093_HB3437

 
                                     LRB093 05085 JAM 05145 b

 1        AN ACT concerning preventive services.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.   The Illinois Act on the Aging is amended by
 5    changing Section 4.02 as follows:

 6        (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
 7        Sec. 4.02.  The Department shall establish a  program  of
 8    services   to  prevent  unnecessary  institutionalization  of
 9    persons age 60 and older in need of long term care or who are
10    established as persons who suffer from Alzheimer's disease or
11    a related disorder under the Alzheimer's  Disease  Assistance
12    Act, thereby enabling them to remain in their own homes or in
13    other  living  arrangements.  Such preventive services, which
14    may be coordinated with  other  programs  for  the  aged  and
15    monitored  by  area agencies on aging in cooperation with the
16    Department, may include, but are not limited to, any  or  all
17    of the following:
18             (a)  home health services;
19             (b)  home nursing services;
20             (c)  homemaker services;
21             (d)  chore and housekeeping services;
22             (e)  day care services;
23             (f)  home-delivered meals;
24             (g)  education in self-care;
25             (h)  personal care services;
26             (i)  adult day health services;
27             (j)  habilitation services;
28             (k)  respite care;
29             (l)  other   nonmedical  social  services  that  may
30        enable the person to become self-supporting; or
31             (m)  clearinghouse  for  information   provided   by
 
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 1        senior  citizen  home owners who want to rent rooms to or
 2        share living space with other senior citizens.
 3        The Department shall establish eligibility standards  for
 4    such  services  taking into consideration the unique economic
 5    and social needs of the target population for whom  they  are
 6    to be provided.  Such eligibility standards shall be based on
 7    the  recipient's  ability  to  pay  for  services;  provided,
 8    however,  that  in  determining  the  amount  and  nature  of
 9    services  for which a person may qualify, consideration shall
10    not be given to the value of cash, property or  other  assets
11    held in the name of the person's spouse pursuant to a written
12    agreement  dividing  marital property into equal but separate
13    shares or pursuant to a transfer of the person's interest  in
14    a home to his spouse, provided that the spouse's share of the
15    marital  property is not made available to the person seeking
16    such services.
17        Beginning July 1, 2002, the Department shall require as a
18    condition of eligibility that all applicants  and  recipients
19    apply  for medical assistance under Article V of the Illinois
20    Public Aid Code in accordance with rules promulgated  by  the
21    Department.
22        The  Department shall, in conjunction with the Department
23    of Public Aid, seek  appropriate  amendments  under  Sections
24    1915 and 1924 of the Social Security Act.  The purpose of the
25    amendments  shall  be  to  extend  eligibility  for  home and
26    community based services under Sections 1915 and 1924 of  the
27    Social  Security  Act  to  persons who transfer to or for the
28    benefit of a spouse those amounts  of  income  and  resources
29    allowed  under  Section  1924  of  the  Social  Security Act.
30    Subject to the approval of such  amendments,  the  Department
31    shall  extend  the  provisions of Section 5-4 of the Illinois
32    Public Aid Code to persons who, but for the provision of home
33    or community-based services, would require the level of  care
34    provided  in  an  institution,  as is provided for in federal
 
