State of Illinois
90th General Assembly
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90_SB0443

      20 ILCS 105/4.02          from Ch. 23, par. 6104.02
          Amends  the  Illinois  Act  on  the  Aging.    Designates
      home-delivered   meals  to  eligible  individuals  through  a
      nutrition provider and funded by area agencies on aging to be
      a necessary preventive service.  Effective immediately.
                                                     LRB9002235MWpc
                                               LRB9002235MWpc
 1        AN ACT to amend the Illinois Act on the Aging by changing
 2    Section 4.02.
 3        Be it enacted by the People of  the  State  of  Illinois,
 4    represented in the General Assembly:
 5        Section  5.   The Illinois Act on the Aging is amended by
 6    changing Section 4.02 as follows:
 7        (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
 8        (Text of Section before amendment by P.A. 89-507)
 9        Sec. 4.02.  The Department shall establish a  program  of
10    services   to  prevent  unnecessary  institutionalization  of
11    persons age 60 and older in need of long term care or who are
12    established as persons who suffer from Alzheimer's disease or
13    a related disorder under the Alzheimer's  Disease  Assistance
14    Act,  enacted  by the 84th General Assembly, thereby enabling
15    them to  remain  in  their  own  homes  or  in  other  living
16    arrangements.   These  Such preventive services, which may be
17    coordinated with other programs for the aged and monitored by
18    area agencies on aging in cooperation  with  the  Department,
19    may  include,  but  are not limited to, any one or all of the
20    following:
21        (a)  home health services.;
22        (b)  home nursing services.;
23        (c)  homemaker services.;
24        (d)  chore and housekeeping services.;
25        (e)  day care services.;
26        (f)  home-delivered meals.;
27        (g)  education in self-care.;
28        (h)  personal care services.;
29        (i)  adult day health services.;
30        (j)  habilitation services.;
31        (k)  respite care.; or
                            -2-                LRB9002235MWpc
 1        (l)  other nonmedical social services that may enable the
 2    person to become self-supporting.
 3        The Department shall establish eligibility standards  for
 4    these  such  services  taking  into  consideration the unique
 5    economic and social needs of the target population  for  whom
 6    they  are  to  be  provided.  For  purposes  of this Section,
 7    home-delivered meals provided to eligible individuals through
 8    a nutrition provider funded by an area agency on aging  shall
 9    be  considered  a  necessary  preventive  service.   The Such
10    eligibility standards  shall  be  based  on  the  recipient's
11    ability  to  pay  for  services;  provided,  however, that in
12    determining the amount and nature of  services  for  which  a
13    person  may  qualify, consideration shall not be given to the
14    value of cash, property, or other assets held in the name  of
15    the  person's spouse pursuant to a written agreement dividing
16    marital property into equal but separate shares  or  pursuant
17    to  a  transfer  of  the  person's  interest in a home to his
18    spouse, provided that  the  spouse's  share  of  the  marital
19    property  is  not  made  available to the person seeking such
20    services. The  Department  shall,  in  conjunction  with  the
21    Department  of  Public Aid, seek appropriate amendments under
22    Sections 1915 and 1924  of  the  Social  Security  Act.   The
23    purpose  of the amendments shall be to extend eligibility for
24    home and community based services  under  Sections  1915  and
25    1924 of the Social Security Act to persons who transfer to or
26    for  the  benefit  of  a  spouse  those amounts of income and
27    resources allowed under Section 1924 of the  Social  Security
28    Act.   Subject  to  the  approval  of  such  amendments,  the
29    Department  shall extend the provisions of Section 5-4 of the
30    Illinois  Public  Aid  Code  to  persons  who,  but  for  the
31    provision of home or community-based services, would  require
32    the  level of care provided in an institution, as is provided
33    for in federal law. Those  persons  no  longer  found  to  be
34    eligible  for  receiving  noninstitutional  services  due  to
                            -3-                LRB9002235MWpc
 1    changes  in  the  eligibility criteria shall be given 60 days
 2    notice prior to actual termination. Those  persons  receiving
 3    notice  of termination may contact the Department and request
 4    the determination be appealed at any time during the  60  day
 5    notice  period.  With  the exception of the lengthened notice
 6    and time frame for the appeal  request,  the  appeal  process
 7    shall  follow  the normal procedure. In addition, each person
 8    affected regardless of  the  circumstances  for  discontinued
 9    eligibility  shall  be  given  notice  and the opportunity to
10    purchase the necessary services through  the  Community  Care
11    Program.  If  the  individual  does  not  elect  to  purchase
12    services,  the  Department  shall  advise  the  individual of
13    alternative services. The target  population  identified  for
14    the  purposes  of  this  Section are persons age 60 and older
15    with an identified service need. Priority shall be  given  to
16    those  who  are at imminent risk of institutionalization. The
17    services shall be provided to eligible  persons  age  60  and
18    older  to  the  extent that the cost of the services together
19    with the other personal maintenance expenses of  the  persons
20    are  reasonably related to the standards established for care
21    in a group facility appropriate to  the  person's  condition.
