Full Text of HB4919 103rd General Assembly
HB4919 103RD GENERAL ASSEMBLY | | | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB4919 Introduced 2/7/2024, by Rep. Marcus C. Evans, Jr. SYNOPSIS AS INTRODUCED: | | | Amends the Illinois Act on the Aging. In a provision requiring the Department on Aging to require an annual audit from all personal assistant and home care aide vendors contracting with the Department, provides that the annual audit shall assure that each audited vendor's procedures are in compliance with the Department's financial reporting guidelines requiring an 80% or higher employee wage and benefits cost split and an administrative cost split of no more than 20% (rather than an administrative and employee wage and benefits cost split as defined in administrative rules). Provides that subject to federal approval, on and after January 1, 2025, rates for homemaker services shall be increased to $32.75 to sustain a minimum wage of $20 per hour for direct service workers. Provides that rates in subsequent State fiscal years shall be no lower than $32.75 upon federal approval. Requires providers of in-home services to be required to certify to the Department that they remain in compliance with the mandated wage increase for direct service workers. Provides that fringe benefits, including, but not limited to, paid time off and payment for training, health insurance, travel, or transportation, shall not be reduced in relation to the rate increases. Provides that subject to federal approval, on and after January 1, 2025, the Department shall pay a rate add-on under the Community Care Program to those in-home service provider agencies that attest and document their direct service workers attend paid, quarterly, in-person training sessions to fulfill the in-service training requirements. Provides that the add-on shall be 1% of the homemaker services rate. Requires the Department to adopt rules. |
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| | 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) | 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. | 14 | | Such 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. In determining the amount and nature of | 17 | | services for which a person may qualify, consideration shall | 18 | | not be given to the value of cash, property , or other assets | 19 | | held in the name of the person's spouse pursuant to a written | 20 | | agreement dividing marital property into equal but separate | 21 | | shares or pursuant to a transfer of the person's interest in a | 22 | | home to his spouse, provided that the spouse's share of the | 23 | | marital property is not made available to the person seeking | 24 | | such 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 | 5 | | of Public Aid (now Department of Healthcare and Family | 6 | | Services), seek appropriate amendments under Sections 1915 and | 7 | | 1924 of the Social Security Act. The purpose of the amendments | 8 | | shall be to extend eligibility for home and community based | 9 | | services under Sections 1915 and 1924 of the Social Security | 10 | | Act to persons who transfer to or for the benefit of a spouse | 11 | | those amounts of income and resources allowed under Section | 12 | | 1924 of the Social Security Act. Subject to the approval of | 13 | | such amendments, the Department shall extend the provisions of | 14 | | Section 5-4 of the Illinois Public Aid Code to persons who, but | 15 | | for the provision of home or community-based services, would | 16 | | require the level of care provided in an institution, as is | 17 | | provided for in federal law. Those persons no longer found to | 18 | | be eligible for receiving noninstitutional services due to | 19 | | changes in the eligibility criteria shall be given 45 days | 20 | | notice prior to actual termination. Those persons receiving | 21 | | notice of termination may contact the Department and request | 22 | | the determination be appealed at any time during the 45 day | 23 | | notice period. The target population identified for the | 24 | | purposes of this Section are persons age 60 and older with an | 25 | | identified service need. Priority shall be given to those who | 26 | | are at imminent risk of institutionalization. The services |
