Full Text of SB0187 101st General Assembly
SB0187 101ST GENERAL ASSEMBLY |
| | 101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020 SB0187 Introduced 1/30/2019, by Sen. Ram Villivalam SYNOPSIS AS INTRODUCED: |
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20 ILCS 105/4.02 | from Ch. 23, par. 6104.02 |
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Amends the Illinois Act on the Aging. Expands the Community Care Program to provide services to all persons, regardless of age, who have Alzheimer's disease or a related disorder as defined under the Alzheimer's Disease
Assistance Act.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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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 (i) persons age 60 and older in
need of | 10 | | long term care or (ii) persons, regardless of age, who are | 11 | | established as persons who suffer from
Alzheimer's disease or a | 12 | | related disorder under the Alzheimer's Disease
Assistance Act, | 13 | | thereby enabling them
to remain in their own homes or in other | 14 | | living arrangements. Such
preventive services, which may be | 15 | | coordinated with other programs for the
aged and monitored by | 16 | | area agencies on aging in cooperation with the
Department, may | 17 | | include, but are not 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. In determining the amount and nature of services
| 17 | | for which a person may qualify, consideration shall not be | 18 | | given to the
value of cash, property or other assets held in | 19 | | the name of the person's
spouse pursuant to a written agreement | 20 | | dividing marital property into equal
but separate shares or | 21 | | pursuant to a transfer of the person's interest in a
home to | 22 | | his spouse, provided that the spouse's share of the marital
| 23 | | property is not made available to the person seeking such | 24 | | services.
| 25 | | Beginning January 1, 2008, the Department shall require as | 26 | | a condition of eligibility that all new financially eligible |
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| 1 | | applicants apply for and enroll in medical assistance under | 2 | | Article V of the Illinois Public Aid Code in accordance with | 3 | | rules promulgated by the Department.
| 4 | | The Department shall, in conjunction with the Department of | 5 | | Public Aid (now Department of Healthcare and Family Services),
| 6 | | seek appropriate amendments under Sections 1915 and 1924 of the | 7 | | Social
Security Act. The purpose of the amendments shall be to | 8 | | extend eligibility
for home and community based services under | 9 | | Sections 1915 and 1924 of the
Social Security Act to persons | 10 | | who transfer to or for the benefit of a
spouse those amounts of | 11 | | income and resources allowed under Section 1924 of
the Social | 12 | | Security Act. Subject to the approval of such amendments, the
| 13 | | Department shall extend the provisions of Section 5-4 of the | 14 | | Illinois
Public Aid Code to persons who, but for the provision | 15 | | of home or
community-based services, would require the level of | 16 | | care provided in an
institution, as is provided for in federal | 17 | | law. Those persons no longer
found to be eligible for receiving | 18 | | noninstitutional services due to changes
in the eligibility | 19 | | criteria shall be given 45 days notice prior to actual
| 20 | | termination. Those persons receiving notice of termination may | 21 | | contact the
Department and request the determination be | 22 | | appealed at any time during the
45 day notice period. The | 23 | | target
population identified for the purposes of this Section | 24 | | are persons age 60
and older with an identified service need | 25 | | and persons, regardless of age, who suffer from Alzheimer's | 26 | | disease or a related disorder under the Alzheimer's Disease |
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| 1 | | Assistance Act . Priority shall be given to those
who are at | 2 | | imminent risk of institutionalization. The services shall be
| 3 | | provided to eligible persons age 60 and older to the extent | 4 | | that the cost
of the services together with the other personal | 5 | | maintenance
expenses of the persons are reasonably related to | 6 | | the standards
established for care in a group facility | 7 | | appropriate to the person's
condition. These non-institutional | 8 | | services, pilot projects or
experimental facilities may be | 9 | | provided as part of or in addition to
those authorized by | 10 | | federal law or those funded and administered by the
Department | 11 | | of Human Services. The Departments of Human Services, | 12 | | Healthcare and Family Services,
Public Health, Veterans' | 13 | | Affairs, and Commerce and Economic Opportunity and
