Full Text of SB0765 95th General Assembly
SB0765sam001 95TH GENERAL ASSEMBLY
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Sen. M. Maggie Crotty
Filed: 3/21/2007
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| AMENDMENT TO SENATE BILL 765
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| AMENDMENT NO. ______. Amend Senate Bill 765 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Disabilities Services Act of 2003 is | 5 |
| amended by adding a heading to of Article 1 immediately before | 6 |
| Section 1 of the Act, by adding a heading to Article 2 | 7 |
| immediately before Section 5 of the Act, by adding Article 3 | 8 |
| and a heading to Article 99 immediately after Section 30 of the | 9 |
| Act as follows: | 10 |
| (20 ILCS 2407/Art. 1 heading new) | 11 |
| ARTICLE 1. SHORT TITLE | 12 |
| (20 ILCS 2407/Art. 2 heading new) | 13 |
| ARTICLE 2. DISABILITIES SERVICES ACT of 2003 |
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| (20 ILCS 2407/Art. 3 heading new) | 2 |
| ARTICLE 3. OLMSTEAD IMPLEMENTATION ACT | 3 |
| (20 ILCS 2407/51 new)
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| Sec. 51. Legislative intent. It is the intent of the | 5 |
| General Assembly to promote the civil rights of persons with | 6 |
| disabilities by providing community-based services for persons | 7 |
| with disabilities when such services are determined | 8 |
| appropriate and desired by the affected persons, as required by | 9 |
| Title II of the Americans with Disabilities Act under the | 10 |
| United States Supreme Court's decision in Olmstead v. L.C., 527 | 11 |
| U.S. 581 (1999). In accordance with Section 6071 of the Deficit | 12 |
| Reduction Act of 2005 (P.L. 109-171), the purpose of this Act | 13 |
| is: (i) to eliminate barriers or mechanisms, whether in State | 14 |
| law, the State Medicaid plan, the State budget, or otherwise, | 15 |
| that prevent or restrict the flexible use of funds to enable | 16 |
| individuals with disabilities to receive support for | 17 |
| appropriate and necessary long-term services in the community | 18 |
| settings of their choice; (ii) to increase the use of home and | 19 |
| community-based, rather than institutional, long-term care | 20 |
| services; (iii) to increase the ability of the State Medicaid | 21 |
| program to ensure continued provision of home and | 22 |
| community-based long-term care service to eligible individuals | 23 |
| who choose to transition from an institutional to a community | 24 |
| setting; and (iv) to ensure that procedures are in place that | 25 |
| are at least comparable to those required under the qualified |
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| HCB program to provide quality assurance for eligible | 2 |
| individuals receiving Medicaid home and community-based | 3 |
| long-term care services and to provide for continuous quality | 4 |
| improvement in such services. More specifically, this Article | 5 |
| amends the Illinois Disability Services Act of 2003 | 6 |
| (notwithstanding Section 30 of the Act) to mandate the creation | 7 |
| of a flexible system of financing for long-term services and | 8 |
| supports in Illinois that would allow available Medicaid funds | 9 |
| budgeted for nursing homes and institutional services to be | 10 |
| spent on home and community-based
services when an individual | 11 |
| residing in an institution moves to the most appropriate and | 12 |
| preferred community-based setting of his or her choice. | 13 |
| (20 ILCS 2407/52 new)
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| Sec. 52. Applicability; definitions. In accordance with | 15 |
| section 6071 of the Deficit Reduction Act of 2005 (P.L. | 16 |
| 109-171), as used in this Article: | 17 |
| "Home and community-based long-term care services". The | 18 |
| term "home and community-based long-term care services" means, | 19 |
| with respect to a State Medicaid program, a service, aid, or | 20 |
| benefit that is provided to a person with a disability (and is | 21 |
| voluntarily accepted) as part of his or her long-term care | 22 |
| that: (i) is provided under the State's qualified HCB program | 23 |
| or that could be provided under such a program but is otherwise | 24 |
| provided under the Medicaid program; (ii) is delivered in a | 25 |
| qualified residence; and (iii) is necessary for the person with |
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| a disability to live in the community. | 2 |
| "Eligible individual". The term "eligible individual" | 3 |
| means a person with a disability of any age in Illinois: (i) | 4 |
| who is receiving Medicaid benefits for inpatient services | 5 |
| furnished by an inpatient facility; (ii) with respect to whom a | 6 |
| determination has been made that, but for the provision of home | 7 |
| and community-based long-term care services, the individual | 8 |