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| 1 | | shall be provided to eligible persons age 60 and older to the | 2 | | extent that the cost of the services together with the other | 3 | | personal maintenance expenses of the persons are reasonably | 4 | | related to the standards established for care in a group | 5 | | facility appropriate to the person's condition. These | 6 | | non-institutional services, pilot projects , or experimental | 7 | | facilities may be provided as part of or in addition to those | 8 | | authorized by federal law or those funded and administered by | 9 | | the Department of Human Services. The Departments of Human | 10 | | Services, Healthcare and Family Services, Public Health, | 11 | | Veterans' Affairs, and Commerce and Economic Opportunity and | 12 | | other appropriate agencies of State, federal , and local | 13 | | governments shall cooperate with the Department on Aging in | 14 | | the establishment and development of the non-institutional | 15 | | services. The Department shall require an annual audit from | 16 | | all personal assistant and home care aide vendors contracting | 17 | | with the Department under this Section. The annual audit shall | 18 | | assure that each audited vendor's procedures are in compliance | 19 | | with the Department's financial reporting guidelines requiring | 20 | | an 80% or higher employee wage and benefits cost split and an | 21 | | administrative cost split of no more than 20% 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 | 6 | | State where they are not currently available or are | 7 | | undeveloped. On and after July 1, 1996, all nursing home | 8 | | prescreenings for individuals 60 years of age or older shall | 9 | | be conducted by the Department. | 10 | | As part of the Department on Aging's routine training of | 11 | | case managers and case manager supervisors, the Department may | 12 | | include information on family futures planning for persons who | 13 | | are age 60 or older and who are caregivers of their adult | 14 | | children with developmental disabilities. The content of the | 15 | | training shall be at the Department's discretion. | 16 | | The Department is authorized to establish a system of | 17 | | recipient copayment for services provided under this Section, | 18 | | such copayment to be based upon the recipient's ability to pay | 19 | | but in no case to exceed the actual cost of the services | 20 | | provided. Additionally, any portion of a person's income which | 21 | | is equal to or less than the federal poverty standard shall not | 22 | | be considered by the Department in determining the copayment. | 23 | | The level of such copayment shall be adjusted whenever | 24 | | necessary to reflect any change in the officially designated | 25 | | federal poverty standard. | 26 | | The Department, or the Department's authorized |
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| 1 | | representative, may recover the amount of moneys expended for | 2 | | services provided to or in behalf of a person under this | 3 | | Section by a claim against the person's estate or against the | 4 | | estate of the person's surviving spouse, but no recovery may | 5 | | be had until after the death of the surviving spouse, if any, | 6 | | and then only at such time when there is no surviving child who | 7 | | is under age 21 or blind or who has a permanent and total | 8 | | disability. This paragraph, however, shall not bar recovery, | 9 | | at the death of the person, of moneys for services provided to | 10 | | the person or in behalf of the person under this Section to | 11 | | which the person was not entitled; provided that such recovery | 12 | | shall not be enforced against any real estate while it is | 13 | | occupied as a homestead by the surviving spouse or other | 14 | | dependent, if no claims by other creditors have been filed | 15 | | against the estate, or, if such claims have been filed, they | 16 | | remain dormant for failure of prosecution or failure of the | 17 | | claimant to compel administration of the estate for the | 18 | | purpose of payment. This paragraph shall not bar recovery from | 19 | | the estate of a spouse, under Sections 1915 and 1924 of the | 20 | | Social Security Act and Section 5-4 of the Illinois Public Aid | 21 | | Code, who precedes a person receiving services under this | 22 | | Section in death. All moneys for services paid to or in behalf | 23 | | of the person under this Section shall be claimed for recovery | 24 | | from the deceased spouse's estate. "Homestead", as used in | 25 | | this paragraph, means the dwelling house and contiguous real | 26 | | estate occupied by a surviving spouse or relative, as defined |
