97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5736

 

Introduced 2/16/2012, by Rep. Bill Mitchell

 

SYNOPSIS AS INTRODUCED:
 
320 ILCS 42/25

    Amends the Older Adult Services Act. Requires the Department on Aging to place service providers that provide services aimed at ensuring the health and safety of the older adult, such as abuse prevention, housing, and food services, on an expedited payment schedule as prescribed by the Department. Authorizes the Department to promulgate rules necessary to implement this provision.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning aging.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Older Adult Services Act is amended by
5changing Section 25 as follows:
 
6    (320 ILCS 42/25)
7    Sec. 25. Older adult services restructuring. No later than
8January 1, 2005, the Department shall commence the process of
9restructuring the older adult services delivery system.
10Priority shall be given to both the expansion of services and
11the development of new services in priority service areas.
12Subject to the availability of funding, the restructuring shall
13include, but not be limited to, the following:
14    (1) Planning. The Department on Aging and the Departments
15of Public Health and Healthcare and Family Services shall
16develop a plan to restructure the State's service delivery
17system for older adults pursuant to this Act no later than
18September 30, 2010. The plan shall include a schedule for the
19implementation of the initiatives outlined in this Act and all
20other initiatives identified by the participating agencies to
21fulfill the purposes of this Act and shall protect the rights
22of all older Illinoisans to services based on their health
23circumstances and functioning level, regardless of whether

 

 

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1they receive their care in their homes, in a community setting,
2or in a residential facility. Financing for older adult
3services shall be based on the principle that "money follows
4the individual" taking into account individual preference, but
5shall not jeopardize the health, safety, or level of care of
6nursing home residents. The plan shall also identify potential
7impediments to delivery system restructuring and include any
8known regulatory or statutory barriers.
9    (2) Comprehensive case management. The Department shall
10implement a statewide system of holistic comprehensive case
11management. The system shall include the identification and
12implementation of a universal, comprehensive assessment tool
13to be used statewide to determine the level of functional,
14cognitive, socialization, and financial needs of older adults.
15This tool shall be supported by an electronic intake,
16assessment, and care planning system linked to a central
17location. "Comprehensive case management" includes services
18and coordination such as (i) comprehensive assessment of the
19older adult (including the physical, functional, cognitive,
20psycho-social, and social needs of the individual); (ii)
21development and implementation of a service plan with the older
22adult to mobilize the formal and family resources and services
23identified in the assessment to meet the needs of the older
24adult, including coordination of the resources and services
25with any other plans that exist for various formal services,
26such as hospital discharge plans, and with the information and

 

 

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1assistance services; (iii) coordination and monitoring of
2formal and family service delivery, including coordination and
3monitoring to ensure that services specified in the plan are
4being provided; (iv) periodic reassessment and revision of the
5status of the older adult with the older adult or, if
6necessary, the older adult's designated representative; and
7(v) in accordance with the wishes of the older adult, advocacy
8on behalf of the older adult for needed services or resources.
9    (3) Coordinated point of entry. The Department shall
10implement and publicize a statewide coordinated point of entry
11using a uniform name, identity, logo, and toll-free number.
12    (4) Public web site. The Department shall develop a public
13web site that provides links to available services, resources,
14and reference materials concerning caregiving, diseases, and
15best practices for use by professionals, older adults, and
16family caregivers.
17    (5) Expansion of older adult services. The Department shall
18expand older adult services that promote independence and
19permit older adults to remain in their own homes and
20communities.
21    (6) Consumer-directed home and community-based services.
22The Department shall expand the range of service options
23available to permit older adults to exercise maximum choice and
24control over their care.
25    (7) Comprehensive delivery system. The Department shall
26expand opportunities for older adults to receive services in

 

 

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1systems that integrate acute and chronic care.
2    (8) Enhanced transition and follow-up services. The
3Department shall implement a program of transition from one
4residential setting to another and follow-up services,
5regardless of residential setting, pursuant to rules with
6respect to (i) resident eligibility, (ii) assessment of the
7resident's health, cognitive, social, and financial needs,
8(iii) development of transition plans, and (iv) the level of
9services that must be available before transitioning a resident
10from one setting to another.
11    (9) Family caregiver support. The Department shall develop
12strategies for public and private financing of services that
13supplement and support family caregivers.
14    (10) Quality standards and quality improvement. The
15Department shall establish a core set of uniform quality
16standards for all providers that focus on outcomes and take
17into consideration consumer choice and satisfaction, and the
18Department shall require each provider to implement a
19continuous quality improvement process to address consumer
20issues. The continuous quality improvement process must
21benchmark performance, be person-centered and data-driven, and
22focus on consumer satisfaction.
23    (11) Workforce. The Department shall develop strategies to
24attract and retain a qualified and stable worker pool, provide
25living wages and benefits, and create a work environment that
26is conducive to long-term employment and career development.

