Full Text of HB2275 98th General Assembly
HB2275ham001 98TH GENERAL ASSEMBLY | Rep. Sara Feigenholtz Filed: 4/12/2013
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| 1 | | AMENDMENT TO HOUSE BILL 2275
| 2 | | AMENDMENT NO. ______. Amend House Bill 2275 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Illinois Act on the Aging is amended by | 5 | | changing Sections 4.01 and 4.02 as follows:
| 6 | | (20 ILCS 105/4.01) (from Ch. 23, par. 6104.01)
| 7 | | Sec. 4.01. Additional powers and duties of the Department. | 8 | | In addition
to powers and duties otherwise provided by law, the | 9 | | Department shall have the
following powers and duties:
| 10 | | (1) To evaluate all programs, services, and facilities for | 11 | | the aged
and for minority senior citizens within the State and | 12 | | determine the extent
to which present public or private | 13 | | programs, services and facilities meet the
needs of the aged.
| 14 | | (2) To coordinate and evaluate all programs, services, and | 15 | | facilities
for the Aging and for minority senior citizens | 16 | | presently furnished by State
agencies and make appropriate |
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| 1 | | recommendations regarding such services, programs
and | 2 | | facilities to the Governor and/or the General Assembly.
| 3 | | (2-a) To request, receive, and share information | 4 | | electronically through the use of data-sharing agreements for | 5 | | the purpose of (i) establishing and verifying the initial and | 6 | | continuing eligibility of older adults to participate in | 7 | | programs administered by the Department; (ii) maximizing | 8 | | federal financial participation in State assistance | 9 | | expenditures; and (iii) investigating allegations of fraud or | 10 | | other abuse of publicly funded benefits. Notwithstanding any | 11 | | other law to the contrary, but only for the limited purposes | 12 | | identified in the preceding sentence, this paragraph (2-a) | 13 | | expressly authorizes the exchanges of income, identification, | 14 | | and other pertinent eligibility information by and among the | 15 | | Department and the Social Security Administration, the | 16 | | Department of Employment Security, the Department of | 17 | | Healthcare and Family Services, the Department of Human | 18 | | Services, the Department of Revenue, the Secretary of State, | 19 | | the U.S. Department of Veterans Affairs, and any other | 20 | | governmental entity. The confidentiality of information | 21 | | otherwise shall be maintained as required by law. In addition, | 22 | | the Department on Aging shall verify employment information at | 23 | | the request of a community care provider for the purpose of | 24 | | ensuring program integrity under the Community Care Program. | 25 | | (3) To function as the sole State agency to develop a | 26 | | comprehensive
plan to meet the needs of the State's senior |
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| 1 | | citizens and the State's
minority senior citizens.
| 2 | | (4) To receive and disburse State and federal funds made | 3 | | available
directly to the Department including those funds made | 4 | | available under the
Older Americans Act and the Senior | 5 | | Community Service Employment Program for
providing services | 6 | | for senior citizens and minority senior citizens or for
| 7 | | purposes related thereto, and shall develop and administer any | 8 | | State Plan
for the Aging required by federal law.
| 9 | | (5) To solicit, accept, hold, and administer in behalf of | 10 | | the State
any grants or legacies of money, securities, or | 11 | | property to the State of
Illinois for services to senior | 12 | | citizens and minority senior citizens or
purposes related | 13 | | thereto.
| 14 | | (6) To provide consultation and assistance to communities, | 15 | | area agencies
on aging, and groups developing local services | 16 | | for senior citizens and
minority senior citizens.
| 17 | | (7) To promote community education regarding the problems | 18 | | of senior
citizens and minority senior citizens through | 19 | | institutes, publications,
radio, television and the local | 20 | | press.
| 21 | | (8) To cooperate with agencies of the federal government in | 22 | | studies
and conferences designed to examine the needs of senior | 23 | | citizens and minority
senior citizens and to prepare programs | 24 | | and facilities to meet those needs.
| 25 | | (9) To establish and maintain information and referral | 26 | | sources
throughout the State when not provided by other |
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| 1 | | agencies.
| 2 | | (10) To provide the staff support that may reasonably be | 3 | | required
by the Council.
| 4 | | (11) To make and enforce rules and regulations necessary | 5 | | and proper
to the performance of its duties.
| 6 | | (12) To establish and fund programs or projects or | 7 | | experimental facilities
that are specially designed as | 8 | | alternatives to institutional care.
| 9 | | (13) To develop a training program to train the counselors | 10 | | presently
employed by the Department's aging network to provide | 11 | | Medicare
beneficiaries with counseling and advocacy in | 12 | | Medicare, private health
insurance, and related health care | 13 | | coverage plans. The Department shall
report to the General | 14 | | Assembly on the implementation of the training
program on or | 15 | | before December 1, 1986.
| 16 | | (14) To make a grant to an institution of higher learning | 17 | | to study the
feasibility of establishing and implementing an | 18 | | affirmative action
employment plan for the recruitment, | 19 | | hiring, training and retraining of
persons 60 or more years old | 20 | | for jobs for which their employment would not
be precluded by | 21 | | law.
| 22 | | (15) To present one award annually in each of the | 23 | | categories of community
service, education, the performance | 24 | | and graphic arts, and the labor force
to outstanding Illinois | 25 | | senior citizens and minority senior citizens in
recognition of | 26 | | their individual contributions to either community service,
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| 1 | | education, the performance and graphic arts, or the labor | 2 | | force. The awards
shall be presented to 4 senior citizens and | 3 | | minority senior citizens
selected from a list of 44 nominees | 4 | | compiled annually by
the Department. Nominations shall be | 5 | | solicited from senior citizens'
service providers, area | 6 | | agencies on aging, senior citizens'
centers, and senior | 7 | | citizens' organizations. The Department shall establish a | 8 | | central location within
the State to be designated as the | 9 | | Senior Illinoisans Hall of Fame for the
public display of all | 10 | | the annual awards, or replicas thereof.
| 11 | | (16) To establish multipurpose senior centers through area | 12 | | agencies on
aging and to fund those new and existing | 13 | | multipurpose senior centers
through area agencies on aging, the | 14 | | establishment and funding to begin in
such areas of the State | 15 | | as the Department shall designate by rule and as
specifically | 16 | | appropriated funds become available.
| 17 | | (17) To develop the content and format of the | 18 | | acknowledgment regarding
non-recourse reverse mortgage loans | 19 | | under Section 6.1 of the Illinois
Banking Act; to provide | 20 | | independent consumer information on reverse
mortgages and | 21 | | alternatives; and to refer consumers to independent
counseling | 22 | | services with expertise in reverse mortgages.
| 23 | | (18) To develop a pamphlet in English and Spanish which may | 24 | | be used by
physicians licensed to practice medicine in all of | 25 | | its branches pursuant
to the Medical Practice Act of 1987, | 26 | | pharmacists licensed pursuant to the
Pharmacy Practice Act, and |
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| 1 | | Illinois residents 65 years of age or
older for the purpose of | 2 | | assisting physicians, pharmacists, and patients in
monitoring | 3 | | prescriptions provided by various physicians and to aid persons
| 4 | | 65 years of age or older in complying with directions for | 5 | | proper use of
pharmaceutical prescriptions. The pamphlet may | 6 | | provide space for recording
information including but not | 7 | | limited to the following:
| 8 | | (a) name and telephone number of the patient;
| 9 | | (b) name and telephone number of the prescribing | 10 | | physician;
| 11 | | (c) date of prescription;
| 12 | | (d) name of drug prescribed;
| 13 | | (e) directions for patient compliance; and
| 14 | | (f) name and telephone number of dispensing pharmacy.
| 15 | | In developing the pamphlet, the Department shall consult | 16 | | with the
Illinois State Medical Society, the Center for | 17 | | Minority Health Services,
the Illinois Pharmacists Association | 18 | | and
senior citizens organizations. The Department shall | 19 | | distribute the
pamphlets to physicians, pharmacists and | 20 | | persons 65 years of age or older
or various senior citizen | 21 | | organizations throughout the State.
| 22 | | (19) To conduct a study of the feasibility of
implementing | 23 | | the Senior Companion Program throughout the State.
| 24 | | (20) The reimbursement rates paid through the community | 25 | | care program
for chore housekeeping services and home care | 26 | | aides
shall be the same.
