Illinois General Assembly - Full Text of SB3590
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Full Text of SB3590  96th General Assembly




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1     AN ACT concerning State government.
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 changing Section 4.02 as follows:
6     (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
7     Sec. 4.02. Community Care Program. The Department shall
8 establish a program of services to prevent unnecessary
9 institutionalization of persons age 60 and older in need of
10 long term care or who are established as persons who suffer
11 from Alzheimer's disease or a related disorder under the
12 Alzheimer's Disease Assistance Act, thereby enabling them to
13 remain in their own homes or in other living arrangements. Such
14 preventive services, which may be coordinated with other
15 programs for the aged and monitored by area agencies on aging
16 in cooperation with the Department, may include, but are not
17 limited to, any or all of the following:
18         (a) (blank);
19         (b) (blank);
20         (c) home care aide services;
21         (d) personal assistant services;
22         (e) adult day services;
23         (f) home-delivered meals;



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



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1 made available to the person seeking such services.
2     Beginning July 1, 2002, the Department shall require as a
3 condition of eligibility that all financially eligible
4 applicants apply for medical assistance under Article V of the
5 Illinois Public Aid Code in accordance with rules promulgated
6 by the Department.
7     Beginning January 1, 2008, the Department shall require as
8 a condition of eligibility that all new financially eligible
9 applicants apply for and enroll in medical assistance under
10 Article V of the Illinois Public Aid Code in accordance with
11 rules promulgated by the Department.
12     The Department shall, in conjunction with the Department of
13 Public Aid (now Department of Healthcare and Family Services),
14 seek appropriate amendments under Sections 1915 and 1924 of the
15 Social Security Act. The purpose of the amendments shall be to
16 extend eligibility for home and community based services under
17 Sections 1915 and 1924 of the Social Security Act to persons
18 who transfer to or for the benefit of a spouse those amounts of
19 income and resources allowed under Section 1924 of the Social
20 Security Act. Subject to the approval of such amendments, the
21 Department shall extend the provisions of Section 5-4 of the
22 Illinois Public Aid Code to persons who, but for the provision
23 of home or community-based services, would require the level of
24 care provided in an institution, as is provided for in federal
25 law. Those persons no longer found to be eligible for receiving
26 noninstitutional services due to changes in the eligibility



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1 criteria shall be given 60 days notice prior to actual
2 termination. Those persons receiving notice of termination may
3 contact the Department and request the determination be
4 appealed at any time during the 60 day notice period. With the
5 exception of the lengthened notice and time frame for the
6 appeal request, the appeal process shall follow the normal
7 procedure. In addition, each person affected regardless of the
8 circumstances for discontinued eligibility shall be given
9 notice and the opportunity to purchase the necessary services
10 through the Community Care Program. If the individual does not
11 elect to purchase services, the Department shall advise the
12 individual of alternative services. The target population
13 identified for the purposes of this Section are persons age 60
14 and older with an identified service need. Priority shall be
15 given to those who are at imminent risk of
16 institutionalization. The services shall be provided to
17 eligible persons age 60 and older to the extent that the cost
18 of the services together with the other personal maintenance
19 expenses of the persons are reasonably related to the standards
20 established for care in a group facility appropriate to the
21 person's condition. These non-institutional services, pilot
22 projects or experimental facilities may be provided as part of
23 or in addition to those authorized by federal law or those
24 funded and administered by the Department of Human Services.
25 The Departments of Human Services, Healthcare and Family
26 Services, Public Health, Veterans' Affairs, and Commerce and



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1 Economic Opportunity and other appropriate agencies of State,
2 federal and local governments shall cooperate with the
3 Department on Aging in the establishment and development of the
4 non-institutional services. The Department shall require an
5 annual audit from all personal assistant and home care aide
6 vendors contracting with the Department under this Section. The
7 annual audit shall assure that each audited vendor's procedures
8 are in compliance with Department's financial reporting
9 guidelines requiring an administrative and employee wage and
10 benefits cost split as defined in administrative rules. The
11 audit is a public record under the Freedom of Information Act.
12 The Department shall execute, relative to the nursing home
13 prescreening project, written inter-agency agreements with the
14 Department of Human Services and the Department of Healthcare
15 and Family Services, to effect the following: (1) intake
16 procedures and common eligibility criteria for those persons
17 who are receiving non-institutional services; and (2) the
18 establishment and development of non-institutional services in
19 areas of the State where they are not currently available or
20 are undeveloped. On and after July 1, 1996, all nursing home
21 prescreenings for individuals 60 years of age or older shall be
22 conducted by the Department.
23     As part of the Department on Aging's routine training of
24 case managers and case manager supervisors, the Department may
25 include information on family futures planning for persons who
26 are age 60 or older and who are caregivers of their adult



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1 children with developmental disabilities. The content of the
2 training shall be at the Department's discretion.
3     The Department is authorized to establish a system of
4 recipient copayment for services provided under this Section,
5 such copayment to be based upon the recipient's ability to pay
6 but in no case to exceed the actual cost of the services
7 provided. Additionally, any portion of a person's income which
8 is equal to or less than the federal poverty standard shall not
9 be considered by the Department in determining the copayment.
10 The level of such copayment shall be adjusted whenever
11 necessary to reflect any change in the officially designated
12 federal poverty standard.
13     The Department, or the Department's authorized
14 representative, shall recover the amount of moneys expended for
15 services provided to or in behalf of a person under this
16 Section by a claim against the person's estate or against the
17 estate of the person's surviving spouse, but no recovery may be
18 had until after the death of the surviving spouse, if any, and
19 then only at such time when there is no surviving child who is
20 under age 21, blind, or permanently and totally disabled. This
21 paragraph, however, shall not bar recovery, at the death of the
22 person, of moneys for services provided to the person or in
23 behalf of the person under this Section to which the person was
24 not entitled; provided that such recovery shall not be enforced
25 against any real estate while it is occupied as a homestead by
26 the surviving spouse or other dependent, if no claims by other