other | 14 | | appropriate agencies of State, federal and local governments | 15 | | shall
cooperate with the Department on Aging in the | 16 | | establishment and development
of the non-institutional | 17 | | services. The Department shall require an annual
audit from all | 18 | | personal assistant
and home care aide vendors contracting with
| 19 | | the Department under this Section. The annual audit shall | 20 | | assure that each
audited vendor's procedures are in compliance | 21 | | with Department's financial
reporting guidelines requiring an | 22 | | administrative and employee wage and benefits cost split as | 23 | | defined in administrative rules. The audit is a public record | 24 | | under
the Freedom of Information Act. The Department shall | 25 | | execute, relative to
the nursing home prescreening project, | 26 | | written inter-agency
agreements with the Department of Human |
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| 1 | | Services and the Department
of Healthcare and Family Services, | 2 | | to effect the following: (1) intake procedures and common
| 3 | | eligibility criteria for those persons who are receiving | 4 | | non-institutional
services; and (2) the establishment and | 5 | | development of non-institutional
services in areas of the State | 6 | | where they are not currently available or are
undeveloped. On | 7 | | and after July 1, 1996, all nursing home prescreenings for
| 8 | | individuals 60 years of age or older and for other persons | 9 | | eligible for services under the Community Care Program shall be | 10 | | conducted by the Department.
| 11 | | As part of the Department on Aging's routine training of | 12 | | case managers and case manager supervisors, the Department may | 13 | | include information on family futures planning for persons who | 14 | | are age 60 or older and who are caregivers of their adult | 15 | | children with developmental disabilities and for persons with | 16 | | Alzheimer's disease or a related disorder . The content of the | 17 | | training shall be at the Department's discretion. | 18 | | The Department is authorized to establish a system of | 19 | | recipient copayment
for services provided under this Section, | 20 | | such copayment to be based upon
the recipient's ability to pay | 21 | | but in no case to exceed the actual cost of
the services | 22 | | provided. Additionally, any portion of a person's income which
| 23 | | is equal to or less than the federal poverty standard shall not | 24 | | be
considered by the Department in determining the copayment. | 25 | | The level of
such copayment shall be adjusted whenever | 26 | | necessary to reflect any change
in the officially designated |
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| 1 | | federal poverty standard.
| 2 | | The Department, or the Department's authorized | 3 | | representative, may
recover the amount of moneys expended for | 4 | | services provided to or in
behalf of a person under this | 5 | | Section by a claim against the person's
estate or against the | 6 | | estate of the person's surviving spouse, but no
recovery may be | 7 | | had until after the death of the surviving spouse, if
any, and | 8 | | then only at such time when there is no surviving child who
is | 9 | | under age 21 or blind or who has a permanent and total | 10 | | disability. This
paragraph, however, shall not bar recovery, at | 11 | | the death of the person, of
moneys for services provided to the | 12 | | person or in behalf of the person under
this Section to which | 13 | | the person was not entitled;
provided that such recovery shall | 14 | | not be enforced against any real estate while
it is occupied as | 15 | | a homestead by the surviving spouse or other dependent, if no
| 16 | | claims by other creditors have been filed against the estate, | 17 | | or, if such
claims have been filed, they remain dormant for | 18 | | failure of prosecution or
failure of the claimant to compel | 19 | | administration of the estate for the purpose
of payment. This | 20 | | paragraph shall not bar recovery from the estate of a spouse,
| 21 | | under Sections 1915 and 1924 of the Social Security Act and | 22 | | Section 5-4 of the
Illinois Public Aid Code, who precedes a | 23 | | person receiving services under this
Section in death. All | 24 | | moneys for services
paid to or in behalf of the person under | 25 | | this Section shall be claimed for
recovery from the deceased | 26 | | spouse's estate. "Homestead", as used
in this paragraph, means |
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| 1 | | the dwelling house and
contiguous real estate occupied by a | 2 | | surviving spouse
or relative, as defined by the rules and | 3 | | regulations of the Department of Healthcare and Family | 4 | | Services, regardless of the value of the property.
