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Rep. Julie Hamos
Filed: 4/15/2008
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09500HB5703ham001 |
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LRB095 17678 DRJ 48745 a |
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| AMENDMENT TO HOUSE BILL 5703
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| AMENDMENT NO. ______. Amend House Bill 5703 on page 1, |
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| after line 3, inserting the following:
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| "Section 5. The Illinois Act on the Aging is amended by |
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| changing Sections 4.02 and 4.12 as follows:
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| (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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| (Text of Section before amendment by P.A. 95-565 ) |
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| Sec. 4.02. The Department shall establish a program of |
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| services to
prevent unnecessary institutionalization of |
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| persons age 60 and older in
need of long term care or who are |
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| established as persons who suffer from
Alzheimer's disease or a |
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| related disorder under the Alzheimer's Disease
Assistance Act, |
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| thereby enabling them
to remain in their own homes or in other |
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| living arrangements. Such
preventive services, which may be |
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| coordinated with other programs for the
aged and monitored by |
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| area agencies on aging in cooperation with the
Department, may |
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LRB095 17678 DRJ 48745 a |
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| include, but are not limited to, any or all of the following:
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| (a) home health services;
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| (b) home nursing services;
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| (c) home care aide services;
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| (d) chore and housekeeping services;
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| (e) adult day services;
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| (f) home-delivered meals;
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| (g) education in self-care;
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| (h) personal care services;
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| (i) adult day health services;
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| (j) habilitation services;
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| (k) respite care;
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| (k-5) community reintegration services;
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| (l) other nonmedical social services that may enable |
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| the person
to become self-supporting; or
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| (m) clearinghouse for information provided by senior |
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| citizen home owners
who want to rent rooms to or share |
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| living space with other senior citizens.
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| The Department shall establish eligibility standards for |
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| such
services taking into consideration the unique economic and |
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| social needs
of the target population for whom they are to be |
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| provided. Such eligibility
standards shall be based on the |
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| recipient's ability to pay for services;
provided, however, |
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| that in determining the amount and nature of services
for which |
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| a person may qualify, consideration shall not be given to the
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| value of cash, property or other assets held in the name of the |
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LRB095 17678 DRJ 48745 a |
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| person's
spouse pursuant to a written agreement dividing |
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| marital property into equal
but separate shares or pursuant to |
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| a transfer of the person's interest in a
home to his spouse, |
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| provided that the spouse's share of the marital
property is not |
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| made available to the person seeking such services.
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| Beginning July 1, 2002, the Department shall require as a |
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| condition of
eligibility that all financially eligible |
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| applicants and recipients apply
for medical assistance
under |
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| Article V of the Illinois Public Aid Code in accordance with |
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| rules
promulgated by the Department.
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| The Department shall, in conjunction with the Department of |
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| Public Aid (now Department of Healthcare and Family Services),
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| seek appropriate amendments under Sections 1915 and 1924 of the |
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| Social
Security Act. The purpose of the amendments shall be to |
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| extend eligibility
for home and community based services under |
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| Sections 1915 and 1924 of the
Social Security Act to persons |
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| who transfer to or for the benefit of a
spouse those amounts of |
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| income and resources allowed under Section 1924 of
the Social |
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| Security Act. Subject to the approval of such amendments, the
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| Department shall extend the provisions of Section 5-4 of the |
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| Illinois
Public Aid Code to persons who, but for the provision |
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| of home or
community-based services, would require the level of |
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| care provided in an
institution, as is provided for in federal |
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| law. Those persons no longer
found to be eligible for receiving |
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| noninstitutional services due to changes
in the eligibility |
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| criteria shall be given 60 days notice prior to actual
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LRB095 17678 DRJ 48745 a |
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| termination. Those persons receiving notice of termination may |
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| contact the
Department and request the determination be |
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| appealed at any time during the
60 day notice period. With the |
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| exception of the lengthened notice and time
frame for the |
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| appeal request, the appeal process shall follow the normal
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| procedure. In addition, each person affected regardless of the
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| circumstances for discontinued eligibility shall be given |
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| notice and the
opportunity to purchase the necessary services |
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| through the Community Care
Program. If the individual does not |
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| elect to purchase services, the
Department shall advise the |
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| individual of alternative services. The target
population |
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| identified for the purposes of this Section are persons age 60
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| and older with an identified service need. Priority shall be |
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| given to those
who are at imminent risk of |
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| institutionalization. The services shall be
provided to |
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| eligible persons age 60 and older to the extent that the cost
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| of the services together with the other personal maintenance
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| expenses of the persons are reasonably related to the standards
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| established for care in a group facility appropriate to the |
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| person's
condition. These non-institutional services, pilot |
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| projects or
experimental facilities may be provided as part of |
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| or in addition to
those authorized by federal law or those |
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| funded and administered by the
Department of Human Services. |
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| The Departments of Human Services, Healthcare and Family |
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| Services,
Public Health, Veterans' Affairs, and Commerce and |
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| Economic Opportunity and
other appropriate agencies of State, |
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LRB095 17678 DRJ 48745 a |
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| federal and local governments shall
cooperate with the |
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| Department on Aging in the establishment and development
of the |
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| non-institutional services. The Department shall require an |
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| annual
audit from all chore/housekeeping and home care aide |
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| vendors contracting with
the Department under this Section. The |
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| annual audit shall assure that each
audited vendor's procedures |
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| are in compliance with Department's financial
reporting |
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| guidelines requiring an administrative and employee wage and |
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| benefits cost split as defined in administrative rules. The |
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| audit is a public record under
the Freedom of Information Act. |
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| The Department shall execute, relative to
the nursing home |
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| prescreening project, written inter-agency
agreements with the |
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| Department of Human Services and the Department
of Healthcare |
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| and Family Services, to effect the following: (1) intake |
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| procedures and common
eligibility criteria for those persons |
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| who are receiving non-institutional
services; and (2) the |
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| establishment and development of non-institutional
services in |
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| areas of the State where they are not currently available or |
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| are
undeveloped. On and after July 1, 1996, all nursing home |
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| prescreenings for
individuals 60 years of age or older shall be |
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| conducted by the Department.
