HB5161 93RD GENERAL ASSEMBLY

LRB093 15226 DRJ 40822 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB5161

Introduced 02/05/04, by Joseph M. Lyons

SYNOPSIS AS INTRODUCED:

New Act

Creates the Independent Living Projects Act. Requires the Department on Aging and the Department of Human Services to contract with independent living projects in different regions of the State to demonstrate the feasibility and cost-effectiveness of using low-cost home care and other residential alternatives to nursing home care and to achieve other goals. Sets forth criteria that such projects must meet. Requires the Department on Aging to conduct a public awareness campaign.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning long-term care.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Independent Living Projects Act.

Section 5. Purpose; objectives.

(a) The purpose of implementing independent living projects under this Act is to demonstrate a new cooperative strategy for the long-term care system in the State of Illinois. The projects are part of the initial plan for a 20-year strategy. The mission of the 20-year strategy is to create a new community-based care paradigm for long-term care in Illinois in order to maximize independence of the older adult population and to ensure cost-effective use of financial and human resources. The goals for the 20-year strategy are to:

(1) achieve a broad awareness and use of low-cost home care and other residential alternatives to nursing homes;

(2) develop a statewide system of information and assistance to enable easy access to long-term care services;

(3) develop sufficient alternatives to nursing homes to serve the increased number of people needing long-term care;

(4) maintain a moratorium on new construction of nursing home beds and to lower the percentage of elderly persons served in institutional settings; and

(5) build a community-based approach and community commitment to delivering long-term care services for elderly persons in their homes.

(b) The objective for the strategy is to continue at least 4 but not more than 6 projects in anticipation of a statewide program. These projects will continue the process of implementing:

(1) a coordinated planning and administrative process;

(2) a refocused function of the preadmission screening program;

(3) the development of additional home, community, and residential alternatives to nursing homes;

(4) a program to support the informal caregivers for elderly persons;

(5) programs to strengthen the use of volunteers; and

(6) programs to support the building of community commitment to provide long-term care for elderly persons.

The services offered through these projects shall be made available to those who have their own funds to pay for services, as well as to persons who are eligible for medical assistance under Article V of the Illinois Public Aid Code and to persons who are 180-day eligible clients to the extent authorized in this Act.

Section 10. Definitions. In this Act, "Department" means the Department on Aging or the Department of Human Services, as applicable.

Section 15. Independent living projects.

(a) The Department on Aging and the Department of Human Services shall contract with independent living projects in 4 to 6 service regions of the State to demonstrate the feasibility and cost-effectiveness of a local long-term care strategy that is consistent with the State's long-term care goals identified in Section 5. Each department shall publish a notice in the Illinois Procurement Bulletin announcing the availability of project funding and giving instructions for making an application for funding. The instructions for the application shall identify the amount of funding available for project components.

(b) To be selected for the project, an applicant must establish a long-term care coordinating team consisting of social service agencies, public health nursing service agencies, local boards of health, a representative of local nursing home providers, a representative of local home care providers, and the area agencies on aging in a geographic area. The team is responsible for:

(1) developing a local long-term care strategy consistent with State goals and objectives;

(2) submitting an application to be selected as a project;

(3) coordinating planning for funds to provide services to elderly persons, including funds received under Title III of the Older Americans Act, the Community Social Services Act, Title XX of the Social Security Act, and the Local Public Health Act; and

(4) ensuring efficient services provision and nonduplication of funding.

(c) The applicant must designate a public agency to serve as the lead agency. The lead agency shall receive and manage the project funds from the State and is responsible for the implementation of the local strategy. If selected as a project, the local long-term care coordinating team must evaluate the progress of the local long-term care strategy in meeting State measures of performance and results as established in the contract. The team must conduct such an evaluation every 6 months.

(d) Each member of the local coordinating team must indicate its endorsement of the local strategy. The local long-term care coordinating team may include in its membership other units of government that provide funding for services to the frail elderly. The team must cooperate with consumers and other public and private agencies, including nursing homes, in the geographic area in order to develop and offer a variety of cost-effective services to the elderly and their caregivers.

(e) An applicant must apply to be selected as a project. If the project is selected, the Department on Aging or the Department of Human Services, as applicable, shall contract with the lead agency for the project and shall provide additional administrative funds for implementing the provisions of the contract, within the appropriation available for this purpose.

(f) A project may not be selected unless it demonstrates that:

(1) the objectives of the local project will help to achieve the State's long-term care goals as defined in Section 5;

(2) there is a designated local lead agency that is empowered to make contracts with the State and local vendors on behalf of all participants;

(3) the project proposal demonstrates that the local cooperating agencies have the ability to perform the project as described and that the implementation of the project has a reasonable chance of achieving its objectives; and

(4) the local coordinating team documents efforts of cooperation with consumers and other agencies and organizations, both public and private, in planning for service delivery.

Section 20. Long-term care strategy. The local long-term care strategy must list performance outcomes and indicators that meet the State's objectives. The local strategy must provide for the following:

(1) Accessible information, assessment, and preadmission screening activities as described in Section 25.

(2) An increase in numbers of alternative care clients served, including those who are relocated from nursing homes, which results in a reduction of the medical assistance nursing home caseload.