| 5 | | The Department shall increase the effectiveness of the | 6 | | existing Community Care Program by: | 7 | | (1) ensuring that in-home services included in the care | 8 | | plan are available on evenings and weekends; | 9 | | (2) ensuring that care plans contain the services that | 10 | | eligible participants
need based on the number of days in a | 11 | | month, not limited to specific blocks of time, as | 12 | | identified by the comprehensive assessment tool selected | 13 | | by the Department for use statewide, not to exceed the | 14 | | total monthly service cost maximum allowed for each | 15 | | service; the Department shall develop administrative rules | 16 | | to implement this item (2); | 17 | | (3) ensuring that the participants have the right to | 18 | | choose the services contained in their care plan and to | 19 | | direct how those services are provided, based on | 20 | | administrative rules established by the Department; | 21 | | (4) ensuring that the determination of need tool is | 22 | | accurate in determining the participants' level of need; to | 23 | | achieve this, the Department, in conjunction with the Older | 24 | | Adult Services Advisory Committee, shall institute a study | 25 | | of the relationship between the Determination of Need | 26 | | scores, level of need, service cost maximums, and the |
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| 1 | | development and utilization of service plans no later than | 2 | | May 1, 2008; findings and recommendations shall be | 3 | | presented to the Governor and the General Assembly no later | 4 | | than January 1, 2009; recommendations shall include all | 5 | | needed changes to the service cost maximums schedule and | 6 | | additional covered services; | 7 | | (5) ensuring that homemakers can provide personal care | 8 | | services that may or may not involve contact with clients, | 9 | | including but not limited to: | 10 | | (A) bathing; | 11 | | (B) grooming; | 12 | | (C) toileting; | 13 | | (D) nail care; | 14 | | (E) transferring; | 15 | | (F) respiratory services; | 16 | | (G) exercise; or | 17 | | (H) positioning; | 18 | | (6) ensuring that homemaker program vendors are not | 19 | | restricted from hiring homemakers who are family members of | 20 | | clients or recommended by clients; the Department may not, | 21 | | by rule or policy, require homemakers who are family | 22 | | members of clients or recommended by clients to accept | 23 | | assignments in homes other than the client; | 24 | | (7) ensuring that the State may access maximum federal | 25 | | matching funds by seeking approval for the Centers for | 26 | | Medicare and Medicaid Services for modifications to the |
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| 1 | | State's home and community based services waiver and | 2 | | additional waiver opportunities, including applying for | 3 | | enrollment in the Balance Incentive Payment Program by May | 4 | | 1, 2013, in order to maximize federal matching funds; this | 5 | | shall include, but not be limited to, modification that | 6 | | reflects all changes in the Community Care Program services | 7 | | and all increases in the services cost maximum; | 8 | | (8) ensuring that the determination of need tool | 9 | | accurately reflects the service needs of individuals with | 10 | | Alzheimer's disease and related dementia disorders; | 11 | | (9) ensuring that services are authorized accurately | 12 | | and consistently for the Community Care Program (CCP); the | 13 | | Department shall implement a Service Authorization policy | 14 | | directive; the purpose shall be to ensure that eligibility | 15 | | and services are authorized accurately and consistently in | 16 | | the CCP program; the policy directive shall clarify service | 17 | | authorization guidelines to Care Coordination Units and | 18 | | Community Care Program providers no later than May 1, 2013; | 19 | | (10) working in conjunction with Care Coordination | 20 | | Units, the Department of Healthcare and Family Services, | 21 | | the Department of Human Services, Community Care Program | 22 | | providers, and other stakeholders to make improvements to | 23 | | the Medicaid claiming processes and the Medicaid | 24 | | enrollment procedures or requirements as needed, | 25 | | including, but not limited to, specific policy changes or | 26 | | rules to improve the up-front enrollment of participants in |