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| 1 | | by the rules and regulations of the Department of Healthcare | 2 | | and Family Services, regardless of the value of the property. | 3 | | The Department shall increase the effectiveness of the | 4 | | existing Community Care Program by: | 5 | | (1) ensuring that in-home services included in the | 6 | | care plan are available on evenings and weekends; | 7 | | (2) ensuring that care plans contain the services that | 8 | | eligible participants need based on the number of days in | 9 | | a month, not limited to specific blocks of time, as | 10 | | identified by the comprehensive assessment tool selected | 11 | | by the Department for use statewide, not to exceed the | 12 | | total monthly service cost maximum allowed for each | 13 | | service; the Department shall develop administrative rules | 14 | | to implement this item (2); | 15 | | (3) ensuring that the participants have the right to | 16 | | choose the services contained in their care plan and to | 17 | | direct how those services are provided, based on | 18 | | administrative rules established by the Department; | 19 | | (4) ensuring that the determination of need tool is | 20 | | accurate in determining the participants' level of need; | 21 | | to achieve this, the Department, in conjunction with the | 22 | | Older Adult Services Advisory Committee, shall institute a | 23 | | study of the relationship between the Determination of | 24 | | Need scores, level of need, service cost maximums, and the | 25 | | development and utilization of service plans no later than | 26 | | May 1, 2008; findings and recommendations shall be |
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| 1 | | presented to the Governor and the General Assembly no | 2 | | later than January 1, 2009; recommendations shall include | 3 | | all needed changes to the service cost maximums schedule | 4 | | and additional covered services; | 5 | | (5) ensuring that homemakers can provide personal care | 6 | | services that may or may not involve contact with clients, | 7 | | including , but not limited to: | 8 | | (A) bathing; | 9 | | (B) grooming; | 10 | | (C) toileting; | 11 | | (D) nail care; | 12 | | (E) transferring; | 13 | | (F) respiratory services; | 14 | | (G) exercise; or | 15 | | (H) positioning; | 16 | | (6) ensuring that homemaker program vendors are not | 17 | | restricted from hiring homemakers who are family members | 18 | | of clients or recommended by clients; the Department may | 19 | | not, by rule or policy, require homemakers who are family | 20 | | members of clients or recommended by clients to accept | 21 | | assignments in homes other than the client; | 22 | | (7) ensuring that the State may access maximum federal | 23 | | matching funds by seeking approval for the Centers for | 24 | | Medicare and Medicaid Services for modifications to the | 25 | | State's home and community based services waiver and | 26 | | additional waiver opportunities, including applying for |
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| 1 | | enrollment in the Balance Incentive Payment Program by May | 2 | | 1, 2013, in order to maximize federal matching funds; this | 3 | | shall include, but not be limited to, modification that | 4 | | reflects all changes in the Community Care Program | 5 | | services and all increases in the services cost maximum; | 6 | | (8) ensuring that the determination of need tool | 7 | | accurately reflects the service needs of individuals with | 8 | | Alzheimer's disease and related dementia disorders; | 9 | | (9) ensuring that services are authorized accurately | 10 | | and consistently for the Community Care Program (CCP); the | 11 | | Department shall implement a Service Authorization policy | 12 | | directive; the purpose shall be to ensure that eligibility | 13 | | and services are authorized accurately and consistently in | 14 | | the CCP program; the policy directive shall clarify | 15 | | service authorization guidelines to Care Coordination | 16 | | Units and Community Care Program providers no later than | 17 | | May 1, 2013; | 18 | | (10) working in conjunction with Care Coordination | 19 | | Units, the Department of Healthcare and Family Services, | 20 | | the Department of Human Services, Community Care Program | 21 | | providers, and other stakeholders to make improvements to | 22 | | the Medicaid claiming processes and the Medicaid | 23 | | enrollment procedures or requirements as needed, | 24 | | including, but not limited to, specific policy changes or | 25 | | rules to improve the up-front enrollment of participants | 26 | | in the Medicaid program and specific policy changes or |
