Illinois General Assembly - Full Text of Public Act 095-0565
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Public Act 095-0565




Public Act 095-0565
HB0652 Enrolled LRB095 05122 HLH 28290 b

    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 Section 4.02 as follows:
    (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
    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); home health services;
        (b) (blank); home nursing services;
        (c) homemaker services;
        (d) personal assistant services chore and housekeeping
        (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) 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 taking into consideration the unique economic and
social needs of the target population for whom they are to be
provided. Such eligibility standards shall be based on the
recipient's ability to pay for services; provided, however,
that 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 home to his spouse,
provided that the spouse's share of the marital property is not
made available to the person seeking such services.
    Beginning July 1, 2002, the Department shall require as a
condition of eligibility that all financially eligible
applicants and recipients apply for medical assistance under
Article V of the Illinois Public Aid Code in accordance with
rules promulgated by the Department.
    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 60 days notice prior to actual
termination. Those persons receiving notice of termination may
contact the Department and request the determination be
appealed at any time during the 60 day notice period. With the
exception of the lengthened notice and time frame for the
appeal request, the appeal process shall follow the normal
procedure. In addition, each person affected regardless of the
circumstances for discontinued eligibility shall be given
notice and the opportunity to purchase the necessary services
through the Community Care Program. If the individual does not
elect to purchase services, the Department shall advise the
individual of alternative services. 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 chore/housekeeping and homemaker 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 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
    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
necessary to reflect any change in the officially designated
federal poverty standard.
    The Department, or the Department's authorized
representative, shall 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, blind, or permanently and totally disabled. 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 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) 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 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; and
        (7) ensuring that the State may access maximum federal
    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 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.
    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
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.
    Beginning on the effective date of this Amendatory Act of
1991, no person may perform chore/housekeeping and homemaker
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- 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
staff 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
    The Department is required to develop a system to ensure
that persons working as homemakers and chore housekeepers
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 homemakers and
chore housekeepers. An employer that cannot ensure that the
minimum wage increase is being given to homemakers and chore
housekeepers shall be denied any increase in reimbursement
    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 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 Committee shall include, but not be limited to,
representatives from the following agencies and organizations:
        (a) at least 4 adult day service representatives;
        (b) at least 4 case coordination unit representatives;
        (c) at least 4 representatives from in-home direct care
    service agencies;
        (d) at least 2 representatives of statewide trade or
    labor unions that represent in-home direct care service
        (e) at least 2 representatives of Area Agencies on
        (f) at least 2 non-provider representatives from a
    policy, advocacy, research, or other service organization;
        (g) at least 2 representatives from a statewide
    membership organization for senior citizens; and
        (h) at least 2 citizen members 60 years of age or
    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.
At no time may a member serve more than one consecutive term in
any capacity on the committee. 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 September 30 each year.
    The requirement for reporting to the General Assembly shall
be satisfied by filing copies of the report with the Speaker,
the Minority Leader and the Clerk of the House of
Representatives and the President, the Minority Leader and the
Secretary of the Senate and the Legislative Research Unit, 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
    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
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
(Source: P.A. 93-85, eff. 1-1-04; 93-902, eff. 8-10-04; 94-48,
eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, eff. 7-26-05;
94-954, eff. 6-27-06.)

Effective Date: 6/1/2008