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 1    law.  Those persons  no  longer  found  to  be  eligible  for
 2    receiving  noninstitutional  services  due  to changes in the
 3    eligibility criteria shall be given 60 days notice  prior  to
 4    actual   termination.   Those  persons  receiving  notice  of
 5    termination  may  contact  the  Department  and  request  the
 6    determination be appealed at  any  time  during  the  60  day
 7    notice  period.   With the exception of the lengthened notice
 8    and time frame for the appeal  request,  the  appeal  process
 9    shall  follow the normal procedure.  In addition, each person
10    affected regardless of  the  circumstances  for  discontinued
11    eligibility  shall  be  given  notice  and the opportunity to
12    purchase the necessary services through  the  Community  Care
13    Program.   If  the  individual  does  not  elect  to purchase
14    services, the  Department  shall  advise  the  individual  of
15    alternative  services.   The target population identified for
16    the purposes of this Section are persons  age  60  and  older
17    with  an identified service need.  Priority shall be given to
18    those who are at imminent risk of institutionalization.   The
19    services  shall  be  provided  to eligible persons age 60 and
20    older to the extent that the cost of  the  services  together
21    with  the  other personal maintenance expenses of the persons
22    are reasonably related to the standards established for  care
23    in  a  group  facility appropriate to the person's condition.
24    These   non-institutional   services,   pilot   projects   or
25    experimental facilities may be provided  as  part  of  or  in
26    addition  to  those authorized by federal law or those funded
27    and administered by the Department of  Human  Services.   The
28    Departments  of  Human  Services,  Public Aid, Public Health,
29    Veterans' Affairs, and Commerce  and  Community  Affairs  and
30    other  appropriate  agencies  of  State,  federal  and  local
31    governments  shall  cooperate with the Department on Aging in
32    the establishment and development  of  the  non-institutional
33    services.   The Department shall require an annual audit from
34    all chore/housekeeping and homemaker vendors contracting with
 
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 1    the Department under this Section.  The  annual  audit  shall
 2    assure   that   each   audited  vendor's  procedures  are  in
 3    compliance with Department's financial  reporting  guidelines
 4    requiring  a 27% administrative cost split and a 73% employee
 5    wages and benefits cost split.  The audit is a public  record
 6    under  the  Freedom of Information Act.  The Department shall
 7    execute, relative to the nursing home  prescreening  project,
 8    written  inter-agency agreements with the Department of Human
 9    Services and the Department of  Public  Aid,  to  effect  the
10    following:   (1)  intake  procedures  and  common eligibility
11    criteria   for    those    persons    who    are    receiving
12    non-institutional  services;  and  (2)  the establishment and
13    development of non-institutional services  in  areas  of  the
14    State   where   they  are  not  currently  available  or  are
15    undeveloped.  On and after July 1,  1996,  all  nursing  home
16    prescreenings  for individuals 60 years of age or older shall
17    be conducted by the Department.
18        The Department is authorized to  establish  a  system  of
19    recipient copayment for services provided under this Section,
20    such  copayment  to  be based upon the recipient's ability to
21    pay but in no case to exceed the actual cost of the  services
22    provided.  Additionally,  any  portion  of  a person's income
23    which is equal to or less than the federal  poverty  standard
24    shall  not be considered by the Department in determining the
25    copayment.  The level of such  copayment  shall  be  adjusted
26    whenever  necessary  to  reflect any change in the officially
27    designated federal poverty standard.
28        The   Department,   or   the   Department's    authorized
29    representative,  shall  recover the amount of moneys expended
30    for services provided to or in behalf of a person under  this
31    Section by a claim against the person's estate or against the
32    estate  of the person's surviving spouse, but no recovery may
33    be had until after the death of the surviving spouse, if any,
34    and then only at such time when there is no  surviving  child
 
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 1    who  is  under  age  21,  blind,  or  permanently and totally
 2    disabled.  This paragraph, however, shall not  bar  recovery,
 3    at  the  death of the person, of moneys for services provided
 4    to the person or in behalf of the person under  this  Section
 5    to  which  the  person  was  not entitled; provided that such
 6    recovery shall not be enforced against any real estate  while
 7    it  is  occupied  as  a  homestead by the surviving spouse or
 8    other dependent, if no claims by other  creditors  have  been
 9    filed against the estate, or, if such claims have been filed,
10    they  remain dormant for failure of prosecution or failure of
11    the claimant to compel administration of the estate  for  the
12    purpose  of  payment.   This paragraph shall not bar recovery
13    from the estate of a spouse, under Sections 1915 and 1924  of
14    the  Social  Security  Act  and  Section  5-4 of the Illinois
15    Public Aid Code, who precedes  a  person  receiving  services
16    under this Section in death.  All moneys for services paid to
17    or  in  behalf  of  the  person  under  this Section shall be
18    claimed for  recovery  from  the  deceased  spouse's  estate.
19    "Homestead",  as  used  in this paragraph, means the dwelling
20    house and contiguous real  estate  occupied  by  a  surviving
21    spouse  or  relative, as defined by the rules and regulations
22    of the Illinois Department of Public Aid, regardless  of  the
23    value of the property.
24        The   Department  shall  develop  procedures  to  enhance
25    availability of services on evenings,  weekends,  and  on  an
26    emergency  basis  to  meet  the  respite needs of caregivers.
27    Procedures shall be developed to permit  the  utilization  of
28    services  in  successive blocks of 24 hours up to the monthly
29    maximum established by the  Department.    Workers  providing
30    these services shall be appropriately trained.
31        Beginning on the effective date of this Amendatory Act of
32    1991,  no person may perform chore/housekeeping and homemaker
33    services under a program authorized by  this  Section  unless
34    that  person  has been issued a certificate of pre-service to
 