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| 1 | | (21) From funds appropriated to the Department from the | 2 | | Meals on Wheels
Fund, a special fund in the State treasury that | 3 | | is hereby created, and in
accordance with State and federal | 4 | | guidelines and the intrastate funding
formula, to make grants | 5 | | to area agencies on aging, designated by the
Department, for | 6 | | the sole purpose of delivering meals to homebound persons 60
| 7 | | years of age and older.
| 8 | | (22) To distribute, through its area agencies on aging, | 9 | | information
alerting seniors on safety issues regarding | 10 | | emergency weather
conditions, including extreme heat and cold, | 11 | | flooding, tornadoes, electrical
storms, and other severe storm | 12 | | weather. The information shall include all
necessary | 13 | | instructions for safety and all emergency telephone numbers of
| 14 | | organizations that will provide additional information and | 15 | | assistance.
| 16 | | (23) To develop guidelines for the organization and | 17 | | implementation of
Volunteer Services Credit Programs to be | 18 | | administered by Area Agencies on
Aging or community based | 19 | | senior service organizations. The Department shall
hold public | 20 | | hearings on the proposed guidelines for public comment, | 21 | | suggestion,
and determination of public interest. The | 22 | | guidelines shall be based on the
findings of other states and | 23 | | of community organizations in Illinois that are
currently | 24 | | operating volunteer services credit programs or demonstration
| 25 | | volunteer services credit programs. The Department shall offer | 26 | | guidelines for
all aspects of the programs including, but not |
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| 1 | | limited to, the following:
| 2 | | (a) types of services to be offered by volunteers;
| 3 | | (b) types of services to be received upon the | 4 | | redemption of service
credits;
| 5 | | (c) issues of liability for the volunteers and the | 6 | | administering
organizations;
| 7 | | (d) methods of tracking service credits earned and | 8 | | service credits
redeemed;
| 9 | | (e) issues of time limits for redemption of service | 10 | | credits;
| 11 | | (f) methods of recruitment of volunteers;
| 12 | | (g) utilization of community volunteers, community | 13 | | service groups, and
other resources for delivering | 14 | | services to be received by service credit
program clients;
| 15 | | (h) accountability and assurance that services will be | 16 | | available to
individuals who have earned service credits; | 17 | | and
| 18 | | (i) volunteer screening and qualifications.
| 19 | | The Department shall submit a written copy of the guidelines to | 20 | | the General
Assembly by July 1, 1998.
| 21 | | (Source: P.A. 95-298, eff. 8-20-07; 95-689, eff. 10-29-07; | 22 | | 95-876, eff. 8-21-08; 96-918, eff. 6-9-10.)
| 23 | | (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
| 24 | | Sec. 4.02. Community Care Program. The Department shall | 25 | | establish a program of services to
prevent unnecessary |
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| 1 | | institutionalization of persons age 60 and older in
need of | 2 | | long term care or who are established as persons who suffer | 3 | | from
Alzheimer's disease or a related disorder under the | 4 | | Alzheimer's Disease
Assistance Act, thereby enabling them
to | 5 | | remain in their own homes or in other living arrangements. Such
| 6 | | preventive services, which may be coordinated with other | 7 | | programs for the
aged and monitored by area agencies on aging | 8 | | in cooperation with the
Department, may include, but are not | 9 | | limited to, any or all of the following:
| 10 | | (a) (blank);
| 11 | | (b) (blank);
| 12 | | (c) home care aide services;
| 13 | | (d) personal assistant services;
| 14 | | (e) adult day services;
| 15 | | (f) home-delivered meals;
| 16 | | (g) education in self-care;
| 17 | | (h) personal care services;
| 18 | | (i) adult day health services;
| 19 | | (j) habilitation services;
| 20 | | (k) respite care;
| 21 | | (k-5) community reintegration services;
| 22 | | (k-6) flexible senior services; | 23 | | (k-7) medication management; | 24 | | (k-8) emergency home response;
| 25 | | (l) other nonmedical social services that may enable | 26 | | the person
to become self-supporting; or
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| 1 | | (m) clearinghouse for information provided by senior | 2 | | citizen home owners
who want to rent rooms to or share | 3 | | living space with other senior citizens.
| 4 | | The Department shall establish eligibility standards for | 5 | | such
services. In determining the amount and nature of services
| 6 | | for which a person may qualify, consideration shall not be | 7 | | given to the
value of cash, property or other assets held in | 8 | | the name of the person's
spouse pursuant to a written agreement | 9 | | dividing marital property into equal
but separate shares or | 10 | | pursuant to a transfer of the person's interest in a
home to | 11 | | his spouse, provided that the spouse's share of the marital
| 12 | | property is not made available to the person seeking such | 13 | | services.
| 14 | | Beginning January 1, 2008, the Department shall require as | 15 | | a condition of eligibility that all new financially eligible | 16 | | applicants apply for and enroll in medical assistance under | 17 | | Article V of the Illinois Public Aid Code in accordance with | 18 | | rules promulgated by the Department.
| 19 | | The Department shall, in conjunction with the Department of | 20 | | Public Aid (now Department of Healthcare and Family Services),
| 21 | | seek appropriate amendments under Sections 1915 and 1924 of the | 22 | | Social
Security Act. The purpose of the amendments shall be to | 23 | | extend eligibility
for home and community based services under | 24 | | Sections 1915 and 1924 of the
Social Security Act to persons | 25 | | who transfer to or for the benefit of a
spouse those amounts of | 26 | | income and resources allowed under Section 1924 of
the Social |
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| 1 | | Security Act. Subject to the approval of such amendments, the
| 2 | | Department shall extend the provisions of Section 5-4 of the | 3 | | Illinois
Public Aid Code to persons who, but for the provision | 4 | | of home or
community-based services, would require the level of | 5 | | care provided in an
institution, as is provided for in federal | 6 | | law. Those persons no longer
found to be eligible for receiving | 7 | | noninstitutional services due to changes
in the eligibility | 8 | | criteria shall be given 45 days notice prior to actual
| 9 | | termination. Those persons receiving notice of termination may | 10 | | contact the
Department and request the determination be | 11 | | appealed at any time during the
45 day notice period. The | 12 | | target
population identified for the purposes of this Section | 13 | | are persons age 60
and older with an identified service need. | 14 | | Priority shall be given to those
who are at imminent risk of | 15 | | institutionalization. The services shall be
provided to | 16 | | eligible persons age 60 and older to the extent that the cost
| 17 | | of the services together with the other personal maintenance
| 18 | | expenses of the persons are reasonably related to the standards
| 19 | | established for care in a group facility appropriate to the | 20 | | person's
condition. These non-institutional services, pilot | 21 | | projects or
experimental facilities may be provided as part of | 22 | | or in addition to
those authorized by federal law or those | 23 | | funded and administered by the
Department of Human Services. | 24 | | The Departments of Human Services, Healthcare and Family | 25 | | Services,
Public Health, Veterans' Affairs, and Commerce and | 26 | | Economic Opportunity and
other appropriate agencies of State, |
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| 1 | | federal and local governments shall
cooperate with the | 2 | | Department on Aging in the establishment and development
of the | 3 | | non-institutional services. The Department shall require an | 4 | | annual
audit from all personal assistant
and home care aide | 5 | | vendors contracting with
the Department under this Section. The | 6 | | annual audit shall assure that each
audited vendor's procedures | 7 | | are in compliance with Department's financial
reporting | 8 | | guidelines requiring an administrative and employee wage and | 9 | | benefits cost split as defined in administrative rules. The | 10 | | audit is a public record under
the Freedom of Information Act. | 11 | | The Department shall execute, relative to
the nursing home | 12 | | prescreening project, written inter-agency
agreements with the | 13 | | Department of Human Services and the Department
of Healthcare | 14 | | and Family Services, to effect the following: (1) intake | 15 | | procedures and common
eligibility criteria for those persons | 16 | | who are receiving non-institutional
services; and (2) the | 17 | | establishment and development of non-institutional
services in | 18 | | areas of the State where they are not currently available or | 19 | | are
undeveloped. On and after July 1, 1996, all nursing home | 20 | | prescreenings for
individuals 60 years of age or older shall be | 21 | | conducted by the Department.