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| 1 | | rules to insure more prompt submission of bills to the | 2 | | federal government to secure maximum federal matching | 3 | | dollars as promptly as possible; the Department on Aging | 4 | | shall have at least 3 meetings with stakeholders by | 5 | | January 1, 2014 in order to address these improvements; | 6 | | (11) requiring home care service providers to comply | 7 | | with the rounding of hours worked provisions under the | 8 | | federal Fair Labor Standards Act (FLSA) and as set forth | 9 | | in 29 CFR 785.48(b) by May 1, 2013; | 10 | | (12) implementing any necessary policy changes or | 11 | | promulgating any rules, no later than January 1, 2014, to | 12 | | assist the Department of Healthcare and Family Services in | 13 | | moving as many participants as possible, consistent with | 14 | | federal regulations, into coordinated care plans if a care | 15 | | coordination plan that covers long term care is available | 16 | | in the recipient's area; and | 17 | | (13) maintaining fiscal year 2014 rates at the same | 18 | | level established on January 1, 2013. | 19 | | By January 1, 2009 or as soon after the end of the Cash and | 20 | | Counseling Demonstration Project as is practicable, the | 21 | | Department may, based on its evaluation of the demonstration | 22 | | project, promulgate rules concerning personal assistant | 23 | | services, to include, but need not be limited to, | 24 | | qualifications, employment screening, rights under fair labor | 25 | | standards, training, fiduciary agent, and supervision | 26 | | requirements. All applicants shall be subject to the |
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| 1 | | provisions of the Health Care Worker Background Check Act. | 2 | | The Department shall develop procedures to enhance | 3 | | availability of services on evenings, weekends, and on an | 4 | | emergency basis to meet the respite needs of caregivers. | 5 | | Procedures shall be developed to permit the utilization of | 6 | | services in successive blocks of 24 hours up to the monthly | 7 | | maximum established by the Department. Workers providing these | 8 | | services shall be appropriately trained. | 9 | | Beginning on September 23, 1991 ( the effective date of | 10 | | Public Act 87-729) this amendatory Act of 1991 , no person may | 11 | | perform chore/housekeeping and home care aide services under a | 12 | | program authorized by this Section unless that person has been | 13 | | issued a certificate of pre-service to do so by his or her | 14 | | employing agency. Information gathered to effect such | 15 | | certification shall include (i) the person's name, (ii) the | 16 | | date the person was hired by his or her current employer, and | 17 | | (iii) the training, including dates and levels. Persons | 18 | | engaged in the program authorized by this Section before the | 19 | | effective date of this amendatory Act of 1991 shall be issued a | 20 | | certificate of all pre-service 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-service pre- and in-service training, | 24 | | and shall provide such records to the Department upon request | 25 | | and upon termination of the employer's contract with the | 26 | | Department. In addition, the employing agency is responsible |
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| 1 | | for the issuance of certifications of in-service training | 2 | | completed to their employees. | 3 | | The Department is required to develop a system to ensure | 4 | | that persons working as home care aides and personal | 5 | | assistants receive increases in their wages when the federal | 6 | | minimum wage is increased by requiring vendors to certify that | 7 | | they are meeting the federal minimum wage statute for home | 8 | | care aides and personal assistants. An employer that cannot | 9 | | ensure that the minimum wage increase is being given to home | 10 | | care aides and personal assistants shall be denied any | 11 | | increase in reimbursement costs. | 12 | | The Community Care Program Advisory Committee is created | 13 | | in the Department on Aging. The Director shall appoint | 14 | | individuals to serve in the Committee, who shall serve at | 15 | | their own expense. Members of the Committee must abide by all | 16 | | applicable ethics laws. The Committee shall advise the | 17 | | Department on issues related to the Department's program of | 18 | | services to prevent unnecessary institutionalization. The | 19 | | Committee shall meet on a bi-monthly basis and shall serve to | 20 | | identify and advise the Department on present and potential | 21 | | issues affecting the service delivery network, the program's | 22 | | clients, and the Department and to recommend solution | 23 | | strategies. Persons appointed to the Committee shall be | 24 | | appointed on, but not limited to, their own and their agency's | 25 | | experience with the program, geographic representation, and | 26 | | willingness to serve. The Director shall appoint members to |