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 1    do so by his or her employing agency.   Information  gathered
 2    to  effect  such certification shall include (i) the person's
 3    name, (ii) the date the  person  was  hired  by  his  or  her
 4    current employer, and (iii) the training, including dates and
 5    levels.   Persons  engaged  in the program authorized by this
 6    Section before the effective date of this amendatory  Act  of
 7    1991 shall be issued a certificate of all pre- and in-service
 8    training  from  his  or  her  employer  upon  submitting  the
 9    necessary   information.    The  employing  agency  shall  be
10    required to retain records of all staff pre-  and  in-service
11    training,  and  shall  provide such records to the Department
12    upon request and upon termination of the employer's  contract
13    with  the  Department.   In addition, the employing agency is
14    responsible for the issuance of certifications of  in-service
15    training completed to their employees.
16        The  Department is required to develop a system to ensure
17    that persons working as  homemakers  and  chore  housekeepers
18    receive  increases  in  their  wages when the federal minimum
19    wage is increased by requiring vendors to certify  that  they
20    are  meeting  the federal minimum wage statute for homemakers
21    and chore housekeepers.  An employer that cannot ensure  that
22    the  minimum  wage  increase is being given to homemakers and
23    chore  housekeepers  shall  be   denied   any   increase   in
24    reimbursement  costs.  Beginning  July  1,  2003, the vendors
25    shall receive a rate increase equal to the  percent  increase
26    in  the  federal  minimum  wage each time the federal minimum
27    wage is increased.
28        The Department on  Aging  and  the  Department  of  Human
29    Services shall cooperate in the development and submission of
30    an annual report on programs and services provided under this
31    Section.   Such joint report shall be filed with the Governor
32    and the General Assembly on or before September 30 each year.
33        The requirement for reporting  to  the  General  Assembly
34    shall  be  satisfied  by filing copies of the report with the
 
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 1    Speaker, the Minority Leader and the Clerk of  the  House  of
 2    Representatives  and  the  President, the Minority Leader and
 3    the Secretary of the  Senate  and  the  Legislative  Research
 4    Unit,  as  required  by  Section  3.1 of the General Assembly
 5    Organization Act  and filing such additional copies with  the
 6    State  Government  Report Distribution Center for the General
 7    Assembly as is required under paragraph (t) of Section  7  of
 8    the State Library Act.
 9        Those  persons  previously  found  eligible for receiving
10    non-institutional services whose services  were  discontinued
11    under  the  Emergency Budget Act of Fiscal Year 1992, and who
12    do not meet the eligibility standards in effect on  or  after
13    July  1,  1992,  shall remain ineligible on and after July 1,
14    1992.  Those persons previously not  required  to  cost-share
15    and  who were required to cost-share effective March 1, 1992,
16    shall continue to meet cost-share requirements on  and  after
17    July  1,  1992.   Beginning July 1, 1992, all clients will be
18    required  to  meet   eligibility,   cost-share,   and   other
19    requirements  and  will have services discontinued or altered
20    when they fail to meet these requirements.
21    (Source: P.A.  91-303,  eff.  1-1-00;  91-798,  eff.  7-9-00;
22    92-597, eff. 6-28-02.)

