Full Text of HB0387 97th General Assembly
HB0387ham002 97TH GENERAL ASSEMBLY | Rep. Robyn Gabel Filed: 5/24/2011
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| 1 | | AMENDMENT TO HOUSE BILL 387
| 2 | | AMENDMENT NO. ______. Amend House Bill 387 by replacing | 3 | | everything after the enacting clause with the following:
| 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 |
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| 1 | | limited to, any or all of the following:
| 2 | | (a) (blank);
| 3 | | (b) (blank);
| 4 | | (c) home care aide services;
| 5 | | (d) personal assistant services;
| 6 | | (e) adult day services;
| 7 | | (f) home-delivered meals;
| 8 | | (g) education in self-care;
| 9 | | (h) personal care services;
| 10 | | (i) adult day health services;
| 11 | | (j) habilitation services;
| 12 | | (k) respite care;
| 13 | | (k-5) community reintegration services;
| 14 | | (k-6) flexible senior services; | 15 | | (k-7) medication management; | 16 | | (k-8) emergency home response;
| 17 | | (l) other nonmedical social services that may enable | 18 | | the person
to become self-supporting; or
| 19 | | (m) clearinghouse for information provided by senior | 20 | | citizen home owners
who want to rent rooms to or share | 21 | | living space with other senior citizens.
| 22 | | The Department shall establish eligibility standards for | 23 | | such
services. In determining the amount and nature of services
| 24 | | for which a person may qualify, consideration shall not be | 25 | | given to the
value of cash, property or other assets held in | 26 | | the name of the person's
spouse pursuant to a written agreement |
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| 1 | | dividing marital property into equal
but separate shares or | 2 | | pursuant to a transfer of the person's interest in a
home to | 3 | | his spouse, provided that the spouse's share of the marital
| 4 | | property is not made available to the person seeking such | 5 | | services.
| 6 | | Beginning January 1, 2008, the Department shall require as | 7 | | a condition of eligibility that all new financially eligible | 8 | | applicants apply for and enroll in medical assistance under | 9 | | Article V of the Illinois Public Aid Code in accordance with | 10 | | rules promulgated by the Department.
| 11 | | The Department shall, in conjunction with the Department of | 12 | | Public Aid (now Department of Healthcare and Family Services),
| 13 | | seek appropriate amendments under Sections 1915 and 1924 of the | 14 | | Social
Security Act. The purpose of the amendments shall be to | 15 | | extend eligibility
for home and community based services under | 16 | | Sections 1915 and 1924 of the
Social Security Act to persons | 17 | | who transfer to or for the benefit of a
spouse those amounts of | 18 | | income and resources allowed under Section 1924 of
the Social | 19 | | Security Act. Subject to the approval of such amendments, the
| 20 | | Department shall extend the provisions of Section 5-4 of the | 21 | | Illinois
Public Aid Code to persons who, but for the provision | 22 | | of home or
community-based services, would require the level of | 23 | | care provided in an
institution, as is provided for in federal | 24 | | law. Those persons no longer
found to be eligible for receiving | 25 | | noninstitutional services due to changes
in the eligibility | 26 | | criteria shall be given 45 days notice prior to actual
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| 1 | | termination. Those persons receiving notice of termination may | 2 | | contact the
Department and request the determination be | 3 | | appealed at any time during the
45 day notice period. The | 4 | | target
population identified for the purposes of this Section | 5 | | are persons age 60
and older with an identified service need. | 6 | | Priority shall be given to those
who are at imminent risk of | 7 | | institutionalization. The services shall be
provided to | 8 | | eligible persons age 60 and older to the extent that the cost
| 9 | | of the services together with the other personal maintenance
| 10 | | expenses of the persons are reasonably related to the standards
| 11 | | established for care in a group facility appropriate to the | 12 | | person's
condition. These non-institutional services, pilot | 13 | | projects or
experimental facilities may be provided as part of | 14 | | or in addition to
those authorized by federal law or those | 15 | | funded and administered by the
Department of Human Services. | 16 | | The Departments of Human Services, Healthcare and Family | 17 | | Services,
Public Health, Veterans' Affairs, and Commerce and | 18 | | Economic Opportunity and
other appropriate agencies of State, | 19 | | federal and local governments shall
cooperate with the | 20 | | Department on Aging in the establishment and development
of the | 21 | | non-institutional services. The Department shall require an | 22 | | annual
audit from all personal assistant
and home care aide | 23 | | vendors contracting with
the Department under this Section. The | 24 | | annual audit shall assure that each
audited vendor's procedures | 25 | | are in compliance with Department's financial
reporting | 26 | | guidelines requiring an administrative and employee wage and |
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| 1 | | benefits cost split as defined in administrative rules. The | 2 | | audit is a public record under
the Freedom of Information Act. | 3 | | The Department shall execute, relative to
the nursing home | 4 | | prescreening project, written inter-agency
agreements with the | 5 | | Department of Human Services and the Department
of Healthcare | 6 | | and Family Services, to effect the following: (1) intake | 7 | | procedures and common
eligibility criteria for those persons | 8 | | who are receiving non-institutional
services; and (2) the | 9 | | establishment and development of non-institutional
services in | 10 | | areas of the State where they are not currently available or | 11 | | are
undeveloped. On and after July 1, 1996, all nursing home | 12 | | prescreenings for
individuals 60 years of age or older shall be | 13 | | conducted by the Department.