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| As part of the Department on Aging's routine training of |
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| care coordinators and care coordinator supervisors case |
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| managers and case manager supervisors , the Department may |
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| include information on family futures planning for persons who |
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| are age 60 or older and who are caregivers of their adult |
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LRB095 17678 DRJ 48745 a |
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| children with developmental disabilities. The content of the |
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| training shall be at the Department's discretion. |
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| No later than July 1, 2008, the Department's case |
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| management program shall be transitioned to a fully integrated |
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| care coordination program. The care coordination program shall |
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| incorporate the concepts of client direction and consumer focus |
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| and shall take into account the client's needs and preferences. |
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| Comprehensive care coordination shall include activities such |
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| as: (1) comprehensive assessment of the client; (2) development |
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| and implementation of a service plan with the client to |
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| mobilize the formal and family resources and services |
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| identified in the assessment to meet the needs of the client, |
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| including coordination of the resources and services with (A) |
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| any other plans that exist for various formal services, such as |
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| hospital discharge plans, and (B) the information and |
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| assistance services; (3) coordination and monitoring of formal |
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| and family service delivery, regardless of the funding source, |
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| including coordination and monitoring to ensure that services |
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| specified in the plan are being provided; (4) assistance with |
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| the completion of applications for services, referrals to |
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| non-government funded services, health promotion, and ensuring |
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| continuity of care across care settings; (5) periodic |
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| reassessment and revision of the status of the client with the |
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| client or, if necessary, the client's designated |
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| representative; and (6) in accordance with the wishes of the |
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| client, advocacy on behalf of the client for needed services or |
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LRB095 17678 DRJ 48745 a |
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| resources. |
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| A comprehensive assessment shall be performed, using a |
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| holistic tool identified by the Department and supported by an |
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| electronic intake assessment and care planning system linked to |
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| a central location. The comprehensive assessment process shall |
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| include a face to face interview in the client's home or |
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| temporary overnight abode and shall determine the level of |
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| physical, functional, cognitive, psycho-social, financial, and |
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| social needs of the client. Assessment interviews shall |
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| accommodate the scheduling needs of the client and the client's |
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| representative or representatives, who shall participate at |
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| the discretion of the client. The Department shall provide |
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| guidelines for determining the conditions under which a |
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| comprehensive assessment shall be performed and the activities |
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| of care coordination offered to each care recipient. The care |
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| plan shall include the needs identified by the assessment and |
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| incorporate the goals and preferences of the client. Care plans |
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| shall also include all services needed by the client regardless |
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| of the funding source and delineate between services provided, |
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| services unavailable, and services refused by the client. Case |
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| coordination units shall be reimbursed for care coordination in |
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| a just and equitable manner reflective of the actual cost of |
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| providing care coordination. By July 1, 2009, the Department |
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| shall develop a rate structure, in collaboration with case |
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| coordination units and advocates for care recipients, that |
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| reflects the activities of coordination provided. The |
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LRB095 17678 DRJ 48745 a |
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| Department shall reevaluate the rate structure every other year |
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| thereafter. |
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| The Department is authorized to establish a system of |
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| recipient copayment
for services provided under this Section, |
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| such copayment to be based upon
the recipient's ability to pay |
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| but in no case to exceed the actual cost of
the services |
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| provided. Additionally, any portion of a person's income which
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| is equal to or less than the federal poverty standard shall not |
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| be
considered by the Department in determining the copayment. |
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| The level of
such copayment shall be adjusted whenever |
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| necessary to reflect any change
in the officially designated |
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| federal poverty standard.
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| The Department, or the Department's authorized |
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| representative, shall
recover the amount of moneys expended for |
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| services provided to or in
behalf of a person under this |
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| Section by a claim against the person's
estate or against the |
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| estate of the person's surviving spouse, but no
recovery may be |
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| had until after the death of the surviving spouse, if
any, and |
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| then only at such time when there is no surviving child who
is |
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| under age 21, blind, or permanently and totally disabled. This
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| paragraph, however, shall not bar recovery, at the death of the |
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| person, of
moneys for services provided to the person or in |
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| behalf of the person under
this Section to which the person was |
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| not entitled;
provided that such recovery shall not be enforced |
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| against any real estate while
it is occupied as a homestead by |
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| the surviving spouse or other dependent, if no
claims by other |
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LRB095 17678 DRJ 48745 a |
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| creditors have been filed against the estate, or, if such
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| claims have been filed, they remain dormant for failure of |
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| prosecution or
failure of the claimant to compel administration |
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| of the estate for the purpose
of payment. This paragraph shall |
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| not bar recovery from the estate of a spouse,
under Sections |
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| 1915 and 1924 of the Social Security Act and Section 5-4 of the
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| Illinois Public Aid Code, who precedes a person receiving |
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| services under this
Section in death. All moneys for services
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| paid to or in behalf of the person under this Section shall be |
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| claimed for
recovery from the deceased spouse's estate. |
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| "Homestead", as used
in this paragraph, means the dwelling |
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| house and
contiguous real estate occupied by a surviving spouse
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| or relative, as defined by the rules and regulations of the |
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| Department of Healthcare and Family Services, regardless of the |
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| value of the property.
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| The Department shall develop procedures to enhance |
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| availability of
services on evenings, weekends, and on an |
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| emergency basis to meet the
respite needs of caregivers. |
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| Procedures shall be developed to permit the
utilization of |
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| services in successive blocks of 24 hours up to the monthly
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| maximum established by the Department. Workers providing these |
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| services
shall be appropriately trained.
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| Beginning on the effective date of this Amendatory Act of |
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| 1991, no person
may perform chore/housekeeping and home care |
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| aide services under a program
authorized by this Section unless |
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| that person has been issued a certificate
of pre-service to do |
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LRB095 17678 DRJ 48745 a |
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| so by his or her employing agency. Information
gathered to |
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| effect such certification shall include (i) the person's name,
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| (ii) the date the person was hired by his or her current |
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| employer, and
(iii) the training, including dates and levels. |
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| Persons engaged in the
program authorized by this Section |
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| before the effective date of this
amendatory Act of 1991 shall |
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| be issued a certificate of all pre- and
in-service training |
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| from his or her employer upon submitting the necessary
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| information. The employing agency shall be required to retain |
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| records of
all staff pre- and in-service training, and shall |
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| provide such records to
the Department upon request and upon |
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| termination of the employer's contract
with the Department. In |
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| addition, the employing agency is responsible for
the issuance |
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| of certifications of in-service training completed to their
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| employees.
