Rep. Daniel V. Beiser

Filed: 5/15/2013

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1197

2    AMENDMENT NO. ______. Amend Senate Bill 1197 by replacing
3everything after the enacting clause with the following:
 
4    "Section 3. The Illinois Act on the Aging is amended by
5changing Section 4.03 as follows:
 
6    (20 ILCS 105/4.03)  (from Ch. 23, par. 6104.03)
7    Sec. 4.03. The Department on Aging, in cooperation with the
8Department of Human Services and any other appropriate State,
9local or federal agency, shall, without regard to income
10guidelines, establish a nursing home prescreening program to
11determine whether Alzheimer's Disease and related disorders
12victims, and persons who are deemed as blind or disabled as
13defined by the Social Security Act and who are in need of long
14term care, may be satisfactorily cared for in their homes
15through the use of home and community based services.
16Responsibility for prescreening shall be vested with case

 

 

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1coordination units. Prescreening shall occur: (i) when
2hospital discharge planners have advised the case coordination
3unit of the imminent risk of nursing home placement of a
4patient who meets the above criteria and in advance of
5discharge of the patient; or (ii) when a case coordination unit
6has been advised of the imminent risk of nursing home placement
7of an individual in the community. The individual who is
8prescreened shall be informed of all appropriate options,
9including placement in a nursing home and the availability of
10in-home and community-based services and shall be advised of
11her or his right to refuse nursing home, in-home,
12community-based, or all services. In addition, the individual
13being prescreened shall be informed of spousal impoverishment
14requirements, the need to submit financial information to
15access services, and the consequences for failure to do so in a
16form and manner developed jointly by the Department on Aging,
17the Department of Human Services, and the Department of
18Healthcare and Family Services. Case coordination units under
19contract with the Department may charge a fee for the
20prescreening provided under this Section and the fee shall be
21no greater than the cost of such services to the case
22coordination unit. At the time of each prescreening, case
23coordination units shall provide information regarding the
24Office of State Long Term Care Ombudsman's Residents Right to
25Know database as authorized in subsection (c-5) of Section
264.04.

 

 

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1    Notice by the Department as it relates to spousal
2impoverishment requirements, the need to submit financial
3information to access services, the consequences for failure to
4do so, or the termination of benefits hereunder shall be deemed
5adequate if notice is served upon the institutionalized spouse
6or community spouse, or, if either spouse has been deemed
7incompetent or adjudicated disabled, the spouse's authorized
8legal representative, including, but not limited to, the
9spouse's agent under power of attorney or guardian.
10(Source: P.A. 95-80, eff. 8-13-07; 95-823, eff. 1-1-09; 96-328,
11eff. 8-11-09.)
 
12    Section 5. The Nursing Home Care Act is amended by changing
13Section 2-201 as follows:
 
14    (210 ILCS 45/2-201)  (from Ch. 111 1/2, par. 4152-201)
15    Sec. 2-201. To protect the residents' funds, the facility:
16    (1) Shall at the time of admission provide, in order of
17priority, each resident, or the resident's guardian, if any, or
18the resident's representative, if any, or the resident's
19immediate family member, if any, with a written statement
20explaining to the resident and to the resident's spouse (a)
21their spousal impoverishment rights, as defined at Section 5-4
22of the Illinois Public Aid Code, and at Section 303 of Title
23III of the Medicare Catastrophic Coverage Act of 1988 (P.L.
24100-360), and (b) their obligation to comply with the asset and

 

 

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1income disclosure requirements of Title XIX of the federal
2Social Security Act and the regulations duly promulgated
3thereunder, except that this item (b) does not apply to
4facilities operated by the Illinois Department of Veterans'
5Affairs that do not participate in the State Medicaid program,
6and (c) the resident's rights regarding personal funds and
7listing the services for which the resident will be charged.
8The facility shall obtain a signed acknowledgment from each
9resident or the resident's guardian, if any, or the resident's
10representative, if any, or the resident's immediate family
11member, if any, that such person has received the statement.
12    (2) May accept funds from a resident for safekeeping and
13managing, if it receives written authorization from, in order
14of priority, the resident or the resident's guardian, if any,
15or the resident's representative, if any, or the resident's
16immediate family member, if any; such authorization shall be
17attested to by a witness who has no pecuniary interest in the
18facility or its operations, and who is not connected in any way
19to facility personnel or the administrator in any manner
20whatsoever.
21    (3) Shall maintain and allow, in order of priority, each
22resident or the resident's guardian, if any, or the resident's
23representative, if any, or the resident's immediate family
24member, if any, access to a written record of all financial
25arrangements and transactions involving the individual
26resident's funds.

