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Public Act 103-0670 |
HB4346 Enrolled | LRB103 36391 KTG 66492 b |
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AN ACT concerning State government. |
Be it enacted by the People of the State of Illinois, |
represented in the General Assembly: |
Section 5. The Illinois Act on the Aging is amended by |
changing Sections 3.11, 4.01, and 4.02 and by adding Section |
5.03 as follows: |
(20 ILCS 105/3.11) |
Sec. 3.11. Greatest social need. "Greatest For the |
purposes of 89 Ill. Adm. Code 210.50, "greatest social need" |
means the need caused by noneconomic factors that restrict an |
individual's ability to perform normal daily tasks or that |
threaten his or her capacity to live independently. These |
factors include , but are not limited to, physical or mental |
disability, language barriers, and cultural or social |
isolation caused by, among other things, racial and ethnic |
status, sexual orientation, gender identity, gender |
expression, or HIV status. |
(Source: P.A. 101-325, eff. 8-9-19.) |
(20 ILCS 105/4.01) (from Ch. 23, par. 6104.01) |
Sec. 4.01. Additional powers and duties of the Department. |
In addition to powers and duties otherwise provided by law, |
the Department shall have the following powers and duties: |
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(1) To evaluate all programs, services, and facilities for |
the aged and for minority senior citizens within the State and |
determine the extent to which present public or private |
programs, services and facilities meet the needs of the aged. |
(2) To coordinate and evaluate all programs, services, and |
facilities for the Aging and for minority senior citizens |
presently furnished by State agencies and make appropriate |
recommendations regarding such services, programs and |
facilities to the Governor and/or the General Assembly. |
(2-a) To request, receive, and share information |
electronically through the use of data-sharing agreements for |
the purpose of (i) establishing and verifying the initial and |
continuing eligibility of older adults to participate in |
programs administered by the Department; (ii) maximizing |
federal financial participation in State assistance |
expenditures; and (iii) investigating allegations of fraud or |
other abuse of publicly funded benefits. Notwithstanding any |
other law to the contrary, but only for the limited purposes |
identified in the preceding sentence, this paragraph (2-a) |
expressly authorizes the exchanges of income, identification, |
and other pertinent eligibility information by and among the |
Department and the Social Security Administration, the |
Department of Employment Security, the Department of |
Healthcare and Family Services, the Department of Human |
Services, the Department of Revenue, the Secretary of State, |
the U.S. Department of Veterans Affairs, and any other |
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governmental entity. The confidentiality of information |
otherwise shall be maintained as required by law. In addition, |
the Department on Aging shall verify employment information at |
the request of a community care provider for the purpose of |
ensuring program integrity under the Community Care Program. |
(3) To function as the sole State agency to develop a |
comprehensive plan to meet the needs of the State's senior |
citizens and the State's minority senior citizens. |
(4) To receive and disburse State and federal funds made |
available directly to the Department including those funds |
made available under the Older Americans Act and the Senior |
Community Service Employment Program for providing services |
for senior citizens and minority senior citizens or for |
purposes related thereto, and shall develop and administer any |
State Plan for the Aging required by federal law. |
(5) To solicit, accept, hold, and administer in behalf of |
the State any grants or legacies of money, securities, or |
property to the State of Illinois for services to senior |
citizens and minority senior citizens or purposes related |
thereto. |
(6) To provide consultation and assistance to communities, |
area agencies on aging, and groups developing local services |
for senior citizens and minority senior citizens. |
(7) To promote community education regarding the problems |
of senior citizens and minority senior citizens through |
institutes, publications, radio, television and the local |
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press. |
(8) To cooperate with agencies of the federal government |
in studies and conferences designed to examine the needs of |
senior citizens and minority senior citizens and to prepare |
programs and facilities to meet those needs. |
(9) To establish and maintain information and referral |
sources throughout the State when not provided by other |
agencies. |
(10) To provide the staff support that may reasonably be |
required by the Council. |
(11) To make and enforce rules and regulations necessary |
and proper to the performance of its duties. |
(12) To establish and fund programs or projects or |
experimental facilities that are specially designed as |
alternatives to institutional care. |
(13) To develop a training program to train the counselors |
presently employed by the Department's aging network to |
provide Medicare beneficiaries with counseling and advocacy in |
Medicare, private health insurance, and related health care |
coverage plans. The Department shall report to the General |
Assembly on the implementation of the training program on or |
before December 1, 1986. |
(14) To make a grant to an institution of higher learning |
to study the feasibility of establishing and implementing an |
affirmative action employment plan for the recruitment, |
hiring, training and retraining of persons 60 or more years |
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old for jobs for which their employment would not be precluded |