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| 1 | | the Medicaid program and specific policy changes or rules | 2 | | to insure more prompt submission of bills to the federal | 3 | | government to secure maximum federal matching dollars as | 4 | | promptly as possible; the Department on Aging shall have at | 5 | | least 3 meetings with stakeholders by January 1, 2014 in | 6 | | order to address these improvements; | 7 | | (11) requiring home care service providers to comply | 8 | | with the rounding of hours worked provisions under the | 9 | | federal Fair Labor Standards Act (FLSA) and as set forth in | 10 | | 29 CFR 785.48(b) by May 1, 2013; | 11 | | (12) implementing any necessary policy changes or | 12 | | promulgating any rules, no later than January 1, 2014, to | 13 | | assist the Department of Healthcare and Family Services in | 14 | | moving as many participants as possible, consistent with | 15 | | federal regulations, into coordinated care plans if a care | 16 | | coordination plan that covers long term care is available | 17 | | in the recipient's area; and | 18 | | (13) maintaining fiscal year 2014 rates at the same | 19 | | level established on January 1, 2013. | 20 | | By January 1, 2009 or as soon after the end of the Cash and | 21 | | Counseling Demonstration Project as is practicable, the | 22 | | Department may, based on its evaluation of the demonstration | 23 | | project, promulgate rules concerning personal assistant | 24 | | services, to include, but need not be limited to, | 25 | | qualifications, employment screening, rights under fair labor | 26 | | standards, training, fiduciary agent, and supervision |
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| 1 | | requirements. All applicants shall be subject to the provisions | 2 | | of the Health Care Worker Background Check Act.
| 3 | | The Department shall develop procedures to enhance | 4 | | availability of
services on evenings, weekends, and on an | 5 | | emergency basis to meet the
respite needs of caregivers. | 6 | | Procedures shall be developed to permit the
utilization of | 7 | | services in successive blocks of 24 hours up to the monthly
| 8 | | maximum established by the Department. Workers providing these | 9 | | services
shall be appropriately trained.
| 10 | | Beginning on the effective date of this amendatory Act of | 11 | | 1991, no person
may perform chore/housekeeping and home care | 12 | | aide services under a program
authorized by this Section unless | 13 | | that person has been issued a certificate
of pre-service to do | 14 | | so by his or her employing agency. Information
gathered to | 15 | | effect such certification shall include (i) the person's name,
| 16 | | (ii) the date the person was hired by his or her current | 17 | | employer, and
(iii) the training, including dates and levels. | 18 | | Persons engaged in the
program authorized by this Section | 19 | | before the effective date of this
amendatory Act of 1991 shall | 20 | | be issued a certificate of all pre- and
in-service training | 21 | | from his or her employer upon submitting the necessary
| 22 | | information. The employing agency shall be required to retain | 23 | | records of
all staff pre- and in-service training, and shall | 24 | | provide such records to
the Department upon request and upon | 25 | | termination of the employer's contract
with the Department. In | 26 | | addition, the employing agency is responsible for
the issuance |
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| 1 | | of certifications of in-service training completed to their
| 2 | | employees.
| 3 | | The Department is required to develop a system to ensure | 4 | | that persons
working as home care aides and personal assistants
| 5 | | receive increases in their
wages when the federal minimum wage | 6 | | is increased by requiring vendors to
certify that they are | 7 | | meeting the federal minimum wage statute for home care aides
| 8 | | and personal assistants. An employer that cannot ensure that | 9 | | the minimum
wage increase is being given to home care aides and | 10 | | personal assistants
shall be denied any increase in | 11 | | reimbursement costs.
