97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
SB3587

 

Introduced 2/10/2012, by Sen. Jacqueline Y. Collins

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.02  from Ch. 23, par. 6104.02
20 ILCS 105/4.03  from Ch. 23, par. 6104.03
20 ILCS 105/4.09

    Amends the Illinois Act on the Aging. Requires the Department on Aging to increase the effectiveness of the existing Community Care Program by implementing an exception process to allow an individual to exceed his or her service cost maximum, if necessary to prevent institutionalization, as determined by the individual's case coordination unit. Provides that all persons admitted to a nursing home facility who remain in the facility for a period of 30 days shall be rescreened between 30 and 45 days after admittance to assess their continuing need for nursing facility care and shall be advised of all other available care options. Provides that the Department shall establish a program to assist persons 60 years of age or older in managing their medications (rather than subject to appropriation, the Department shall establish a program to assist persons 60 years of age or older in managing their medications).


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB3587LRB097 19425 KTG 64678 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Sections 4.02, 4.03, and 4.09 as follows:
 
6    (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
7    Sec. 4.02. Community Care Program. The Department shall
8establish a program of services to prevent unnecessary
9institutionalization of persons age 60 and older in need of
10long term care or who are established as persons who suffer
11from Alzheimer's disease or a related disorder under the
12Alzheimer's Disease Assistance Act, thereby enabling them to
13remain in their own homes or in other living arrangements. Such
14preventive services, which may be coordinated with other
15programs for the aged and monitored by area agencies on aging
16in cooperation with the Department, may include, but are not
17limited to, any or all of the following:
18        (a) (blank);
19        (b) (blank);
20        (c) home care aide services;
21        (d) personal assistant services;
22        (e) adult day services;
23        (f) home-delivered meals;

 

 

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1        (g) education in self-care;
2        (h) personal care services;
3        (i) adult day health services;
4        (j) habilitation services;
5        (k) respite care;
6        (k-5) community reintegration services;
7        (k-6) flexible senior services;
8        (k-7) medication management;
9        (k-8) emergency home response;
10        (l) other nonmedical social services that may enable
11    the person to become self-supporting; or
12        (m) clearinghouse for information provided by senior
13    citizen home owners who want to rent rooms to or share
14    living space with other senior citizens.
15    The Department shall establish eligibility standards for
16such services. In determining the amount and nature of services
17for which a person may qualify, consideration shall not be
18given to the value of cash, property or other assets held in
19the name of the person's spouse pursuant to a written agreement
20dividing marital property into equal but separate shares or
21pursuant to a transfer of the person's interest in a home to
22his spouse, provided that the spouse's share of the marital
23property is not made available to the person seeking such
24services.
25    Beginning January 1, 2008, the Department shall require as
26a condition of eligibility that all new financially eligible

 

 

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1applicants apply for and enroll in medical assistance under
2Article V of the Illinois Public Aid Code in accordance with
3rules promulgated by the Department.
4    The Department shall, in conjunction with the Department of
5Public Aid (now Department of Healthcare and Family Services),
6seek appropriate amendments under Sections 1915 and 1924 of the
7Social Security Act. The purpose of the amendments shall be to
8extend eligibility for home and community based services under
9Sections 1915 and 1924 of the Social Security Act to persons
10who transfer to or for the benefit of a spouse those amounts of
11income and resources allowed under Section 1924 of the Social
12Security Act. Subject to the approval of such amendments, the
13Department shall extend the provisions of Section 5-4 of the
14Illinois Public Aid Code to persons who, but for the provision
15of home or community-based services, would require the level of
16care provided in an institution, as is provided for in federal
17law. Those persons no longer found to be eligible for receiving
18noninstitutional services due to changes in the eligibility
19criteria shall be given 45 days notice prior to actual
20termination. Those persons receiving notice of termination may
21contact the Department and request the determination be
22appealed at any time during the 45 day notice period. The
23target population identified for the purposes of this Section
24are persons age 60 and older with an identified service need.
25Priority shall be given to those who are at imminent risk of
26institutionalization. The services shall be provided to

 

 