by law. |
(15) To present one award annually in each of the |
categories of community service, education, the performance |
and graphic arts, and the labor force to outstanding Illinois |
senior citizens and minority senior citizens in recognition of |
their individual contributions to either community service, |
education, the performance and graphic arts, or the labor |
force. The awards shall be presented to 4 senior citizens and |
minority senior citizens selected from a list of 44 nominees |
compiled annually by the Department. Nominations shall be |
solicited from senior citizens' service providers, area |
agencies on aging, senior citizens' centers, and senior |
citizens' organizations. If there are no nominations in a |
category, the Department may award a second person in one of |
the remaining categories. The Department shall establish a |
central location within the State to be designated as the |
Senior Illinoisans Hall of Fame for the public display of all |
the annual awards, or replicas thereof. |
(16) To establish multipurpose senior centers through area |
agencies on aging and to fund those new and existing |
multipurpose senior centers through area agencies on aging, |
the establishment and funding to begin in such areas of the |
State as the Department shall designate by rule and as |
specifically appropriated funds become available. |
(17) (Blank). |
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(18) To develop a pamphlet in English and Spanish which |
may be used by physicians licensed to practice medicine in all |
of its branches pursuant to the Medical Practice Act of 1987, |
pharmacists licensed pursuant to the Pharmacy Practice Act, |
and Illinois residents 65 years of age or older for the purpose |
of assisting physicians, pharmacists, and patients in |
monitoring prescriptions provided by various physicians and to |
aid persons 65 years of age or older in complying with |
directions for proper use of pharmaceutical prescriptions. The |
pamphlet may provide space for recording information including |
but not limited to the following: |
(a) name and telephone number of the patient; |
(b) name and telephone number of the prescribing |
physician; |
(c) date of prescription; |
(d) name of drug prescribed; |
(e) directions for patient compliance; and |
(f) name and telephone number of dispensing pharmacy. |
In developing the pamphlet, the Department shall consult |
with the Illinois State Medical Society, the Center for |
Minority Health Services, the Illinois Pharmacists Association |
and senior citizens organizations. The Department shall |
distribute the pamphlets to physicians, pharmacists and |
persons 65 years of age or older or various senior citizen |
organizations throughout the State. |
(19) To conduct a study of the feasibility of implementing |
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the Senior Companion Program throughout the State. |
(20) The reimbursement rates paid through the community |
care program for chore housekeeping services and home care |
aides shall be the same. |
(21) From funds appropriated to the Department from the |
Meals on Wheels Fund, a special fund in the State treasury that |
is hereby created, and in accordance with State and federal |
guidelines and the intrastate funding formula, to make grants |
to area agencies on aging, designated by the Department, for |
the sole purpose of delivering meals to homebound persons 60 |
years of age and older. |
(22) To distribute, through its area agencies on aging, |
information alerting seniors on safety issues regarding |
emergency weather conditions, including extreme heat and cold, |
flooding, tornadoes, electrical storms, and other severe storm |
weather. The information shall include all necessary |
instructions for safety and all emergency telephone numbers of |
organizations that will provide additional information and |
assistance. |
(23) To develop guidelines for the organization and |
implementation of Volunteer Services Credit Programs to be |
administered by Area Agencies on Aging or community based |
senior service organizations. The Department shall hold public |
hearings on the proposed guidelines for public comment, |
suggestion, and determination of public interest. The |
guidelines shall be based on the findings of other states and |
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of community organizations in Illinois that are currently |
operating volunteer services credit programs or demonstration |
volunteer services credit programs. The Department shall offer |
guidelines for all aspects of the programs including, but not |
limited to, the following: |
(a) types of services to be offered by volunteers; |
(b) types of services to be received upon the |
redemption of service credits; |
(c) issues of liability for the volunteers and the |
administering organizations; |
(d) methods of tracking service credits earned and |
service credits redeemed; |
(e) issues of time limits for redemption of service |
credits; |
(f) methods of recruitment of volunteers; |
(g) utilization of community volunteers, community |
service groups, and other resources for delivering |
services to be received by service credit program clients; |
(h) accountability and assurance that services will be |
available to individuals who have earned service credits; |
and |
(i) volunteer screening and qualifications. |
The Department shall submit a written copy of the guidelines |
to the General Assembly by July 1, 1998. |
(24) To function as the sole State agency to receive and |
disburse State and federal funds for providing adult |
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protective services in a domestic living situation in |
accordance with the Adult Protective Services Act. |
(25) To hold conferences, trainings, and other programs |
for which the Department shall determine by rule a reasonable |