| 12 | | The Community Care Program Advisory Committee is created in | 13 | | the Department on Aging. The Director shall appoint individuals | 14 | | to serve in the Committee, who shall serve at their own | 15 | | expense. Members of the Committee must abide by all applicable | 16 | | ethics laws. The Committee shall advise the Department on | 17 | | issues related to the Department's program of services to | 18 | | prevent unnecessary institutionalization. The Committee shall | 19 | | meet on a bi-monthly basis and shall serve to identify and | 20 | | advise the Department on present and potential issues affecting | 21 | | the service delivery network, the program's clients, and the | 22 | | Department and to recommend solution strategies. Persons | 23 | | appointed to the Committee shall be appointed on, but not | 24 | | limited to, their own and their agency's experience with the | 25 | | program, geographic representation, and willingness to serve. | 26 | | The Director shall appoint members to the Committee to |
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| 1 | | represent provider, advocacy, policy research, and other | 2 | | constituencies committed to the delivery of high quality home | 3 | | and community-based services to older adults and to persons | 4 | | with Alzheimer's disease or a related disorder . | 5 | | Representatives shall be appointed to ensure representation | 6 | | from community care providers including, but not limited to, | 7 | | adult day service providers, homemaker providers, case | 8 | | coordination and case management units, emergency home | 9 | | response providers, statewide trade or labor unions that | 10 | | represent home care
aides and direct care staff, area agencies | 11 | | on aging, adults over age 60, membership organizations | 12 | | representing older adults, and other organizational entities, | 13 | | providers of care, or individuals with demonstrated interest | 14 | | and expertise in the field of home and community care as | 15 | | determined by the Director. | 16 | | Nominations may be presented from any agency or State | 17 | | association with interest in the program. The Director, or his | 18 | | or her designee, shall serve as the permanent co-chair of the | 19 | | advisory committee. One other co-chair shall be nominated and | 20 | | approved by the members of the committee on an annual basis. | 21 | | Committee members' terms of appointment shall be for 4 years | 22 | | with one-quarter of the appointees' terms expiring each year. A | 23 | | member shall continue to serve until his or her replacement is | 24 | | named. The Department shall fill vacancies that have a | 25 | | remaining term of over one year, and this replacement shall | 26 | | occur through the annual replacement of expiring terms. The |
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| 1 | | Director shall designate Department staff to provide technical | 2 | | assistance and staff support to the committee. Department | 3 | | representation shall not constitute membership of the | 4 | | committee. All Committee papers, issues, recommendations, | 5 | | reports, and meeting memoranda are advisory only. The Director, | 6 | | or his or her designee, shall make a written report, as | 7 | | requested by the Committee, regarding issues before the | 8 | | Committee.
| 9 | | The Department on Aging and the Department of Human | 10 | | Services
shall cooperate in the development and submission of | 11 | | an annual report on
programs and services provided under this | 12 | | Section. Such joint report
shall be filed with the Governor and | 13 | | the General Assembly on or before
September 30 each year.
| 14 | | The requirement for reporting to the General Assembly shall | 15 | | be satisfied
by filing copies of the report with the Speaker, | 16 | | the Minority Leader and
the Clerk of the House of | 17 | | Representatives and the President, the Minority
Leader and the | 18 | | Secretary of the Senate and the Legislative Research Unit,
as | 19 | | required by Section 3.1 of the General Assembly Organization | 20 | | Act and
filing such additional copies with the State Government | 21 | | Report Distribution
Center for the General Assembly as is | 22 | | required under paragraph (t) of
Section 7 of the State Library | 23 | | Act.
