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| | 98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014 HB5279 Introduced , by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED: |
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20 ILCS 105/4.02 | from Ch. 23, par. 6104.02 |
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Amends the Illinois Act on the Aging. In provisions concerning the Community Care Program, provides that in regard to reforms of service delivery and changes to the State's home and community based services waiver, the Community Care Program shall ensure the availability of services to clients of the program, including, but not limited to: assistance in the home, adult day services, emergency home response, community reintegration services, and medication management. Provides that these services shall be made available to clients that demonstrate a need for them regardless of the model of service delivery or federal waiver under which their care is delivered. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| | HB5279 | | LRB098 19783 KTG 54998 b |
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1 | | AN ACT concerning State government.
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2 | | Be it enacted by the People of the State of Illinois,
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3 | | represented in the General Assembly:
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4 | | Section 5. The Illinois Act on the Aging is amended by |
5 | | changing Section 4.02 as follows:
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6 | | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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7 | | Sec. 4.02. Community Care Program. The Department shall |
8 | | establish a program of services to
prevent unnecessary |
9 | | institutionalization of persons age 60 and older in
need of |
10 | | long term care or who are established as persons who suffer |
11 | | from
Alzheimer's disease or a related disorder under the |
12 | | Alzheimer's Disease
Assistance Act, thereby enabling them
to |
13 | | remain in their own homes or in other living arrangements. Such
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14 | | preventive services, which may be coordinated with other |
15 | | programs for the
aged and monitored by area agencies on aging |
16 | | in cooperation with the
Department, may include, but are not |
17 | | limited to, any or all of the following:
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18 | | (a) (blank);
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19 | | (b) (blank);
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20 | | (c) home care aide services;
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21 | | (d) personal assistant services;
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22 | | (e) adult day services;
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23 | | (f) home-delivered meals;
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1 | | (g) education in self-care;
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2 | | (h) personal care services;
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3 | | (i) adult day health services;
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4 | | (j) habilitation services;
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5 | | (k) respite care;
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6 | | (k-5) community reintegration services;
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7 | | (k-6) flexible senior services; |
8 | | (k-7) medication management; |
9 | | (k-8) emergency home response;
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10 | | (l) other nonmedical social services that may enable |
11 | | the person
to become self-supporting; or
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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.
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15 | | The Department shall establish eligibility standards for |
16 | | such
services. In determining the amount and nature of services
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17 | | for which a person may qualify, consideration shall not be |
18 | | given to the
value of cash, property or other assets held in |
19 | | the name of the person's
spouse pursuant to a written agreement |
20 | | dividing marital property into equal
but separate shares or |
21 | | pursuant to a transfer of the person's interest in a
home to |
22 | | his spouse, provided that the spouse's share of the marital
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23 | | property is not made available to the person seeking such |
24 | | services.
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25 | | Beginning January 1, 2008, the Department shall require as |
26 | | a condition of eligibility that all new financially eligible |
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1 | | applicants apply for and enroll in medical assistance under |
2 | | Article V of the Illinois Public Aid Code in accordance with |
3 | | rules promulgated by the Department.
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4 | | The Department shall, in conjunction with the Department of |
5 | | Public Aid (now Department of Healthcare and Family Services),
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6 | | seek appropriate amendments under Sections 1915 and 1924 of the |
7 | | Social
Security Act. The purpose of the amendments shall be to |
8 | | extend eligibility
for home and community based services under |
9 | | Sections 1915 and 1924 of the
Social Security Act to persons |
10 | | who transfer to or for the benefit of a
spouse those amounts of |
11 | | income and resources allowed under Section 1924 of
the Social |
12 | | Security Act. Subject to the approval of such amendments, the
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13 | | Department shall extend the provisions of Section 5-4 of the |
14 | | Illinois
Public Aid Code to persons who, but for the provision |
15 | | of home or
community-based services, would require the level of |
16 | | care provided in an
institution, as is provided for in federal |
17 | | law. Those persons no longer
found to be eligible for receiving |
18 | | noninstitutional services due to changes
in the eligibility |
19 | | criteria shall be given 45 days notice prior to actual