23        Section  10.  The  Disabled Persons Rehabilitation Act is
24    amended by changing Section 3 as follows:

25        (20 ILCS 2405/3) (from Ch. 23, par. 3434)
26        Sec. 3.  Powers and duties. The Department shall have the
27    powers and duties enumerated herein:
28        (a)  To co-operate with the  federal  government  in  the
29    administration    of    the   provisions   of   the   federal
30    Rehabilitation Act of 1973,  as  amended,  of  the  Workforce
31    Investment  Act  of  1998, and of the federal Social Security
32    Act to the extent and in the manner provided in these Acts.
 
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 1        (b)  To  prescribe  and   supervise   such   courses   of
 2    vocational training and provide such other services as may be
 3    necessary  for the habilitation and rehabilitation of persons
 4    with one or more disabilities, including  the  administrative
 5    activities  under  subsection  (e)  of  this  Section, and to
 6    co-operate with State and local school authorities and  other
 7    recognized  agencies  engaged in habilitation, rehabilitation
 8    and comprehensive rehabilitation services; and  to  cooperate
 9    with the Department of Children and Family Services regarding
10    the   care  and  education  of  children  with  one  or  more
11    disabilities.
12        (c)  (Blank).
13        (d)  To report in writing, to the Governor,  annually  on
14    or  before the first day of December, and at such other times
15    and in such manner and upon such subjects as the Governor may
16    require.  The annual report shall contain (1) a statement  of
17    the   existing   condition  of  comprehensive  rehabilitation
18    services, habilitation and rehabilitation in the State; (2) a
19    statement of suggestions and recommendations  with  reference
20    to  the development of comprehensive rehabilitation services,
21    habilitation and rehabilitation in  the  State;  and  (3)  an
22    itemized  statement  of  the  amounts  of money received from
23    federal, State and other sources,  and  of  the  objects  and
24    purposes  to  which  the  respective  items  of these several
25    amounts have been devoted.
26        (e)  (Blank).
27        (f)  To  establish  a  program  of  services  to  prevent
28    unnecessary institutionalization of persons with  Alzheimer's
29    disease and related disorders or persons in need of long term
30    care  who  are established as blind or disabled as defined by
31    the Social Security Act, thereby enabling them to  remain  in
32    their own homes or other living arrangements. Such preventive
33    services  may  include, but are not limited to, any or all of
34    the following:
 
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 1             (1)  home health services;
 2             (2)  home nursing services;
 3             (3)  homemaker services;
 4             (4)  chore and housekeeping services;
 5             (5)  day care services;
 6             (6)  home-delivered meals;
 7             (7)  education in self-care;
 8             (8)  personal care services;
 9             (9)  adult day health services;
10             (10)  habilitation services;
11             (11)  respite care; or
12             (12)  other  nonmedical  social  services  that  may
13        enable the person to become self-supporting.
14        The Department shall establish eligibility standards  for
15    such  services  taking into consideration the unique economic
16    and social needs of the population for whom they  are  to  be
17    provided.   Such  eligibility  standards  may be based on the
18    recipient's ability to pay for services;  provided,  however,
19    that  any  portion  of  a person's income that is equal to or
20    less  than  the  "protected  income"  level  shall   not   be
21    considered by the Department in determining eligibility.  The
22    "protected   income"   level   shall  be  determined  by  the
23    Department, shall never be  less  than  the  federal  poverty
24    standard,  and shall be adjusted each year to reflect changes
25    in the Consumer  Price  Index  For  All  Urban  Consumers  as
26    determined   by   the  United  States  Department  of  Labor.
27    Additionally,  in  determining  the  amount  and  nature   of
28    services  for which a person may qualify, consideration shall
29    not be given to the value of cash, property or  other  assets
30    held in the name of the person's spouse pursuant to a written
31    agreement  dividing  marital property into equal but separate
32    shares or pursuant to a transfer of the person's interest  in
33    a home to his spouse, provided that the spouse's share of the
34    marital  property is not made available to the person seeking
 