| 24 | | Those persons previously found eligible for receiving | 25 | | non-institutional
services whose services were discontinued | 26 | | under the Emergency Budget Act of
Fiscal Year 1992, and who do |
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| 1 | | not meet the eligibility standards in effect
on or after July | 2 | | 1, 1992, shall remain ineligible on and after July 1,
1992. | 3 | | Those persons previously not required to cost-share and who | 4 | | were
required to cost-share effective March 1, 1992, shall | 5 | | continue to meet
cost-share requirements on and after July 1, | 6 | | 1992. Beginning July 1, 1992,
all clients will be required to | 7 | | meet
eligibility, cost-share, and other requirements and will | 8 | | have services
discontinued or altered when they fail to meet | 9 | | these requirements. | 10 | | For the purposes of this Section, "flexible senior | 11 | | services" refers to services that require one-time or periodic | 12 | | expenditures including, but not limited to, respite care, home | 13 | | modification, assistive technology, housing assistance, and | 14 | | transportation.
| 15 | | The Department shall implement an electronic service | 16 | | verification based on global positioning systems or other | 17 | | cost-effective technology for the Community Care Program no | 18 | | later than January 1, 2014. | 19 | | The Department shall require, as a condition of | 20 | | eligibility, enrollment in the medical assistance program | 21 | | under Article V of the Illinois Public Aid Code (i) beginning | 22 | | August 1, 2013, if the Auditor General has reported that the | 23 | | Department has failed
to comply with the reporting requirements | 24 | | of Section 2-27 of
the Illinois State Auditing Act; or (ii) | 25 | | beginning June 1, 2014, if the Auditor General has reported | 26 | | that the
Department has not undertaken the required actions |
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| 1 | | listed in
the report required by subsection (a) of Section 2-27 | 2 | | of the
Illinois State Auditing Act. | 3 | | The Department shall delay Community Care Program services | 4 | | until an applicant is determined eligible for medical | 5 | | assistance under Article V of the Illinois Public Aid Code (i) | 6 | | beginning August 1, 2013, if the Auditor General has reported | 7 | | that the Department has failed
to comply with the reporting | 8 | | requirements of Section 2-27 of
the Illinois State Auditing | 9 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has | 10 | | reported that the
Department has not undertaken the required | 11 | | actions listed in
the report required by subsection (a) of | 12 | | Section 2-27 of the
Illinois State Auditing Act. | 13 | | The Department shall implement co-payments for the | 14 | | Community Care Program at the federally allowable maximum level | 15 | | (i) beginning August 1, 2013, if the Auditor General has | 16 | | reported that the Department has failed
to comply with the | 17 | | reporting requirements of Section 2-27 of
the Illinois State | 18 | | Auditing Act; or (ii) beginning June 1, 2014, if the Auditor | 19 | | General has reported that the
Department has not undertaken the | 20 | | required actions listed in
the report required by subsection | 21 | | (a) of Section 2-27 of the
Illinois State Auditing Act. | 22 | | The Department shall provide a bi-monthly report on the | 23 | | progress of the Community Care Program reforms set forth in | 24 | | this amendatory Act of the 98th General Assembly to the | 25 | | Governor, the Speaker of the House of Representatives, the | 26 | | Minority Leader of the House of Representatives, the
President |
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| 1 | | of the
Senate, and the Minority Leader of the Senate. | 2 | | The Department shall conduct a quarterly review of Care | 3 | | Coordination Unit performance and adherence to service | 4 | | guidelines. The quarterly review shall be reported to the | 5 | | Speaker of the House of Representatives, the Minority Leader of | 6 | | the House of Representatives, the
President of the