| would continue to require the level of care provided in an | 9 |
| inpatient facility; (iii) who is deemed appropriate by the | 10 |
| State's treatment professionals for home or community-based | 11 |
| services; and (iv) who wants to transfer from an inpatient | 12 |
| facility to a qualified residence. For the purposes of this | 13 |
| Act, "eligible individual" does not include a person with a | 14 |
| disability receiving acute care mental health treatment in a | 15 |
| State-operated mental health center for less than 30 | 16 |
| consecutive days in a one-year period. | 17 |
| "Inpatient facility". The term "inpatient facility" means | 18 |
| a skilled nursing or intermediate long-term care facility | 19 |
| subject to licensure by the Department of Public Health under | 20 |
| the Nursing Care Act, an intermediate care facility for the | 21 |
| mentally retarded (ICF-DDs), an institution for mental | 22 |
| diseases, child care institutions licensed by the Department of | 23 |
| Children and Family Services, and a State-operated | 24 |
| developmental center or mental health center, whether publicly | 25 |
| or privately owned. | 26 |
| "Qualified HCB program". The term "qualified HCB program" |
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| means a program providing home and community-based long-term | 2 |
| care services operating under Medicaid, whether or not | 3 |
| operating under waiver authority. | 4 |
| "Qualified residence". The term "qualified residence" | 5 |
| means, with respect to an eligible individual: (i) a home owned | 6 |
| or leased by the individual or the individual's authorized | 7 |
| representative (as defined by P.L. 109-171); (ii) an apartment | 8 |
| with an individual lease, with lockable access and egress, and | 9 |
| which includes living, sleeping, bathing, and cooking areas | 10 |
| over which the individual or the individual's family has domain | 11 |
| and control; and (iii) a residence, in a community-based | 12 |
| residential setting, in which no more than 4 unrelated | 13 |
| individuals reside. | 14 |
| "Self-directed services". The term "self-directed | 15 |
| services" means, with respect to home and community-based | 16 |
| long-term care services for an eligible individual, such | 17 |
| services for the individual that are planned and purchased | 18 |
| under the direction and control of such individual or the | 19 |
| individual's authorized representative, including the amount, | 20 |
| duration, scope, provider, and location of such services, as | 21 |
| described in the individual service or treatment plan. | 22 |
| "Public funds" means any funds appropriated by the General | 23 |
| Assembly to the Department of Human Services, the Department on | 24 |
| Aging, the Department of Children and Family Services, or the | 25 |
| Department of Healthcare and Family Services.
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| (20 ILCS 2407/53 new)
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| Sec. 53. Redistribution of public funds for community | 3 |
| services. | 4 |
| (a) Any eligible individual, as defined in Section 52, has | 5 |
| the right to have public funds that are, or would have been, | 6 |
| expended for his or her care in an inpatient facility | 7 |
| transferred to pay for his or her home and community-based | 8 |
| long-term care services in a qualified residence. | 9 |
| (b) In accordance with Sections 15(2) and 20(b)(2) of this | 10 |
| Act, all eligible individuals under this Act shall have an | 11 |
| individual service or treatment plan that is reviewed at least | 12 |
| annually that is consistent with the requirements under | 13 |
| subsection (b)(8)(A) of section 6071 of the Deficit Reduction | 14 |
| Act of 2005 (P.L. 109-171), and that includes an individualized | 15 |
| budget that identifies the dollar value of the services and | 16 |
| supports under the control and direction of the individual or | 17 |
| the individual's authorized representative. The service or | 18 |
| treatment plan must contain assurances that each eligible | 19 |
| individual has been provided the opportunity to make an | 20 |
| informed choice regarding their right under subsection (a). | 21 |
| (c) In accordance with any Disability Services Plan or Plan | 22 |
| update developed under this Act and section 6071 of the Deficit | 23 |
| Reduction Act of 2005 (P.L. 109-171), the Departments of Human | 24 |
| Services, Aging, Children and Family Services, Department of | 25 |
| Healthcare and Family Services, and Public Health shall develop | 26 |
| appropriate fiscal payment mechanisms and methodologies that |
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| effectively support choice (money follows the person) and | 2 |
| eliminate any legal, budgetary, or other barriers to | 3 |
| flexibility in the availability of Medicaid funds to pay for | 4 |