| 22 | | As part of the Department on Aging's routine training of | 23 | | case managers and case manager supervisors, the Department may | 24 | | include information on family futures planning for persons who | 25 | | are age 60 or older and who are caregivers of their adult | 26 | | children with developmental disabilities. The content of the |
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| 1 | | training shall be at the Department's discretion. | 2 | | The Department is authorized to establish a system of | 3 | | recipient copayment
for services provided under this Section, | 4 | | such copayment to be based upon
the recipient's ability to pay | 5 | | but in no case to exceed the actual cost of
the services | 6 | | provided. Additionally, any portion of a person's income which
| 7 | | is equal to or less than the federal poverty standard shall not | 8 | | be
considered by the Department in determining the copayment. | 9 | | The level of
such copayment shall be adjusted whenever | 10 | | necessary to reflect any change
in the officially designated | 11 | | federal poverty standard.
| 12 | | The Department, or the Department's authorized | 13 | | representative, may
recover the amount of moneys expended for | 14 | | services provided to or in
behalf of a person under this | 15 | | Section by a claim against the person's
estate or against the | 16 | | estate of the person's surviving spouse, but no
recovery may be | 17 | | had until after the death of the surviving spouse, if
any, and | 18 | | then only at such time when there is no surviving child who
is | 19 | | under age 21, blind, or permanently and totally disabled. This
| 20 | | paragraph, however, shall not bar recovery, at the death of the | 21 | | person, of
moneys for services provided to the person or in | 22 | | behalf of the person under
this Section to which the person was | 23 | | not entitled;
provided that such recovery shall not be enforced | 24 | | against any real estate while
it is occupied as a homestead by | 25 | | the surviving spouse or other dependent, if no
claims by other | 26 | | creditors have been filed against the estate, or, if such
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| 1 | | claims have been filed, they remain dormant for failure of | 2 | | prosecution or
failure of the claimant to compel administration | 3 | | of the estate for the purpose
of payment. This paragraph shall | 4 | | not bar recovery from the estate of a spouse,
under Sections | 5 | | 1915 and 1924 of the Social Security Act and Section 5-4 of the
| 6 | | Illinois Public Aid Code, who precedes a person receiving | 7 | | services under this
Section in death. All moneys for services
| 8 | | paid to or in behalf of the person under this Section shall be | 9 | | claimed for
recovery from the deceased spouse's estate. | 10 | | "Homestead", as used
in this paragraph, means the dwelling | 11 | | house and
contiguous real estate occupied by a surviving spouse
| 12 | | or relative, as defined by the rules and regulations of the | 13 | | Department of Healthcare and Family Services, regardless of the | 14 | | value of the property.
| 15 | | The Department shall increase the effectiveness of the | 16 | | existing Community Care Program by: | 17 | | (1) ensuring that in-home services included in the care | 18 | | plan are available on evenings and weekends; | 19 | | (2) ensuring that care plans contain the services that | 20 | | eligible participants
need based on the number of days in a | 21 | | month, not limited to specific blocks of time, as | 22 | | identified by the comprehensive assessment tool selected | 23 | | by the Department for use statewide, not to exceed the | 24 | | total monthly service cost maximum allowed for each | 25 | | service; the Department shall develop administrative rules | 26 | | to implement this item (2); |
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| 1 | | (3) ensuring that the participants have the right to | 2 | | choose the services contained in their care plan and to | 3 | | direct how those services are provided, based on | 4 | | administrative rules established by the Department; | 5 | | (4) ensuring that the determination of need tool is | 6 | | accurate in determining the participants' level of need; to | 7 | | achieve this, the Department, in conjunction with the Older | 8 | | Adult Services Advisory Committee, shall institute a study | 9 | | of the relationship between the Determination of Need | 10 | | scores, level of need, service cost maximums, and the | 11 | | development and utilization of service plans no later than | 12 | | May 1, 2008; findings and recommendations shall be | 13 | | presented to the Governor and the General Assembly no later | 14 | | than January 1, 2009; recommendations shall include all | 15 | | needed changes to the service cost maximums schedule and | 16 | | additional covered services; | 17 | | (5) ensuring that homemakers can provide personal care | 18 | | services that may or may not involve contact with clients, | 19 | | including but not limited to: | 20 | | (A) bathing; | 21 | | (B) grooming; | 22 | | (C) toileting; | 23 | | (D) nail care; | 24 | | (E) transferring; | 25 | | (F) respiratory services; | 26 | | (G) exercise; or |
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| 1 | | (H) positioning; | 2 | | (6) ensuring that homemaker program vendors are not | 3 | | restricted from hiring homemakers who are family members of | 4 | | clients or recommended by clients; the Department may not, | 5 | | by rule or policy, require homemakers who are family | 6 | | members of clients or recommended by clients to accept | 7 | | assignments in homes other than the client; | 8 | | (7) ensuring that the State may access maximum federal | 9 | | matching funds by seeking approval for the Centers for | 10 | | Medicare and Medicaid Services for modifications to the | 11 | | State's home and community based services waiver and | 12 | | additional waiver opportunities , including applying for | 13 | | enrollment in the Balance Incentive Payment Program by May | 14 | | 1, 2013, in order to maximize federal matching funds; this | 15 | | shall include, but not be limited to, modification that | 16 | | reflects all changes in the Community Care Program services | 17 | | and all increases in the services cost maximum; and | 18 | | (8) ensuring that the determination of need tool | 19 | | accurately reflects the service needs of individuals with | 20 | | Alzheimer's disease and related dementia disorders ; . | 21 | | (9) ensuring that services are authorized accurately | 22 | | and consistently for the Community Care Program (CCP); the | 23 | | Department shall implement a Service Authorization policy | 24 | | directive; the purpose shall be to ensure that eligibility | 25 | | and services are authorized accurately and consistently in | 26 | | the CCP program; the policy directive shall clarify service |
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| 1 | | authorization guidelines to Care Coordination Units and | 2 | | Community Care Program providers no later than May 1, 2013; | 3 | | (10) working in conjunction with Care Coordination | 4 | | Units, the Department of Healthcare and Family Services, | 5 | | the Department of Human Services, Community Care Program | 6 | | providers, and other stakeholders to make improvements to | 7 | | the Medicaid claiming processes and the Medicaid | 8 | | enrollment procedures or requirements as needed, | 9 | | including, but not limited to, specific policy changes or | 10 | | rules to improve the up-front enrollment of participants in | 11 | | the Medicaid program and specific policy changes or rules | 12 | | to insure more prompt submission of bills to the federal | 13 | | government to secure maximum federal matching dollars as | 14 | | promptly as possible; the Department on Aging shall have at | 15 | | least 3 meetings with stakeholders by January 1, 2014 in | 16 | | order to address these improvements; | 17 | | (11) requiring home care service providers to comply | 18 | | with the rounding of hours worked provisions under the | 19 | | federal Fair Labor Standards Act (FLSA) and as set forth in | 20 | | 29 CFR 785.48(b) by May 1, 2013; | 21 | | (12) implementing any necessary policy changes or | 22 | | promulgating any rules, no later than January 1, 2014, to | 23 | | assist the Department of Healthcare and Family Services in | 24 | | moving as many participants as possible, consistent with | 25 | | federal regulations, into coordinated care plans if a care | 26 | | coordination plan that covers long term care is available |
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| 1 | | in the recipient's area; and | 2 | | (13) maintaining fiscal year 2014 rates at the same | 3 | | level established on January 1, 2013. | 4 | | By January 1, 2009 or as soon after the end of the Cash and | 5 | | Counseling Demonstration Project as is practicable, the | 6 | | Department may, based on its evaluation of the demonstration | 7 | | project, promulgate rules concerning personal assistant | 8 | | services, to include, but need not be limited to, | 9 | | qualifications, employment screening, rights under fair labor | 10 | | standards, training, fiduciary agent, and supervision | 11 | | requirements. All applicants shall be subject to the provisions | 12 | | of the Health Care Worker Background Check Act.
| 13 | | The Department shall develop procedures to enhance | 14 | | availability of
services on evenings, weekends, and on an | 15 | | emergency basis to meet the
respite needs of caregivers. | 16 | | Procedures shall be developed to permit the
utilization of | 17 | | services in successive blocks of 24 hours up to the monthly
| 18 | | maximum established by the Department. Workers providing these | 19 | | services
shall be appropriately trained.