22    These   non-institutional   services,   pilot   projects   or
23    experimental  facilities  may  be  provided  as part of or in
24    addition to those authorized by federal law or  those  funded
25    and   administered   by   the  Department  of  Rehabilitation
26    Services. The Departments of Rehabilitation Services,  Public
27    Aid,  Mental  Health  and  Developmental Disabilities, Public
28    Health, Veterans' Affairs, and Commerce and Community Affairs
29    and other appropriate agencies of State,  federal  and  local
30    governments  shall  cooperate with the Department on Aging in
31    the establishment and development  of  the  non-institutional
32    services.  The  Department shall require an annual audit from
33    all chore/housekeeping and homemaker vendors contracting with
34    the Department under this Section.  The  annual  audit  shall
                            -4-                LRB9002235MWpc
 1    assure   that   each   audited  vendor's  procedures  are  in
 2    compliance with Department's financial  reporting  guidelines
 3    requiring  a 27% administrative cost split and a 73% employee
 4    wages and benefits cost split. The audit is a  public  record
 5    under  the  Freedom  of Information Act. The Department shall
 6    execute, relative to the nursing home  prescreening  project,
 7    written   inter-agency  agreements  with  the  Department  of
 8    Rehabilitation Services and the Department of Public Aid,  to
 9    effect  the  following:   (1)  intake  procedures  and common
10    eligibility criteria for  those  persons  who  are  receiving
11    non-institutional  services;  and  (2)  the establishment and
12    development of non-institutional services  in  areas  of  the
13    State   where   they  are  not  currently  available  or  are
14    undeveloped. On and after July  1,  1996,  all  nursing  home
15    prescreenings  for individuals 60 years of age or older shall
16    be conducted by the Department.
17        The Department is authorized to  establish  a  system  of
18    recipient copayment for services provided under this Section,
19    such  copayment  to  be based upon the recipient's ability to
20    pay but in no case to exceed the actual cost of the  services
21    provided.  Additionally,  any  portion  of  a person's income
22    which is equal to or less than the federal  poverty  standard
23    shall  not be considered by the Department in determining the
24    copayment. The level of  such  copayment  shall  be  adjusted
25    whenever  necessary  to  reflect any change in the officially
26    designated federal poverty standard.
27        The   Department,   or   the   Department's    authorized
28    representative,  shall  recover the amount of moneys expended
29    for services provided to or in behalf of a person under  this
30    Section by a claim against the person's estate or against the
31    estate  of the person's surviving spouse, but no recovery may
32    be had until after the death of the surviving spouse, if any,
33    and then only at such time when there is no  surviving  child
34    who  is  under  age  21,  blind,  or  permanently and totally
                            -5-                LRB9002235MWpc
 1    disabled.  This paragraph, however, shall not  bar  recovery,
 2    at  the  death of the person, of moneys for services provided
 3    to the person or in behalf of the person under  this  Section
 4    to  which  the  person  was  not entitled; provided that such
 5    recovery shall not be enforced against any real estate  while
 6    it  is  occupied  as  a  homestead by the surviving spouse or
 7    other dependent, if no claims by other  creditors  have  been
 8    filed against the estate, or, if such claims have been filed,
 9    they  remain dormant for failure of prosecution or failure of
10    the claimant to compel administration of the estate  for  the
11    purpose  of  payment.   This paragraph shall not bar recovery
12    from the estate of a spouse, under Sections 1915 and 1924  of
13    the  Social  Security  Act  and  Section  5-4 of the Illinois
14    Public Aid Code, who precedes  a  person  receiving  services
15    under this Section in death.  All moneys for services paid to
16    or  in  behalf  of  the  person  under  this Section shall be
17    claimed for  recovery  from  the  deceased  spouse's  estate.