fee to cover related administrative costs. Rules to implement |
the fee authority granted by this paragraph (25) must be |
adopted in accordance with all provisions of the Illinois |
Administrative Procedure Act and all rules and procedures of |
the Joint Committee on Administrative Rules; any purported |
rule not so adopted, for whatever reason, is unauthorized. |
(Source: P.A. 98-8, eff. 5-3-13; 98-49, eff. 7-1-13; 98-380, |
eff. 8-16-13; 98-756, eff. 7-16-14; 99-331, eff. 1-1-16 .) |
(20 ILCS 105/4.02) |
Sec. 4.02. Community Care Program. The Department shall |
establish a program of services to prevent unnecessary |
institutionalization of persons age 60 and older in need of |
long term care or who are established as persons who suffer |
from Alzheimer's disease or a related disorder under the |
Alzheimer's Disease Assistance Act, thereby enabling them to |
remain in their own homes or in other living arrangements. |
Such preventive services, which may be coordinated with other |
programs for the aged and monitored by area agencies on aging |
in cooperation with the Department , may include, but are not |
limited to, any or all of the following: |
(a) (blank); |
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(b) (blank); |
(c) home care aide services; |
(d) personal assistant services; |
(e) adult day services; |
(f) home-delivered meals; |
(g) education in self-care; |
(h) personal care services; |
(i) adult day health services; |
(j) habilitation services; |
(k) respite care; |
(k-5) community reintegration services; |
(k-6) flexible senior services; |
(k-7) medication management; |
(k-8) emergency home response; |
(l) other nonmedical social services that may enable |
the person to become self-supporting; or |
(m) (blank). clearinghouse for information provided by |
senior citizen home owners who want to rent rooms to or |
share living space with other senior citizens. |
The Department shall establish eligibility standards for |
such services. In determining the amount and nature of |
services for which a person may qualify, consideration shall |
not be given to the value of cash, property , or other assets |
held in the name of the person's spouse pursuant to a written |
agreement dividing marital property into equal but separate |
shares or pursuant to a transfer of the person's interest in a |
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home to his spouse, provided that the spouse's share of the |
marital property is not made available to the person seeking |
such services. |
The Beginning January 1, 2008, the Department shall |
require as a condition of eligibility that all new financially |
eligible applicants apply for and enroll in medical assistance |
under Article V of the Illinois Public Aid Code in accordance |
with rules promulgated by the Department. |
The Department shall, in conjunction with the Department |
of Public Aid (now Department of Healthcare and Family |
Services), seek appropriate amendments under Sections 1915 and |
1924 of the Social Security Act. The purpose of the amendments |
shall be to extend eligibility for home and community based |
services under Sections 1915 and 1924 of the Social Security |
Act to persons who transfer to or for the benefit of a spouse |
those amounts of income and resources allowed under Section |
1924 of the Social Security Act. Subject to the approval of |
such amendments, the Department shall extend the provisions of |
Section 5-4 of the Illinois Public Aid Code to persons who, but |
for the provision of home or community-based services, would |
require the level of care provided in an institution, as is |
provided for in federal law. Those persons no longer found to |
be eligible for receiving noninstitutional services due to |
changes in the eligibility criteria shall be given 45 days |
notice prior to actual termination. Those persons receiving |
notice of termination may contact the Department and request |
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the determination be appealed at any time during the 45 day |
notice period. The target population identified for the |
purposes of this Section are persons age 60 and older with an |
identified service need. Priority shall be given to those who |
are at imminent risk of institutionalization. The services |
shall be provided to eligible persons age 60 and older to the |
extent that the cost of the services together with the other |
personal maintenance expenses of the persons are reasonably |
related to the standards established for care in a group |
facility appropriate to the person's condition. These |
non-institutional services, pilot projects , or experimental |
facilities may be provided as part of or in addition to those |
authorized by federal law or those funded and administered by |
the Department of Human Services. The Departments of Human |
Services, Healthcare and Family Services, Public Health, |
Veterans' Affairs, and Commerce and Economic Opportunity and |
other appropriate agencies of State, federal , and local |
governments shall cooperate with the Department on Aging in |
the establishment and development of the non-institutional |
services. The Department shall require an annual audit from |
all personal assistant and home care aide vendors contracting |
with the Department under this Section. The annual audit shall |
assure that each audited vendor's procedures are in compliance |
with Department's financial reporting guidelines requiring an |
administrative and employee wage and benefits cost split as |
defined in administrative rules. The audit is a public record |
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under the Freedom of Information Act. The Department shall |
execute, relative to the nursing home prescreening project, |
written inter-agency agreements with the Department of Human |
Services and the Department of Healthcare and Family Services, |
to effect the following: (1) intake procedures and common |