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1eligible persons age 60 and older to the extent that the cost
2of the services together with the other personal maintenance
3expenses of the persons are reasonably related to the standards
4established for care in a group facility appropriate to the
5person's condition. These non-institutional services, pilot
6projects or experimental facilities may be provided as part of
7or in addition to those authorized by federal law or those
8funded and administered by the Department of Human Services.
9The Departments of Human Services, Healthcare and Family
10Services, Public Health, Veterans' Affairs, and Commerce and
11Economic Opportunity and other appropriate agencies of State,
12federal and local governments shall cooperate with the
13Department on Aging in the establishment and development of the
14non-institutional services. The Department shall require an
15annual audit from all personal assistant and home care aide
16vendors contracting with the Department under this Section. The
17annual audit shall assure that each audited vendor's procedures
18are in compliance with Department's financial reporting
19guidelines requiring an administrative and employee wage and
20benefits cost split as defined in administrative rules. The
21audit is a public record under the Freedom of Information Act.
22The Department shall execute, relative to the nursing home
23prescreening project, written inter-agency agreements with the
24Department of Human Services and the Department of Healthcare
25and Family Services, to effect the following: (1) intake
26procedures and common eligibility criteria for those persons

 

 

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1who are receiving non-institutional services; and (2) the
2establishment and development of non-institutional services in
3areas of the State where they are not currently available or
4are undeveloped. On and after July 1, 1996, all nursing home
5prescreenings for individuals 60 years of age or older shall be
6conducted by the Department.
7    As part of the Department on Aging's routine training of
8case managers and case manager supervisors, the Department may
9include information on family futures planning for persons who
10are age 60 or older and who are caregivers of their adult
11children with developmental disabilities. The content of the
12training shall be at the Department's discretion.
13    The Department is authorized to establish a system of
14recipient copayment for services provided under this Section,
15such copayment to be based upon the recipient's ability to pay
16but in no case to exceed the actual cost of the services
17provided. Additionally, any portion of a person's income which
18is equal to or less than the federal poverty standard shall not
19be considered by the Department in determining the copayment.
20The level of such copayment shall be adjusted whenever
21necessary to reflect any change in the officially designated
22federal poverty standard.
23    The Department, or the Department's authorized
24representative, may recover the amount of moneys expended for
25services provided to or in behalf of a person under this
26Section by a claim against the person's estate or against the

 

 

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1estate of the person's surviving spouse, but no recovery may be
2had until after the death of the surviving spouse, if any, and
3then only at such time when there is no surviving child who is
4under age 21, blind, or permanently and totally disabled. This
5paragraph, however, shall not bar recovery, at the death of the
6person, of moneys for services provided to the person or in
7behalf of the person under this Section to which the person was
8not entitled; provided that such recovery shall not be enforced
9against any real estate while it is occupied as a homestead by
10the surviving spouse or other dependent, if no claims by other
11creditors have been filed against the estate, or, if such
12claims have been filed, they remain dormant for failure of
13prosecution or failure of the claimant to compel administration
14of the estate for the purpose of payment. This paragraph shall
15not bar recovery from the estate of a spouse, under Sections
161915 and 1924 of the Social Security Act and Section 5-4 of the
17Illinois Public Aid Code, who precedes a person receiving
18services under this Section in death. All moneys for services
19paid to or in behalf of the person under this Section shall be
20claimed for recovery from the deceased spouse's estate.
21"Homestead", as used in this paragraph, means the dwelling
22house and contiguous real estate occupied by a surviving spouse
23or relative, as defined by the rules and regulations of the
24Department of Healthcare and Family Services, regardless of the
25value of the property.
26    The Department shall increase the effectiveness of the

 

 

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1existing Community Care Program by:
2        (1) ensuring that in-home services included in the care
3    plan are available on evenings and weekends;
4        (2) ensuring that care plans contain the services that
5    eligible participants need based on the number of days in a
6    month, not limited to specific blocks of time, as
7    identified by the comprehensive assessment tool selected
8    by the Department for use statewide, not to exceed the
9    total monthly service cost maximum allowed for each
10    service; the Department shall develop administrative rules
11    to implement this item (2);
12        (3) ensuring that the participants have the right to
13    choose the services contained in their care plan and to
14    direct how those services are provided, based on
15    administrative rules established by the Department;
16        (4) ensuring that the determination of need tool is
17    accurate in determining the participants' level of need; to
18    achieve this, the Department, in conjunction with the Older
19    Adult Services Advisory Committee, shall institute a study
20    of the relationship between the Determination of Need
21    scores, level of need, service cost maximums, and the
22    development and utilization of service plans no later than
23    May 1, 2008; findings and recommendations shall be
24    presented to the Governor and the General Assembly no later
25    than January 1, 2009; recommendations shall include all
26    needed changes to the service cost maximums schedule and

 

 