 

 

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1    (4) Shall provide, in order of priority, each resident, or
2the resident's guardian, if any, or the resident's
3representative, if any, or the resident's immediate family
4member, if any, with a written itemized statement at least
5quarterly, of all financial transactions involving the
6resident's funds.
7    (5) Shall purchase a surety bond, or otherwise provide
8assurance satisfactory to the Departments of Public Health and
9Insurance that all residents' personal funds deposited with the
10facility are secure against loss, theft, and insolvency.
11    (6) Shall keep any funds received from a resident for
12safekeeping in an account separate from the facility's funds,
13and shall at no time withdraw any part or all of such funds for
14any purpose other than to return the funds to the resident upon
15the request of the resident or any other person entitled to
16make such request, to pay the resident his allowance, or to
17make any other payment authorized by the resident or any other
18person entitled to make such authorization.
19    (7) Shall deposit any funds received from a resident in
20excess of $100 in an interest bearing account insured by
21agencies of, or corporations chartered by, the State or federal
22government. The account shall be in a form which clearly
23indicates that the facility has only a fiduciary interest in
24the funds and any interest from the account shall accrue to the
25resident. The facility may keep up to $100 of a resident's
26money in a non-interest bearing account or petty cash fund, to

 

 

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1be readily available for the resident's current expenditures.
2    (8) Shall return to the resident, or the person who
3executed the written authorization required in subsection (2)
4of this Section, upon written request, all or any part of the
5resident's funds given the facility for safekeeping, including
6the interest accrued from deposits.
7    (9) Shall (a) place any monthly allowance to which a
8resident is entitled in that resident's personal account, or
9give it to the resident, unless the facility has written
10authorization from the resident or the resident's guardian or
11if the resident is a minor, his parent, to handle it
12differently, (b) take all steps necessary to ensure that a
13personal needs allowance that is placed in a resident's
14personal account is used exclusively by the resident or for the
15benefit of the resident, and (c) where such funds are withdrawn
16from the resident's personal account by any person other than
17the resident, require such person to whom funds constituting
18any part of a resident's personal needs allowance are released,
19to execute an affidavit that such funds shall be used
20exclusively for the benefit of the resident.
21    (10) Unless otherwise provided by State law, upon the death
22of a resident, shall provide the executor or administrator of
23the resident's estate with a complete accounting of all the
24resident's personal property, including any funds of the
25resident being held by the facility.
26    (11) If an adult resident is incapable of managing his

 

 

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1funds and does not have a resident's representative, guardian,
2or an immediate family member, shall notify the Office of the
3State Guardian of the Guardianship and Advocacy Commission.
4    (12) If the facility is sold, shall provide the buyer with
5a written verification by a public accountant of all residents'
6monies and properties being transferred, and obtain a signed
7receipt from the new owner.
8(Source: P.A. 86-410; 86-486; 86-1028; 87-551; 87-1122.)
 