| 14 | | As part of the Department on Aging's routine training of | 15 | | case managers and case manager supervisors, the Department may | 16 | | include information on family futures planning for persons who | 17 | | are age 60 or older and who are caregivers of their adult | 18 | | children with developmental disabilities. The content of the | 19 | | training shall be at the Department's discretion. | 20 | | The Department is authorized to establish a system of | 21 | | recipient copayment
for services provided under this Section, | 22 | | such copayment to be based upon
the recipient's ability to pay | 23 | | but in no case to exceed the actual cost of
the services | 24 | | provided. Additionally, any portion of a person's income which
| 25 | | is equal to or less than the federal poverty standard shall not | 26 | | be
considered by the Department in determining the copayment. |
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| 1 | | The level of
such copayment shall be adjusted whenever | 2 | | necessary to reflect any change
in the officially designated | 3 | | federal poverty standard.
| 4 | | The Department, or the Department's authorized | 5 | | representative, may
recover the amount of moneys expended for | 6 | | services provided to or in
behalf of a person under this | 7 | | Section by a claim against the person's
estate or against the | 8 | | estate of the person's surviving spouse, but no
recovery may be | 9 | | had until after the death of the surviving spouse, if
any, and | 10 | | then only at such time when there is no surviving child who
is | 11 | | under age 21, blind, or permanently and totally disabled. This
| 12 | | paragraph, however, shall not bar recovery, at the death of the | 13 | | person, of
moneys for services provided to the person or in | 14 | | behalf of the person under
this Section to which the person was | 15 | | not entitled;
provided that such recovery shall not be enforced | 16 | | against any real estate while
it is occupied as a homestead by | 17 | | the surviving spouse or other dependent, if no
claims by other | 18 | | creditors have been filed against the estate, or, if such
| 19 | | claims have been filed, they remain dormant for failure of | 20 | | prosecution or
failure of the claimant to compel administration | 21 | | of the estate for the purpose
of payment. This paragraph shall | 22 | | not bar recovery from the estate of a spouse,
under Sections | 23 | | 1915 and 1924 of the Social Security Act and Section 5-4 of the
| 24 | | Illinois Public Aid Code, who precedes a person receiving | 25 | | services under this
Section in death. All moneys for services
| 26 | | paid to or in behalf of the person under this Section shall be |
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| 1 | | claimed for
recovery from the deceased spouse's estate. | 2 | | "Homestead", as used
in this paragraph, means the dwelling | 3 | | house and
contiguous real estate occupied by a surviving spouse
| 4 | | or relative, as defined by the rules and regulations of the | 5 | | Department of Healthcare and Family Services, regardless of the | 6 | | value of the property.
| 7 | | The Department shall increase the effectiveness of the | 8 | | existing Community Care Program by: | 9 | | (1) ensuring that in-home services included in the care | 10 | | plan are available on evenings and weekends; | 11 | | (2) ensuring that care plans contain the services that | 12 | | eligible participants
need based on the number of days in a | 13 | | month, not limited to specific blocks of time, as | 14 | | identified by the comprehensive assessment tool selected | 15 | | by the Department for use statewide, not to exceed the | 16 | | total monthly service cost maximum allowed for each | 17 | | service; the Department shall develop administrative rules | 18 | | to implement this item (2); | 19 | | (3) ensuring that the participants have the right to | 20 | | choose the services contained in their care plan and to | 21 | | direct how those services are provided, based on | 22 | | administrative rules established by the Department; | 23 | | (4) ensuring that the determination of need tool is | 24 | | accurate in determining the participants' level of need; to | 25 | | achieve this, the Department, in conjunction with the Older | 26 | | Adult Services Advisory Committee, shall institute a study |