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| The Department is required to develop a system to ensure |
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| that persons
working as home care aides and chore housekeepers |
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| receive increases in their
wages when the federal minimum wage |
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| is increased by requiring vendors to
certify that they are |
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| meeting the federal minimum wage statute for home care aides
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| and chore housekeepers. An employer that cannot ensure that the |
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| minimum
wage increase is being given to home care aides and |
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| chore housekeepers
shall be denied any increase in |
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| reimbursement costs.
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| The Community Care Program Advisory Committee is created in |
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| the Department on Aging. The Director shall appoint individuals |
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LRB095 17678 DRJ 48745 a |
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| to serve in the Committee, who shall serve at their own |
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| expense. Members of the Committee must abide by all applicable |
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| ethics laws. The Committee shall advise the Department on |
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| issues related to the Department's program of services to |
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| prevent unnecessary institutionalization. The Committee shall |
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| meet on a bi-monthly basis and shall serve to identify and |
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| advise the Department on present and potential issues affecting |
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| the service delivery network, the program's clients, and the |
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| Department and to recommend solution strategies. Persons |
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| appointed to the Committee shall be appointed on, but not |
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| limited to, their own and their agency's experience with the |
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| program, geographic representation, and willingness to serve. |
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| The Director shall appoint members to the Committee to |
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| represent provider, advocacy, policy research, and other |
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| constituencies committed to the delivery of high quality home |
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| and community-based services to older adults. Representatives |
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| shall be appointed to ensure representation from community care |
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| providers including, but not limited to, adult day service |
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| providers, homemaker providers, case coordination and case |
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| management units, emergency home response providers, statewide |
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| trade or labor unions that represent home care
homecare aides |
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| and direct care staff, area agencies on aging, adults over age |
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| 60, membership organizations representing older adults, and |
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| other organizational entities, providers of care, or |
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| individuals with demonstrated interest and expertise in the |
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| field of home and community care as determined by the Director. |
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| Nominations may be presented from any agency or State |
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| association with interest in the program. The Director, or his |
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| or her designee, shall serve as the permanent co-chair of the |
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| advisory committee. One other co-chair shall be nominated and |
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| approved by the members of the committee on an annual basis. |
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| Committee members' terms of appointment shall be for 4 years |
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| with one-quarter of the appointees' terms expiring each year. A |
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| member shall continue to serve until his or her replacement is |
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| named. The Department shall fill vacancies that have a |
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| remaining term of over one year, and this replacement shall |
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| occur through the annual replacement of expiring terms. The |
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| Director shall designate Department staff to provide technical |
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| assistance and staff support to the committee. Department |
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| representation shall not constitute membership of the |
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| committee. All Committee papers, issues, recommendations, |
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| reports, and meeting memoranda are advisory only. The Director, |
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| or his or her designee, shall make a written report, as |
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| requested by the Committee, regarding issues before the |
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| Committee.
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| The Department on Aging and the Department of Human |
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| Services
shall cooperate in the development and submission of |
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| an annual report on
programs and services provided under this |
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| Section. Such joint report
shall be filed with the Governor and |
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| the General Assembly on or before
September 30 each year.
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| The requirement for reporting to the General Assembly shall |
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| be satisfied
by filing copies of the report with the Speaker, |
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| the Minority Leader and
the Clerk of the House of |
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| Representatives and the President, the Minority
Leader and the |
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| Secretary of the Senate and the Legislative Research Unit,
as |
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| required by Section 3.1 of the General Assembly Organization |
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| Act and
filing such additional copies with the State Government |
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| Report Distribution
Center for the General Assembly as is |
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| required under paragraph (t) of
Section 7 of the State Library |
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| Act.
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| Those persons previously found eligible for receiving |
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| non-institutional
services whose services were discontinued |
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| under the Emergency Budget Act of
Fiscal Year 1992, and who do |
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| not meet the eligibility standards in effect
on or after July |
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| 1, 1992, shall remain ineligible on and after July 1,
1992. |
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| Those persons previously not required to cost-share and who |
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| were
required to cost-share effective March 1, 1992, shall |
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| continue to meet
cost-share requirements on and after July 1, |
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| 1992. Beginning July 1, 1992,
all clients will be required to |
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| meet
eligibility, cost-share, and other requirements and will |
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| have services
discontinued or altered when they fail to meet |
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| these requirements.
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| (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, |
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| eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; |
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| 95-473, eff. 8-27-07; revised 10-30-07.)
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| (Text of Section after amendment by P.A. 95-565 ) |
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| Sec. 4.02. Community Care Program. The Department shall |
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LRB095 17678 DRJ 48745 a |
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| establish a program of services to
prevent unnecessary |
2 |
| institutionalization of persons age 60 and older in
need of |
3 |
| long term care or who are established as persons who suffer |
4 |
| from
Alzheimer's disease or a related disorder under the |
5 |
| Alzheimer's Disease
Assistance Act, thereby enabling them
to |
6 |
| remain in their own homes or in other living arrangements. Such
|
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| preventive services, which may be coordinated with other |
8 |
| programs for the
aged and monitored by area agencies on aging |
9 |
| in cooperation with the
Department, may include, but are not |
10 |
| limited to, any or all of the following:
|
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| (a) (blank);
|
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| (b) (blank);
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| (c) home care aide services;
|
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| (d) personal assistant services;
|
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| (e) adult day services;
|
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| (f) home-delivered meals;
|
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| (g) education in self-care;
|
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| (h) personal care services;
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| (i) adult day health services;
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| (j) habilitation services;
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| (k) respite care;
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| (k-5) community reintegration services;
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| (k-6) flexible senior services; |
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| (k-7) medication management; |
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| (k-8) emergency home response;
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| (l) other nonmedical social services that may enable |
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LRB095 17678 DRJ 48745 a |
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| the person
to become self-supporting; or
|
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| (m) clearinghouse for information provided by senior |
3 |
| citizen home owners
who want to rent rooms to or share |
4 |
| living space with other senior citizens.