eligibility criteria for those persons who are receiving |
non-institutional services; and (2) the establishment and |
development of non-institutional services in areas of the |
State where they are not currently available or are |
undeveloped. On and after July 1, 1996, all nursing home |
prescreenings for individuals 60 years of age or older shall |
be conducted by the Department. |
As part of the Department on Aging's routine training of |
case managers and case manager supervisors, the Department may |
include information on family futures planning for persons who |
are age 60 or older and who are caregivers of their adult |
children with developmental disabilities. The content of the |
training shall be at the Department's discretion. |
The Department is authorized to establish a system of |
recipient copayment for services provided under this Section, |
such copayment to be based upon the recipient's ability to pay |
but in no case to exceed the actual cost of the services |
provided. Additionally, any portion of a person's income which |
is equal to or less than the federal poverty standard shall not |
be considered by the Department in determining the copayment. |
The level of such copayment shall be adjusted whenever |
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necessary to reflect any change in the officially designated |
federal poverty standard. |
The Department, or the Department's authorized |
representative, may recover the amount of moneys expended for |
services provided to or in behalf of a person under this |
Section by a claim against the person's estate or against the |
estate of the person's surviving spouse, but no recovery may |
be had until after the death of the surviving spouse, if any, |
and then only at such time when there is no surviving child who |
is under age 21 or blind or who has a permanent and total |
disability. This paragraph, however, shall not bar recovery, |
at the death of the person, of moneys for services provided to |
the person or in behalf of the person under this Section to |
which the person was not entitled; provided that such recovery |
shall not be enforced against any real estate while it is |
occupied as a homestead by the surviving spouse or other |
dependent, if no claims by other creditors have been filed |
against the estate, or, if such claims have been filed, they |
remain dormant for failure of prosecution or failure of the |
claimant to compel administration of the estate for the |
purpose of payment. This paragraph shall not bar recovery from |
the estate of a spouse, under Sections 1915 and 1924 of the |
Social Security Act and Section 5-4 of the Illinois Public Aid |
Code, who precedes a person receiving services under this |
Section in death. All moneys for services paid to or in behalf |
of the person under this Section shall be claimed for recovery |
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from the deceased spouse's estate. "Homestead", as used in |
this paragraph, means the dwelling house and contiguous real |
estate occupied by a surviving spouse or relative, as defined |
by the rules and regulations of the Department of Healthcare |
and Family Services, regardless of the value of the property. |
The Department shall increase the effectiveness of the |
existing Community Care Program by: |
(1) ensuring that in-home services included in the |
care plan are available on evenings and weekends; |
(2) ensuring that care plans contain the services that |
eligible participants need based on the number of days in |
a month, not limited to specific blocks of time, as |
identified by the comprehensive assessment tool selected |
by the Department for use statewide, not to exceed the |
total monthly service cost maximum allowed for each |
service; the Department shall develop administrative rules |
to implement this item (2); |
(3) ensuring that the participants have the right to |
choose the services contained in their care plan and to |
direct how those services are provided, based on |
administrative rules established by the Department; |
(4) (blank); ensuring that the determination of need |
tool is accurate in determining the participants' level of |
need; to achieve this, the Department, in conjunction with |
the Older Adult Services Advisory Committee, shall |
institute a study of the relationship between the |
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Determination of Need scores, level of need, service cost |
maximums, and the development and utilization of service |
plans no later than May 1, 2008; findings and |
recommendations shall be presented to the Governor and the |
General Assembly no later than January 1, 2009; |
recommendations shall include all needed changes to the |
service cost maximums schedule and additional covered |
services; |
(5) ensuring that homemakers can provide personal care |
services that may or may not involve contact with clients, |
including , but not limited to: |
(A) bathing; |
(B) grooming; |
(C) toileting; |
(D) nail care; |
(E) transferring; |
(F) respiratory services; |
(G) exercise; or |
(H) positioning; |
(6) ensuring that homemaker program vendors are not |
restricted from hiring homemakers who are family members |
of clients or recommended by clients; the Department may |
not, by rule or policy, require homemakers who are family |
members of clients or recommended by clients to accept |
assignments in homes other than the client; |
(7) ensuring that the State may access maximum federal |
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matching funds by seeking approval for the Centers for |
Medicare and Medicaid Services for modifications to the |
State's home and community based services waiver and |
additional waiver opportunities, including applying for |
enrollment in the Balance Incentive Payment Program by May |
1, 2013, in order to maximize federal matching funds; this |