18    "Homestead",  as  used  in this paragraph, means the dwelling
19    house and contiguous real  estate  occupied  by  a  surviving
20    spouse  or  relative, as defined by the rules and regulations
21    of the Illinois Department of Public Aid, regardless  of  the
22    value of the property.
23        The   Department  shall  develop  procedures  to  enhance
24    availability of services on evenings,  weekends,  and  on  an
25    emergency  basis  to  meet  the  respite needs of caregivers.
26    Procedures shall be developed to permit  the  utilization  of
27    services  in  successive blocks of 24 hours up to the monthly
28    maximum established by the  Department.    Workers  providing
29    these services shall be appropriately trained.
30        The   Department  shall  work  in  conjunction  with  the
31    Alzheimer's  Task  Force  and  members  of  the   Alzheimer's
32    Association  and  other  senior  citizens'  organizations  in
33    developing these procedures by December 30, 1991.
34        Beginning on the effective date of this Amendatory Act of
                            -6-                LRB9002235MWpc
 1    1991,  no person may perform chore/housekeeping and homemaker
 2    services under a program authorized by  this  Section  unless
 3    that  person  has been issued a certificate of pre-service to
 4    do so by his or her employing agency.   Information  gathered
 5    to  effect  such certification shall include (i) the person's
 6    name, (ii) the date the  person  was  hired  by  his  or  her
 7    current employer, and (iii) the training, including dates and
 8    levels.   Persons  engaged  in the program authorized by this
 9    Section before the effective date of this Amendatory  Act  of
10    1991 shall be issued a certificate of all pre- and in-service
11    training  from  his  or  her  employer  upon  submitting  the
12    necessary   information.    The  employing  agency  shall  be
13    required to retain records of all staff pre-  and  in-service
14    training,  and  shall  provide such records to the Department
15    upon request and upon termination of the employer's  contract
16    with  the  Department.   In addition, the employing agency is
17    responsible for the issuance of certifications of  in-service
18    training completed to their employees.
19        The  Department is required to develop a system to ensure
20    that persons working as  homemakers  and  chore  housekeepers
21    receive  increases  in  their  wages when the federal minimum
22    wage is increased by requiring vendors to certify  that  they
23    are  meeting  the federal minimum wage statute for homemakers
24    and chore housekeepers.  An employer that cannot ensure  that
25    the  minimum  wage  increase is being given to homemakers and
26    chore  housekeepers  shall  be   denied   any   increase   in
27    reimbursement costs.
28        The   Department   on   Aging   and   the  Department  of
29    Rehabilitation Services shall cooperate  in  the  development
30    and  submission  of an annual report on programs and services
31    provided under this Section. Such joint report shall be filed
32    with the Governor and  the  General  Assembly  on  or  before
33    September 30 each year.
34        The  requirement  for  reporting  to the General Assembly
                            -7-                LRB9002235MWpc
 1    shall be satisfied by filing copies of the  report  with  the
 2    Speaker,  the  Minority  Leader and the Clerk of the House of
 3    Representatives and the President, the  Minority  Leader  and
 4    the  Secretary  of  the  Senate  and the Legislative Research
 5    Unit, as required by Section  3.1  of  the  General  Assembly
 6    Organization  Act  and filing such additional copies with the
 7    State Government Report Distribution Center for  the  General
 8    Assembly  as  is required under paragraph (t) of Section 7 of
 9    the State Library Act.
10        Those persons previously  found  eligible  for  receiving
11    non-institutional  services  whose services were discontinued
12    under the Emergency Budget Act of Fiscal Year 1992,  and  who
13    do  not  meet the eligibility standards in effect on or after
14    July 1, 1992, shall remain ineligible on and  after  July  1,
15    1992.   Those  persons  previously not required to cost-share
16    and who were required to cost-share effective March 1,  1992,
17    shall  continue  to meet cost-share requirements on and after
18    July 1, 1992.  Beginning July 1, 1992, all  clients  will  be
19    required   to   meet   eligibility,   cost-share,  and  other
20    requirements and will have services discontinued  or  altered
21    when they fail to meet these requirements.