| 20 | | Beginning on the effective date of this Amendatory Act of | 21 | | 1991, no person
may perform chore/housekeeping and home care | 22 | | aide services under a program
authorized by this Section unless | 23 | | that person has been issued a certificate
of pre-service to do | 24 | | so by his or her employing agency. Information
gathered to | 25 | | effect such certification shall include (i) the person's name,
| 26 | | (ii) the date the person was hired by his or her current |
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| 1 | | employer, and
(iii) the training, including dates and levels. | 2 | | Persons engaged in the
program authorized by this Section | 3 | | before the effective date of this
amendatory Act of 1991 shall | 4 | | be issued a certificate of all pre- and
in-service training | 5 | | from his or her employer upon submitting the necessary
| 6 | | information. The employing agency shall be required to retain | 7 | | records of
all staff pre- and in-service training, and shall | 8 | | provide such records to
the Department upon request and upon | 9 | | termination of the employer's contract
with the Department. In | 10 | | addition, the employing agency is responsible for
the issuance | 11 | | of certifications of in-service training completed to their
| 12 | | employees.
| 13 | | The Department is required to develop a system to ensure | 14 | | that persons
working as home care aides and personal assistants
| 15 | | receive increases in their
wages when the federal minimum wage | 16 | | is increased by requiring vendors to
certify that they are | 17 | | meeting the federal minimum wage statute for home care aides
| 18 | | and personal assistants. An employer that cannot ensure that | 19 | | the minimum
wage increase is being given to home care aides and | 20 | | personal assistants
shall be denied any increase in | 21 | | reimbursement costs.
| 22 | | The Community Care Program Advisory Committee is created in | 23 | | the Department on Aging. The Director shall appoint individuals | 24 | | to serve in the Committee, who shall serve at their own | 25 | | expense. Members of the Committee must abide by all applicable | 26 | | ethics laws. The Committee shall advise the Department on |
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| 1 | | issues related to the Department's program of services to | 2 | | prevent unnecessary institutionalization. The Committee shall | 3 | | meet on a bi-monthly basis and shall serve to identify and | 4 | | advise the Department on present and potential issues affecting | 5 | | the service delivery network, the program's clients, and the | 6 | | Department and to recommend solution strategies. Persons | 7 | | appointed to the Committee shall be appointed on, but not | 8 | | limited to, their own and their agency's experience with the | 9 | | program, geographic representation, and willingness to serve. | 10 | | The Director shall appoint members to the Committee to | 11 | | represent provider, advocacy, policy research, and other | 12 | | constituencies committed to the delivery of high quality home | 13 | | and community-based services to older adults. Representatives | 14 | | shall be appointed to ensure representation from community care | 15 | | providers including, but not limited to, adult day service | 16 | | providers, homemaker providers, case coordination and case | 17 | | management units, emergency home response providers, statewide | 18 | | trade or labor unions that represent home care
aides and direct | 19 | | care staff, area agencies on aging, adults over age 60, | 20 | | membership organizations representing older adults, and other | 21 | | organizational entities, providers of care, or individuals | 22 | | with demonstrated interest and expertise in the field of home | 23 | | and community care as determined by the Director. | 24 | | Nominations may be presented from any agency or State | 25 | | association with interest in the program. The Director, or his | 26 | | or her designee, shall serve as the permanent co-chair of the |
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| 1 | | advisory committee. One other co-chair shall be nominated and | 2 | | approved by the members of the committee on an annual basis. | 3 | | Committee members' terms of appointment shall be for 4 years | 4 | | with one-quarter of the appointees' terms expiring each year. A | 5 | | member shall continue to serve until his or her replacement is | 6 | | named. The Department shall fill vacancies that have a | 7 | | remaining term of over one year, and this replacement shall | 8 | | occur through the annual replacement of expiring terms. The | 9 | | Director shall designate Department staff to provide technical | 10 | | assistance and staff support to the committee. Department | 11 | | representation shall not constitute membership of the | 12 | | committee. All Committee papers, issues, recommendations, | 13 | | reports, and meeting memoranda are advisory only. The Director, | 14 | | or his or her designee, shall make a written report, as | 15 | | requested by the Committee, regarding issues before the | 16 | | Committee.
| 17 | | The Department on Aging and the Department of Human | 18 | | Services
shall cooperate in the development and submission of | 19 | | an annual report on
programs and services provided under this | 20 | | Section. Such joint report
shall be filed with the Governor and | 21 | | the General Assembly on or before
September 30 each year.
| 22 | | The requirement for reporting to the General Assembly shall | 23 | | be satisfied
by filing copies of the report with the Speaker, | 24 | | the Minority Leader and
the Clerk of the House of | 25 | | Representatives and the President, the Minority
Leader and the | 26 | | Secretary of the Senate and the Legislative Research Unit,
as |
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| 1 | | required by Section 3.1 of the General Assembly Organization | 2 | | Act and
filing such additional copies with the State Government | 3 | | Report Distribution
Center for the General Assembly as is | 4 | | required under paragraph (t) of
Section 7 of the State Library | 5 | | Act.
| 6 | | Those persons previously found eligible for receiving | 7 | | non-institutional
services whose services were discontinued | 8 | | under the Emergency Budget Act of
Fiscal Year 1992, and who do | 9 | | not meet the eligibility standards in effect
on or after July | 10 | | 1, 1992, shall remain ineligible on and after July 1,
1992. | 11 | | Those persons previously not required to cost-share and who | 12 | | were
required to cost-share effective March 1, 1992, shall | 13 | | continue to meet
cost-share requirements on and after July 1, | 14 | | 1992. Beginning July 1, 1992,
all clients will be required to | 15 | | meet
eligibility, cost-share, and other requirements and will | 16 | | have services
discontinued or altered when they fail to meet | 17 | | these requirements. | 18 | | For the purposes of this Section, "flexible senior | 19 | | services" refers to services that require one-time or periodic | 20 | | expenditures including, but not limited to, respite care, home | 21 | | modification, assistive technology, housing assistance, and | 22 | | transportation.