shall include, but not be limited to, modification that |
reflects all changes in the Community Care Program |
services and all increases in the services cost maximum; |
(8) ensuring that the determination of need tool |
accurately reflects the service needs of individuals with |
Alzheimer's disease and related dementia disorders; |
(9) ensuring that services are authorized accurately |
and consistently for the Community Care Program (CCP); the |
Department shall implement a Service Authorization policy |
directive; the purpose shall be to ensure that eligibility |
and services are authorized accurately and consistently in |
the CCP program; the policy directive shall clarify |
service authorization guidelines to Care Coordination |
Units and Community Care Program providers no later than |
May 1, 2013; |
(10) working in conjunction with Care Coordination |
Units, the Department of Healthcare and Family Services, |
the Department of Human Services, Community Care Program |
providers, and other stakeholders to make improvements to |
the Medicaid claiming processes and the Medicaid |
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enrollment procedures or requirements as needed, |
including, but not limited to, specific policy changes or |
rules to improve the up-front enrollment of participants |
in the Medicaid program and specific policy changes or |
rules to insure more prompt submission of bills to the |
federal government to secure maximum federal matching |
dollars as promptly as possible; the Department on Aging |
shall have at least 3 meetings with stakeholders by |
January 1, 2014 in order to address these improvements; |
(11) requiring home care service providers to comply |
with the rounding of hours worked provisions under the |
federal Fair Labor Standards Act (FLSA) and as set forth |
in 29 CFR 785.48(b) by May 1, 2013; |
(12) implementing any necessary policy changes or |
promulgating any rules, no later than January 1, 2014, to |
assist the Department of Healthcare and Family Services in |
moving as many participants as possible, consistent with |
federal regulations, into coordinated care plans if a care |
coordination plan that covers long term care is available |
in the recipient's area; and |
(13) (blank). maintaining fiscal year 2014 rates at |
the same level established on January 1, 2013. |
By January 1, 2009 or as soon after the end of the Cash and |
Counseling Demonstration Project as is practicable, the |
Department may, based on its evaluation of the demonstration |
project, promulgate rules concerning personal assistant |
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services, to include, but need not be limited to, |
qualifications, employment screening, rights under fair labor |
standards, training, fiduciary agent, and supervision |
requirements. All applicants shall be subject to the |
provisions of the Health Care Worker Background Check Act. |
The Department shall develop procedures to enhance |
availability of services on evenings, weekends, and on an |
emergency basis to meet the respite needs of caregivers. |
Procedures shall be developed to permit the utilization of |
services in successive blocks of 24 hours up to the monthly |
maximum established by the Department. Workers providing these |
services shall be appropriately trained. |
No Beginning on the effective date of this amendatory Act |
of 1991, no person may perform chore/housekeeping and home |
care aide services under a program authorized by this Section |
unless that person has been issued a certificate of |
pre-service to do so by his or her employing agency. |
Information gathered to effect such certification shall |
include (i) the person's name, (ii) the date the person was |
hired by his or her current employer, and (iii) the training, |
including dates and levels. Persons engaged in the program |
authorized by this Section before the effective date of this |
amendatory Act of 1991 shall be issued a certificate of all |
pre-service pre- and in-service training from his or her |
employer upon submitting the necessary information. The |
employing agency shall be required to retain records of all |
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staff pre-service pre- and in-service training, and shall |
provide such records to the Department upon request and upon |
termination of the employer's contract with the Department. In |
addition, the employing agency is responsible for the issuance |
of certifications of in-service training completed to their |
employees. |
The Department is required to develop a system to ensure |
that persons working as home care aides and personal |
assistants receive increases in their wages when the federal |
minimum wage is increased by requiring vendors to certify that |
they are meeting the federal minimum wage statute for home |
care aides and personal assistants. An employer that cannot |
ensure that the minimum wage increase is being given to home |
care aides and personal assistants shall be denied any |
increase in reimbursement costs. |
The Community Care Program Advisory Committee is created |
in the Department on Aging. The Director shall appoint |
individuals to serve in the Committee, who shall serve at |
their own expense. Members of the Committee must abide by all |
applicable ethics laws. The Committee shall advise the |
Department on issues related to the Department's program of |
services to prevent unnecessary institutionalization. The |
Committee shall meet on a bi-monthly basis and shall serve to |
identify and advise the Department on present and potential |
issues affecting the service delivery network, the program's |
clients, and the Department and to recommend solution |
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strategies. Persons appointed to the Committee shall be |
appointed on, but not limited to, their own and their agency's |
experience with the program, geographic representation, and |