 

 

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1Resources such as grants, education, and promotion of career
2opportunities may be used.
3    (12) Coordination of services. The Department shall
4identify methods to better coordinate service networks to
5maximize resources and minimize duplication of services and
6ease of application.
7    (13) Barriers to services. The Department shall identify
8barriers to the provision, availability, and accessibility of
9services and shall implement a plan to address those barriers.
10The plan shall: (i) identify barriers, including but not
11limited to, statutory and regulatory complexity, reimbursement
12issues, payment issues, and labor force issues; (ii) recommend
13changes to State or federal laws or administrative rules or
14regulations; (iii) recommend application for federal waivers
15to improve efficiency and reduce cost and paperwork; (iv)
16develop innovative service delivery models; and (v) recommend
17application for federal or private service grants.
18    (14) Reimbursement and funding. The Department shall
19investigate and evaluate costs and payments by defining costs
20to implement a uniform, audited provider cost reporting system
21to be considered by all Departments in establishing payments.
22To the extent possible, multiple cost reporting mandates shall
23not be imposed.
24    (14.5) Expedited payment schedule. The Department shall
25place service providers that provide services aimed at ensuring
26the health and safety of the older adult, such as abuse

 

 

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1prevention, housing, and food services, on an expedited payment
2schedule as prescribed by the Department. The Department shall
3promulgate rules necessary to implement this paragraph.
4    (15) Medicaid nursing home cost containment and Medicare
5utilization. The Department of Healthcare and Family Services
6(formerly Department of Public Aid), in collaboration with the
7Department on Aging and the Department of Public Health and in
8consultation with the Advisory Committee, shall propose a plan
9to contain Medicaid nursing home costs and maximize Medicare
10utilization. The plan must not impair the ability of an older
11adult to choose among available services. The plan shall
12include, but not be limited to, (i) techniques to maximize the
13use of the most cost-effective services without sacrificing
14quality and (ii) methods to identify and serve older adults in
15need of minimal services to remain independent, but who are
16likely to develop a need for more extensive services in the
17absence of those minimal services.
18    (16) Bed reduction. The Department of Public Health shall
19implement a nursing home conversion program to reduce the
20number of Medicaid-certified nursing home beds in areas with
21excess beds. The Department of Healthcare and Family Services
22shall investigate changes to the Medicaid nursing facility
23reimbursement system in order to reduce beds. Such changes may
24include, but are not limited to, incentive payments that will
25enable facilities to adjust to the restructuring and expansion
26of services required by the Older Adult Services Act, including

 

 

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1adjustments for the voluntary closure or layaway of nursing
2home beds certified under Title XIX of the federal Social
3Security Act. Any savings shall be reallocated to fund
4home-based or community-based older adult services pursuant to
5Section 20.
6    (17) Financing. The Department shall investigate and
7evaluate financing options for older adult services and shall
8make recommendations in the report required by Section 15
9concerning the feasibility of these financing arrangements.
10These arrangements shall include, but are not limited to:
11        (A) private long-term care insurance coverage for
12    older adult services;
13        (B) enhancement of federal long-term care financing
14    initiatives;
15        (C) employer benefit programs such as medical savings
16    accounts for long-term care;
17        (D) individual and family cost-sharing options;
18        (E) strategies to reduce reliance on government
19    programs;
20        (F) fraudulent asset divestiture and financial
21    planning prevention; and
22        (G) methods to supplement and support family and
23    community caregiving.
24    (18) Older Adult Services Demonstration Grants. The
25Department shall implement a program of demonstration grants
26that will assist in the restructuring of the older adult

 

 

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1services delivery system, and shall provide funding for
2innovative service delivery models and system change and
3integration initiatives pursuant to subsection (g) of Section
420.
5    (19) Bed need methodology update. For the purposes of
6determining areas with excess beds, the Departments shall
7provide information and assistance to the Health Facilities and
8Services Review Board to update the Bed Need Methodology for
9Long-Term Care to update the assumptions used to establish the
10methodology to make them consistent with modern older adult
11services.
12    (20) Affordable housing. The Departments shall utilize the
13recommendations of Illinois' Annual Comprehensive Housing
14Plan, as developed by the Affordable Housing Task Force through
15the Governor's Executive Order 2003-18, in their efforts to
16address the affordable housing needs of older adults.
17    The Older Adult Services Advisory Committee shall
18investigate innovative and promising practices operating as
19demonstration or pilot projects in Illinois and in other
20states. The Department on Aging shall provide the Older Adult
21Services Advisory Committee with a list of all demonstration or
22pilot projects funded by the Department on Aging, including
23those specified by rule, law, policy memorandum, or funding
24arrangement. The Committee shall work with the Department on
25Aging to evaluate the viability of expanding these programs
26into other areas of the State.

 

 

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1(Source: P.A. 96-31, eff. 6-30-09; 96-248, eff. 8-11-09;
296-1000, eff. 7-2-10.)