|
5 |
| The Department shall establish eligibility standards for |
6 |
| such
services taking into consideration the unique economic and |
7 |
| social needs
of the target population for whom they are to be |
8 |
| provided. Such eligibility
standards shall be based on the |
9 |
| recipient's ability to pay for services;
provided, however, |
10 |
| that in determining the amount and nature of services
for which |
11 |
| a person may qualify, consideration shall not be given to the
|
12 |
| value of cash, property or other assets held in the name of the |
13 |
| person's
spouse pursuant to a written agreement dividing |
14 |
| marital property into equal
but separate shares or pursuant to |
15 |
| a transfer of the person's interest in a
home to his spouse, |
16 |
| provided that the spouse's share of the marital
property is not |
17 |
| made available to the person seeking such services.
|
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| Beginning July 1, 2002, the Department shall require as a |
19 |
| condition of
eligibility that all financially eligible |
20 |
| applicants apply
for medical assistance
under Article V of the |
21 |
| Illinois Public Aid Code in accordance with rules
promulgated |
22 |
| by the Department.
|
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| Beginning January 1, 2008, the Department shall require as |
24 |
| a condition of eligibility that all new financially eligible |
25 |
| applicants apply for and enroll in medical assistance under |
26 |
| Article V of the Illinois Public Aid Code in accordance with |
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LRB095 17678 DRJ 48745 a |
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| rules promulgated by the Department.
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| The Department shall, in conjunction with the Department of |
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| Public Aid (now Department of Healthcare and Family Services),
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| seek appropriate amendments under Sections 1915 and 1924 of the |
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| Social
Security Act. The purpose of the amendments shall be to |
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| extend eligibility
for home and community based services under |
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| Sections 1915 and 1924 of the
Social Security Act to persons |
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| who transfer to or for the benefit of a
spouse those amounts of |
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| income and resources allowed under Section 1924 of
the Social |
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| Security Act. Subject to the approval of such amendments, the
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| Department shall extend the provisions of Section 5-4 of the |
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| Illinois
Public Aid Code to persons who, but for the provision |
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| of home or
community-based services, would require the level of |
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| care provided in an
institution, as is provided for in federal |
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| law. Those persons no longer
found to be eligible for receiving |
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| noninstitutional services due to changes
in the eligibility |
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| criteria shall be given 60 days notice prior to actual
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| termination. Those persons receiving notice of termination may |
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| contact the
Department and request the determination be |
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| appealed at any time during the
60 day notice period. With the |
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| exception of the lengthened notice and time
frame for the |
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| appeal request, the appeal process shall follow the normal
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| procedure. In addition, each person affected regardless of the
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| circumstances for discontinued eligibility shall be given |
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| notice and the
opportunity to purchase the necessary services |
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| through the Community Care
Program. If the individual does not |
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| elect to purchase services, the
Department shall advise the |
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| individual of alternative services. The target
population |
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| identified for the purposes of this Section are persons age 60
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| and older with an identified service need. Priority shall be |
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| given to those
who are at imminent risk of |
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| institutionalization. The services shall be
provided to |
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| eligible persons age 60 and older to the extent that the cost
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| of the services together with the other personal maintenance
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| expenses of the persons are reasonably related to the standards
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| established for care in a group facility appropriate to the |
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| person's
condition. These non-institutional services, pilot |
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| projects or
experimental facilities may be provided as part of |
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| or in addition to
those authorized by federal law or those |
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| funded and administered by the
Department of Human Services. |
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| The Departments of Human Services, Healthcare and Family |
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| Services,
Public Health, Veterans' Affairs, and Commerce and |
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| Economic Opportunity and
other appropriate agencies of State, |
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| federal and local governments shall
cooperate with the |
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| Department on Aging in the establishment and development
of the |
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| non-institutional services. The Department shall require an |
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| annual
audit from all personal assistant
chore/housekeeping |
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| and home care aide vendors contracting with
the Department |
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| under this Section. The annual audit shall assure that each
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| audited vendor's procedures are in compliance with |
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| Department's financial
reporting guidelines requiring an |
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| administrative and employee wage and benefits cost split as |
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| defined in administrative rules. The audit is a public record |
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| under
the Freedom of Information Act. The Department shall |
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| execute, relative to
the nursing home prescreening project, |
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| written inter-agency
agreements with the Department of Human |
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| Services and the Department
of Healthcare and Family Services, |
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| to effect the following: (1) intake procedures and common
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| eligibility criteria for those persons who are receiving |
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| non-institutional
services; and (2) the establishment and |
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| development of non-institutional
services in areas of the State |
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| where they are not currently available or are
undeveloped. On |
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| and after July 1, 1996, all nursing home prescreenings for
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| individuals 60 years of age or older shall be conducted by the |
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| Department.