Senate, and | 7 | | the Minority Leader of the Senate. The Department shall collect | 8 | | and report longitudinal data on the performance of each care | 9 | | coordination unit. Nothing in this paragraph shall be construed | 10 | | to require the Department to identify specific care | 11 | | coordination units. | 12 | | In regard to community care providers, failure to comply | 13 | | with Department on Aging policies shall be cause for | 14 | | disciplinary action, including, but not limited to, | 15 | | disqualification from serving Community Care Program clients. | 16 | | Each provider, upon submission of any bill or invoice to the | 17 | | Department for payment for services rendered, shall include a | 18 | | notarized statement, under penalty of perjury pursuant to | 19 | | Section 1-109 of the Code of Civil Procedure, that the provider | 20 | | has complied with all Department policies. | 21 | | The Director of the Department on Aging shall make | 22 | | information available to the State Board of Elections as may be | 23 | | required by an agreement the State Board of Elections has | 24 | | entered into with a multi-state voter registration list | 25 | | maintenance system. | 26 | | Within 30 days after July 6, 2017 (the effective date of |
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| 1 | | Public Act 100-23), rates shall be increased to $18.29 per | 2 | | hour, for the purpose of increasing, by at least $.72 per hour, | 3 | | the wages paid by those vendors to their employees who provide | 4 | | homemaker services. The Department shall pay an enhanced rate | 5 | | under the Community Care Program to those in-home service | 6 | | provider agencies that offer health insurance coverage as a | 7 | | benefit to their direct service worker employees consistent | 8 | | with the mandates of Public Act 95-713. For State fiscal years | 9 | | 2018 and 2019, the enhanced rate shall be $1.77 per hour. The | 10 | | rate shall be adjusted using actuarial analysis based on the | 11 | | cost of care, but shall not be set below $1.77 per hour. The | 12 | | Department shall adopt rules, including emergency rules under | 13 | | subsections (y) and (bb) of Section 5-45 of the Illinois | 14 | | Administrative Procedure Act, to implement the provisions of | 15 | | this paragraph. | 16 | | The General Assembly finds it necessary to authorize an | 17 | | aggressive Medicaid enrollment initiative designed to maximize | 18 | | federal Medicaid funding for the Community Care Program which | 19 | | produces significant savings for the State of Illinois. The | 20 | | Department on Aging shall establish and implement a Community | 21 | | Care Program Medicaid Initiative. Under the Initiative, the
| 22 | | Department on Aging shall, at a minimum: (i) provide an | 23 | | enhanced rate to adequately compensate care coordination units | 24 | | to enroll eligible Community Care Program clients into | 25 | | Medicaid; (ii) use recommendations from a stakeholder | 26 | | committee on how best to implement the Initiative; and (iii) |
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| 1 | | establish requirements for State agencies to make enrollment in | 2 | | the State's Medical Assistance program easier for seniors. | 3 | | The Community Care Program Medicaid Enrollment Oversight | 4 | | Subcommittee is created as a subcommittee of the Older Adult | 5 | | Services Advisory Committee established in Section 35 of the | 6 | | Older Adult Services Act to make recommendations on how best to | 7 | | increase the number of medical assistance recipients who are | 8 | | enrolled in the Community Care Program. The Subcommittee shall | 9 | | consist of all of the following persons who must be appointed | 10 | | within 30 days after the effective date of this amendatory Act | 11 | | of the 100th General Assembly: | 12 | | (1) The Director of Aging, or his or her designee, who | 13 | | shall serve as the chairperson of the Subcommittee. | 14 | | (2) One representative of the Department of Healthcare | 15 | | and Family Services, appointed by the Director of | 16 | | Healthcare and Family Services. | 17 | | (3) One representative of the Department of Human | 18 | | Services, appointed by the Secretary of Human Services. | 19 | | (4) One individual representing a care coordination | 20 | | unit, appointed by the Director of Aging. | 21 | | (5) One individual from a non-governmental statewide | 22 | | organization that advocates for seniors, appointed by the | 23 | | Director of Aging. | 24 | | (6) One individual representing Area Agencies on | 25 | | Aging, appointed by the Director of Aging. | 26 | | (7) One individual from a statewide association |
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| 1 | | dedicated to Alzheimer's care, support, and research, | 2 | | appointed by the Director of Aging. | 3 | | (8) One individual from an organization that employs | 4 | | persons who provide services under the Community Care | 5 | | Program, appointed by the Director of Aging. | 6 | | (9) One member of a trade or labor union representing | 7 | | persons who provide services under the Community Care | 8 | | Program, appointed by the Director of Aging. | 9 | | (10) One member of the Senate, who shall serve as | 10 | | co-chairperson, appointed by the President of the Senate. | 11 | | (11) One member of the Senate, who shall serve as | 12 | | co-chairperson, appointed by the Minority Leader of the | 13 | | Senate. | 14 | | (12) One member of the House of