| long-term care services for eligible individuals in the | 5 |
| appropriate home and community-based long-term care settings | 6 |
| of their choice, including costs to transition from an | 7 |
| inpatient facility to a qualified residence. With respect to | 8 |
| the individualized budgets described in subsection (b), the | 9 |
| fiscal payment mechanisms and methodologies must: (i) describe | 10 |
| the method for calculating the dollar values in such budgets | 11 |
| based on reliable costs and service utilization; (ii) define a | 12 |
| process for making adjustments in such dollar values to reflect | 13 |
| changes in individual assessments and service plans; and (iii) | 14 |
| provide a procedure to evaluate expenditures under such | 15 |
| budgets. | 16 |
| (d) The cost of home and community-based long-term care | 17 |
| services provided under this Act shall be funded in accordance | 18 |
| with the individual service or treatment plan, but shall not | 19 |
| exceed the cost of care in the inpatient facility in which the | 20 |
| individual most recently resided. | 21 |
| (e) In accordance with Section 4.4 of the Community | 22 |
| Services Act of 2004 (P.L. 094-0498), whenever any | 23 |
| appropriation, or any portion of an appropriation, for any | 24 |
| fiscal year related to the funding of an inpatient facility is | 25 |
| reduced due to the redistribution of funds under this Act, to | 26 |
| the extent that savings are realized, those moneys must be |
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| deposited into the Olmstead Implementation Fund, created as a | 2 |
| special fund in the State treasury, and shall be used to expand | 3 |
| the availability, quality, or stability of home and | 4 |
| community-based long-term care services and supports for | 5 |
| persons with disabilities (such as in-home consumer/family | 6 |
| supports; integrated, accessible, and affordable housing | 7 |
| options and home modifications, etc). | 8 |
| (f) The redistribution required in this Section shall not | 9 |
| have the effect of: (i) diminishing or reducing the quality of | 10 |
| services available to residents of inpatient facilities; or | 11 |
| (ii) forcing any residents of inpatient facilities to | 12 |
| involuntarily accept home and community-based long-term care | 13 |
| services, or causing any residents of inpatient facilities to | 14 |
| be involuntarily transferred or discharged. | 15 |
| (g) Funding for eligible individuals under this Act shall | 16 |
| remain available to the eligible individual, in accordance with | 17 |
| the individual service or treatment plan, as long as he or she | 18 |
| remains eligible for services in an inpatient facility and | 19 |
| prefers home and community-based long-term care services.
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| (20 ILCS 2407/54 new)
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| Sec. 54. Quality assurance and quality improvement. In | 22 |
| accordance with subsection (11) of section 6071 of the Deficit | 23 |
| Reduction Act of 2005 (P.L. 109-171), the Departments of Human | 24 |
| Services, Aging, Children and Family Services, Public Health, | 25 |
| and Department of Healthcare and Family Services shall develop |
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| a plan for quality assurance and quality improvement for home | 2 |
| and community-based long-term care services under the State | 3 |
| Medicaid program, including a plan to assure the health and | 4 |
| welfare of eligible individuals under this Act. | 5 |
| (20 ILCS 2407/55 new)
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| Sec. 55. Dissemination of information; reports. | 7 |
| (a) The State shall ensure that all eligible individuals | 8 |
| are informed of their right to receive home and community-based | 9 |
| long-term care services under this Act. The Departments of | 10 |
| Human Services, Aging, Department of Healthcare and Family | 11 |
| Services, and Public Health shall work together with | 12 |
| organizations comprised of, or representing people with | 13 |
| disabilities, to ensure that persons with disabilities and | 14 |
| their families, guardians, and advocates are informed of their | 15 |
| rights under this Act in a manner that is easily understandable | 16 |
| and accessible to people with disabilities. The Departments | 17 |
| shall ensure that multiple methods of dissemination are | 18 |
| employed and shall make concerted efforts to inform people | 19 |
| currently in inpatient facilities, including at their | 20 |
| individual team or program meetings. The Departments of Human | 21 |
| Services, Aging, Department of Healthcare and Family Services, | 22 |
| and Public Health shall ensure that all nursing home residents | 23 |
| listed under the Minimum Data Set (MDS) of the Centers for | 24 |
