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
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 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 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 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 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, 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
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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 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- 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
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 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 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
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 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 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, 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 the required actions listed in
the report required by subsection (a) of Section 2-27 of the
Illinois State Auditing Act.
The Department 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 provide a bi-monthly report on the progress of the Community Care Program reforms set forth in this amendatory Act of the 98th General Assembly to the Governor, 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 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.
(Source: P.A. 97-333, eff. 8-12-11; 98-8, eff. 5-3-13.)
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