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20 | | termination. Those persons receiving notice of termination may |
21 | | contact the
Department and request the determination be |
22 | | appealed at any time during the
45 day notice period. The |
23 | | target
population identified for the purposes of this Section |
24 | | are persons age 60
and older with an identified service need. |
25 | | Priority shall be given to those
who are at imminent risk of |
26 | | institutionalization. The services shall be
provided to |
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1 | | eligible persons age 60 and older to the extent that the cost
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2 | | of the services together with the other personal maintenance
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3 | | expenses of the persons are reasonably related to the standards
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4 | | established for care in a group facility appropriate to the |
5 | | person's
condition. These non-institutional services, pilot |
6 | | projects or
experimental facilities may be provided as part of |
7 | | or in addition to
those authorized by federal law or those |
8 | | funded and administered by the
Department of Human Services. |
9 | | The Departments of Human Services, Healthcare and Family |
10 | | Services,
Public Health, Veterans' Affairs, and Commerce and |
11 | | Economic Opportunity and
other appropriate agencies of State, |
12 | | federal and local governments shall
cooperate with the |
13 | | Department on Aging in the establishment and development
of the |
14 | | non-institutional services. The Department shall require an |
15 | | annual
audit from all personal assistant
and home care aide |
16 | | vendors contracting with
the Department under this Section. The |
17 | | annual audit shall assure that each
audited vendor's procedures |
18 | | are in compliance with Department's financial
reporting |
19 | | guidelines requiring an administrative and employee wage and |
20 | | benefits cost split as defined in administrative rules. The |
21 | | audit is a public record under
the Freedom of Information Act. |
22 | | The Department shall execute, relative to
the nursing home |
23 | | prescreening project, written inter-agency
agreements with the |
24 | | Department of Human Services and the Department
of Healthcare |
25 | | and Family Services, to effect the following: (1) intake |
26 | | procedures and common
eligibility criteria for those persons |
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1 | | who are receiving non-institutional
services; and (2) the |
2 | | establishment and development of non-institutional
services in |
3 | | areas of the State where they are not currently available or |
4 | | are
undeveloped. On and after July 1, 1996, all nursing home |
5 | | prescreenings for
individuals 60 years of age or older shall be |
6 | | conducted by the Department.
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7 | | As part of the Department on Aging's routine training of |
8 | | case managers and case manager supervisors, the Department may |
9 | | include information on family futures planning for persons who |
10 | | are age 60 or older and who are caregivers of their adult |
11 | | children with developmental disabilities. The content of the |
12 | | training shall be at the Department's discretion. |
13 | | The Department is authorized to establish a system of |
14 | | recipient copayment
for services provided under this Section, |
15 | | such copayment to be based upon
the recipient's ability to pay |
16 | | but in no case to exceed the actual cost of
the services |
17 | | provided. Additionally, any portion of a person's income which
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18 | | is equal to or less than the federal poverty standard shall not |
19 | | be
considered by the Department in determining the copayment. |
20 | | The level of
such copayment shall be adjusted whenever |
21 | | necessary to reflect any change
in the officially designated |
22 | | federal poverty standard.
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23 | | The Department, or the Department's authorized |
24 | | representative, may
recover the amount of moneys expended for |
25 | | services provided to or in
behalf of a person under this |
26 | | Section by a claim against the person's
estate or against the |
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1 | | estate of the person's surviving spouse, but no
recovery may be |
2 | | had until after the death of the surviving spouse, if
any, and |
3 | | then only at such time when there is no surviving child who
is |
4 | | under age 21, blind, or permanently and totally disabled. This
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5 | | paragraph, however, shall not bar recovery, at the death of the |
6 | | person, of
moneys for services provided to the person or in |
7 | | behalf of the person under
this Section to which the person was |
8 | | not entitled;
provided that such recovery shall not be enforced |
9 | | against any real estate while
it is occupied as a homestead by |
10 | | the surviving spouse or other dependent, if no
claims by other |
11 | | creditors have been filed against the estate, or, if such
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12 | | claims have been filed, they remain dormant for failure of |
13 | | prosecution or
failure of the claimant to compel administration |
14 | | of the estate for the purpose
of payment. This paragraph shall |
15 | | not bar recovery from the estate of a spouse,
under Sections |
16 | | 1915 and 1924 of the Social Security Act and Section 5-4 of the
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17 | | Illinois Public Aid Code, who precedes a person receiving |
18 | | services under this
Section in death. All moneys for services
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19 | | paid to or in behalf of the person under this Section shall be |
20 | | claimed for
recovery from the deceased spouse's estate. |
21 | | "Homestead", as used
in this paragraph, means the dwelling |
22 | | house and
contiguous real estate occupied by a surviving spouse
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23 | | or relative, as defined by the rules and regulations of the |
24 | | Department of Healthcare and Family Services, regardless of the |
25 | | value of the property.