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| 1 | | the Committee to represent provider, advocacy, policy | 2 | | research, and other constituencies committed to the delivery | 3 | | of high quality home and community-based services to older | 4 | | adults. Representatives shall be appointed to ensure | 5 | | representation from community care providers , including, but | 6 | | not limited to, adult day service providers, homemaker | 7 | | providers, case coordination and case management units, | 8 | | emergency home response providers, statewide trade or labor | 9 | | unions that represent home care aides and direct care staff, | 10 | | area agencies on aging, adults over age 60, membership | 11 | | 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. | 22 | | A member shall continue to serve until his or her replacement | 23 | | is 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 | 5 | | Director, or his or her designee, shall make a written report, | 6 | | as 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 | 12 | | and the General Assembly on or before March 31 of the following | 13 | | fiscal year. | 14 | | The requirement for reporting to the General Assembly | 15 | | shall be satisfied by filing copies of the report as required | 16 | | by Section 3.1 of the General Assembly Organization Act and | 17 | | filing such additional copies with the State Government Report | 18 | | Distribution Center for the General Assembly as is required | 19 | | under paragraph (t) of Section 7 of the State Library Act. | 20 | | Those persons previously found eligible for receiving | 21 | | non-institutional services whose services were discontinued | 22 | | under the Emergency Budget Act of Fiscal Year 1992, and who do | 23 | | not meet the eligibility standards in effect on or after July | 24 | | 1, 1992, shall remain ineligible on and after July 1, 1992. | 25 | | Those persons previously not required to cost-share and who | 26 | | were required to cost-share effective March 1, 1992, shall |
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| 1 | | continue to meet cost-share requirements on and after July 1, | 2 | | 1992. Beginning July 1, 1992, all clients will be required to | 3 | | meet eligibility, cost-share, and other requirements and will | 4 | | have services discontinued or altered when they fail to meet | 5 | | these requirements. | 6 | | For the purposes of this Section, "flexible senior | 7 | | services" refers to services that require one-time or periodic | 8 | | expenditures , including, but not limited to, respite care, | 9 | | home modification, assistive technology, housing assistance, | 10 | | and transportation. | 11 | | The Department shall implement an electronic service | 12 | | verification based on global positioning systems or other | 13 | | cost-effective technology for the Community Care Program no | 14 | | later than January 1, 2014. | 15 | | The Department shall require, as a condition of | 16 | | eligibility, enrollment in the medical assistance program | 17 | | under Article V of the Illinois Public Aid Code (i) beginning | 18 | | August 1, 2013, if the Auditor General has reported that the | 19 | | Department has failed to comply with the reporting | 20 | | requirements of Section 2-27 of the Illinois State Auditing | 21 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has | 22 | | reported that the Department has not undertaken the required | 23 | | actions listed in the report required by subsection (a) of | 24 | | Section 2-27 of the Illinois State Auditing Act. | 25 | | The Department shall delay Community Care Program services | 26 | | until an applicant is determined eligible for medical |
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| 1 | | assistance under Article V of the Illinois Public Aid Code (i) | 2 | | beginning August 1, 2013, if the Auditor General has reported | 3 | | that the Department has failed to comply with the reporting | 4 | | requirements of Section 2-27 of the Illinois State Auditing | 5 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has | 6 | | reported that the Department has not undertaken the required | 7 | | actions listed in the report required by subsection (a) of | 8 | | Section 2-27 of the Illinois State Auditing Act. | 9 | | The Department shall implement co-payments for the | 10 | | Community Care Program at the federally allowable maximum | 11 | | level (i) beginning August 1, 2013, if the Auditor General has | 12 | | reported that the Department has failed to comply with the | 13 | | reporting requirements of Section 2-27 of the Illinois State | 14 | | Auditing Act; or (ii) beginning June 1, 2014, if the Auditor | 15 | | General has reported that the Department has not undertaken | 16 | | the required actions listed in the report required by | 17 | | subsection (a) of Section 2-27 of the Illinois State Auditing | 18 | | Act. | 19 | | The Department shall continue to provide other Community | 20 | | Care Program reports as required by statute. | 21 | | The Department shall conduct a quarterly review of Care | 22 | | Coordination Unit performance and adherence to service | 23 | | guidelines. The quarterly review shall be reported to the | 24 | | Speaker of the House of Representatives, the Minority Leader | 25 | | of the House of Representatives, the President of the Senate, | 26 | | and the Minority Leader of the Senate. The Department shall |