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| As part of the Department on Aging's routine training of |
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| care coordinators and care coordinator supervisors case |
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| managers and case manager supervisors , the Department may |
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| include information on family futures planning for persons who |
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| are age 60 or older and who are caregivers of their adult |
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| children with developmental disabilities. The content of the |
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| training shall be at the Department's discretion. |
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| No later than July 1, 2008, the Department's case |
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| management program shall be transitioned to a fully integrated |
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| care coordination program. The care coordination program shall |
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| incorporate the concepts of client direction and consumer focus |
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| and shall take into account the client's needs and preferences. |
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| Comprehensive care coordination shall include activities such |
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| as: (1) comprehensive assessment of the client; (2) development |
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| and implementation of a service plan with the client to |
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| mobilize the formal and family resources and services |
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| identified in the assessment to meet the needs of the client, |
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| including coordination of the resources and services with (A) |
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| any other plans that exist for various formal services, such as |
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| hospital discharge plans, and (B) the information and |
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| assistance services; (3) coordination and monitoring of formal |
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| and family service delivery, regardless of the funding source, |
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| including coordination and monitoring to ensure that services |
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| specified in the plan are being provided; (4) assistance with |
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| the completion of applications for services, referrals to |
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| non-government funded services, health promotion, and ensuring |
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| continuity of care across care settings; (5) periodic |
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| reassessment and revision of the status of the client with the |
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| client or, if necessary, the client's designated |
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| representative; and (6) in accordance with the wishes of the |
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| client, advocacy on behalf of the client for needed services or |
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| resources. |
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| A comprehensive assessment shall be performed, using a |
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| holistic tool identified by the Department and supported by an |
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| electronic intake assessment and care planning system linked to |
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| a central location. The comprehensive assessment process shall |
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| include a face to face interview in the client's home or |
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| temporary overnight abode and shall determine the level of |
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| physical, functional, cognitive, psycho-social, financial, and |
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| social needs of the client. Assessment interviews shall |
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| accommodate the scheduling needs of the client and the client's |
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| representative or representatives, who shall participate at |
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| the discretion of the client. The Department shall provide |
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| guidelines for determining the conditions under which a |
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| comprehensive assessment shall be performed and the activities |
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| of care coordination offered to each care recipient. The care |
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| plan shall include the needs identified by the assessment and |
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| incorporate the goals and preferences of the client. Care plans |
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| shall also include all services needed by the client regardless |
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| of the funding source and delineate between services provided, |
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| services unavailable, and services refused by the client. Case |
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| coordination units shall be reimbursed for care coordination in |
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| a just and equitable manner reflective of the actual cost of |
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| providing care coordination. By July 1, 2009, the Department |
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| shall develop a rate structure, in collaboration with case |
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| coordination units and advocates for care recipients, that |
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| reflects the activities of coordination provided. The |
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| Department shall reevaluate the rate structure every other year |
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| thereafter. |
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| The Department is authorized to establish a system of |
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| recipient copayment
for services provided under this Section, |
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| such copayment to be based upon
the recipient's ability to pay |
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| but in no case to exceed the actual cost of
the services |
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| provided. Additionally, any portion of a person's income which
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| is equal to or less than the federal poverty standard shall not |
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| be
considered by the Department in determining the copayment. |
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| The level of
such copayment shall be adjusted whenever |
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| necessary to reflect any change
in the officially designated |
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| federal poverty standard.
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| The Department, or the Department's authorized |
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| representative, shall
recover the amount of moneys expended for |
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| services provided to or in
behalf of a person under this |
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| Section by a claim against the person's
estate or against the |
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| estate of the person's surviving spouse, but no
recovery may be |
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| had until after the death of the surviving spouse, if
any, and |
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| then only at such time when there is no surviving child who
is |
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| under age 21, blind, or permanently and totally disabled. This
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| paragraph, however, shall not bar recovery, at the death of the |
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| person, of
moneys for services provided to the person or in |
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| behalf of the person under
this Section to which the person was |
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| not entitled;
provided that such recovery shall not be enforced |
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| against any real estate while
it is occupied as a homestead by |
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| the surviving spouse or other dependent, if no
claims by other |
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| creditors have been filed against the estate, or, if such
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| claims have been filed, they remain dormant for failure of |
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| prosecution or
failure of the claimant to compel administration |
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| of the estate for the purpose
of payment. This paragraph shall |
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| not bar recovery from the estate of a spouse,
under Sections |
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| 1915 and 1924 of the Social Security Act and Section 5-4 of the
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| Illinois Public Aid Code, who precedes a person receiving |
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| services under this
Section in death. All moneys for services
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| paid to or in behalf of the person under this Section shall be |
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| claimed for
recovery from the deceased spouse's estate. |
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| "Homestead", as used
in this paragraph, means the dwelling |
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| house and
contiguous real estate occupied by a surviving spouse
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| or relative, as defined by the rules and regulations of the |
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| Department of Healthcare and Family Services, regardless of the |
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| value of the property.
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| The Department shall increase the effectiveness of the |
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| existing Community Care Program by: |
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| (1) ensuring that in-home services included in the care |
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| plan are available on evenings and weekends; |
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| (2) ensuring that care plans contain the services that |
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| eligible participants
participants' need based on the |
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| number of days in a month, not limited to specific blocks |
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| of time, as identified by the comprehensive assessment tool |
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| selected by the Department for use statewide, not to exceed |
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| the total monthly service cost maximum allowed for each |
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| service ; the . The Department shall develop administrative |
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| rules to implement this item (2); |
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| (3) ensuring that the participants have the right to |
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| choose the services contained in their care plan and to |
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| direct how those services are provided, based on |
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| administrative rules established by the Department; |
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| (4) ensuring that the determination of need tool is |
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| accurate in determining the participants' level of need; to |
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| achieve this, the Department, in conjunction with the Older |
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| Adult Services Advisory Committee, shall institute a study |
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| of the relationship between the Determination of Need |
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| scores, level of need, service cost maximums , and the |
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| development and utilization of service plans no later than |
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| May 1, 2008; findings and recommendations shall be |
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| presented to the Governor and the General Assembly no later |
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| than January 1, 2009; recommendations shall include all |
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| needed changes to the service cost maximums schedule and |
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| additional covered services; |
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| (5) ensuring that homemakers can provide personal care |
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| services that may or may not involve contact with clients, |
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| including but not limited to: |
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| (A) bathing; |
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| (B) grooming; |
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| (C) toileting; |
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| (D) nail care; |
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| (E) transferring; |
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| (F) respiratory services; |
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| (G) exercise; or |
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| (H) positioning; |
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| (6) ensuring that homemaker program vendors are not |
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| restricted from hiring homemakers who are family members of |
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| clients or recommended by clients; the Department may not, |
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| by rule or policy, require homemakers who are family |
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| members of clients or recommended by clients to accept |
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| assignments in homes other than the client; and |
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| (7) ensuring that the State may access maximum federal |
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| matching funds by seeking approval for the Centers for |
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| Medicare and Medicaid Services for modifications to the |
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| State's home and community based services waiver and |
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| additional waiver opportunities in order to maximize |
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| federal matching funds; this shall include, but not be |
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| limited to, modification that reflects all changes in the |
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| Community Care Program services and all increases in the |
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| services cost maximum. |
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| By January 1, 2009 or as soon after the end of the Cash and |
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| Counseling Demonstration Project as is practicable, the |
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| Department may, based on its evaluation of the demonstration |
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| project, promulgate rules concerning personal assistant |
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| services , to include, but need not be limited to, |
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| qualifications, employment screening, rights under fair labor |
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| standards, training, fiduciary agent, and supervision |
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| requirements. All applicants shall be subject to the provisions |
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| of the Health Care Worker Background Check Act.