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26 | | The Department shall increase the effectiveness of the |
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1 | | existing 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, including applying for |
24 | | enrollment in the Balance Incentive Payment Program by May |
25 | | 1, 2013, in order to maximize federal matching funds; this |
26 | | shall include, but not be limited to, modification that |
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1 | | reflects all changes in the Community Care Program services |
2 | | and all increases in the services cost maximum; |
3 | | (8) ensuring that the determination of need tool |
4 | | accurately reflects the service needs of individuals with |
5 | | Alzheimer's disease and related dementia disorders; |
6 | | (9) ensuring that services are authorized accurately |
7 | | and consistently for the Community Care Program (CCP); the |
8 | | Department shall implement a Service Authorization policy |
9 | | directive; the purpose shall be to ensure that eligibility |
10 | | and services are authorized accurately and consistently in |
11 | | the CCP program; the policy directive shall clarify service |
12 | | authorization guidelines to Care Coordination Units and |
13 | | Community Care Program providers no later than May 1, 2013; |
14 | | (10) working in conjunction with Care Coordination |
15 | | Units, the Department of Healthcare and Family Services, |
16 | | the Department of Human Services, Community Care Program |
17 | | providers, and other stakeholders to make improvements to |
18 | | the Medicaid claiming processes and the Medicaid |
19 | | enrollment procedures or requirements as needed, |
20 | | including, but not limited to, specific policy changes or |
21 | | rules to improve the up-front enrollment of participants in |
22 | | the Medicaid program and specific policy changes or rules |
23 | | to insure more prompt submission of bills to the federal |
24 | | government to secure maximum federal matching dollars as |
25 | | promptly as possible; the Department on Aging shall have at |
26 | | least 3 meetings with stakeholders by January 1, 2014 in |
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1 | | order to address these improvements; |
2 | | (11) requiring home care service providers to comply |
3 | | with the rounding of hours worked provisions under the |
4 | | federal Fair Labor Standards Act (FLSA) and as set forth in |
5 | | 29 CFR 785.48(b) by May 1, 2013; |
6 | | (12) implementing any necessary policy changes or |
7 | | promulgating any rules, no later than January 1, 2014, to |
8 | | assist the Department of Healthcare and Family Services in |
9 | | moving as many participants as possible, consistent with |
10 | | federal regulations, into coordinated care plans if a care |
11 | | coordination plan that covers long term care is available |
12 | | in the recipient's area; and |
13 | | (13) maintaining fiscal year 2014 rates at the same |
14 | | level established on January 1, 2013. |
15 | | By January 1, 2009 or as soon after the end of the Cash and |
16 | | Counseling Demonstration Project as is practicable, the |
17 | | Department may, based on its evaluation of the demonstration |
18 | | project, promulgate rules concerning personal assistant |
19 | | services, to include, but need not be limited to, |
20 | | qualifications, employment screening, rights under fair labor |
21 | | standards, training, fiduciary agent, and supervision |
22 | | requirements. All applicants shall be subject to the provisions |
23 | | of the Health Care Worker Background Check Act.
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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. |
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1 | | Procedures shall be developed to permit the
utilization of |
2 | | services in successive blocks of 24 hours up to the monthly
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3 | | maximum established by the Department. Workers providing these |
4 | | services
shall be appropriately trained.
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5 | | Beginning on the effective date of this Amendatory Act of |
6 | | 1991, no person
may perform chore/housekeeping and home care |
7 | | aide services under a program
authorized by this Section unless |
8 | | that person has been issued a certificate
of pre-service to do |
9 | | so by his or her employing agency. Information
gathered to |
10 | | effect such certification shall include (i) the person's name,
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11 | | (ii) the date the person was hired by his or her current |
12 | | employer, and
(iii) the training, including dates and levels. |
13 | | Persons engaged in the
program authorized by this Section |
14 | | before the effective date of this
amendatory Act of 1991 shall |
15 | | be issued a certificate of all pre- and
in-service training |
16 | | from his or her employer upon submitting the necessary
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17 | | information. The employing agency shall be required to retain |
18 | | records of
all staff pre- and in-service training, and shall |
19 | | provide such records to
the Department upon request and upon |
20 | | termination of the employer's contract
with the Department. In |
21 | | addition, the employing agency is responsible for
the issuance |
22 | | of certifications of in-service training completed to their
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23 | | employees.