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| 1 | | collect and report longitudinal data on the performance of | 2 | | each care coordination unit. Nothing in this paragraph shall | 3 | | be construed to require the Department to identify specific | 4 | | care coordination units. | 5 | | In regard to community care providers, failure to comply | 6 | | with Department on Aging policies shall be cause for | 7 | | disciplinary action, including, but not limited to, | 8 | | disqualification from serving Community Care Program clients. | 9 | | Each provider, upon submission of any bill or invoice to the | 10 | | Department for payment for services rendered, shall include a | 11 | | notarized statement, under penalty of perjury pursuant to | 12 | | Section 1-109 of the Code of Civil Procedure, that the | 13 | | provider has complied with all Department policies. | 14 | | The Director of the Department on Aging shall make | 15 | | information available to the State Board of Elections as may | 16 | | be required by an agreement the State Board of Elections has | 17 | | entered into with a multi-state voter registration list | 18 | | maintenance system. | 19 | | Within 30 days after July 6, 2017 (the effective date of | 20 | | Public Act 100-23), rates shall be increased to $18.29 per | 21 | | hour, for the purpose of increasing, by at least $.72 per hour, | 22 | | the wages paid by those vendors to their employees who provide | 23 | | homemaker services. The Department shall pay an enhanced rate | 24 | | under the Community Care Program to those in-home service | 25 | | provider agencies that offer health insurance coverage as a | 26 | | benefit to their direct service worker employees consistent |
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| 1 | | with the mandates of Public Act 95-713. For State fiscal years | 2 | | 2018 and 2019, the enhanced rate shall be $1.77 per hour. The | 3 | | rate shall be adjusted using actuarial analysis based on the | 4 | | cost of care, but shall not be set below $1.77 per hour. The | 5 | | Department shall adopt rules, including emergency rules under | 6 | | subsections (y) and (bb) of Section 5-45 of the Illinois | 7 | | Administrative Procedure Act, to implement the provisions of | 8 | | this paragraph. | 9 | | Subject to federal approval, beginning on January 1, 2024, | 10 | | rates for adult day services shall be increased to $16.84 per | 11 | | hour and rates for each way transportation services for adult | 12 | | day services shall be increased to $12.44 per unit | 13 | | transportation. | 14 | | Subject to federal approval, on and after January 1, 2024, | 15 | | rates for homemaker services shall be increased to $28.07 to | 16 | | sustain a minimum wage of $17 per hour for direct service | 17 | | workers. Rates in subsequent State fiscal years shall be no | 18 | | lower than the rates put into effect upon federal approval. | 19 | | Providers of in-home services shall be required to certify to | 20 | | the Department that they remain in compliance with the | 21 | | mandated wage increase for direct service workers. Fringe | 22 | | benefits, including, but not limited to, paid time off and | 23 | | payment for training, health insurance, travel, or | 24 | | transportation, shall not be reduced in relation to the rate | 25 | | increases described in this paragraph. | 26 | | Subject to federal approval, on and after January 1, 2025, |
