ||||||
25 | Department of Public
Aid may include any or all of the services | ||||||
26 | in Article 5 of the Illinois
Public Aid Code.
| ||||||
27 | An eligible person may elect to receive services from the | ||||||
28 | PACE program.
If such an election is made, the eligible person | ||||||
29 | shall not remain eligible
for payment through the regular | ||||||
30 | Medicare or Medicaid program. All services
and programs | ||||||
31 | provided through the PACE program shall be provided in
| ||||||
32 | accordance with this Act. An eligible person may elect to |
| |||||||
| |||||||
1 | disenroll from
the PACE program at any time.
| ||||||
2 | For purposes of this Act, "eligible person" means a frail | ||||||
3 | elderly
individual who voluntarily enrolls in the PACE program, | ||||||
4 | whose income and
resources do not exceed limits established by | ||||||
5 | the Illinois Department of
Public Aid and for whom a licensed | ||||||
6 | physician certifies that such a program
provides an appropriate | ||||||
7 | alternative to institutionalized care. The term
"frail | ||||||
8 | elderly" means an individual who meets the age and functional | ||||||
9 | eligibility
requirements , as established by the Illinois | ||||||
10 | Department of Public Aid and
the Department on Aging for | ||||||
11 | nursing home care, and who is 65 years of age
or older .
| ||||||
12 | (Source: P.A. 87-411.)
| ||||||
13 | (320 ILCS 40/15) (from Ch. 23, par. 6915)
| ||||||
14 | Sec. 15. Program implementation.
| ||||||
15 | (a) Upon receipt of federal approval
waivers , the Illinois | ||||||
16 | Department of Public
Aid shall implement the PACE program | ||||||
17 | pursuant to the provisions of the approved Title XIX State plan
| ||||||
18 | as a demonstration program to provide
the services set forth in | ||||||
19 | Section 10 to eligible persons, as defined in
Section 10, for a | ||||||
20 | period of 3 years. After the 3 year demonstration, the
General | ||||||
21 | Assembly shall reexamine the PACE program and determine if the
| ||||||
22 | program should be implemented on a permanent basis .
| ||||||
23 | (b) Using a risk-based financing model, the nonprofit | ||||||
24 | organization providing
the PACE program shall assume | ||||||
25 | responsibility for all costs generated by
the PACE program | ||||||
26 | participants, and it shall create and maintain a risk
reserve | ||||||
27 | fund that will cover any cost overages for any participant. The
| ||||||
28 | PACE program is responsible for the entire range of services in | ||||||
29 | the
consolidated service model, including hospital and nursing | ||||||
30 | home care,
according to participant need as determined by a | ||||||
31 | multidisciplinary team.
The nonprofit organization providing | ||||||
32 | the PACE program is responsible for
the full financial risk at | ||||||
33 | the conclusion of the demonstration period
and when permanent |
| |||||||
| |||||||
1 | waivers from the federal Health Care Financing
Administration | ||||||
2 | are granted . Specific arrangements of the risk-based
financing | ||||||
3 | model shall be adopted and negotiated by the federal Centers | ||||||
4 | for Medicare and Medicaid Services
Health Care
Financing | ||||||
5 | Administration , the nonprofit organization providing the PACE
| ||||||
6 | program, and the Illinois Department of Public Aid .
| ||||||
7 | (Source: P.A. 87-411.)
| ||||||
8 | Section 99. Effective date. This Act takes effect July 1, | ||||||
9 | 2005.".
|