| 23 | | The Department shall implement an electronic service | 24 | | verification based on global positioning systems or other | 25 | | cost-effective technology for the Community Care Program no | 26 | | later than January 1, 2014. |
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| 1 | | The Department shall require, as a condition of | 2 | | eligibility, enrollment in the medical assistance program | 3 | | under Article V of the Illinois Public Aid Code (i) beginning | 4 | | August 1, 2013, if the Auditor General has reported that the | 5 | | Department has failed
to comply with the reporting requirements | 6 | | of Section 2-27 of
the Illinois State Auditing Act; or (ii) | 7 | | beginning June 1, 2014, if the Auditor General has reported | 8 | | that the
Department has not undertaken the required actions | 9 | | listed in
the report required by subsection (a) of Section 2-27 | 10 | | of the
Illinois State Auditing Act. | 11 | | The Department shall delay Community Care Program services | 12 | | until an applicant is determined eligible for medical | 13 | | assistance under Article V of the Illinois Public Aid Code (i) | 14 | | beginning August 1, 2013, if the Auditor General has reported | 15 | | that the Department has failed
to comply with the reporting | 16 | | requirements of Section 2-27 of
the Illinois State Auditing | 17 | | Act; or (ii) beginning June 1, 2014, if the Auditor General has | 18 | | reported that the
Department has not undertaken the required | 19 | | actions listed in
the report required by subsection (a) of | 20 | | Section 2-27 of the
Illinois State Auditing Act. | 21 | | The Department shall implement co-payments for the | 22 | | Community Care Program at the federally allowable maximum level | 23 | | (i) beginning August 1, 2013, if the Auditor General has | 24 | | reported that the Department has failed
to comply with the | 25 | | reporting requirements of Section 2-27 of
the Illinois State | 26 | | Auditing Act; or (ii) beginning June 1, 2014, if the Auditor |
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| 1 | | General has reported that the
Department has not undertaken the | 2 | | required actions listed in
the report required by subsection | 3 | | (a) of Section 2-27 of the
Illinois State Auditing Act. | 4 | | The Department shall provide a bi-monthly report on the | 5 | | progress of the Community Care Program reforms set forth in | 6 | | this amendatory Act of the 98th General Assembly to the | 7 | | Governor, the Speaker of the House of Representatives, the | 8 | | Minority Leader of the House of Representatives, the
President | 9 | | of the
Senate, and the Minority Leader of the Senate. | 10 | | The Department shall conduct a quarterly review of Care | 11 | | Coordination Unit performance and adherence to service | 12 | | guidelines. The quarterly review shall be reported to the | 13 | | Speaker of the House of Representatives, the Minority Leader of | 14 | | the House of Representatives, the
President of the
Senate, and | 15 | | the Minority Leader of the Senate. The Department shall collect | 16 | | and report longitudinal data on the performance of each care | 17 | | coordination unit. Nothing in this paragraph shall be construed | 18 | | to require the Department to identify specific care | 19 | | coordination units. | 20 | | In regard to community care providers, failure to comply | 21 | | with Department on Aging policies shall be cause for | 22 | | disciplinary action, including, but not limited to, | 23 | | disqualification from serving Community Care Program clients. | 24 | | Each provider, upon submission of any bill or invoice to the | 25 | | Department for payment for services rendered, shall include a | 26 | | notarized statement, under penalty of perjury pursuant to |
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| 1 | | Section 1-109 of the Code of Civil Procedure, that the provider | 2 | | has complied with all Department policies. | 3 | | (Source: P.A. 96-918, eff. 6-9-10; 96-1129, eff. 7-20-10; | 4 | | 97-333, eff. 8-12-11.) | 5 | | Section 9. The Illinois State Auditing Act is amended by | 6 | | adding Section 2-27 as follows: | 7 | | (30 ILCS 5/2-27 new) | 8 | | Sec. 2-27. Certification of Community Care Program reform | 9 | | implementation. | 10 | | (a) No later than July 1, 2013, the Department on Aging | 11 | | shall file
a report with the Auditor General, the Governor, the | 12 | | Speaker of
the House of Representatives, the Minority Leader of | 13 | | the House
of Representatives, the President of the Senate, and | 14 | | the Minority Leader of the Senate listing any necessary | 15 | | amendment to the Illinois
Title XIX State plan, any federal | 16 | | waiver request, any State
administrative rule, or any State | 17 | | Policy changes and notifications required to implement this | 18 | | amendatory Act
of the 98th General Assembly. | 19 | | (b) No later than February 1, 2014, the Department on Aging | 20 | | shall
provide evidence to the Auditor General that it has | 21 | | undertaken
the required actions listed in the report required | 22 | | by
subsection (a). | 23 | | (c) No later than April 1, 2014, the Auditor General shall
| 24 | | submit a report to the Governor, the Speaker of the House of
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| 1 | | Representatives, the Minority Leader of the House of
| 2 | | Representatives, the President of the Senate, and the Minority | 3 | | Leader of the Senate as to whether the Department on Aging has | 4 | | undertaken the required
actions listed in the report required | 5 | | by subsection (a). | 6 | | Section 10. The State Finance Act is amended by changing | 7 | | Section 25 as follows:
| 8 | | (30 ILCS 105/25) (from Ch. 127, par. 161)
| 9 | | Sec. 25. Fiscal year limitations.
| 10 | | (a) All appropriations shall be
available for expenditure | 11 | | for the fiscal year or for a lesser period if the
Act making | 12 | | that appropriation so specifies. A deficiency or emergency
| 13 | | appropriation shall be available for expenditure only through | 14 | | June 30 of
the year when the Act making that appropriation is | 15 | | enacted unless that Act
otherwise provides.
| 16 | | (b) Outstanding liabilities as of June 30, payable from | 17 | | appropriations
which have otherwise expired, may be paid out of | 18 | | the expiring
appropriations during the 2-month period ending at | 19 | | the
close of business on August 31. Any service involving
| 20 | | professional or artistic skills or any personal services by an | 21 | | employee whose
compensation is subject to income tax | 22 | | withholding must be performed as of June
30 of the fiscal year | 23 | | in order to be considered an "outstanding liability as of
June | 24 | | 30" that is thereby eligible for payment out of the expiring
|
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| 1 | | appropriation.
| 2 | | (b-1) However, payment of tuition reimbursement claims | 3 | | under Section 14-7.03 or
18-3 of the School Code may be made by | 4 | | the State Board of Education from its
appropriations for those | 5 | | respective purposes for any fiscal year, even though
the claims | 6 | | reimbursed by the payment may be claims attributable to a prior
| 7 | | fiscal year, and payments may be made at the direction of the | 8 | | State
Superintendent of Education from the fund from which the | 9 | | appropriation is made
without regard to any fiscal year | 10 | | limitations, except as required by subsection (j) of this | 11 | | Section. Beginning on June 30, 2021, payment of tuition | 12 | | reimbursement claims under Section 14-7.03 or 18-3 of the | 13 | | School Code as of June 30, payable from appropriations that | 14 | | have otherwise expired, may be paid out of the expiring | 15 | | appropriation during the 4-month period ending at the close of | 16 | | business on October 31.
| 17 | | (b-2) All outstanding liabilities as of June 30, 2010, | 18 | | payable from appropriations that would otherwise expire at the | 19 | | conclusion of the lapse period for fiscal year 2010, and | 20 | | interest penalties payable on those liabilities under the State | 21 | | Prompt Payment Act, may be paid out of the expiring | 22 | | appropriations until December 31, 2010, without regard to the | 23 | | fiscal year in which the payment is made, as long as vouchers | 24 | | for the liabilities are received by the Comptroller no later | 25 | | than August 31, 2010. | 26 | | (b-2.5) All outstanding liabilities as of June 30, 2011, |
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| 1 | | payable from appropriations that would otherwise expire at the | 2 | | conclusion of the lapse period for fiscal year 2011, and | 3 | | interest penalties payable on those liabilities under the State | 4 | | Prompt Payment Act, may be paid out of the expiring | 5 | | appropriations until December 31, 2011, without regard to the | 6 | | fiscal year in which the payment is made, as long as vouchers | 7 | | for the liabilities are received by the Comptroller no later | 8 | | than August 31, 2011. | 9 | | (b-2.6) All outstanding liabilities as of June 30, 2012, | 10 | | payable from appropriations that would otherwise expire at the | 11 | | conclusion of the lapse period for fiscal year 2012, and | 12 | | interest penalties payable on those liabilities under the State | 13 | | Prompt Payment Act, may be paid out of the expiring | 14 | | appropriations until December 31, 2012, without regard to the | 15 | | fiscal year in which the payment is made, as long as vouchers | 16 | | for the liabilities are received by the Comptroller no later | 17 | | than August 31, 2012. | 18 | | (b-2.7) (b-2.6) For fiscal years 2012 and 2013, interest | 19 | | penalties payable under the State Prompt Payment Act associated | 20 | | with a voucher for which payment is issued after June 30 may be | 21 | | paid out of the next fiscal year's appropriation. The future | 22 | | year appropriation must be for the same purpose and from the | 23 | | same fund as the original payment. An interest penalty voucher | 24 | | submitted against a future year appropriation must be submitted | 25 | | within 60 days after the issuance of the associated voucher, | 26 | | and the Comptroller must issue the interest payment within 60 |
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| 1 | | days after acceptance of the interest voucher. | 2 | | (b-3) Medical payments may be made by the Department of | 3 | | Veterans' Affairs from
its
appropriations for those purposes | 4 | | for any fiscal year, without regard to the
fact that the | 5 | | medical services being compensated for by such payment may have
| 6 | | been rendered in a prior fiscal year, except as required by | 7 | | subsection (j) of this Section. Beginning on June 30, 2021, | 8 | | medical payments payable from appropriations that have | 9 | | otherwise expired may be paid out of the expiring appropriation | 10 | | during the 4-month period ending at the close of business on | 11 | | October 31.
| 12 | | (b-4) Medical payments and child care
payments may be made | 13 | | by the Department of
Human Services (as successor to the | 14 | | Department of Public Aid) from
appropriations for those | 15 | | purposes for any fiscal year,
without regard to the fact that | 16 | | the medical or child care services being
compensated for by | 17 | | such payment may have been rendered in a prior fiscal
year; and | 18 | | payments may be made at the direction of the Department of
| 19 | | Healthcare and Family Services (or successor agency) from the | 20 | | Health Insurance Reserve Fund without regard to any fiscal
year | 21 | | limitations, except as required by subsection (j) of this | 22 | | Section. Beginning on June 30, 2021, medical and child care | 23 | | payments made by the Department of Human Services , and payments | 24 | | made at the discretion of the Department of Healthcare and | 25 | | Family Services (or successor agency) from the Health Insurance | 26 | | Reserve Fund and payable from appropriations that have |
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| 1 | | otherwise expired may be paid out of the expiring appropriation | 2 | | during the 4-month period ending at the close of business on | 3 | | October 31.