willingness to serve. The Director shall appoint members to |
the Committee to represent provider, advocacy, policy |
research, and other constituencies committed to the delivery |
of high quality home and community-based services to older |
adults. Representatives shall be appointed to ensure |
representation from community care providers , including, but |
not limited to, adult day service providers, homemaker |
providers, case coordination and case management units, |
emergency home response providers, statewide trade or labor |
unions that represent home care aides and direct care staff, |
area agencies on aging, adults over age 60, membership |
organizations representing older adults, and other |
organizational entities, providers of care, or individuals |
with demonstrated interest and expertise in the field of home |
and community care as determined by the Director. |
Nominations may be presented from any agency or State |
association with interest in the program. The Director, or his |
or her designee, shall serve as the permanent co-chair of the |
advisory committee. One other co-chair shall be nominated and |
approved by the members of the committee on an annual basis. |
Committee members' terms of appointment shall be for 4 years |
with one-quarter of the appointees' terms expiring each year. |
A member shall continue to serve until his or her replacement |
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is named. The Department shall fill vacancies that have a |
remaining term of over one year, and this replacement shall |
occur through the annual replacement of expiring terms. The |
Director shall designate Department staff to provide technical |
assistance and staff support to the committee. Department |
representation shall not constitute membership of the |
committee. All Committee papers, issues, recommendations, |
reports, and meeting memoranda are advisory only. The |
Director, or his or her designee, shall make a written report, |
as requested by the Committee, regarding issues before the |
Committee. |
The Department on Aging and the Department of Human |
Services shall cooperate in the development and submission of |
an annual report on programs and services provided under this |
Section. Such joint report shall be filed with the Governor |
and the General Assembly on or before March 31 of the following |
fiscal year. |
The requirement for reporting to the General Assembly |
shall be satisfied by filing copies of the report as required |
by Section 3.1 of the General Assembly Organization Act and |
filing such additional copies with the State Government Report |
Distribution Center for the General Assembly as is required |
under paragraph (t) of Section 7 of the State Library Act. |
Those persons previously found eligible for receiving |
non-institutional services whose services were discontinued |
under the Emergency Budget Act of Fiscal Year 1992, and who do |
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not meet the eligibility standards in effect on or after July |
1, 1992, shall remain ineligible on and after July 1, 1992. |
Those persons previously not required to cost-share and who |
were required to cost-share effective March 1, 1992, shall |
continue to meet cost-share requirements on and after July 1, |
1992. Beginning July 1, 1992, all clients will be required to |
meet eligibility, cost-share, and other requirements and will |
have services discontinued or altered when they fail to meet |
these requirements. |
For the purposes of this Section, "flexible senior |
services" refers to services that require one-time or periodic |
expenditures , including, but not limited to, respite care, |
home modification, assistive technology, housing assistance, |
and transportation. |
The Department shall implement an electronic service |
verification based on global positioning systems or other |
cost-effective technology for the Community Care Program no |
later than January 1, 2014. |
The Department shall require, as a condition of |
eligibility, application for enrollment in the medical |
assistance program under Article V of the Illinois Public Aid |
Code (i) beginning August 1, 2013, if the Auditor General has |
reported that the Department has failed to comply with the |
reporting requirements of Section 2-27 of the Illinois State |
Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
General has reported that the Department has not undertaken |
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the required actions listed in the report required by |
subsection (a) of Section 2-27 of the Illinois State Auditing |
Act . |
The Department may authorize shall delay Community Care |
Program services until an applicant is determined eligible for |
medical assistance under Article V of the Illinois Public Aid |
Code (i) beginning August 1, 2013, if the Auditor General has |
reported that the Department has failed to comply with the |
reporting requirements of Section 2-27 of the Illinois State |
Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
General has reported that the Department has not undertaken |
the required actions listed in the report required by |
subsection (a) of Section 2-27 of the Illinois State Auditing |
Act . |
The Department shall implement co-payments for the |
Community Care Program at the federally allowable maximum |
level (i) beginning August 1, 2013, if the Auditor General has |
reported that the Department has failed to comply with the |
reporting requirements of Section 2-27 of the Illinois State |
Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
General has reported that the Department has not undertaken |
the required actions listed in the report required by |
subsection (a) of Section 2-27 of the Illinois State Auditing |
Act. |
The Department shall continue to provide other Community |
Care Program reports as required by statute , which shall |