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 1    such services.
 2        The services shall be provided  to  eligible  persons  to
 3    prevent unnecessary or premature institutionalization, to the
 4    extent that the cost of the services, together with the other
 5    personal  maintenance expenses of the persons, are reasonably
 6    related to the standards established  for  care  in  a  group
 7    facility    appropriate    to    their    condition.    These
 8    non-institutional services, pilot  projects  or  experimental
 9    facilities may be provided as part of or in addition to those
10    authorized by federal law or those funded and administered by
11    the Illinois Department on Aging.
12        Personal care attendants shall be paid:
13             (i)  A  $5  per  hour minimum rate beginning July 1,
14        1995.
15             (ii)  A $5.30 per hour minimum rate  beginning  July
16        1, 1997.
17             (iii)  A  $5.40 per hour minimum rate beginning July
18        1, 1998.
19        Beginning July 1, 2003, personal  care  attendants  shall
20    receive  a  percentage increase in wages equal to the percent
21    increase in the federal minimum wage each  time  the  federal
22    minimum wage is increased.
23        The  Department  shall  execute,  relative to the nursing
24    home prescreening project, as authorized by Section  4.03  of
25    the   Illinois   Act   on  the  Aging,  written  inter-agency
26    agreements with the Department on Aging and the Department of
27    Public Aid, to effect the following:  (i)  intake  procedures
28    and  common  eligibility  criteria  for those persons who are
29    receiving   non-institutional   services;   and   (ii)    the
30    establishment  and  development of non-institutional services
31    in areas of the State where they are not currently  available
32    or  are  undeveloped.  On and after July 1, 1996, all nursing
33    home prescreenings for individuals 18 through 59 years of age
34    shall be conducted by the Department.
 
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 1        The Department is authorized to  establish  a  system  of
 2    recipient  cost-sharing  for  services  provided  under  this
 3    Section.    The   cost-sharing   shall   be  based  upon  the
 4    recipient's ability to pay for services, but in no case shall
 5    the recipient's share exceed the actual cost of the  services
 6    provided.   Protected  income  shall not be considered by the
 7    Department in its determination of the recipient's ability to
 8    pay  a  share  of  the  cost  of  services.   The  level   of
 9    cost-sharing  shall  be adjusted each year to reflect changes
10    in the "protected income" level.  The Department shall deduct
11    from the recipient's share of the cost of services any  money
12    expended by the recipient for disability-related expenses.
13        The    Department,   or   the   Department's   authorized
14    representative, shall recover the amount of  moneys  expended
15    for  services provided to or in behalf of a person under this
16    Section by a claim against the person's estate or against the
17    estate of the person's surviving spouse, but no recovery  may
18    be had until after the death of the surviving spouse, if any,
19    and  then  only at such time when there is no surviving child
20    who is under  age  21,  blind,  or  permanently  and  totally
21    disabled.   This  paragraph, however, shall not bar recovery,
22    at the death of the person, of moneys for  services  provided
23    to  the  person or in behalf of the person under this Section
24    to which the person was  not  entitled;  provided  that  such
25    recovery  shall not be enforced against any real estate while
26    it is occupied as a homestead  by  the  surviving  spouse  or
27    other  dependent,  if  no claims by other creditors have been
28    filed against the estate, or, if such claims have been filed,
29    they remain dormant for failure of prosecution or failure  of
30    the  claimant  to compel administration of the estate for the
31    purpose of payment.  This paragraph shall  not  bar  recovery
32    from  the estate of a spouse, under Sections 1915 and 1924 of
33    the Social Security Act  and  Section  5-4  of  the  Illinois
34    Public  Aid  Code,  who  precedes a person receiving services
 