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24 | | The Department is required to develop a system to ensure |
25 | | that persons
working as home care aides and personal assistants
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26 | | receive increases in their
wages when the federal minimum wage |
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1 | | is increased by requiring vendors to
certify that they are |
2 | | meeting the federal minimum wage statute for home care aides
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3 | | and personal assistants. An employer that cannot ensure that |
4 | | the minimum
wage increase is being given to home care aides and |
5 | | personal assistants
shall be denied any increase in |
6 | | reimbursement costs.
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7 | | The Community Care Program Advisory Committee is created in |
8 | | the Department on Aging. The Director shall appoint individuals |
9 | | to serve in the Committee, who shall serve at their own |
10 | | expense. Members of the Committee must abide by all applicable |
11 | | ethics laws. The Committee shall advise the Department on |
12 | | issues related to the Department's program of services to |
13 | | prevent unnecessary institutionalization. The Committee shall |
14 | | meet on a bi-monthly basis and shall serve to identify and |
15 | | advise the Department on present and potential issues affecting |
16 | | the service delivery network, the program's clients, and the |
17 | | Department and to recommend solution strategies. Persons |
18 | | appointed to the Committee shall be appointed on, but not |
19 | | limited to, their own and their agency's experience with the |
20 | | program, geographic representation, and willingness to serve. |
21 | | The Director shall appoint members to the Committee to |
22 | | represent provider, advocacy, policy research, and other |
23 | | constituencies committed to the delivery of high quality home |
24 | | and community-based services to older adults. Representatives |
25 | | shall be appointed to ensure representation from community care |
26 | | providers including, but not limited to, adult day service |
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1 | | providers, homemaker providers, case coordination and case |
2 | | management units, emergency home response providers, statewide |
3 | | trade or labor unions that represent home care
aides and direct |
4 | | care staff, area agencies on aging, adults over age 60, |
5 | | membership organizations representing older adults, and other |
6 | | organizational entities, providers of care, or individuals |
7 | | with demonstrated interest and expertise in the field of home |
8 | | and community care as determined by the Director. |
9 | | Nominations may be presented from any agency or State |
10 | | association with interest in the program. The Director, or his |
11 | | or her designee, shall serve as the permanent co-chair of the |
12 | | advisory committee. One other co-chair shall be nominated and |
13 | | approved by the members of the committee on an annual basis. |
14 | | Committee members' terms of appointment shall be for 4 years |
15 | | with one-quarter of the appointees' terms expiring each year. A |
16 | | member shall continue to serve until his or her replacement is |
17 | | named. The Department shall fill vacancies that have a |
18 | | remaining term of over one year, and this replacement shall |
19 | | occur through the annual replacement of expiring terms. The |
20 | | Director shall designate Department staff to provide technical |
21 | | assistance and staff support to the committee. Department |
22 | | representation shall not constitute membership of the |
23 | | committee. All Committee papers, issues, recommendations, |
24 | | reports, and meeting memoranda are advisory only. The Director, |
25 | | or his or her designee, shall make a written report, as |
26 | | requested by the Committee, regarding issues before the |
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1 | | Committee.
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2 | | The Department on Aging and the Department of Human |
3 | | Services
shall cooperate in the development and submission of |
4 | | an annual report on
programs and services provided under this |
5 | | Section. Such joint report
shall be filed with the Governor and |
6 | | the General Assembly on or before
September 30 each year.
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7 | | The requirement for reporting to the General Assembly shall |
8 | | be satisfied
by filing copies of the report with the Speaker, |
9 | | the Minority Leader and
the Clerk of the House of |
10 | | Representatives and the President, the Minority
Leader and the |
11 | | Secretary of the Senate and the Legislative Research Unit,
as |
12 | | required by Section 3.1 of the General Assembly Organization |
13 | | Act and
filing such additional copies with the State Government |
14 | | Report Distribution
Center for the General Assembly as is |
15 | | required under paragraph (t) of
Section 7 of the State Library |
16 | | Act.
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17 | | Those persons previously found eligible for receiving |
18 | | non-institutional
services whose services were discontinued |
19 | | under the Emergency Budget Act of
Fiscal Year 1992, and who do |
20 | | not meet the eligibility standards in effect
on or after July |
21 | | 1, 1992, shall remain ineligible on and after July 1,
1992. |
22 | | Those persons previously not required to cost-share and who |
23 | | were
required to cost-share effective March 1, 1992, shall |
24 | | continue to meet
cost-share requirements on and after July 1, |
25 | | 1992. Beginning July 1, 1992,
all clients will be required to |
26 | | meet
eligibility, cost-share, and other requirements and will |
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1 | | have services
discontinued or altered when they fail to meet |
2 | | these requirements. |
3 | | For the purposes of this Section, "flexible senior |
4 | | services" refers to services that require one-time or periodic |
5 | | expenditures including, but not limited to, respite care, home |
6 | | modification, assistive technology, housing assistance, and |
7 | | transportation.