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include an annual report on Care Coordination Unit performance |
and adherence to service guidelines and a 6-month supplemental |
report . |
The Department shall conduct a quarterly review of Care |
Coordination Unit performance and adherence to service |
guidelines. The quarterly review shall be reported to the |
Speaker of the House of Representatives, the Minority Leader |
of the House of Representatives, the President of the Senate, |
and the Minority Leader of the Senate. The Department shall |
collect and report longitudinal data on the performance of |
each care coordination unit. Nothing in this paragraph shall |
be construed to require the Department to identify specific |
care coordination units. |
In regard to community care providers, failure to comply |
with Department on Aging policies shall be cause for |
disciplinary action, including, but not limited to, |
disqualification from serving Community Care Program clients. |
Each provider, upon submission of any bill or invoice to the |
Department for payment for services rendered, shall include a |
notarized statement, under penalty of perjury pursuant to |
Section 1-109 of the Code of Civil Procedure, that the |
provider has complied with all Department policies. |
The Director of the Department on Aging shall make |
information available to the State Board of Elections as may |
be required by an agreement the State Board of Elections has |
entered into with a multi-state voter registration list |
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maintenance system. |
Within 30 days after July 6, 2017 (the effective date of |
Public Act 100-23), rates shall be increased to $18.29 per |
hour, for the purpose of increasing, by at least $.72 per hour, |
the wages paid by those vendors to their employees who provide |
homemaker services. The Department shall pay an enhanced rate |
under the Community Care Program to those in-home service |
provider agencies that offer health insurance coverage as a |
benefit to their direct service worker employees consistent |
with the mandates of Public Act 95-713. For State fiscal years |
2018 and 2019, the enhanced rate shall be $1.77 per hour. The |
rate shall be adjusted using actuarial analysis based on the |
cost of care, but shall not be set below $1.77 per hour. The |
Department shall adopt rules, including emergency rules under |
subsections (y) and (bb) of Section 5-45 of the Illinois |
Administrative Procedure Act, to implement the provisions of |
this paragraph. |
The Department shall pay an enhanced rate of at least |
$1.77 per unit under the Community Care Program to those |
in-home service provider agencies that offer health insurance |
coverage as a benefit to their direct service worker employees |
pursuant to rules adopted by the Department. The Department |
shall review the enhanced rate as part of its process to rebase |
in-home service provider reimbursement rates pursuant to |
federal waiver requirements. Subject to federal approval, |
beginning on January 1, 2024, rates for adult day services |
|
shall be increased to $16.84 per hour and rates for each way |
transportation services for adult day services shall be |
increased to $12.44 per unit transportation. |
Subject to federal approval, on and after January 1, 2024, |
rates for homemaker services shall be increased to $28.07 to |
sustain a minimum wage of $17 per hour for direct service |
workers. Rates in subsequent State fiscal years shall be no |
lower than the rates put into effect upon federal approval. |
Providers of in-home services shall be required to certify to |
the Department that they remain in compliance with the |
mandated wage increase for direct service workers. 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 described in this paragraph. |
The General Assembly finds it necessary to authorize an |
aggressive Medicaid enrollment initiative designed to maximize |
federal Medicaid funding for the Community Care Program which |
produces significant savings for the State of Illinois. The |
Department on Aging shall establish and implement a Community |
Care Program Medicaid Initiative. Under the Initiative, the |
Department on Aging shall, at a minimum: (i) provide an |
enhanced rate to adequately compensate care coordination units |
to enroll eligible Community Care Program clients into |
Medicaid; (ii) use recommendations from a stakeholder |
committee on how best to implement the Initiative; and (iii) |
|
establish requirements for State agencies to make enrollment |
in the State's Medical Assistance program easier for seniors. |
The Community Care Program Medicaid Enrollment Oversight |
Subcommittee is created as a subcommittee of the Older Adult |
Services Advisory Committee established in Section 35 of the |
Older Adult Services Act to make recommendations on how best |
to increase the number of medical assistance recipients who |
are enrolled in the Community Care Program. The Subcommittee |
shall consist of all of the following persons who must be |
appointed within 30 days after June 4, 2018 ( the effective |
date of Public Act 100-587) this amendatory Act of the 100th |
General Assembly : |
(1) The Director of Aging, or his or her designee, who |
shall serve as the chairperson of the Subcommittee. |
(2) One representative of the Department of Healthcare |
and Family Services, appointed by the Director of |
Healthcare and Family Services. |
(3) One representative of the Department of Human |
Services, appointed by the Secretary of Human Services. |
(4) One individual representing a care coordination |
unit, appointed by the Director of Aging. |
(5) One individual from a non-governmental statewide |
organization that advocates for seniors, appointed by the |
Director of Aging. |
(6) One individual representing Area Agencies on |
Aging, appointed by the Director of Aging. |
|
(7) One individual from a statewide association |