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| The Department shall develop procedures to enhance |
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| availability of
services on evenings, weekends, and on an |
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| emergency basis to meet the
respite needs of caregivers. |
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| Procedures shall be developed to permit the
utilization of |
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| services in successive blocks of 24 hours up to the monthly
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| maximum established by the Department. Workers providing these |
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| services
shall be appropriately trained.
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| Beginning on the effective date of this Amendatory Act of |
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| 1991, no person
may perform chore/housekeeping and home care |
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| aide services under a program
authorized by this Section unless |
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| that person has been issued a certificate
of pre-service to do |
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| so by his or her employing agency. Information
gathered to |
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| effect such certification shall include (i) the person's name,
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| (ii) the date the person was hired by his or her current |
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| employer, and
(iii) the training, including dates and levels. |
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| Persons engaged in the
program authorized by this Section |
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| before the effective date of this
amendatory Act of 1991 shall |
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| be issued a certificate of all pre- and
in-service training |
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| from his or her employer upon submitting the necessary
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| information. The employing agency shall be required to retain |
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| records of
all staff pre- and in-service training, and shall |
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| provide such records to
the Department upon request and upon |
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| termination of the employer's contract
with the Department. In |
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| addition, the employing agency is responsible for
the issuance |
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| of certifications of in-service training completed to their
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| employees.
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| The Department is required to develop a system to ensure |
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| that persons
working as home care aides and personal assistants
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| chore housekeepers receive increases in their
wages when the |
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| federal minimum wage is increased by requiring vendors to
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| certify that they are meeting the federal minimum wage statute |
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| for home care aides
and personal assistants
chore housekeepers . |
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| An employer that cannot ensure that the minimum
wage increase |
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| is being given to home care aides and personal assistants
chore |
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| housekeepers
shall be denied any increase in reimbursement |
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| costs.
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| The Community Care Program Advisory Committee is created in |
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| the Department on Aging. The Director shall appoint individuals |
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| to serve in the Committee, who shall serve at their own |
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| expense. Members of the Committee must abide by all applicable |
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| ethics laws. The Committee shall advise the Department on |
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| issues related to the Department's program of services to |
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| prevent unnecessary institutionalization. The Committee shall |
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| meet on a bi-monthly basis and shall serve to identify and |
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| advise the Department on present and potential issues affecting |
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| the service delivery network, the program's clients, and the |
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| Department and to recommend solution strategies. Persons |
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| appointed to the Committee shall be appointed on, but not |
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| limited to, their own and their agency's experience with the |
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| program, geographic representation, and willingness to serve. |
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| The Director shall appoint members to the Committee to |
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| represent provider, advocacy, policy research, and other |
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| constituencies committed to the delivery of high quality home |
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| and community-based services to older adults. Representatives |
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| shall be appointed to ensure representation from community care |
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| providers including, but not limited to, adult day service |
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| providers, homemaker providers, case coordination and case |
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| management units, emergency home response providers, statewide |
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| trade or labor unions that represent home care
homecare aides |
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| and direct care staff, area agencies on aging, adults over age |
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| 60, membership organizations representing older adults, and |
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| other organizational entities, providers of care, or |
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| individuals with demonstrated interest and expertise in the |
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| field of home and community care as determined by the Director. |
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| Nominations may be presented from any agency or State |
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| association with interest in the program. The Director, or his |
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| or her designee, shall serve as the permanent co-chair of the |
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| advisory committee. One other co-chair shall be nominated and |
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| approved by the members of the committee on an annual basis. |
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| Committee members' terms of appointment shall be for 4 years |
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| with one-quarter of the appointees' terms expiring each year. A |
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| member shall continue to serve until his or her replacement is |
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| named. The Department shall fill vacancies that have a |
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| remaining term of over one year, and this replacement shall |
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| occur through the annual replacement of expiring terms. The |
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| Director shall designate Department staff to provide technical |
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| assistance and staff support to the committee. Department |
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| representation shall not constitute membership of the |
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| committee. All Committee papers, issues, recommendations, |
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| reports, and meeting memoranda are advisory only. The Director, |
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| or his or her designee, shall make a written report, as |
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| requested by the Committee, regarding issues before the |
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| Committee.
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| The Department on Aging and the Department of Human |
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| Services
shall cooperate in the development and submission of |
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| an annual report on
programs and services provided under this |
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| Section. Such joint report
shall be filed with the Governor and |
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| the General Assembly on or before
September 30 each year.
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| The requirement for reporting to the General Assembly shall |
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| be satisfied
by filing copies of the report with the Speaker, |
5 |
| the Minority Leader and
the Clerk of the House of |
6 |
| Representatives and the President, the Minority
Leader and the |
7 |
| Secretary of the Senate and the Legislative Research Unit,
as |
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| required by Section 3.1 of the General Assembly Organization |
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| Act and
filing such additional copies with the State Government |
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| Report Distribution
Center for the General Assembly as is |
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| required under paragraph (t) of
Section 7 of the State Library |
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| Act.
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| Those persons previously found eligible for receiving |
14 |
| non-institutional
services whose services were discontinued |
15 |
| under the Emergency Budget Act of
Fiscal Year 1992, and who do |
16 |
| not meet the eligibility standards in effect
on or after July |
17 |
| 1, 1992, shall remain ineligible on and after July 1,
1992. |
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| Those persons previously not required to cost-share and who |
19 |
| were
required to cost-share effective March 1, 1992, shall |
20 |
| continue to meet
cost-share requirements on and after July 1, |
21 |
| 1992. Beginning July 1, 1992,
all clients will be required to |
22 |
| meet
eligibility, cost-share, and other requirements and will |
23 |
| have services
discontinued or altered when they fail to meet |
24 |
| these requirements. |
25 |
| For the purposes of this Section, "flexible senior |
26 |
| services" refers to services that require one-time or periodic |
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| expenditures including, but not limited to, respite care, home |
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| modification, assistive technology, housing assistance, and |
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| transportation.