| 4 | | (b-5) Medical payments may be made by the Department of | 5 | | Human Services from its appropriations relating to substance | 6 | | abuse treatment services for any fiscal year, without regard to | 7 | | the fact that the medical services being compensated for by | 8 | | such payment may have been rendered in a prior fiscal year, | 9 | | provided the payments are made on a fee-for-service basis | 10 | | consistent with requirements established for Medicaid | 11 | | reimbursement by the Department of Healthcare and Family | 12 | | Services, except as required by subsection (j) of this Section. | 13 | | Beginning on June 30, 2021, medical payments made by the | 14 | | Department of Human Services relating to substance abuse | 15 | | treatment services payable from appropriations that have | 16 | | otherwise expired may be paid out of the expiring appropriation | 17 | | during the 4-month period ending at the close of business on | 18 | | October 31. | 19 | | (b-6) Additionally, payments may be made by the Department | 20 | | of Human Services from
its appropriations, or any other State | 21 | | agency from its appropriations with
the approval of the | 22 | | Department of Human Services, from the Immigration Reform
and | 23 | | Control Fund for purposes authorized pursuant to the | 24 | | Immigration Reform
and Control Act of 1986, without regard to | 25 | | any fiscal year limitations, except as required by subsection | 26 | | (j) of this Section. Beginning on June 30, 2021, payments made |
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| 1 | | by the Department of Human Services from the Immigration Reform | 2 | | and Control Fund for purposes authorized pursuant to the | 3 | | Immigration Reform and Control Act of 1986 payable from | 4 | | appropriations that have otherwise expired may be paid out of | 5 | | the expiring appropriation during the 4-month period ending at | 6 | | the close of business on October 31.
| 7 | | (b-7) Payments may be made in accordance with a plan | 8 | | authorized by paragraph (11) or (12) of Section 405-105 of the | 9 | | Department of Central Management Services Law from | 10 | | appropriations for those payments without regard to fiscal year | 11 | | limitations. | 12 | | (b-9) Medical payments not exceeding $150,000,000 may be | 13 | | made by the Department on Aging from its appropriations | 14 | | relating to the Community Care Program for fiscal year 2014, | 15 | | without regard to the fact that the medical services being | 16 | | compensated for by such payment may have been rendered in a | 17 | | prior fiscal year, provided the payments are made on a | 18 | | fee-for-service basis consistent with requirements established | 19 | | for Medicaid reimbursement by the Department of Healthcare and | 20 | | Family Services, except as required by subsection (j) of this | 21 | | Section. | 22 | | (c) Further, payments may be made by the Department of | 23 | | Public Health and the
Department of Human Services (acting as | 24 | | successor to the Department of Public
Health under the | 25 | | Department of Human Services Act)
from their respective | 26 | | appropriations for grants for medical care to or on
behalf of |
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| 1 | | premature and high-mortality risk infants and their mothers and
| 2 | | for grants for supplemental food supplies provided under the | 3 | | United States
Department of Agriculture Women, Infants and | 4 | | Children Nutrition Program,
for any fiscal year without regard | 5 | | to the fact that the services being
compensated for by such | 6 | | payment may have been rendered in a prior fiscal year, except | 7 | | as required by subsection (j) of this Section. Beginning on | 8 | | June 30, 2021, payments made by the Department of Public Health | 9 | | and the Department of Human Services from their respective | 10 | | appropriations for grants for medical care to or on behalf of | 11 | | premature and high-mortality risk infants and their mothers and | 12 | | for grants for supplemental food supplies provided under the | 13 | | United States Department of Agriculture Women, Infants and | 14 | | Children Nutrition Program payable from appropriations that | 15 | | have otherwise expired may be paid out of the expiring | 16 | | appropriations during the 4-month period ending at the close of | 17 | | business on October 31.
| 18 | | (d) The Department of Public Health and the Department of | 19 | | Human Services
(acting as successor to the Department of Public | 20 | | Health under the Department of
Human Services Act) shall each | 21 | | annually submit to the State Comptroller, Senate
President, | 22 | | Senate
Minority Leader, Speaker of the House, House Minority | 23 | | Leader, and the
respective Chairmen and Minority Spokesmen of | 24 | | the
Appropriations Committees of the Senate and the House, on | 25 | | or before
December 31, a report of fiscal year funds used to | 26 | | pay for services
provided in any prior fiscal year. This report |
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| 1 | | shall document by program or
service category those | 2 | | expenditures from the most recently completed fiscal
year used | 3 | | to pay for services provided in prior fiscal years.
| 4 | | (e) The Department of Healthcare and Family Services, the | 5 | | Department of Human Services
(acting as successor to the | 6 | | Department of Public Aid), and the Department of Human Services | 7 | | making fee-for-service payments relating to substance abuse | 8 | | treatment services provided during a previous fiscal year shall | 9 | | each annually
submit to the State
Comptroller, Senate | 10 | | President, Senate Minority Leader, Speaker of the House,
House | 11 | | Minority Leader, the respective Chairmen and Minority | 12 | | Spokesmen of the
Appropriations Committees of the Senate and | 13 | | the House, on or before November
30, a report that shall | 14 | | document by program or service category those
expenditures from | 15 | | the most recently completed fiscal year used to pay for (i)
| 16 | | services provided in prior fiscal years and (ii) services for | 17 | | which claims were
received in prior fiscal years.
| 18 | | (f) The Department of Human Services (as successor to the | 19 | | Department of
Public Aid) shall annually submit to the State
| 20 | | Comptroller, Senate President, Senate Minority Leader, Speaker | 21 | | of the House,
House Minority Leader, and the respective | 22 | | Chairmen and Minority Spokesmen of
the Appropriations | 23 | | Committees of the Senate and the House, on or before
December | 24 | | 31, a report
of fiscal year funds used to pay for services | 25 | | (other than medical care)
provided in any prior fiscal year. | 26 | | This report shall document by program or
service category those |
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| 1 | | expenditures from the most recently completed fiscal
year used | 2 | | to pay for services provided in prior fiscal years.
| 3 | | (g) In addition, each annual report required to be | 4 | | submitted by the
Department of Healthcare and Family Services | 5 | | under subsection (e) shall include the following
information | 6 | | with respect to the State's Medicaid program:
| 7 | | (1) Explanations of the exact causes of the variance | 8 | | between the previous
year's estimated and actual | 9 | | liabilities.
| 10 | | (2) Factors affecting the Department of Healthcare and | 11 | | Family Services' liabilities,
including but not limited to | 12 | | numbers of aid recipients, levels of medical
service | 13 | | utilization by aid recipients, and inflation in the cost of | 14 | | medical
services.
| 15 | | (3) The results of the Department's efforts to combat | 16 | | fraud and abuse.
| 17 | | (h) As provided in Section 4 of the General Assembly | 18 | | Compensation Act,
any utility bill for service provided to a | 19 | | General Assembly
member's district office for a period | 20 | | including portions of 2 consecutive
fiscal years may be paid | 21 | | from funds appropriated for such expenditure in
either fiscal | 22 | | year.
| 23 | | (i) An agency which administers a fund classified by the | 24 | | Comptroller as an
internal service fund may issue rules for:
| 25 | | (1) billing user agencies in advance for payments or | 26 | | authorized inter-fund transfers
based on estimated charges |
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| 1 | | for goods or services;
| 2 | | (2) issuing credits, refunding through inter-fund | 3 | | transfers, or reducing future inter-fund transfers
during
| 4 | | the subsequent fiscal year for all user agency payments or | 5 | | authorized inter-fund transfers received during the
prior | 6 | | fiscal year which were in excess of the final amounts owed | 7 | | by the user
agency for that period; and
| 8 | | (3) issuing catch-up billings to user agencies
during | 9 | | the subsequent fiscal year for amounts remaining due when | 10 | | payments or authorized inter-fund transfers
received from | 11 | | the user agency during the prior fiscal year were less than | 12 | | the
total amount owed for that period.