dedicated to Alzheimer's care, support, and research, |
appointed by the Director of Aging. |
(8) One individual from an organization that employs |
persons who provide services under the Community Care |
Program, appointed by the Director of Aging. |
(9) One member of a trade or labor union representing |
persons who provide services under the Community Care |
Program, appointed by the Director of Aging. |
(10) One member of the Senate, who shall serve as |
co-chairperson, appointed by the President of the Senate. |
(11) One member of the Senate, who shall serve as |
co-chairperson, appointed by the Minority Leader of the |
Senate. |
(12) One member of the House of Representatives, who |
shall serve as co-chairperson, appointed by the Speaker of |
the House of Representatives. |
(13) One member of the House of Representatives, who |
shall serve as co-chairperson, appointed by the Minority |
Leader of the House of Representatives. |
(14) One individual appointed by a labor organization |
representing frontline employees at the Department of |
Human Services. |
The Subcommittee shall provide oversight to the Community |
Care Program Medicaid Initiative and shall meet quarterly. At |
each Subcommittee meeting the Department on Aging shall |
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provide the following data sets to the Subcommittee: (A) the |
number of Illinois residents, categorized by planning and |
service area, who are receiving services under the Community |
Care Program and are enrolled in the State's Medical |
Assistance Program; (B) the number of Illinois residents, |
categorized by planning and service area, who are receiving |
services under the Community Care Program, but are not |
enrolled in the State's Medical Assistance Program; and (C) |
the number of Illinois residents, categorized by planning and |
service area, who are receiving services under the Community |
Care Program and are eligible for benefits under the State's |
Medical Assistance Program, but are not enrolled in the |
State's Medical Assistance Program. In addition to this data, |
the Department on Aging shall provide the Subcommittee with |
plans on how the Department on Aging will reduce the number of |
Illinois residents who are not enrolled in the State's Medical |
Assistance Program but who are eligible for medical assistance |
benefits. The Department on Aging shall enroll in the State's |
Medical Assistance Program those Illinois residents who |
receive services under the Community Care Program and are |
eligible for medical assistance benefits but are not enrolled |
in the State's Medicaid Assistance Program. The data provided |
to the Subcommittee shall be made available to the public via |
the Department on Aging's website. |
The Department on Aging, with the involvement of the |
Subcommittee, shall collaborate with the Department of Human |
|
Services and the Department of Healthcare and Family Services |
on how best to achieve the responsibilities of the Community |
Care Program Medicaid Initiative. |
The Department on Aging, the Department of Human Services, |
and the Department of Healthcare and Family Services shall |
coordinate and implement a streamlined process for seniors to |
access benefits under the State's Medical Assistance Program. |
The Subcommittee shall collaborate with the Department of |
Human Services on the adoption of a uniform application |
submission process. The Department of Human Services and any |
other State agency involved with processing the medical |
assistance application of any person enrolled in the Community |
Care Program shall include the appropriate care coordination |
unit in all communications related to the determination or |
status of the application. |
The Community Care Program Medicaid Initiative shall |
provide targeted funding to care coordination units to help |
seniors complete their applications for medical assistance |
benefits. On and after July 1, 2019, care coordination units |
shall receive no less than $200 per completed application, |
which rate may be included in a bundled rate for initial intake |
services when Medicaid application assistance is provided in |
conjunction with the initial intake process for new program |
participants. |
The Community Care Program Medicaid Initiative shall cease |
operation 5 years after June 4, 2018 ( the effective date of |
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Public Act 100-587) this amendatory Act of the 100th General |
Assembly , after which the Subcommittee shall dissolve. |
Effective July 1, 2023, subject to federal approval, the |
Department on Aging shall reimburse Care Coordination Units at |
the following rates for case management services: $252.40 for |
each initial assessment; $366.40 for each initial assessment |
with translation; $229.68 for each redetermination assessment; |
$313.68 for each redetermination assessment with translation; |
$200.00 for each completed application for medical assistance |
benefits; $132.26 for each face-to-face, choices-for-care |
screening; $168.26 for each face-to-face, choices-for-care |
screening with translation; $124.56 for each 6-month, |
face-to-face visit; $132.00 for each MCO participant |
eligibility determination; and $157.00 for each MCO |
participant eligibility determination with translation. |
(Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23; |
103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102, |
Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90, |
Section 90-5, eff. 1-1-24; revised 12-12-23.) |
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(20 ILCS 105/5.03 new) |
Sec. 5.03. Judicial review. All final administrative |
decisions of the Department are subject to judicial review in |
accordance with the provisions of the Administrative Review |
Law, and all rules adopted under the Administrative Review |
Law. The term "administrative decision" is defined as in |