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| 1 | | rates for homemaker services shall be increased to $32.75 to | 2 | | sustain a minimum wage of $20 per hour for direct service | 3 | | workers. Rates in subsequent State fiscal years shall be no | 4 | | lower than $32.75 upon federal approval. Providers of in-home | 5 | | services shall be required to certify to the Department that | 6 | | they remain in compliance with the mandated wage increase for | 7 | | direct service workers. Fringe benefits, including, but not | 8 | | limited to, paid time off and payment for training, health | 9 | | insurance, travel, or transportation, shall not be reduced in | 10 | | relation to the rate increases described in this paragraph. | 11 | | Subject to federal approval, on and after January 1, 2025, | 12 | | the Department shall pay a rate add-on under the Community | 13 | | Care Program to those in-home service provider agencies that | 14 | | attest and document their direct service workers attend paid, | 15 | | quarterly, in-person training sessions to fulfill the | 16 | | in-service training requirements under this Section. The | 17 | | add-on shall be 1% of the homemaker services rate. The | 18 | | Department shall adopt rules to implement the provisions of | 19 | | this paragraph. | 20 | | The General Assembly finds it necessary to authorize an | 21 | | aggressive Medicaid enrollment initiative designed to maximize | 22 | | federal Medicaid funding for the Community Care Program which | 23 | | produces significant savings for the State of Illinois. The | 24 | | Department on Aging shall establish and implement a Community | 25 | | Care Program Medicaid Initiative. Under the Initiative, the | 26 | | Department on Aging shall, at a minimum: (i) provide an |
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| 1 | | enhanced rate to adequately compensate care coordination units | 2 | | to enroll eligible Community Care Program clients into | 3 | | Medicaid; (ii) use recommendations from a stakeholder | 4 | | committee on how best to implement the Initiative; and (iii) | 5 | | establish requirements for State agencies to make enrollment | 6 | | in the State's Medical Assistance program easier for seniors. | 7 | | The Community Care Program Medicaid Enrollment Oversight | 8 | | Subcommittee is created as a subcommittee of the Older Adult | 9 | | Services Advisory Committee established in Section 35 of the | 10 | | Older Adult Services Act to make recommendations on how best | 11 | | to increase the number of medical assistance recipients who | 12 | | are enrolled in the Community Care Program. The Subcommittee | 13 | | shall consist of all of the following persons who must be | 14 | | appointed within 30 days after June 4, 2018 ( the effective | 15 | | date of Public Act 100-587) this amendatory Act of the 100th | 16 | | General Assembly : | 17 | | (1) The Director of Aging, or his or her designee, who | 18 | | shall serve as the chairperson of the Subcommittee. | 19 | | (2) One representative of the Department of Healthcare | 20 | | and Family Services, appointed by the Director of | 21 | | Healthcare and Family Services. | 22 | | (3) One representative of the Department of Human | 23 | | Services, appointed by the Secretary of Human Services. | 24 | | (4) One individual representing a care coordination | 25 | | unit, appointed by the Director of Aging. | 26 | | (5) One individual from a non-governmental statewide |
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| 1 | | organization that advocates for seniors, appointed by the | 2 | | Director of Aging. | 3 | | (6) One individual representing Area Agencies on | 4 | | Aging, appointed by the Director of Aging. | 5 | | (7) One individual from a statewide association | 6 | | dedicated to Alzheimer's care, support, and research, | 7 | | appointed by the Director of Aging. | 8 | | (8) One individual from an organization that employs | 9 | | persons who provide services under the Community Care | 10 | | Program, appointed by the Director of Aging. | 11 | | (9) One member of a trade or labor union representing | 12 | | persons who provide services under the Community Care | 13 | | Program, appointed by the Director of Aging. | 14 | | (10) One member of the Senate, who shall serve as | 15 | | co-chairperson, appointed by the President of the Senate. | 16 | | (11) One member of the Senate, who shall serve as | 17 | | co-chairperson, appointed by the Minority Leader of the | 18 | | Senate. | 19 | | (12) One member of the House of Representatives, who | 20 | | shall serve as co-chairperson, appointed by the Speaker of | 21 | | the House of Representatives. | 22 | | (13) One member of the House of Representatives, who | 23 | | shall serve as co-chairperson, appointed by the Minority | 24 | | Leader of the House of Representatives. | 25 | | (14) One individual appointed by a labor organization | 26 | | representing frontline employees at the Department of |