22    (Source: P.A. 89-21, eff. 7-1-95.)
23        (Text of Section after amendment by P.A. 89-507)
24        Sec.  4.02.  The  Department shall establish a program of
25    services  to  prevent  unnecessary  institutionalization   of
26    persons age 60 and older in need of long term care or who are
27    established as persons who suffer from Alzheimer's disease or
28    a  related  disorder under the Alzheimer's Disease Assistance
29    Act, thereby enabling them to remain in their own homes or in
30    other living arrangements.  These Such  preventive  services,
31    which may be coordinated with other programs for the aged and
32    monitored  by  area agencies on aging in cooperation with the
33    Department, may include, but are not limited to, any  one  or
34    all of the following:
                            -8-                LRB9002235MWpc
 1        (a)  home health services.;
 2        (b)  home nursing services.;
 3        (c)  homemaker services.;
 4        (d)  chore and housekeeping services.;
 5        (e)  day care services.;
 6        (f)  home-delivered meals.;
 7        (g)  education in self-care.;
 8        (h)  personal care services.;
 9        (i)  adult day health services.;
10        (j)  habilitation services.;
11        (k)  respite care.; or
12        (l)  other nonmedical social services that may enable the
13    person to become self-supporting.
14        The  Department shall establish eligibility standards for
15    these such services  taking  into  consideration  the  unique
16    economic  and  social needs of the target population for whom
17    they are to  be  provided.  For  purposes  of  this  Section,
18    home-delivered meals provided to eligible individuals through
19    a  nutrition provider funded by an area agency on aging shall
20    be considered  a  necessary  preventive  service.   The  Such
21    eligibility  standards  shall  be  based  on  the recipient's
22    ability to pay  for  services;  provided,  however,  that  in
23    determining  the  amount  and  nature of services for which a
24    person may qualify, consideration shall not be given  to  the
25    value  of cash, property, or other assets held in the name of
26    the person's spouse pursuant to a written agreement  dividing
27    marital  property  into equal but separate shares or pursuant
28    to a transfer of the person's  interest  in  a  home  to  his
29    spouse,  provided  that  the  spouse's  share  of the marital
30    property is not made available to  the  person  seeking  such
31    services.  The  Department  shall,  in  conjunction  with the
32    Department of Public Aid, seek appropriate  amendments  under
33    Sections  1915  and  1924  of  the  Social Security Act.  The
34    purpose of the amendments shall be to extend eligibility  for
                            -9-                LRB9002235MWpc
 1    home  and  community  based  services under Sections 1915 and
 2    1924 of the Social Security Act to persons who transfer to or
 3    for the benefit of a  spouse  those  amounts  of  income  and
 4    resources  allowed  under Section 1924 of the Social Security
 5    Act.   Subject  to  the  approval  of  such  amendments,  the
 6    Department shall extend the provisions of Section 5-4 of  the
 7    Illinois  Public  Aid  Code  to  persons  who,  but  for  the
 8    provision  of home or community-based services, would require
 9    the level of care provided in an institution, as is  provided
10    for  in  federal  law.  Those  persons  no longer found to be
11    eligible  for  receiving  noninstitutional  services  due  to
12    changes in the eligibility criteria shall be  given  60  days
13    notice  prior  to actual termination. Those persons receiving
14    notice of termination may contact the Department and  request
15    the  determination  be appealed at any time during the 60 day
16    notice period. With the exception of  the  lengthened  notice
17    and  time  frame  for  the appeal request, the appeal process
18    shall follow the normal procedure. In addition,  each  person
19    affected  regardless  of  the  circumstances for discontinued
20    eligibility shall be given  notice  and  the  opportunity  to
21    purchase  the  necessary  services through the Community Care
22    Program.  If  the  individual  does  not  elect  to  purchase
23    services,  the  Department  shall  advise  the  individual of
24    alternative services. The target  population  identified  for
25    the  purposes  of  this  Section are persons age 60 and older
26    with an identified service need.  Priority shall be given  to
27    those  who are at imminent risk of institutionalization.  The
28    services shall be provided to eligible  persons  age  60  and
29    older  to  the  extent that the cost of the services together
30    with the other personal maintenance expenses of  the  persons
31    are  reasonably related to the standards established for care
32    in a group facility appropriate to  the  person's  condition.