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| (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, |
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| eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; |
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| 95-473, eff. 8-27-07; 95-565, eff. 6-1-08; revised 10-30-07.)
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| (20 ILCS 105/4.12) |
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| Sec. 4.12. Assistance to nursing home residents. |
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| (a) The Department on Aging shall assist eligible nursing |
10 |
| home residents and their families to select long-term care |
11 |
| options that meet their needs and reflect their preferences. At |
12 |
| any time during the process, the resident or his or her |
13 |
| representative may decline further assistance. |
14 |
| (b) To provide assistance, the Department shall develop a |
15 |
| program of transition services with follow-up in selected areas |
16 |
| of the State, to be expanded statewide as funding becomes |
17 |
| available. The program shall be developed in consultation with |
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| nursing homes, care coordinators case managers , Area Agencies |
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| on Aging, and others interested in the well-being of frail |
20 |
| elderly Illinois residents. The Department shall establish |
21 |
| administrative rules pursuant to the Illinois Administrative |
22 |
| Procedure Act with respect to resident eligibility, assessment |
23 |
| of the resident's health, cognitive, social, and financial |
24 |
| needs, development of comprehensive service transition plans, |
25 |
| and the level of services that must be available prior to |
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| transition of a resident into the community.
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| (Source: P.A. 95-331, eff. 8-21-07.)
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| Section 10. The Older Adult Services Act is amended by |
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| changing Section 25 as follows: |
5 |
| (320 ILCS 42/25)
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| Sec. 25. Older adult services restructuring. No later than |
7 |
| January 1, 2005, the Department shall commence the process of |
8 |
| restructuring the older adult services delivery system. |
9 |
| Priority shall be given to both the expansion of services and |
10 |
| the development of new services in priority service areas. |
11 |
| Subject to the availability of funding, the restructuring shall |
12 |
| include, but not be limited to, the following:
|
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| (1) Planning. The Department shall develop a plan to |
14 |
| restructure the State's service delivery system for older |
15 |
| adults. The plan shall include a schedule for the |
16 |
| implementation of the initiatives outlined in this Act and all |
17 |
| other initiatives identified by the participating agencies to |
18 |
| fulfill the purposes of this Act. Financing for older adult |
19 |
| services shall be based on the principle that "money follows |
20 |
| the individual". The plan shall also identify potential |
21 |
| impediments to delivery system restructuring and include any |
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| known regulatory or statutory barriers. |
23 |
| (2) Comprehensive care coordination case management . The |
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| Department shall implement a statewide system of holistic |
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| comprehensive case management. The system shall include the |
2 |
| identification and implementation of a universal, |
3 |
| comprehensive assessment tool to be used statewide to determine |
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| the level of physical, functional, cognitive, psycho-social, |
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| social socialization , and financial needs of older adults. This |
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| tool shall be supported by an electronic intake, assessment, |
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| and care planning system linked to a central location. |
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| "Comprehensive care coordination case management " shall |
9 |
| include activities such includes services and coordination |
10 |
| such as (i) comprehensive assessment of the older adult |
11 |
| (including the physical, functional, cognitive, psycho-social, |
12 |
| and social needs of the individual) ; (ii) development and |
13 |
| implementation of a service plan with the older adult to |
14 |
| mobilize the formal and family resources and services |
15 |
| identified in the assessment to meet the needs of the older |
16 |
| adult, including coordination of the resources and services |
17 |
| with any other plans that exist for various formal services, |
18 |
| such as hospital discharge plans, and with the information and |
19 |
| assistance services; (iii) coordination and monitoring of |
20 |
| formal and family service delivery, regardless of the funding |
21 |
| source, including coordination and monitoring to ensure that |
22 |
| services specified in the plan are being provided; (iv) |
23 |
| assistance with completion of applications for services, |
24 |
| referrals to non-government funded services, health promotion, |
25 |
| and ensuring continuity of care across care settings; (v) |
26 |
| periodic reassessment and revision of the status of the older |
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| adult with the older adult or, if necessary, the older adult's |
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| designated representative; and (vi) (v) in accordance with the |
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| wishes of the older adult, advocacy on behalf of the older |
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| adult for needed services or resources. |
5 |
| (3) Coordinated point of entry. The Department shall |
6 |
| implement and publicize a statewide coordinated point of entry |
7 |
| using a uniform name, identity, logo, and toll-free number. |
8 |
| (4) Public web site. The Department shall develop a public |
9 |
| web site that provides links to available services, resources, |
10 |
| and reference materials concerning caregiving, diseases, and |
11 |
| best practices for use by professionals, older adults, and |
12 |
| family caregivers. |
13 |
| (5) Expansion of older adult services. The Department shall |
14 |
| expand older adult services that promote independence and |
15 |
| permit older adults to remain in their own homes and |
16 |
| communities. |
17 |
| (6) Consumer-directed home and community-based services. |
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| The Department shall expand the range of service options |
19 |
| available to permit older adults to exercise maximum choice and |
20 |
| control over their care. |
21 |
| (7) Comprehensive delivery system. The Department shall |
22 |
| expand opportunities for older adults to receive services in |
23 |
| systems that integrate acute and chronic care. |
24 |
| (8) Enhanced transition and follow-up services. The |
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| Department shall implement a program of transition from one |
26 |
| residential setting to another and follow-up services, |
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| regardless of residential setting, pursuant to rules with |
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| respect to (i) resident eligibility, (ii) assessment of the |
3 |
| resident's health, cognitive, social, and financial needs, |
4 |
| (iii) development of transition plans, and (iv) the level of |
5 |
| services that must be available before transitioning a resident |
6 |
| from one setting to another. |
7 |
| (9) Family caregiver support. The Department shall develop |
8 |
| strategies for public and private financing of services that |
9 |
| supplement and support family caregivers.
|
10 |
| (10) Quality standards and quality improvement. The |
11 |
| Department shall establish a core set of uniform quality |
12 |
| standards for all providers that focus on outcomes and take |
13 |
| into consideration consumer choice and satisfaction, and the |
14 |
| Department shall require each provider to implement a |
15 |
| continuous quality improvement process to address consumer |
16 |
| issues. The continuous quality improvement process must |
17 |
| benchmark performance, be person-centered and data-driven, and |
18 |
| focus on consumer satisfaction.