9    Section 10. The Illinois Public Aid Code is amended by
10changing Section 5-4 as follows:
 
11    (305 ILCS 5/5-4)  (from Ch. 23, par. 5-4)
12    Sec. 5-4. Amount and nature of medical assistance.
13    (a) The amount and nature of medical assistance shall be
14determined in accordance with the standards, rules, and
15regulations of the Department of Healthcare and Family
16Services, with due regard to the requirements and conditions in
17each case, including contributions available from legally
18responsible relatives. However, the amount and nature of such
19medical assistance shall not be affected by the payment of any
20grant under the Senior Citizens and Disabled Persons Property
21Tax Relief Act or any distributions or items of income
22described under subparagraph (X) of paragraph (2) of subsection
23(a) of Section 203 of the Illinois Income Tax Act. The amount
24and nature of medical assistance shall not be affected by the

 

 

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1receipt of donations or benefits from fundraisers in cases of
2serious illness, as long as neither the person nor members of
3the person's family have actual control over the donations or
4benefits or the disbursement of the donations or benefits.
5    In determining the income and resources available to the
6institutionalized spouse and to the community spouse, the
7Department of Healthcare and Family Services shall follow the
8procedures established by federal law. If an institutionalized
9spouse or community spouse refuses to comply with the
10requirements of Title XIX of the federal Social Security Act
11and the regulations duly promulgated thereunder by failing to
12provide the total value of assets, including income and
13resources, to the extent either the institutionalized spouse or
14community spouse has an ownership interest in them pursuant to
1542 U.S.C. 1396r-5, such refusal may result in the
16institutionalized spouse being denied eligibility and
17continuing to remain ineligible for the medical assistance
18program based on failure to cooperate.
19    Subject to federal approval, the community spouse resource
20allowance shall be established and maintained at the higher of
21$109,560 or the minimum level permitted pursuant to Section
221924(f)(2) of the Social Security Act, as now or hereafter
23amended, or an amount set after a fair hearing, whichever is
24greater. The monthly maintenance allowance for the community
25spouse shall be established and maintained at the higher of
26$2,739 per month or the minimum level permitted pursuant to

 

 

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1Section 1924(d)(3)(C) of the Social Security Act, as now or
2hereafter amended, or an amount set after a fair hearing,
3whichever is greater. Subject to the approval of the Secretary
4of the United States Department of Health and Human Services,
5the provisions of this Section shall be extended to persons who
6but for the provision of home or community-based services under
7Section 4.02 of the Illinois Act on the Aging, would require
8the level of care provided in an institution, as is provided
9for in federal law.
10    (b) Spousal support for institutionalized spouses
11receiving medical assistance.
12        (i) The Department may seek support for an
13    institutionalized spouse, who has assigned his or her right
14    of support from his or her spouse to the State, from the
15    resources and income available to the community spouse.
16        (ii) The Department may bring an action in the circuit
17    court to establish support orders or itself establish
18    administrative support orders by any means and procedures
19    authorized in this Code, as applicable, except that the
20    standard and regulations for determining ability to
21    support in Section 10-3 shall not limit the amount of
22    support that may be ordered.
23        (iii) Proceedings may be initiated to obtain support,
24    or for the recovery of aid granted during the period such
25    support was not provided, or both, for the obtainment of
26    support and the recovery of the aid provided. Proceedings

 

 

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1    for the recovery of aid may be taken separately or they may
2    be consolidated with actions to obtain support. Such
3    proceedings may be brought in the name of the person or
4    persons requiring support or may be brought in the name of
5    the Department, as the case requires.
6        (iv) The orders for the payment of moneys for the
7    support of the person shall be just and equitable and may
8    direct payment thereof for such period or periods of time
9    as the circumstances require, including support for a
10    period before the date the order for support is entered. In
11    no event shall the orders reduce the community spouse
12    resource allowance below the level established in
13    subsection (a) of this Section or an amount set after a
14    fair hearing, whichever is greater, or reduce the monthly
15    maintenance allowance for the community spouse below the
16    level permitted pursuant to subsection (a) of this Section.
17    (c) Notice by the Department as it relates to spousal
18impoverishment requirements, the need to submit financial
19information to access services, the consequences for failure to
20do so, or the termination of benefits hereunder shall be deemed
21adequate if notice is served upon the institutionalized spouse
22or community spouse, or, if either spouse has been deemed
23incompetent or adjudicated disabled, the spouse's authorized
24legal representative, including, but not limited to, the
25spouse's agent under power of attorney or guardian.
26(Source: P.A. 97-689, eff. 6-14-12.)
 

 

 

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1    Section 99. Effective date. This Act takes effect upon
2becoming law.".