Illinois General Assembly - Full Text of HB4837
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Full Text of HB4837  93rd General Assembly



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1     AN ACT concerning the Department on Aging.
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4     Section 5. The Illinois Act on the Aging is amended by
5 adding Section 4.02c as follows:
6     (20 ILCS 105/4.02c new)
7     Sec. 4.02c. Comprehensive Care in Residential Settings
8 Demonstration Project.
9     (a) The Department may establish and fund a demonstration
10 program of bundled services designed to support the specialized
11 needs of clients currently residing in projects that were
12 formerly designated as Community Based Residential Facilities.
13 Participating projects must hold a valid license, which remains
14 unsuspended, unrevoked, and unexpired, under the provisions of
15 the Assisted Living and Shared Housing Act.
16     (b) The demonstration program must include, at a minimum:
17         (1) 3 meals per day;
18         (2) routine housekeeping services;
19         (3) 24-hour-a-day security;
20         (4) an emergency response system;
21         (5) personal laundry and linen service;
22         (6) assistance with activities of daily living;
23         (7) medication management; and
24         (8) money management.
25     Optional services, such as transportation and social
26 activities, may be provided.
27     (c) Reimbursement for the program shall be based on the
28 client's level of need and functional impairment, as determined
29 by the Department. Clients must meet all eligibility
30 requirements established by rule. The Department may establish
31 a capitated reimbursement mechanism based on the client's level
32 of need and functional impairment. Reimbursement for program



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1 must be made to the Department-contracted provider delivering
2 the services.
3     (d) The Department shall adopt rules and provide oversight
4 for the project, with assistance and advice provided by the
5 Assisted Living and Shared Housing Advisory Board and Assisted
6 Living and Shared Housing Quality of Life Committee.
7     The project may be funded through the Department
8 appropriations that may include Medicaid waiver funds.
9     (e) Before January 1, 2008, the Department, in consultation
10 with the Assisted Living and Shared Housing Advisory Board,
11 must report to the General Assembly on the results of the
12 demonstration project. The report must include, without
13 limitation, any recommendations for changes or improvements,
14 including changes or improvements in the administration of the
15 program and an evaluation.
16     Section 10. The Assisted Living and Shared Housing Act is
17 amended by changing Sections 90 and 140 as follows:
18     (210 ILCS 9/90)
19     Sec. 90. Contents of service delivery contract. A contract
20 between an establishment and a resident must be entitled
21 "assisted living establishment contract" or "shared housing
22 establishment contract" as applicable, shall be printed in no
23 less than 12 point type, and shall include at least the
24 following elements in the body or through supporting documents
25 or attachments:
26         (1) the name, street address, and mailing address of
27     the establishment;
28         (2) the name and mailing address of the owner or owners
29     of the establishment and, if the owner or owners are not
30     natural persons, the type of business entity of the owner
31     or owners;
32         (3) the name and mailing address of the managing agent
33     of the establishment, whether hired under a management
34     agreement or lease agreement, if the managing agent is



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1     different from the owner or owners;
2         (4) the name and address of at least one natural person
3     who is authorized to accept service on behalf of the owners
4     and managing agent;
5         (5) a statement describing the license status of the
6     establishment and the license status of all providers of
7     health-related or supportive services to a resident under
8     arrangement with the establishment;
9         (6) the duration of the contract;
10         (7) the base rate to be paid by the resident and a
11     description of the services to be provided as part of this
12     rate;
13         (8) a description of any additional services to be
14     provided for an additional fee by the establishment
15     directly or by a third party provider under arrangement
16     with the establishment;
17         (9) the fee schedules outlining the cost of any
18     additional services;
19         (10) a description of the process through which the
20     contract may be modified, amended, or terminated;
21         (11) a description of the establishment's complaint
22     resolution process available to residents and notice of the
23     availability of the Department on Aging's Senior Helpline
24     for complaints;
25         (12) the name of the resident's designated
26     representative, if any;
27         (13) the resident's obligations in order to maintain
28     residency and receive services including compliance with
29     all assessments required under Section 15;
30         (14) the billing and payment procedures and
31     requirements;
32         (15) a statement affirming the resident's freedom to
33     receive services from service providers with whom the
34     establishment does not have a contractual arrangement,
35     which may also disclaim liability on the part of the
36     establishment for those services;



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1         (16) a statement that medical assistance under Article
2     V or Article VI of the Illinois Public Aid Code is not
3     available for payment for services provided in an
4     establishment, excluding contracts executed with residents
5     residing in licensed establishments participating in the
6     Department on Aging's Comprehensive Care in Residential
7     Settings Demonstration Project;
8         (17) a statement detailing the admission, risk
9     management, and residency termination criteria and
10     procedures;
11         (18) a statement listing the rights specified in
12     Section 95 and acknowledging that, by contracting with the
13     assisted living or shared housing establishment, the
14     resident does not forfeit those rights; and
15         (19) a statement detailing the Department's annual
16     on-site review process including what documents contained
17     in a resident's personal file shall be reviewed by the
18     on-site reviewer as defined by rule.
19 (Source: P.A. 91-656, eff. 1-1-01.)
20     (210 ILCS 9/140)
21     Sec. 140. State and private funding. Nothing in this Act
22 shall:
23         (1) require or authorize the State agency responsible
24     for the administration of the medical assistance program
25     established under Article V and Article VI of the Illinois
26     Public Aid Code to approve, supply, or cover services
27     provided in an assisted living or shared housing
28     establishment, with the exception of licensed facilities
29     that participate in the Department on Aging's
30     Comprehensive Care in Residential Settings Demonstration
31     Project, which may be covered under provisions of the
32     Illinois Public Aid Code;
33         (2) require an agency or a managed care organization to
34     approve, supply, or cover services provided in an assisted
35     living or shared housing establishment; or



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1         (3) require any other third party payer to approve,
2     supply or cover medically necessary home care services
3     provided in an assisted living establishment.
4 (Source: P.A. 91-656, eff. 1-1-01.)
5     (20 ILCS 105/4.02b rep.)  (from Ch. 23, par. 6104.02b)
6     Section 90. The Illinois Act on the Aging is amended by
7 repealing Section 4.02b.