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1 creditors have been filed against the estate, or, if such
2 claims have been filed, they remain dormant for failure of
3 prosecution or failure of the claimant to compel administration
4 of the estate for the purpose of payment. This paragraph shall
5 not bar recovery from the estate of a spouse, under Sections
6 1915 and 1924 of the Social Security Act and Section 5-4 of the
7 Illinois Public Aid Code, who precedes a person receiving
8 services under this Section in death. All moneys for services
9 paid to or in behalf of the person under this Section shall be
10 claimed for recovery from the deceased spouse's estate.
11 "Homestead", as used in this paragraph, means the dwelling
12 house and contiguous real estate occupied by a surviving spouse
13 or relative, as defined by the rules and regulations of the
14 Department of Healthcare and Family Services, regardless of the
15 value of the property.
16     The Department shall increase the effectiveness of the
17 existing Community Care Program by:
18         (1) ensuring that in-home services included in the care
19     plan are available on evenings and weekends;
20         (2) ensuring that care plans contain the services that
21     eligible participants need based on the number of days in a
22     month, not limited to specific blocks of time, as
23     identified by the comprehensive assessment tool selected
24     by the Department for use statewide, not to exceed the
25     total monthly service cost maximum allowed for each
26     service; the Department shall develop administrative rules



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1     to implement this item (2);
2         (3) ensuring that the participants have the right to
3     choose the services contained in their care plan and to
4     direct how those services are provided, based on
5     administrative rules established by the Department;
6         (4) ensuring that the determination of need tool is
7     accurate in determining the participants' level of need; to
8     achieve this, the Department, in conjunction with the Older
9     Adult Services Advisory Committee, shall institute a study
10     of the relationship between the Determination of Need
11     scores, level of need, service cost maximums, and the
12     development and utilization of service plans no later than
13     May 1, 2008; findings and recommendations shall be
14     presented to the Governor and the General Assembly no later
15     than January 1, 2009; recommendations shall include all
16     needed changes to the service cost maximums schedule and
17     additional covered services;
18         (5) ensuring that homemakers can provide personal care
19     services that may or may not involve contact with clients,
20     including but not limited to:
21             (A) bathing;
22             (B) grooming;
23             (C) toileting;
24             (D) nail care;
25             (E) transferring;
26             (F) respiratory services;



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1             (G) exercise; or
2             (H) positioning;
3         (6) ensuring that homemaker program vendors are not
4     restricted from hiring homemakers who are family members of
5     clients or recommended by clients; the Department may not,
6     by rule or policy, require homemakers who are family
7     members of clients or recommended by clients to accept
8     assignments in homes other than the client; and
9         (7) ensuring that the State may access maximum federal
10     matching funds by seeking approval for the Centers for
11     Medicare and Medicaid Services for modifications to the
12     State's home and community based services waiver and
13     additional waiver opportunities in order to maximize
14     federal matching funds; this shall include, but not be
15     limited to, modification that reflects all changes in the
16     Community Care Program services and all increases in the
17     services cost maximum; and .
18         (8) ensuring that the determination of need tool
19     accurately reflects the service needs of individuals with
20     Alzheimer's disease and related dementia disorders.
21     By January 1, 2009 or as soon after the end of the Cash and
22 Counseling Demonstration Project as is practicable, the
23 Department may, based on its evaluation of the demonstration
24 project, promulgate rules concerning personal assistant
25 services, to include, but need not be limited to,
26 qualifications, employment screening, rights under fair labor



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



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



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



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1 assistance and staff support to the committee. Department
2 representation shall not constitute membership of the
3 committee. All Committee papers, issues, recommendations,
4 reports, and meeting memoranda are advisory only. The Director,
5 or his or her designee, shall make a written report, as
6 requested by the Committee, regarding issues before the
7 Committee.
8     The Department on Aging and the Department of Human
9 Services shall cooperate in the development and submission of
10 an annual report on programs and services provided under this
11 Section. Such joint report shall be filed with the Governor and
12 the General Assembly on or before September 30 each year.
13     The requirement for reporting to the General Assembly shall
14 be satisfied by filing copies of the report with the Speaker,
15 the Minority Leader and the Clerk of the House of
16 Representatives and the President, the Minority Leader and the
17 Secretary of the Senate and the Legislative Research Unit, as
18 required by Section 3.1 of the General Assembly Organization
19 Act and filing such additional copies with the State Government
20 Report Distribution Center for the General Assembly as is
21 required under paragraph (t) of Section 7 of the State Library
22 Act.
23     Those persons previously found eligible for receiving
24 non-institutional services whose services were discontinued
25 under the Emergency Budget Act of Fiscal Year 1992, and who do
26 not meet the eligibility standards in effect on or after July



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1 1, 1992, shall remain ineligible on and after July 1, 1992.
2 Those persons previously not required to cost-share and who
3 were required to cost-share effective March 1, 1992, shall
4 continue to meet cost-share requirements on and after July 1,
5 1992. Beginning July 1, 1992, all clients will be required to
6 meet eligibility, cost-share, and other requirements and will
7 have services discontinued or altered when they fail to meet
8 these requirements.
9     For the purposes of this Section, "flexible senior
10 services" refers to services that require one-time or periodic
11 expenditures including, but not limited to, respite care, home
12 modification, assistive technology, housing assistance, and
13 transportation.
14 (Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336,
15 eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07;
16 95-473, eff. 8-27-07; 95-565, eff. 6-1-08; 95-876, eff.
17 8-21-08.)
18     Section 99. Effective date. This Act takes effect upon
19 becoming law.