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1    additional covered services;
2        (5) ensuring that homemakers can provide personal care
3    services that may or may not involve contact with clients,
4    including but not limited to:
5            (A) bathing;
6            (B) grooming;
7            (C) toileting;
8            (D) nail care;
9            (E) transferring;
10            (F) respiratory services;
11            (G) exercise; or
12            (H) positioning;
13        (6) ensuring that homemaker program vendors are not
14    restricted from hiring homemakers who are family members of
15    clients or recommended by clients; the Department may not,
16    by rule or policy, require homemakers who are family
17    members of clients or recommended by clients to accept
18    assignments in homes other than the client;
19        (7) ensuring that the State may access maximum federal
20    matching funds by seeking approval for the Centers for
21    Medicare and Medicaid Services for modifications to the
22    State's home and community based services waiver and
23    additional waiver opportunities in order to maximize
24    federal matching funds; this shall include, but not be
25    limited to, modification that reflects all changes in the
26    Community Care Program services and all increases in the

 

 

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1    services cost maximum; and
2        (8) ensuring that the determination of need tool
3    accurately reflects the service needs of individuals with
4    Alzheimer's disease and related dementia disorders; and .
5        (9) implementing an exception process to allow an
6    individual to exceed his or her service cost maximum, if
7    necessary to prevent institutionalization, as determined
8    by the individual's case coordination unit.
9    By January 1, 2009 or as soon after the end of the Cash and
10Counseling Demonstration Project as is practicable, the
11Department may, based on its evaluation of the demonstration
12project, promulgate rules concerning personal assistant
13services, to include, but need not be limited to,
14qualifications, employment screening, rights under fair labor
15standards, training, fiduciary agent, and supervision
16requirements. All applicants shall be subject to the provisions
17of the Health Care Worker Background Check Act.
18    The Department shall develop procedures to enhance
19availability of services on evenings, weekends, and on an
20emergency basis to meet the respite needs of caregivers.
21Procedures shall be developed to permit the utilization of
22services in successive blocks of 24 hours up to the monthly
23maximum established by the Department. Workers providing these
24services shall be appropriately trained.
25    Beginning on the effective date of this Amendatory Act of
261991, no person may perform chore/housekeeping and home care

 

 

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1aide services under a program authorized by this Section unless
2that person has been issued a certificate of pre-service to do
3so by his or her employing agency. Information gathered to
4effect such certification shall include (i) the person's name,
5(ii) the date the person was hired by his or her current
6employer, and (iii) the training, including dates and levels.
7Persons engaged in the program authorized by this Section
8before the effective date of this amendatory Act of 1991 shall
9be issued a certificate of all pre- and in-service training
10from his or her employer upon submitting the necessary
11information. The employing agency shall be required to retain
12records of all staff pre- and in-service training, and shall
13provide such records to the Department upon request and upon
14termination of the employer's contract with the Department. In
15addition, the employing agency is responsible for the issuance
16of certifications of in-service training completed to their
17employees.
18    The Department is required to develop a system to ensure
19that persons working as home care aides and personal assistants
20receive increases in their wages when the federal minimum wage
21is increased by requiring vendors to certify that they are
22meeting the federal minimum wage statute for home care aides
23and personal assistants. An employer that cannot ensure that
24the minimum wage increase is being given to home care aides and
25personal assistants shall be denied any increase in
26reimbursement costs.

 

 

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1    The Community Care Program Advisory Committee is created in
2the Department on Aging. The Director shall appoint individuals
3to serve in the Committee, who shall serve at their own
4expense. Members of the Committee must abide by all applicable
5ethics laws. The Committee shall advise the Department on
6issues related to the Department's program of services to
7prevent unnecessary institutionalization. The Committee shall
8meet on a bi-monthly basis and shall serve to identify and
9advise the Department on present and potential issues affecting
10the service delivery network, the program's clients, and the
11Department and to recommend solution strategies. Persons
12appointed to the Committee shall be appointed on, but not
13limited to, their own and their agency's experience with the
14program, geographic representation, and willingness to serve.
15The Director shall appoint members to the Committee to
16represent provider, advocacy, policy research, and other
17constituencies committed to the delivery of high quality home
18and community-based services to older adults. Representatives
19shall be appointed to ensure representation from community care
20providers including, but not limited to, adult day service
21providers, homemaker providers, case coordination and case
22management units, emergency home response providers, statewide
23trade or labor unions that represent home care aides and direct
24care staff, area agencies on aging, adults over age 60,
25membership organizations representing older adults, and other
26organizational entities, providers of care, or individuals

 

 