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| 1 | | of the relationship between the Determination of Need | 2 | | scores, level of need, service cost maximums, and the | 3 | | development and utilization of service plans no later than | 4 | | May 1, 2008; findings and recommendations shall be | 5 | | presented to the Governor and the General Assembly no later | 6 | | than January 1, 2009; recommendations shall include all | 7 | | needed changes to the service cost maximums schedule and | 8 | | additional covered services; | 9 | | (5) ensuring that homemakers can provide personal care | 10 | | services that may or may not involve contact with clients, | 11 | | including but not limited to: | 12 | | (A) bathing; | 13 | | (B) grooming; | 14 | | (C) toileting; | 15 | | (D) nail care; | 16 | | (E) transferring; | 17 | | (F) respiratory services; | 18 | | (G) exercise; or | 19 | | (H) positioning; | 20 | | (6) ensuring that homemaker program vendors are not | 21 | | restricted from hiring homemakers who are family members of | 22 | | clients or recommended by clients; the Department may not, | 23 | | by rule or policy, require homemakers who are family | 24 | | members of clients or recommended by clients to accept | 25 | | assignments in homes other than the client; | 26 | | (7) ensuring that the State may access maximum federal |
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| 1 | | matching funds by seeking approval for the Centers for | 2 | | Medicare and Medicaid Services for modifications to the | 3 | | State's home and community based services waiver and | 4 | | additional waiver opportunities in order to maximize | 5 | | federal matching funds; this shall include, but not be | 6 | | limited to, modification that reflects all changes in the | 7 | | Community Care Program services and all increases in the | 8 | | services cost maximum; and | 9 | | (8) ensuring that the determination of need tool | 10 | | accurately reflects the service needs of individuals with | 11 | | Alzheimer's disease and related dementia disorders. | 12 | | By January 1, 2009 or as soon after the end of the Cash and | 13 | | Counseling Demonstration Project as is practicable, the | 14 | | Department may, based on its evaluation of the demonstration | 15 | | project, promulgate rules concerning personal assistant | 16 | | services, to include, but need not be limited to, | 17 | | qualifications, employment screening, rights under fair labor | 18 | | standards, training, fiduciary agent, and supervision | 19 | | requirements. All applicants shall be subject to the provisions | 20 | | of the Health Care Worker Background Check Act.
| 21 | | The Department shall develop procedures to enhance | 22 | | availability of
services on evenings, weekends, and on an | 23 | | emergency basis to meet the
respite needs of caregivers. | 24 | | Procedures shall be developed to permit the
utilization of | 25 | | services in successive blocks of 24 hours up to the monthly
| 26 | | maximum established by the Department. Workers providing these |
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| 1 | | services
shall be appropriately trained.
| 2 | | Beginning on the effective date of this Amendatory Act of | 3 | | 1991, no person
may perform chore/housekeeping and home care | 4 | | aide services under a program
authorized by this Section unless | 5 | | that person has been issued a certificate
of pre-service to do | 6 | | so by his or her employing agency. Information
gathered to | 7 | | effect such certification shall include (i) the person's name,
| 8 | | (ii) the date the person was hired by his or her current | 9 | | employer, and
(iii) the training, including dates and levels. | 10 | | Persons engaged in the
program authorized by this Section | 11 | | before the effective date of this
amendatory Act of 1991 shall | 12 | | be issued a certificate of all pre- and
in-service training | 13 | | from his or her employer upon submitting the necessary
| 14 | | information. The employing agency shall be required to retain | 15 | | records of
all staff pre- and in-service training, and shall | 16 | | provide such records to
the Department upon request and upon | 17 | | termination of the employer's contract
with the Department. In | 18 | | addition, the employing agency is responsible for
the issuance | 19 | | of certifications of in-service training completed to their
| 20 | | employees.
| 21 | | The Department is required to develop a system to ensure | 22 | | that persons
working as home care aides and personal assistants
| 23 | | receive increases in their
wages when the federal minimum wage | 24 | | is increased by requiring vendors to
certify that they are | 25 | | meeting the federal minimum wage statute for home care aides
| 26 | | and personal assistants. An employer that cannot ensure that |
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| 1 | | the minimum
wage increase is being given to home care aides and | 2 | | personal assistants
shall be denied any increase in | 3 | | reimbursement costs.