| 13 | | User agencies are authorized to reimburse internal service | 14 | | funds for catch-up
billings by vouchers drawn against their | 15 | | respective appropriations for the
fiscal year in which the | 16 | | catch-up billing was issued or by increasing an authorized | 17 | | inter-fund transfer during the current fiscal year. For the | 18 | | purposes of this Act, "inter-fund transfers" means transfers | 19 | | without the use of the voucher-warrant process, as authorized | 20 | | by Section 9.01 of the State Comptroller Act.
| 21 | | (i-1) Beginning on July 1, 2021, all outstanding | 22 | | liabilities, not payable during the 4-month lapse period as | 23 | | described in subsections (b-1), (b-3), (b-4), (b-5), (b-6), and | 24 | | (c) of this Section, that are made from appropriations for that | 25 | | purpose for any fiscal year, without regard to the fact that | 26 | | the services being compensated for by those payments may have |
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| 1 | | been rendered in a prior fiscal year, are limited to only those | 2 | | claims that have been incurred but for which a proper bill or | 3 | | invoice as defined by the State Prompt Payment Act has not been | 4 | | received by September 30th following the end of the fiscal year | 5 | | in which the service was rendered. | 6 | | (j) Notwithstanding any other provision of this Act, the | 7 | | aggregate amount of payments to be made without regard for | 8 | | fiscal year limitations as contained in subsections (b-1), | 9 | | (b-3), (b-4), (b-5), (b-6), and (c) of this Section, and | 10 | | determined by using Generally Accepted Accounting Principles, | 11 | | shall not exceed the following amounts: | 12 | | (1) $6,000,000,000 for outstanding liabilities related | 13 | | to fiscal year 2012; | 14 | | (2) $5,300,000,000 for outstanding liabilities related | 15 | | to fiscal year 2013; | 16 | | (3) $4,600,000,000 for outstanding liabilities related | 17 | | to fiscal year 2014; | 18 | | (4) $4,000,000,000 for outstanding liabilities related | 19 | | to fiscal year 2015; | 20 | | (5) $3,300,000,000 for outstanding liabilities related | 21 | | to fiscal year 2016; | 22 | | (6) $2,600,000,000 for outstanding liabilities related | 23 | | to fiscal year 2017; | 24 | | (7) $2,000,000,000 for outstanding liabilities related | 25 | | to fiscal year 2018; | 26 | | (8) $1,300,000,000 for outstanding liabilities related |
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| 1 | | to fiscal year 2019; | 2 | | (9) $600,000,000 for outstanding liabilities related | 3 | | to fiscal year 2020; and | 4 | | (10) $0 for outstanding liabilities related to fiscal | 5 | | year 2021 and fiscal years thereafter. | 6 | | (k) Department of Healthcare and Family Services Medical | 7 | | Assistance Payments. | 8 | | (1) Definition of Medical Assistance. | 9 | | For purposes of this subsection, the term "Medical | 10 | | Assistance" shall include, but not necessarily be | 11 | | limited to, medical programs and services authorized | 12 | | under Titles XIX and XXI of the Social Security Act, | 13 | | the Illinois Public Aid Code, the Children's Health | 14 | | Insurance Program Act, the Covering ALL KIDS Health | 15 | | Insurance Act, the Long Term Acute Care Hospital | 16 | | Quality Improvement Transfer Program Act, and medical | 17 | | care to or on behalf of persons suffering from chronic | 18 | | renal disease, persons suffering from hemophilia , and | 19 | | victims of sexual assault. | 20 | | (2) Limitations on Medical Assistance payments that | 21 | | may be paid from future fiscal year appropriations. | 22 | | (A) The maximum amounts of annual unpaid Medical | 23 | | Assistance bills received and recorded by the | 24 | | Department of Healthcare and Family Services on or | 25 | | before June 30th of a particular fiscal year | 26 | | attributable in aggregate to the General Revenue Fund, |
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| 1 | | Healthcare Provider Relief Fund, Tobacco Settlement | 2 | | Recovery Fund, Long-Term Care Provider Fund, and the | 3 | | Drug Rebate Fund that may be paid in total by the | 4 | | Department from future fiscal year Medical Assistance | 5 | | appropriations to those funds are:
$700,000,000 for | 6 | | fiscal year 2013 and $100,000,000 for fiscal year 2014 | 7 | | and each fiscal year thereafter. | 8 | | (B) Bills for Medical Assistance services rendered | 9 | | in a particular fiscal year, but received and recorded | 10 | | by the Department of Healthcare and Family Services | 11 | | after June 30th of that fiscal year, may be paid from | 12 | | either appropriations for that fiscal year or future | 13 | | fiscal year appropriations for Medical Assistance. | 14 | | Such payments shall not be subject to the requirements | 15 | | of subparagraph (A). | 16 | | (C) Medical Assistance bills received by the | 17 | | Department of Healthcare and Family Services in a | 18 | | particular fiscal year, but subject to payment amount | 19 | | adjustments in a future fiscal year may be paid from a | 20 | | future fiscal year's appropriation for Medical | 21 | | Assistance. Such payments shall not be subject to the | 22 | | requirements of subparagraph (A). | 23 | | (D) Medical Assistance payments made by the | 24 | | Department of Healthcare and Family Services from | 25 | | funds other than those specifically referenced in | 26 | | subparagraph (A) may be made from appropriations for |
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| 1 | | those purposes for any fiscal year without regard to | 2 | | the fact that the Medical Assistance services being | 3 | | compensated for by such payment may have been rendered | 4 | | in a prior fiscal year. Such payments shall not be | 5 | | subject to the requirements of subparagraph (A). | 6 | | (3) Extended lapse period for Department of Healthcare | 7 | | and Family Services Medical Assistance payments. | 8 | | Notwithstanding any other State law to the contrary, | 9 | | outstanding Department of Healthcare and Family Services | 10 | | Medical Assistance liabilities, as of June 30th, payable | 11 | | from appropriations which have otherwise expired, may be | 12 | | paid out of the expiring appropriations during the 6-month | 13 | | period ending at the close of business on December 31st. | 14 | | (l) The changes to this Section made by Public Act 97-691 | 15 | | this amendatory Act of the 97th General Assembly shall be | 16 | | effective for payment of Medical Assistance bills incurred in | 17 | | fiscal year 2013 and future fiscal years. The changes to this | 18 | | Section made by Public Act 97-691 this amendatory Act of the | 19 | | 97th General Assembly shall not be applied to Medical | 20 | | Assistance bills incurred in fiscal year 2012 or prior fiscal | 21 | | years. | 22 | | (m) (k) The Comptroller must issue payments against | 23 | | outstanding liabilities that were received prior to the lapse | 24 | | period deadlines set forth in this Section as soon thereafter | 25 | | as practical, but no payment may be issued after the 4 months | 26 | | following the lapse period deadline without the signed |
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| 1 | | authorization of the Comptroller and the Governor. | 2 | | (Source: P.A. 96-928, eff. 6-15-10; 96-958, eff. 7-1-10; | 3 | | 96-1501, eff. 1-25-11; 97-75, eff. 6-30-11; 97-333, eff. | 4 | | 8-12-11; 97-691, eff. 7-1-12; 97-732, eff. 6-30-12; 97-932, | 5 | | eff. 8-10-12; revised 8-23-12.)
| 6 | | Section 15. The Illinois Public Aid Code is amended by | 7 | | changing Section 12-13.1 as follows:
| 8 | | (305 ILCS 5/12-13.1)
| 9 | | Sec. 12-13.1. Inspector General.
| 10 | | (a) The Governor shall appoint, and the Senate shall | 11 | | confirm, an Inspector
General who shall function within the | 12 | | Illinois Department of Public Aid (now Healthcare and Family | 13 | | Services) and
report to the Governor. The term of the Inspector | 14 | | General shall expire on the
third Monday of January, 1997 and | 15 | | every 4 years thereafter.
| 16 | | (b) In order to prevent, detect, and eliminate fraud, | 17 | | waste, abuse,
mismanagement, and misconduct, the Inspector | 18 | | General shall oversee the
Department of Healthcare and Family | 19 | | Services' and the Department on Aging's integrity
functions, | 20 | | which include, but are not limited to, the following:
| 21 | | (1) Investigation of misconduct by employees, vendors, | 22 | | contractors and
medical providers, except for allegations | 23 | | of violations of the State Officials and Employees Ethics | 24 | | Act which shall be referred to the Office of the Governor's |
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| 1 | | Executive Inspector General for investigation.