                            -12-     LRB093 05085 JAM 05145 b
 1    under this Section in death.  All moneys for services paid to
 2    or in behalf of  the  person  under  this  Section  shall  be
 3    claimed  for  recovery  from  the  deceased  spouse's estate.
 4    "Homestead", as used in this paragraph,  means  the  dwelling
 5    house  and  contiguous  real  estate  occupied by a surviving
 6    spouse or relative, as defined by the rules  and  regulations
 7    of  the  Illinois Department of Public Aid, regardless of the
 8    value of the property.
 9        The  Department  and  the  Department  on   Aging   shall
10    cooperate  in  the  development  and  submission of an annual
11    report on programs and services provided under this  Section.
12    Such  joint  report  shall be filed with the Governor and the
13    General Assembly on or before March 30 each year.
14        The requirement for reporting  to  the  General  Assembly
15    shall  be  satisfied  by filing copies of the report with the
16    Speaker, the Minority Leader and the Clerk of  the  House  of
17    Representatives  and  the  President, the Minority Leader and
18    the Secretary of the  Senate  and  the  Legislative  Research
19    Unit,  as  required  by  Section  3.1 of the General Assembly
20    Organization Act, and filing additional copies with the State
21    Government  Report  Distribution  Center  for   the   General
22    Assembly  as required under paragraph (t) of Section 7 of the
23    State Library Act.
24        (g)  To establish such subdivisions of the Department  as
25    shall be desirable and assign to the various subdivisions the
26    responsibilities  and  duties  placed  upon the Department by
27    law.
28        (h)  To cooperate and enter into any necessary agreements
29    with the Department of Employment Security for the  provision
30    of  job placement and job referral services to clients of the
31    Department,  including  job  service  registration  of   such
32    clients  with Illinois Employment Security offices and making
33    job listings  maintained  by  the  Department  of  Employment
34    Security available to such clients.
 
                            -13-     LRB093 05085 JAM 05145 b
 1        (i)  To  possess  all powers reasonable and necessary for
 2    the exercise and administration of  the  powers,  duties  and
 3    responsibilities  of the Department which are provided for by
 4    law.
 5        (j)  To establish a procedure whereby  new  providers  of
 6    personal care attendant services shall submit vouchers to the
 7    State  for  payment  two  times  during  their first month of
 8    employment and one time per month  thereafter.   In  no  case
 9    shall  the  Department pay personal care attendants an hourly
10    wage that is less than the federal minimum wage.
11        (k)  To provide adequate notice to providers of chore and
12    housekeeping services informing them that they  are  entitled
13    to  an  interest payment on bills which are not promptly paid
14    pursuant to Section 3 of the State Prompt Payment Act.
15        (l)  To  establish,  operate  and  maintain  a  Statewide
16    Housing Clearinghouse of information on available, government
17    subsidized  housing  accessible  to  disabled   persons   and
18    available  privately  owned  housing  accessible  to disabled
19    persons.  The information shall include but not be limited to
20    the  location,  rental  requirements,  access  features   and
21    proximity to public transportation of available housing.  The
22    Clearinghouse  shall  consist  of  at  least  a  computerized
23    database  for  the storage and retrieval of information and a
24    separate or shared toll free  telephone  number  for  use  by
25    those seeking information from the Clearinghouse.  Department
26    offices  and personnel throughout the State shall also assist
27    in the operation  of  the  Statewide  Housing  Clearinghouse.
28    Cooperation  with  local,  State and federal housing managers
29    shall be sought and  extended  in  order  to  frequently  and
30    promptly update the Clearinghouse's information.
31        (m)  To assure that the names and case records of persons
32    who  received  or are receiving services from the Department,
33    including persons receiving vocational  rehabilitation,  home
34    services,  or  other services, and those attending one of the
 
                            -14-     LRB093 05085 JAM 05145 b
 1    Department's schools or other supervised  facility  shall  be
 2    confidential  and  not  be open to the general public.  Those
 3    case records and reports  or  the  information  contained  in
 4    those  records and reports shall be disclosed by the Director
 5    only  to  proper  law  enforcement   officials,   individuals
 6    authorized  by a court, the General Assembly or any committee
 7    or commission of the General Assembly, and other persons  and
 8    for  reasons  as the Director designates by rule.  Disclosure
 9    by  the  Director  may  be  only  in  accordance  with  other
10    applicable law.
11    (Source: P.A. 91-540, eff. 8-13-99; 92-84, eff. 7-1-02.)

12        Section 99.  Effective date. This Act takes  effect  July
13    1, 2003.