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| 1 | | Human Services. | 2 | | The Subcommittee shall provide oversight to the Community | 3 | | Care Program Medicaid Initiative and shall meet quarterly. At | 4 | | each Subcommittee meeting the Department on Aging shall | 5 | | provide the following data sets to the Subcommittee: (A) the | 6 | | number of Illinois residents, categorized by planning and | 7 | | service area, who are receiving services under the Community | 8 | | Care Program and are enrolled in the State's Medical | 9 | | Assistance Program; (B) the number of Illinois residents, | 10 | | categorized by planning and service area, who are receiving | 11 | | services under the Community Care Program, but are not | 12 | | enrolled in the State's Medical Assistance Program; and (C) | 13 | | the number of Illinois residents, categorized by planning and | 14 | | service area, who are receiving services under the Community | 15 | | Care Program and are eligible for benefits under the State's | 16 | | Medical Assistance Program, but are not enrolled in the | 17 | | State's Medical Assistance Program. In addition to this data, | 18 | | the Department on Aging shall provide the Subcommittee with | 19 | | plans on how the Department on Aging will reduce the number of | 20 | | Illinois residents who are not enrolled in the State's Medical | 21 | | Assistance Program but who are eligible for medical assistance | 22 | | benefits. The Department on Aging shall enroll in the State's | 23 | | Medical Assistance Program those Illinois residents who | 24 | | receive services under the Community Care Program and are | 25 | | eligible for medical assistance benefits but are not enrolled | 26 | | in the State's Medicaid Assistance Program. The data provided |
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| 1 | | to the Subcommittee shall be made available to the public via | 2 | | the Department on Aging's website. | 3 | | The Department on Aging, with the involvement of the | 4 | | Subcommittee, shall collaborate with the Department of Human | 5 | | Services and the Department of Healthcare and Family Services | 6 | | on how best to achieve the responsibilities of the Community | 7 | | Care Program Medicaid Initiative. | 8 | | The Department on Aging, the Department of Human Services, | 9 | | and the Department of Healthcare and Family Services shall | 10 | | coordinate and implement a streamlined process for seniors to | 11 | | access benefits under the State's Medical Assistance Program. | 12 | | The Subcommittee shall collaborate with the Department of | 13 | | Human Services on the adoption of a uniform application | 14 | | submission process. The Department of Human Services and any | 15 | | other State agency involved with processing the medical | 16 | | assistance application of any person enrolled in the Community | 17 | | Care Program shall include the appropriate care coordination | 18 | | unit in all communications related to the determination or | 19 | | status of the application. | 20 | | The Community Care Program Medicaid Initiative shall | 21 | | provide targeted funding to care coordination units to help | 22 | | seniors complete their applications for medical assistance | 23 | | benefits. On and after July 1, 2019, care coordination units | 24 | | shall receive no less than $200 per completed application, | 25 | | which rate may be included in a bundled rate for initial intake | 26 | | services when Medicaid application assistance is provided in |
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| 1 | | conjunction with the initial intake process for new program | 2 | | participants. | 3 | | The Community Care Program Medicaid Initiative shall cease | 4 | | operation 5 years after June 4, 2018 ( the effective date of | 5 | | Public Act 100-587) this amendatory Act of the 100th General | 6 | | Assembly , after which the Subcommittee shall dissolve. | 7 | | Effective July 1, 2023, subject to federal approval, the | 8 | | Department on Aging shall reimburse Care Coordination Units at | 9 | | the following rates for case management services: $252.40 for | 10 | | each initial assessment; $366.40 for each initial assessment | 11 | | with translation; $229.68 for each redetermination assessment; | 12 | | $313.68 for each redetermination assessment with translation; | 13 | | $200.00 for each completed application for medical assistance | 14 | | benefits; $132.26 for each face-to-face, choices-for-care | 15 | | screening; $168.26 for each face-to-face, choices-for-care | 16 | | screening with translation; $124.56 for each 6-month, | 17 | | face-to-face visit; $132.00 for each MCO participant | 18 | | eligibility determination; and $157.00 for each MCO | 19 | | participant eligibility determination with translation. | 20 | | (Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23; | 21 | | 103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102, | 22 | | Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90, | 23 | | Section 90-5, eff. 1-1-24; revised 12-12-23.) |
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