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8 | | The Department shall implement an electronic service |
9 | | verification based on global positioning systems or other |
10 | | cost-effective technology for the Community Care Program no |
11 | | later than January 1, 2014. |
12 | | The Department shall require, as a condition of |
13 | | eligibility, enrollment in the medical assistance program |
14 | | under Article V of the Illinois Public Aid Code (i) beginning |
15 | | August 1, 2013, if the Auditor General has reported that the |
16 | | Department has failed
to comply with the reporting requirements |
17 | | of Section 2-27 of
the Illinois State Auditing Act; or (ii) |
18 | | beginning June 1, 2014, if the Auditor General has reported |
19 | | that the
Department has not undertaken the required actions |
20 | | listed in
the report required by subsection (a) of Section 2-27 |
21 | | of the
Illinois State Auditing Act. |
22 | | The Department shall delay Community Care Program services |
23 | | until an applicant is determined eligible for medical |
24 | | assistance under Article V of the Illinois Public Aid Code (i) |
25 | | beginning August 1, 2013, if the Auditor General has reported |
26 | | that the Department has failed
to comply with the reporting |
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1 | | requirements of Section 2-27 of
the Illinois State Auditing |
2 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has |
3 | | reported that the
Department has not undertaken the required |
4 | | actions listed in
the report required by subsection (a) of |
5 | | Section 2-27 of the
Illinois State Auditing Act. |
6 | | The Department shall implement co-payments for the |
7 | | Community Care Program at the federally allowable maximum level |
8 | | (i) beginning August 1, 2013, if the Auditor General has |
9 | | reported that the Department has failed
to comply with the |
10 | | reporting requirements of Section 2-27 of
the Illinois State |
11 | | Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
12 | | General has reported that the
Department has not undertaken the |
13 | | required actions listed in
the report required by subsection |
14 | | (a) of Section 2-27 of the
Illinois State Auditing Act. |
15 | | The Department shall provide a bi-monthly report on the |
16 | | progress of the Community Care Program reforms set forth in |
17 | | this amendatory Act of the 98th General Assembly to the |
18 | | Governor, the Speaker of the House of Representatives, the |
19 | | Minority Leader of the House of Representatives, the
President |
20 | | of the
Senate, and the Minority Leader of the Senate. |
21 | | The Department shall conduct a quarterly review of Care |
22 | | Coordination Unit performance and adherence to service |
23 | | guidelines. The quarterly review shall be reported to the |
24 | | Speaker of the House of Representatives, the Minority Leader of |
25 | | the House of Representatives, the
President of the
Senate, and |
26 | | the Minority Leader of the Senate. The Department shall collect |
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1 | | and report longitudinal data on the performance of each care |
2 | | coordination unit. Nothing in this paragraph shall be construed |
3 | | to require the Department to identify specific care |
4 | | coordination units. |
5 | | In regard to community care providers, failure to comply |
6 | | with Department on Aging policies shall be cause for |
7 | | disciplinary action, including, but not limited to, |
8 | | disqualification from serving Community Care Program clients. |
9 | | Each provider, upon submission of any bill or invoice to the |
10 | | Department for payment for services rendered, shall include a |
11 | | notarized statement, under penalty of perjury pursuant to |
12 | | Section 1-109 of the Code of Civil Procedure, that the provider |
13 | | has complied with all Department policies. |
14 | | In regard to reforms of service delivery and changes to the |
15 | | State's home and community based services waiver, the Community |
16 | | Care Program shall ensure the availability of services to |
17 | | clients of the program, including, but not limited to: |
18 | | assistance in the home, adult day services, emergency home |
19 | | response, community reintegration services, and medication |
20 | | management. These services shall be made available to clients |
21 | | that demonstrate a need for them regardless of the model of |
22 | | service delivery or federal waiver under which their care is |
23 | | delivered. |
24 | | (Source: P.A. 97-333, eff. 8-12-11; 98-8, eff. 5-3-13.)
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25 | | Section 99. Effective date. This Act takes effect upon |
26 | | becoming law.
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