(3) The development of additional services, such as adult family foster care homes; family adult day care; assisted living projects and congregate housing service projects in apartment buildings; expanded home care services for evenings and weekends; expanded volunteer services; and caregiver support and respite care projects.

The applicant selected for the project shall be required to comply with federal regulations, alternative care funding policies, and federal waiver programs' policies.

Section 25. Accessible information, screening, and assessment function.

(a) A project selected by and under contract with the Department shall establish an accessible information, screening, and assessment function for persons who need assistance and information regarding long-term care. This accessible information, screening, and assessment function shall include information and referral, early intervention, follow-up contacts, telephone screening, home visits, assessments, preadmission screening, and relocation case management for the frail elderly and their caregivers in the area served by the project. The purpose is to ensure that information and help is provided to elderly persons and their families in a timely fashion, when they are making decisions about long-term care. These functions may be split among various agencies, but must be coordinated by the local long-term care coordinating team.

(b) The lead agency or the agencies under contract with the lead agency that are responsible for the accessible information, screening, and assessment function must complete the forms and reports required by the Department as specified in the contract.

Section 30. Service development and delivery. In addition to the access, screening, and assessment function described in Section 25, each local strategy may include provisions for the following:

(1) The addition of a full-time staff person who is responsible to develop the following services and recruit providers as established in the contract:

(A) Additional adult family foster care homes.

(B) Family adult day care providers.

(C) An assisted living program in an apartment.

(D) A congregate housing service project in a subsidized housing project.

(E) The expansion of evening and weekend coverage of home care services as deemed necessary by the local strategic plan.

(2) Small incentive grants to new adult family care providers for renovations needed to meet licensure requirements.

(3) A plan to apply for a congregate housing service project, authorized by the Department, to the extent that funds are available.

(4) A plan to divert new applicants to nursing homes and to relocate a targeted population from nursing homes, using an individual's own resources or the funding available for services.

(5) One or more caregiver support and respite care projects, as described in Section 35.

Section 35. Caregiver support and respite care.

(a) The Department shall establish up to 6 projects to expand the respite care network in the State and to support caregivers in their responsibilities for care. The purpose of each project shall be to:

(1) establish a local coordinated network of volunteer and paid respite workers;

(2) coordinate assignment of respite workers to clients and care receivers and assure the health and safety of the client; and

(3) provide training for caregivers and ensure that support groups are available in the community.

(b) The caregiver support and respite care funds shall be available to the 4 to 6 local long-term care strategy projects designated under this Act.

(c) The Department shall publish a notice in the Illinois Procurement Bulletin to solicit proposals from public or private nonprofit agencies for the projects not included in the 4 to 6 local long-term care strategy projects defined in Section 15. An agency may, alone or in combination with other agencies, apply for caregiver support and respite care project funds. A public or nonprofit agency within a designated independent living project area may apply for project funds if the agency has a letter of agreement with the service region in which services will be developed, stating the intention to coordinate the activities with those projects.

(d) The Department shall select grantees based on the following criteria:

(1) The ability of the proposal to demonstrate need in the area served, as evidenced by a community needs assessment or other demographic data.

(2) The ability of the proposal to clearly describe how the project will achieve the purpose set forth in subsection (a).

(3) The ability of the proposal to reach underserved populations.

(4) The ability of the proposal to demonstrate community commitment to the project, as evidenced by letters of support and cooperation as well as formation of a community task force.

(5) The ability of the proposal to clearly describe the process for recruiting, training, and retraining volunteers.

(6) The inclusion in the proposal of the plan to promote the project in the community, including outreach to persons needing the services.

(e) Funds for all projects under this Section may be used to do the following:

(1) Hire a coordinator to develop a coordinated network of volunteer and paid respite care services and assign workers to clients.

(2) Recruit and train volunteer providers.

(3) Train caregivers.

(4) Ensure the development of support groups for caregivers.

(5) Advertise the availability of the caregiver support and respite care project.

(6) Purchase equipment to maintain a system of assigning workers to clients.

(f) Project funds may not be used to supplant existing funding sources.

Section 40. Independent living projects evaluation. The Department shall evaluate the success of the independent living projects against the objective stated in subsection (b) of Section 5, and recommend to the legislature the continuation or expansion of the long-term care strategy by February 15, 2008.

Section 45. Public awareness campaign. The Department shall contract for a public awareness campaign to educate the general public, seniors, consumers, caregivers, and professionals about the aging process, the long-term care system, and alternatives available including alternative care and residential alternatives. Particular emphasis shall be given to informing consumers on how to access the alternatives and obtain information on the long-term care system. The Department shall pursue the development of new names for preadmission screening, alternative care, foster care, and other services as deemed necessary for the public awareness campaign.

Section 50. Community service grants. The Department shall award contracts for grants to public and private nonprofit agencies to establish services that strengthen a community's ability to provide a system of home and community-based services for elderly persons. The Department shall use a request for proposal process. The Department shall give preference when awarding grants under this Section to areas where nursing facility closures have occurred or are occurring. The Department shall consider grants for the following:

(1) Caregiver support and respite care projects under Section 35.

(2) On-site coordination.

(3) Services identified as needed for community transition.