|Public Act 094-0236
||LRB094 08053 DRJ 38236 b
AN ACT concerning aging.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
The Older Adult Services Act is amended by
changing Section 25 as follows:
(320 ILCS 42/25)
Older adult services restructuring.
No later than
January 1, 2005, the Department shall commence the process of
restructuring the older adult services delivery system.
Priority shall be given to both the expansion of services and
the development of new services in priority service areas.
Subject to the availability of funding, the restructuring shall
include, but not be limited to, the following:
(1) Planning. The Department shall develop a plan to
restructure the State's service delivery system for older
adults. The plan shall include a schedule for the
implementation of the initiatives outlined in this Act and all
other initiatives identified by the participating agencies to
fulfill the purposes of this Act. Financing for older adult
services shall be based on the principle that "money follows
the individual". The plan shall also identify potential
impediments to delivery system restructuring and include any
known regulatory or statutory barriers.
(2) Comprehensive case management. The Department shall
implement a statewide system of holistic comprehensive case
management. The system shall include the identification and
implementation of a universal, comprehensive assessment tool
to be used statewide to determine the level of functional,
cognitive, socialization, and financial needs of older adults.
This tool shall be supported by an electronic intake,
assessment, and care planning system linked to a central
location. "Comprehensive case management" includes services
and coordination such as (i) comprehensive assessment of the
older adult (including the physical, functional, cognitive,
psycho-social, and social needs of the individual); (ii)
development and implementation of a service plan with the older
adult to mobilize the formal and family resources and services
identified in the assessment to meet the needs of the older
adult, including coordination of the resources and services
with any other plans that exist for various formal services,
such as hospital discharge plans, and with the information and
assistance services; (iii) coordination and monitoring of
formal and family service delivery, including coordination and
monitoring to ensure that services specified in the plan are
being provided; (iv) periodic reassessment and revision of the
status of the older adult with the older adult or, if
necessary, the older adult's designated representative; and
(v) in accordance with the wishes of the older adult, advocacy
on behalf of the older adult for needed services or resources.
(3) Coordinated point of entry. The Department shall
implement and publicize a statewide coordinated point of entry
using a uniform name, identity, logo, and toll-free number.
(4) Public web site. The Department shall develop a public
web site that provides links to available services, resources,
and reference materials concerning caregiving, diseases, and
best practices for use by professionals, older adults, and
(5) Expansion of older adult services. The Department shall
expand older adult services that promote independence and
permit older adults to remain in their own homes and
(6) Consumer-directed home and community-based services.
The Department shall expand the range of service options
available to permit older adults to exercise maximum choice and
control over their care.
(7) Comprehensive delivery system. The Department shall
expand opportunities for older adults to receive services in
systems that integrate acute and chronic care.
(8) Enhanced transition and follow-up services. The
Department shall implement a program of transition from one
residential setting to another and follow-up services,
regardless of residential setting, pursuant to rules with
respect to (i) resident eligibility, (ii) assessment of the
resident's health, cognitive, social, and financial needs,
(iii) development of transition plans, and (iv) the level of
services that must be available before transitioning a resident
from one setting to another.
(9) Family caregiver support. The Department shall develop
strategies for public and private financing of services that
supplement and support family caregivers.
(10) Quality standards and quality improvement. The
Department shall establish a core set of uniform quality
standards for all providers that focus on outcomes and take
into consideration consumer choice and satisfaction, and the
Department shall require each provider to implement a
continuous quality improvement process to address consumer
issues. The continuous quality improvement process must
benchmark performance, be person-centered and data-driven, and
focus on consumer satisfaction.
(11) Workforce. The Department shall develop strategies to
attract and retain a qualified and stable worker pool, provide
living wages and benefits, and create a work environment that
is conducive to long-term employment and career development.
Resources such as grants, education, and promotion of career
opportunities may be used.
(12) Coordination of services. The Department shall
identify methods to better coordinate service networks to
maximize resources and minimize duplication of services and
ease of application.
(13) Barriers to services. The Department shall identify
barriers to the provision, availability, and accessibility of
services and shall implement a plan to address those barriers.
The plan shall: (i) identify barriers, including but not
limited to, statutory and regulatory complexity, reimbursement
issues, payment issues, and labor force issues; (ii) recommend
changes to State or federal laws or administrative rules or
regulations; (iii) recommend application for federal waivers
to improve efficiency and reduce cost and paperwork; (iv)
develop innovative service delivery models; and (v) recommend
application for federal or private service grants.
(14) Reimbursement and funding. The Department shall
investigate and evaluate costs and payments by defining costs
to implement a uniform, audited provider cost reporting system
to be considered by all Departments in establishing payments.
To the extent possible, multiple cost reporting mandates shall
not be imposed.
(15) Medicaid nursing home cost containment and Medicare
utilization. The Department of Public Aid, in collaboration
with the Department on Aging and the Department of Public
Health and in consultation with the Advisory Committee, shall
propose a plan to contain Medicaid nursing home costs and
maximize Medicare utilization. The plan must not impair the
ability of an older adult to choose among available services.
The plan shall include, but not be limited to, (i) techniques
to maximize the use of the most cost-effective services without
sacrificing quality and (ii) methods to identify and serve
older adults in need of minimal services to remain independent,
but who are likely to develop a need for more extensive
services in the absence of those minimal services.
(16) Bed reduction. The Department of Public Health shall
implement a nursing home conversion program to reduce the
number of Medicaid-certified nursing home beds in areas with
excess beds. The Department of Public Aid shall investigate
changes to the Medicaid nursing facility reimbursement system
in order to reduce beds. Such changes may include, but are not
limited to, incentive payments that will enable facilities to
adjust to the restructuring and expansion of services required
by the Older Adult Services Act, including adjustments for the
voluntary closure or layaway of nursing home beds certified
under Title XIX of the federal Social Security Act. Any savings
shall be reallocated to fund home-based or community-based
older adult services pursuant to Section 20.
(17) Financing. The Department shall investigate and
evaluate financing options for older adult services and shall
make recommendations in the report required by Section 15
concerning the feasibility of these financing arrangements.
These arrangements shall include, but are not limited to:
(A) private long-term care insurance coverage for
older adult services;
(B) enhancement of federal long-term care financing
(C) employer benefit programs such as medical savings
accounts for long-term care;
(D) individual and family cost-sharing options;
(E) strategies to reduce reliance on government
(F) fraudulent asset divestiture and financial
planning prevention; and
(G) methods to supplement and support family and
(18) Older Adult Services Demonstration Grants. The
Department shall implement a program of demonstration grants
that will assist in the restructuring of the older adult
services delivery system, and shall provide funding for
innovative service delivery models and system change and
integration initiatives pursuant to subsection (g) of Section
(19) Bed need methodology update. For the purposes of
determining areas with excess beds, the Departments shall
provide information and assistance to the Health Facilities
Planning Board to update the Bed Need Methodology for Long-Term
Care to update the assumptions used to establish the
methodology to make them consistent with modern older adult
(20) Affordable housing. The Departments shall utilize the
recommendations of Illinois' Annual Comprehensive Housing