| Medicare and Medicaid Services as preferring to live in the | 25 |
| community are informed of and given the opportunity to exercise |
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| their rights under this Act. The Department of Public Health | 2 |
| shall ensure that, as a condition of licensing and | 3 |
| certification, all inpatient facilities covered under this Act | 4 |
| shall inform all residents annually of their opportunities to | 5 |
| choose home and community alternatives under this Act. | 6 |
| Additionally, the Department shall require each inpatient | 7 |
| facility to post in a prominent location on each residential | 8 |
| ward a notice containing information on rights and services | 9 |
| available under this Act. Signs posted on residential wards | 10 |
| shall comply with the accessibility standards of the Americans | 11 |
| with Disabilities Act. | 12 |
| (b) On or before January 1 of each year, the Department of | 13 |
| Healthcare and Family Services and the Department of Public | 14 |
| Health shall report to the Governor and the General Assembly on | 15 |
| the implementation of this Act and include, at a minimum, the | 16 |
| following data: (i) a description of the fiscal payment | 17 |
| mechanisms and methodologies developed under this Act that | 18 |
| effectively support choice (money follows the person); (ii) an | 19 |
| accounting of the savings realized under this Act and the ways | 20 |
| in which these savings were spent; (iii) information concerning | 21 |
| the dollar amounts of State Medicaid expenditures for fiscal | 22 |
| years 2006 and 2007, for long-term care services and the | 23 |
| percentage of such expenditures that were for institutional | 24 |
| long-term care services or were for home and community-based | 25 |
| long-term care services; (iv) a description of the Departments' | 26 |
| efforts to inform all eligible individuals of their rights |
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| under this Act; (v) the number of eligible individuals referred | 2 |
| or identified under this Act in the previous fiscal year, the | 3 |
| number of eligible individuals who applied to transfer to home | 4 |
| and community-based long-term care services in the previous | 5 |
| fiscal year, and the number of eligible individuals who, in | 6 |
| fact, transferred from an inpatient facility to a qualified | 7 |
| residence in the previous fiscal year; (vi) documentation that | 8 |
| the Departments have met the requirements under Section 5 to | 9 |
| assure the health and welfare of eligible individuals receiving | 10 |
| home and community-based long-term care services; and (vii) Any | 11 |
| obstacles the Department confronted in assisting residents of | 12 |
| inpatient facilities to make the transition to a qualified | 13 |
| residence, and the Department's recommendations for removing | 14 |
| those obstacles. This report must be made available to the | 15 |
| general public, including via the Departments' websites.
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| (20 ILCS 2407/56 new)
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| Sec. 56. Effect on existing rights. | 18 |
| (a) This Article does not alter or affect the manner in | 19 |
| which persons with disabilities are determined eligible or | 20 |
| appropriate for home and community-based long-term care | 21 |
| services, except to the extent the determinations are based on | 22 |
| the availability of community services. | 23 |
| (b) This Article shall not be read to limit in any way the | 24 |
| rights of people with disabilities under the U.S. Constitution, | 25 |
| the Americans with Disabilities Act, Section 504 of the |
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| Rehabilitation Act, the Social Security Act, or any other | 2 |
| federal or State law.
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| (20 ILCS 2407/57 new)
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| Sec. 57. Rules. The Departments of Human Services, Aging, | 5 |
| Children and Family Services, Department of Healthcare and | 6 |
| Family Services, and Public Health shall adopt any rules | 7 |
| necessary for the implementation and administration of this | 8 |
| Act.
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| (20 ILCS 2407/Art. 99 heading new)
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| ARTICLE 99. AMENDATORY PROVISIONS; EFFECTIVE DATE
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| Section 90. The State Finance Act is amended by adding | 12 |
| Section 5.675 as follows: | 13 |
| (30 ILCS 105/5.675 new) | 14 |
| Sec. 5.675. The Olmstead Implementation Fund.
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| Section 99. Effective date. This Act takes effect July 1, | 16 |
| 2007.".
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