33    These   non-institutional   services,   pilot   projects   or
34    experimental  facilities  may  be  provided  as part of or in
                            -10-               LRB9002235MWpc
 1    addition to those authorized by federal law or  those  funded
 2    and  administered  by  the Department of Human Services.  The
 3    Departments of Human Services,  Public  Aid,  Public  Health,
 4    Veterans'  Affairs,  and  Commerce  and Community Affairs and
 5    other  appropriate  agencies  of  State,  federal  and  local
 6    governments shall cooperate with the Department on  Aging  in
 7    the  establishment  and  development of the non-institutional
 8    services.  The Department shall require an annual audit  from
 9    all chore/housekeeping and homemaker vendors contracting with
10    the  Department  under  this Section.  The annual audit shall
11    assure  that  each  audited  vendor's   procedures   are   in
12    compliance  with  Department's financial reporting guidelines
13    requiring a 27% administrative cost split and a 73%  employee
14    wages  and benefits cost split.  The audit is a public record
15    under the Freedom of Information Act.  The  Department  shall
16    execute,  relative  to the nursing home prescreening project,
17    written inter-agency agreements with the Department of  Human
18    Services  and  the  Department  of  Public Aid, to effect the
19    following:  (1)  intake  procedures  and  common  eligibility
20    criteria    for    those    persons    who    are   receiving
21    non-institutional services; and  (2)  the  establishment  and
22    development  of  non-institutional  services  in areas of the
23    State  where  they  are  not  currently  available   or   are
24    undeveloped.  On  and  after  July  1, 1996, all nursing home
25    prescreenings for individuals 60 years of age or older  shall
26    be conducted by the Department.
27        The  Department  is  authorized  to establish a system of
28    recipient copayment for services provided under this Section,
29    such copayment to be based upon the  recipient's  ability  to
30    pay  but in no case to exceed the actual cost of the services
31    provided. Additionally, any  portion  of  a  person's  income
32    which  is  equal to or less than the federal poverty standard
33    shall not be considered by the Department in determining  the
34    copayment.  The  level  of  such  copayment shall be adjusted
                            -11-               LRB9002235MWpc
 1    whenever necessary to reflect any change  in  the  officially
 2    designated federal poverty standard.
 3        The    Department,   or   the   Department's   authorized
 4    representative, shall recover the amount of  moneys  expended
 5    for  services provided to or in behalf of a person under this
 6    Section by a claim against the person's estate or against the
 7    estate of the person's surviving spouse, but no recovery  may
 8    be had until after the death of the surviving spouse, if any,
 9    and  then  only at such time when there is no surviving child
10    who is under  age  21,  blind,  or  permanently  and  totally
11    disabled.   This  paragraph, however, shall not bar recovery,
12    at the death of the person, of moneys for  services  provided
13    to  the  person or in behalf of the person under this Section
14    to which the person was  not  entitled;  provided  that  such
15    recovery  shall not be enforced against any real estate while
16    it is occupied as a homestead  by  the  surviving  spouse  or
17    other  dependent,  if  no claims by other creditors have been
18    filed against the estate, or, if such claims have been filed,
19    they remain dormant for failure of prosecution or failure  of
20    the  claimant  to compel administration of the estate for the
21    purpose of payment.  This paragraph shall  not  bar  recovery
22    from  the estate of a spouse, under Sections 1915 and 1924 of
23    the Social Security Act  and  Section  5-4  of  the  Illinois
24    Public  Aid  Code,  who  precedes a person receiving services
25    under this Section in death.  All moneys for services paid to
26    or in behalf of  the  person  under  this  Section  shall  be
27    claimed  for  recovery  from  the  deceased  spouse's estate.
28    "Homestead", as used in this paragraph,  means  the  dwelling
29    house  and  contiguous  real  estate  occupied by a surviving
30    spouse or relative, as defined by the rules  and  regulations
31    of  the  Illinois Department of Public Aid, regardless of the
32    value of the property.
33        The  Department  shall  develop  procedures  to   enhance
34    availability  of  services  on  evenings, weekends, and on an
                            -12-               LRB9002235MWpc
 1    emergency basis to meet  the  respite  needs  of  caregivers.