| 4 | | The Community Care Program Advisory Committee is created in | 5 | | the Department on Aging. The Director shall appoint individuals | 6 | | to serve in the Committee, who shall serve at their own | 7 | | expense. Members of the Committee must abide by all applicable | 8 | | ethics laws. The Committee shall advise the Department on | 9 | | issues related to the Department's program of services to | 10 | | prevent unnecessary institutionalization. The Committee shall | 11 | | meet on a bi-monthly basis and shall serve to identify and | 12 | | advise the Department on present and potential issues affecting | 13 | | the service delivery network, the program's clients, and the | 14 | | Department and to recommend solution strategies. Persons | 15 | | appointed to the Committee shall be appointed on, but not | 16 | | limited to, their own and their agency's experience with the | 17 | | program, geographic representation, and willingness to serve. | 18 | | The Director shall appoint members to the Committee to | 19 | | represent provider, advocacy, policy research, and other | 20 | | constituencies committed to the delivery of high quality home | 21 | | and community-based services to older adults. Representatives | 22 | | shall be appointed to ensure representation from community care | 23 | | providers including, but not limited to, adult day service | 24 | | providers, homemaker providers, case coordination and case | 25 | | management units, emergency home response providers, statewide | 26 | | trade or labor unions that represent home care
aides and direct |
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| 1 | | care staff, area agencies on aging, adults over age 60, | 2 | | membership organizations representing older adults, and other | 3 | | organizational entities, providers of care, or individuals | 4 | | with demonstrated interest and expertise in the field of home | 5 | | and community care as determined by the Director. | 6 | | Nominations may be presented from any agency or State | 7 | | association with interest in the program. The Director, or his | 8 | | or her designee, shall serve as the permanent co-chair of the | 9 | | advisory committee. One other co-chair shall be nominated and | 10 | | approved by the members of the committee on an annual basis. | 11 | | Committee members' terms of appointment shall be for 4 years | 12 | | with one-quarter of the appointees' terms expiring each year. A | 13 | | member shall continue to serve until his or her replacement is | 14 | | named. The Department shall fill vacancies that have a | 15 | | remaining term of over one year, and this replacement shall | 16 | | occur through the annual replacement of expiring terms. The | 17 | | Director shall designate Department staff to provide technical | 18 | | assistance and staff support to the committee. Department | 19 | | representation shall not constitute membership of the | 20 | | committee. All Committee papers, issues, recommendations, | 21 | | reports, and meeting memoranda are advisory only. The Director, | 22 | | or his or her designee, shall make a written report, as | 23 | | requested by the Committee, regarding issues before the | 24 | | Committee.
| 25 | | The Department on Aging and the Department of Human | 26 | | Services
shall cooperate in the development and submission of |
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| 1 | | an annual report on
programs and services provided under this | 2 | | Section. Such joint report
shall be filed with the Governor and | 3 | | the General Assembly on or before
September 30 each year.
| 4 | | The requirement for reporting to the General Assembly shall | 5 | | be satisfied
by filing copies of the report with the Speaker, | 6 | | the Minority Leader and
the Clerk of the House of | 7 | | Representatives and the President, the Minority
Leader and the | 8 | | Secretary of the Senate and the Legislative Research Unit,
as | 9 | | required by Section 3.1 of the General Assembly Organization | 10 | | Act and
filing such additional copies with the State Government | 11 | | Report Distribution
Center for the General Assembly as is | 12 | | required under paragraph (t) of
Section 7 of the State Library | 13 | | Act.
| 14 | | Those persons previously found eligible for receiving | 15 | | non-institutional
services whose services were discontinued | 16 | | under the Emergency Budget Act of
Fiscal Year 1992, and who do | 17 | | not meet the eligibility standards in effect
on or after July | 18 | | 1, 1992, shall remain ineligible on and after July 1,
1992. | 19 | | Those persons previously not required to cost-share and who | 20 | | were
required to cost-share effective March 1, 1992, shall | 21 | | continue to meet
cost-share requirements on and after July 1, | 22 | | 1992. Beginning July 1, 1992,
all clients will be required to | 23 | | meet
eligibility, cost-share, and other requirements and will | 24 | | have services
discontinued or altered when they fail to meet | 25 | | these requirements. | 26 | | The Department shall pay an enhanced rate under the |
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| 1 | | Community Care Program to those in-home service provider | 2 | | agencies that offer health insurance coverage as a benefit to | 3 | | their direct service worker employees consistent with the | 4 | | mandates of Public Act 95-713. | 5 | | Vendors who receive an enhanced per hour payment for the | 6 | | purpose of providing health insurance coverage to their | 7 | | employees may contribute such payment to a Taft-Hartley welfare | 8 | | plan or other qualified health plan that provides for coverage | 9 | | in months later than the months for which the payments are | 10 | | received, provided that the plan bases eligibility for coverage | 11 | | on the hours worked during the months for which the payment is | 12 | | received. Vendors who submit the full payments to such a plan | 13 | | in good faith shall not be required to return the payments to | 14 | | the Department on Aging for months paid for benefits to be | 15 | | provided at a later date. | 16 | | For the purposes of this Section, "flexible senior | 17 | | services" refers to services that require one-time or periodic | 18 | | expenditures including, but not limited to, respite care, home | 19 | | modification, assistive technology, housing assistance, and | 20 | | transportation.
| 21 | | (Source: P.A. 95-298, eff. 8-20-07; 95-473, eff. 8-27-07; | 22 | | 95-565, eff. 6-1-08; 95-876, eff. 8-21-08; 96-918, eff. 6-9-10; | 23 | | 96-1129, eff. 7-20-10; revised 9-2-10.)".
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