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1with demonstrated interest and expertise in the field of home
2and community care as determined by the Director.
3    Nominations may be presented from any agency or State
4association with interest in the program. The Director, or his
5or her designee, shall serve as the permanent co-chair of the
6advisory committee. One other co-chair shall be nominated and
7approved by the members of the committee on an annual basis.
8Committee members' terms of appointment shall be for 4 years
9with one-quarter of the appointees' terms expiring each year. A
10member shall continue to serve until his or her replacement is
11named. The Department shall fill vacancies that have a
12remaining term of over one year, and this replacement shall
13occur through the annual replacement of expiring terms. The
14Director shall designate Department staff to provide technical
15assistance and staff support to the committee. Department
16representation shall not constitute membership of the
17committee. All Committee papers, issues, recommendations,
18reports, and meeting memoranda are advisory only. The Director,
19or his or her designee, shall make a written report, as
20requested by the Committee, regarding issues before the
21Committee.
22    The Department on Aging and the Department of Human
23Services shall cooperate in the development and submission of
24an annual report on programs and services provided under this
25Section. Such joint report shall be filed with the Governor and
26the General Assembly on or before September 30 each year.

 

 

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1    The requirement for reporting to the General Assembly shall
2be satisfied by filing copies of the report with the Speaker,
3the Minority Leader and the Clerk of the House of
4Representatives and the President, the Minority Leader and the
5Secretary of the Senate and the Legislative Research Unit, as
6required by Section 3.1 of the General Assembly Organization
7Act and filing such additional copies with the State Government
8Report Distribution Center for the General Assembly as is
9required under paragraph (t) of Section 7 of the State Library
10Act.
11    Those persons previously found eligible for receiving
12non-institutional services whose services were discontinued
13under the Emergency Budget Act of Fiscal Year 1992, and who do
14not meet the eligibility standards in effect on or after July
151, 1992, shall remain ineligible on and after July 1, 1992.
16Those persons previously not required to cost-share and who
17were required to cost-share effective March 1, 1992, shall
18continue to meet cost-share requirements on and after July 1,
191992. Beginning July 1, 1992, all clients will be required to
20meet eligibility, cost-share, and other requirements and will
21have services discontinued or altered when they fail to meet
22these requirements.
23    For the purposes of this Section, "flexible senior
24services" refers to services that require one-time or periodic
25expenditures including, but not limited to, respite care, home
26modification, assistive technology, housing assistance, and

 

 

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1transportation.
2(Source: P.A. 96-918, eff. 6-9-10; 96-1129, eff. 7-20-10;
397-333, eff. 8-12-11.)
 
4    (20 ILCS 105/4.03)  (from Ch. 23, par. 6104.03)
5    Sec. 4.03. The Department on Aging, in cooperation with the
6Department of Human Services and any other appropriate State,
7local or federal agency, shall, without regard to income
8guidelines, establish a nursing home prescreening program to
9determine whether Alzheimer's Disease and related disorders
10victims, and persons who are deemed as blind or disabled as
11defined by the Social Security Act and who are in need of long
12term care, may be satisfactorily cared for in their homes
13through the use of home and community based services.
14Responsibility for prescreening shall be vested with case
15coordination units. Prescreening shall occur: (i) when
16hospital discharge planners have advised the case coordination
17unit of the imminent risk of nursing home placement of a
18patient who meets the above criteria and in advance of
19discharge of the patient; or (ii) when a case coordination unit
20has been advised of the imminent risk of nursing home placement
21of an individual in the community. The individual who is
22prescreened shall be informed of all appropriate options,
23including placement in a nursing home and the availability of
24in-home and community-based services and shall be advised of
25her or his right to refuse nursing home, in-home,

 

 

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1community-based, or all services. All persons admitted to a
2nursing home facility who remain in the facility for a period
3of 30 days shall be rescreened between 30 and 45 days after
4admittance to assess their continuing need for nursing facility
5care and shall be advised of all other available care options.
6Case coordination units under contract with the Department may
7charge a fee for the screenings prescreening provided under
8this Section and the fee shall be no greater than the cost of
9such services to the case coordination unit. At the time of
10each prescreening, case coordination units shall provide
11information regarding the Office of State Long Term Care
12Ombudsman's Residents Right to Know database as authorized in
13subsection (c-5) of Section 4.04.
14(Source: P.A. 95-80, eff. 8-13-07; 95-823, eff. 1-1-09; 96-328,
15eff. 8-11-09.)
 
16    (20 ILCS 105/4.09)
17    Sec. 4.09. Medication management program. The Subject to
18appropriation, the Department shall establish a program to
19assist persons 60 years of age or older in managing their
20medications. The Department shall establish guidelines and
21standards for the program by rule.
22(Source: P.A. 95-535, eff. 8-28-07; 95-876, eff. 8-21-08.)