 2    Procedures  shall  be  developed to permit the utilization of
 3    services in successive blocks of 24 hours up to  the  monthly
 4    maximum  established  by  the Department.   Workers providing
 5    these services shall be appropriately trained.
 6        The  Department  shall  work  in  conjunction  with   the
 7    Alzheimer's   Task  Force  and  members  of  the  Alzheimer's
 8    Association  and  other  senior  citizens'  organizations  in
 9    developing these procedures by December 30, 1991.
10        Beginning on the effective date of this Amendatory Act of
11    1991, no person may perform chore/housekeeping and  homemaker
12    services  under  a  program authorized by this Section unless
13    that person has been issued a certificate of  pre-service  to
14    do  so  by his or her employing agency.  Information gathered
15    to effect such certification shall include (i)  the  person's
16    name,  (ii)  the  date  the  person  was  hired by his or her
17    current employer, and (iii) the training, including dates and
18    levels.  Persons engaged in the program  authorized  by  this
19    Section  before  the effective date of this amendatory Act of
20    1991 shall be issued a certificate of all pre- and in-service
21    training  from  his  or  her  employer  upon  submitting  the
22    necessary  information.   The  employing  agency   shall   be
23    required  to  retain records of all staff pre- and in-service
24    training, and shall provide such records  to  the  Department
25    upon  request and upon termination of the employer's contract
26    with the Department.  In addition, the  employing  agency  is
27    responsible  for the issuance of certifications of in-service
28    training completed to their employees.
29        The Department is required to develop a system to  ensure
30    that  persons  working  as  homemakers and chore housekeepers
31    receive increases in their wages  when  the  federal  minimum
32    wage  is  increased by requiring vendors to certify that they
33    are meeting the federal minimum wage statute  for  homemakers
34    and  chore housekeepers.  An employer that cannot ensure that
                            -13-               LRB9002235MWpc
 1    the minimum wage increase is being given  to  homemakers  and
 2    chore   housekeepers   shall   be   denied  any  increase  in
 3    reimbursement costs.
 4        The Department on  Aging  and  the  Department  of  Human
 5    Services shall cooperate in the development and submission of
 6    an annual report on programs and services provided under this
 7    Section.   Such joint report shall be filed with the Governor
 8    and the General Assembly on or before September 30 each year.
 9        The requirement for reporting  to  the  General  Assembly
10    shall  be  satisfied  by filing copies of the report with the
11    Speaker, the Minority Leader and the Clerk of  the  House  of
12    Representatives  and  the  President, the Minority Leader and
13    the Secretary of the  Senate  and  the  Legislative  Research
14    Unit,  as  required  by  Section  3.1 of the General Assembly
15    Organization Act  and filing such additional copies with  the
16    State  Government  Report Distribution Center for the General
17    Assembly as is required under paragraph (t) of Section  7  of
18    the State Library Act.
19        Those  persons  previously  found  eligible for receiving
20    non-institutional services whose services  were  discontinued
21    under  the  Emergency Budget Act of Fiscal Year 1992, and who
22    do not meet the eligibility standards in effect on  or  after
23    July  1,  1992,  shall remain ineligible on and after July 1,
24    1992.  Those persons previously not  required  to  cost-share
25    and  who were required to cost-share effective March 1, 1992,
26    shall continue to meet cost-share requirements on  and  after
27    July  1,  1992.   Beginning July 1, 1992, all clients will be
28    required  to  meet   eligibility,   cost-share,   and   other
29    requirements  and  will have services discontinued or altered
30    when they fail to meet these requirements.
31    (Source: P.A. 89-21, eff. 7-1-95; 89-507, eff. 7-1-97.)
32        Section 95.  No acceleration or delay.   Where  this  Act
33    makes changes in a statute that is represented in this Act by
                            -14-               LRB9002235MWpc
 1    text  that  is not yet or no longer in effect (for example, a
 2    Section represented by multiple versions), the  use  of  that
 3    text  does  not  accelerate or delay the taking effect of (i)
 4    the changes made by this Act or (ii) provisions derived  from
 5    any other Public Act.
 6        Section  99.  Effective date.  This Act takes effect upon
 7    becoming law.

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