|
19 |
| (11) Workforce. The Department shall develop strategies to |
20 |
| attract and retain a qualified and stable worker pool, provide |
21 |
| living wages and benefits, and create a work environment that |
22 |
| is conducive to long-term employment and career development. |
23 |
| Resources such as grants, education, and promotion of career |
24 |
| opportunities may be used. |
25 |
| (12) Coordination of services. The Department shall |
26 |
| identify methods to better coordinate service networks to |
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| maximize resources and minimize duplication of services and |
2 |
| ease of application. |
3 |
| (13) Barriers to services. The Department shall identify |
4 |
| barriers to the provision, availability, and accessibility of |
5 |
| services and shall implement a plan to address those barriers. |
6 |
| The plan shall: (i) identify barriers, including but not |
7 |
| limited to, statutory and regulatory complexity, reimbursement |
8 |
| issues, payment issues, and labor force issues; (ii) recommend |
9 |
| changes to State or federal laws or administrative rules or |
10 |
| regulations; (iii) recommend application for federal waivers |
11 |
| to improve efficiency and reduce cost and paperwork; (iv) |
12 |
| develop innovative service delivery models; and (v) recommend |
13 |
| application for federal or private service grants. |
14 |
| (14) Reimbursement and funding. The Department shall |
15 |
| investigate and evaluate costs and payments by defining costs |
16 |
| to implement a uniform, audited provider cost reporting system |
17 |
| to be considered by all Departments in establishing payments. |
18 |
| To the extent possible, multiple cost reporting mandates shall |
19 |
| not be imposed. |
20 |
| (15) Medicaid nursing home cost containment and Medicare |
21 |
| utilization. The Department of Healthcare and Family Services |
22 |
| (formerly Department of Public Aid), in collaboration with the |
23 |
| Department on Aging and the Department of Public Health and in |
24 |
| consultation with the Advisory Committee, shall propose a plan |
25 |
| to contain Medicaid nursing home costs and maximize Medicare |
26 |
| utilization. The plan must not impair the ability of an older |
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| adult to choose among available services. The plan shall |
2 |
| include, but not be limited to, (i) techniques to maximize the |
3 |
| use of the most cost-effective services without sacrificing |
4 |
| quality and (ii) methods to identify and serve older adults in |
5 |
| need of minimal services to remain independent, but who are |
6 |
| likely to develop a need for more extensive services in the |
7 |
| absence of those minimal services. |
8 |
| (16) Bed reduction. The Department of Public Health shall |
9 |
| implement a nursing home conversion program to reduce the |
10 |
| number of Medicaid-certified nursing home beds in areas with |
11 |
| excess beds. The Department of Healthcare and Family Services |
12 |
| shall investigate changes to the Medicaid nursing facility |
13 |
| reimbursement system in order to reduce beds. Such changes may |
14 |
| include, but are not limited to, incentive payments that will |
15 |
| enable facilities to adjust to the restructuring and expansion |
16 |
| of services required by the Older Adult Services Act, including |
17 |
| adjustments for the voluntary closure or layaway of nursing |
18 |
| home beds certified under Title XIX of the federal Social |
19 |
| Security Act. Any savings shall be reallocated to fund |
20 |
| home-based or community-based older adult services pursuant to |
21 |
| Section 20. |
22 |
| (17) Financing. The Department shall investigate and |
23 |
| evaluate financing options for older adult services and shall |
24 |
| make recommendations in the report required by Section 15 |
25 |
| concerning the feasibility of these financing arrangements. |
26 |
| These arrangements shall include, but are not limited to: |
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| (A) private long-term care insurance coverage for |
2 |
| older adult services; |
3 |
| (B) enhancement of federal long-term care financing |
4 |
| initiatives; |
5 |
| (C) employer benefit programs such as medical savings |
6 |
| accounts for long-term care; |
7 |
| (D) individual and family cost-sharing options; |
8 |
| (E) strategies to reduce reliance on government |
9 |
| programs; |
10 |
| (F) fraudulent asset divestiture and financial |
11 |
| planning prevention; and |
12 |
| (G) methods to supplement and support family and |
13 |
| community caregiving. |
14 |
| (18) Older Adult Services Demonstration Grants. The |
15 |
| Department shall implement a program of demonstration grants |
16 |
| that will assist in the restructuring of the older adult |
17 |
| services delivery system, and shall provide funding for |
18 |
| innovative service delivery models and system change and |
19 |
| integration initiatives pursuant to subsection (g) of Section |
20 |
| 20. |
21 |
| (19) Bed need methodology update. For the purposes of |
22 |
| determining areas with excess beds, the Departments shall |
23 |
| provide information and assistance to the Health Facilities |
24 |
| Planning Board to update the Bed Need Methodology for Long-Term |
25 |
| Care to update the assumptions used to establish the |
26 |
| methodology to make them consistent with modern older adult |
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| services.
|
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| (20) Affordable housing. The Departments shall utilize the |
3 |
| recommendations of Illinois' Annual Comprehensive Housing |
4 |
| Plan, as developed by the Affordable Housing Task Force through |
5 |
| the Governor's Executive Order 2003-18, in their efforts to |
6 |
| address the affordable housing needs of older adults.
|
7 |
| The Older Adult Services Advisory Committee shall |
8 |
| investigate innovative and promising practices operating as |
9 |
| demonstration or pilot projects in Illinois and in other |
10 |
| states. The Department on Aging shall provide the Older Adult |
11 |
| Services Advisory Committee with a list of all demonstration or |
12 |
| pilot projects funded by the Department on Aging, including |
13 |
| those specified by rule, law, policy memorandum, or funding |
14 |
| arrangement. The Committee shall work with the Department on |
15 |
| Aging to evaluate the viability of expanding these programs |
16 |
| into other areas of the State.
|
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| (Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05; |
18 |
| 94-766, eff. 1-1-07.)"; and |
19 |
| on page 1, line 5, by changing "Section 5." to "Section 15."; |
20 |
| and |
21 |
| on page 1, after line 6, by inserting the following: |
22 |
| "Section 95. No acceleration or delay. Where this Act makes |
23 |
| changes in a statute that is represented in this Act by text |