Representatives, who | 15 | | shall serve as co-chairperson, appointed by the Speaker of | 16 | | the House of Representatives. | 17 | | (13) One member of the House of Representatives, who | 18 | | shall serve as co-chairperson, appointed by the Minority | 19 | | Leader of the House of Representatives. | 20 | | (14) One individual appointed by a labor organization | 21 | | representing frontline employees at the Department of | 22 | | Human Services. | 23 | | The Subcommittee shall provide oversight to the Community | 24 | | Care Program Medicaid Initiative and shall meet quarterly. At | 25 | | each Subcommittee meeting the Department on Aging shall provide | 26 | | the following data sets to the Subcommittee: (A) the number of |
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| 1 | | Illinois residents, categorized by planning and service area, | 2 | | who are receiving services under the Community Care Program and | 3 | | are enrolled in the State's Medical Assistance Program; (B) the | 4 | | number of Illinois residents, categorized by planning and | 5 | | service area, who are receiving services under the Community | 6 | | Care Program, but are not enrolled in the State's Medical | 7 | | Assistance Program; and (C) the number of Illinois residents, | 8 | | categorized by planning and service area, who are receiving | 9 | | services under the Community Care Program and are eligible for | 10 | | benefits under the State's Medical Assistance Program, but are | 11 | | not enrolled in the State's Medical Assistance Program. In | 12 | | addition to this data, the Department on Aging shall provide | 13 | | the Subcommittee with plans on how the Department on Aging will | 14 | | reduce the number of Illinois residents who are not enrolled in | 15 | | the State's Medical Assistance Program but who are eligible for | 16 | | medical assistance benefits. The Department on Aging shall | 17 | | enroll in the State's Medical Assistance Program those Illinois | 18 | | residents who receive services under the Community Care Program | 19 | | and are eligible for medical assistance benefits but are not | 20 | | enrolled in the State's Medicaid Assistance Program. The data | 21 | | provided to the Subcommittee shall be made available to the | 22 | | public via the Department on Aging's website. | 23 | | The Department on Aging, with the involvement of the | 24 | | Subcommittee, shall collaborate with the Department of Human | 25 | | Services and the Department of Healthcare and Family Services | 26 | | on how best to achieve the responsibilities of the Community |
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| 1 | | Care Program Medicaid Initiative. | 2 | | The Department on Aging, the Department of Human Services, | 3 | | and the Department of Healthcare and Family Services shall | 4 | | coordinate and implement a streamlined process for seniors to | 5 | | access benefits under the State's Medical Assistance Program. | 6 | | The Subcommittee shall collaborate with the Department of | 7 | | Human Services on the adoption of a uniform application | 8 | | submission process. The Department of Human Services and any | 9 | | other State agency involved with processing the medical | 10 | | assistance application of any person enrolled in the Community | 11 | | Care Program shall include the appropriate care coordination | 12 | | unit in all communications related to the determination or | 13 | | status of the application. | 14 | | The Community Care Program Medicaid Initiative shall | 15 | | provide targeted funding to care coordination units to help | 16 | | seniors and other persons eligible for services under the | 17 | | Community Care Program complete their applications for medical | 18 | | assistance benefits. On and after July 1, 2019, care | 19 | | coordination units shall receive no less than $200 per | 20 | | completed application. | 21 | | The Community Care Program Medicaid Initiative shall cease | 22 | | operation 5 years after the effective date of this amendatory | 23 | | Act of the 100th General Assembly, after which the Subcommittee | 24 | | shall dissolve. | 25 | | (Source: P.A. 99-143, eff. 7-27-15; 100-23, eff. 7-6-17; | 26 | | 100-587, eff. 6-4-18.)
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