| 2 | | (2) Prepayment and post-payment audits of medical | 3 | | providers related to ensuring that appropriate
payments | 4 | | are made for services rendered and to the prevention and | 5 | | recovery of overpayments.
| 6 | | (3) Monitoring of quality assurance programs | 7 | | administered by the Department of Healthcare and Family
| 8 | | Services and the Community Care Program administered by the | 9 | | Department on Aging .
| 10 | | (4) Quality control measurements of the programs | 11 | | administered by the
Department of Healthcare and Family | 12 | | Services and the Community Care Program administered by the | 13 | | Department on Aging .
| 14 | | (5) Investigations of fraud or intentional program | 15 | | violations committed by
clients of the Department of | 16 | | Healthcare and Family Services and the Community Care | 17 | | Program administered by the Department on Aging .
| 18 | | (6) Actions initiated against contractors, vendors, or | 19 | | medical providers for any of
the following reasons:
| 20 | | (A) Violations of the medical assistance program | 21 | | and the Community Care Program administered by the | 22 | | Department on Aging .
| 23 | | (B) Sanctions against providers brought in | 24 | | conjunction with the
Department of Public Health or the | 25 | | Department of Human Services (as successor
to the | 26 | | Department of Mental Health and Developmental |
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| 1 | | Disabilities).
| 2 | | (C) Recoveries of assessments against hospitals | 3 | | and long-term care
facilities.
| 4 | | (D) Sanctions mandated by the United States | 5 | | Department of Health and
Human Services against | 6 | | medical providers.
| 7 | | (E) Violations of contracts related to any | 8 | | programs administered by the Department of Healthcare
| 9 | | and Family Services and the Community Care Program | 10 | | administered by the Department on Aging .
| 11 | | (7) Representation of the Department of Healthcare and | 12 | | Family Services at
hearings with the Illinois Department of | 13 | | Financial and Professional Regulation in actions
taken | 14 | | against professional licenses held by persons who are in | 15 | | violation of
orders for child support payments.
| 16 | | (b-5) At the request of the Secretary of Human Services, | 17 | | the Inspector
General shall, in relation to any function | 18 | | performed by the Department of Human
Services as successor to | 19 | | the Department of Public Aid, exercise one or more
of the | 20 | | powers provided under this Section as if those powers related | 21 | | to the
Department of Human Services; in such matters, the | 22 | | Inspector General shall
report his or her findings to the | 23 | | Secretary of Human Services.
| 24 | | (c) Notwithstanding, and in addition to, any other
| 25 | | provision of law, the Inspector General shall have access to | 26 | | all information, personnel
and facilities of the
Department of |
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| 1 | | Healthcare and Family Services and the Department of
Human | 2 | | Services (as successor to the Department of Public Aid), their | 3 | | employees, vendors, contractors and medical providers and any | 4 | | federal,
State or local governmental agency that are necessary | 5 | | to perform the duties of
the Office as directly related to | 6 | | public assistance programs administered by
those departments. | 7 | | No medical provider shall
be compelled, however, to provide | 8 | | individual medical records of patients who
are not clients of | 9 | | the programs administered by the Department of Healthcare and
| 10 | | Family Services. State and local
governmental agencies are | 11 | | authorized and directed to provide the requested
information, | 12 | | assistance or cooperation.
| 13 | | For purposes of enhanced program integrity functions and
| 14 | | oversight, and to the extent consistent with applicable
| 15 | | information and privacy, security, and disclosure laws, State
| 16 | | agencies and departments shall provide the Office of Inspector | 17 | | General access to confidential and other information and data, | 18 | | and the Inspector General is authorized to enter into | 19 | | agreements with appropriate federal agencies and departments | 20 | | to secure similar data. This includes, but is not limited to, | 21 | | information pertaining to: licensure; certification; earnings; | 22 | | immigration status; citizenship; wage reporting; unearned and | 23 | | earned income; pension income;
employment; supplemental | 24 | | security income; social security
numbers; National Provider | 25 | | Identifier (NPI) numbers; the
National Practitioner Data Bank | 26 | | (NPDB); program and agency
exclusions; taxpayer identification |
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| 1 | | numbers; tax delinquency;
corporate information; and death | 2 | | records. | 3 | | The Inspector General shall enter into agreements with | 4 | | State agencies and departments, and is authorized to enter into | 5 | | agreements with federal agencies and departments, under which | 6 | | such agencies and departments shall share data necessary for | 7 | | medical assistance program integrity functions and oversight. | 8 | | The Inspector General shall enter into agreements with State | 9 | | agencies and departments, and is authorized to enter into | 10 | | agreements with federal agencies and departments, under which | 11 | | such agencies shall share data necessary for recipient and | 12 | | vendor screening, review, and investigation, including but not | 13 | | limited to vendor payment and recipient eligibility | 14 | | verification. The Inspector General shall develop, in | 15 | | cooperation with other State and federal agencies and | 16 | | departments, and in compliance with applicable federal laws and | 17 | | regulations, appropriate and effective
methods to share such | 18 | | data. The Inspector General shall enter into agreements with | 19 | | State agencies and departments, and is authorized to enter into | 20 | | agreements with federal agencies and departments, including, | 21 | | but not limited to: the Secretary of State; the
Department of | 22 | | Revenue; the Department of Public Health; the
Department of | 23 | | Human Services; and the Department of Financial and | 24 | | Professional Regulation. | 25 | | The Inspector General shall have the authority to deny | 26 | | payment, prevent overpayments, and recover overpayments. |
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| 1 | | The Inspector General shall have the authority to deny or
| 2 | | suspend payment to, and deny, terminate, or suspend the
| 3 | | eligibility of, any vendor who fails to grant the Inspector
| 4 | | General timely access to full and complete records, including | 5 | | records of recipients under the medical assistance program for | 6 | | the most recent 6 years, in accordance with Section 140.28 of | 7 | | Title 89 of the Illinois Administrative Code, and other | 8 | | information for the purpose of audits, investigations, or other | 9 | | program integrity functions, after reasonable written request | 10 | | by the Inspector General. | 11 | | (d) The Inspector General shall serve as the
Department of | 12 | | Healthcare and Family Services'
primary liaison with law | 13 | | enforcement,
investigatory and prosecutorial agencies, | 14 | | including but not limited to the
following:
| 15 | | (1) The Department of State Police.
| 16 | | (2) The Federal Bureau of Investigation and other | 17 | | federal law enforcement
agencies.
| 18 | | (3) The various Inspectors General of federal agencies | 19 | | overseeing the
programs administered by the
Department of | 20 | | Healthcare and Family Services.
| 21 | | (4) The various Inspectors General of any other State | 22 | | agencies with
responsibilities for portions of programs | 23 | | primarily administered by the
Department of Healthcare and | 24 | | Family Services.
| 25 | | (5) The Offices of the several United States Attorneys | 26 | | in Illinois.
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| 1 | | (6) The several State's Attorneys.
| 2 | | (7) The offices of the Centers for Medicare and | 3 | | Medicaid Services that administer the Medicare and | 4 | | Medicaid integrity programs. | 5 | | The Inspector General shall meet on a regular basis with | 6 | | these entities to
share information regarding possible | 7 | | misconduct by any persons or entities
involved with the public | 8 | | aid programs administered by the Department
of Healthcare and | 9 | | Family Services.
| 10 | | (e) All investigations conducted by the Inspector General | 11 | | shall be conducted
in a manner that ensures the preservation of | 12 | | evidence for use in criminal
prosecutions. If the Inspector | 13 | | General determines that a possible criminal act
relating to | 14 | | fraud in the provision or administration of the medical | 15 | | assistance
program has been committed, the Inspector General | 16 | | shall immediately notify the
Medicaid Fraud Control Unit. If | 17 | | the Inspector General determines that a
possible criminal act | 18 | | has been committed within the jurisdiction of the Office,
the | 19 | | Inspector General may request the special expertise of the | 20 | | Department of
State Police. The Inspector General may present | 21 | | for prosecution the findings
of any criminal investigation to | 22 | | the Office of the Attorney General, the
Offices of the several | 23 | | United States Attorneys in Illinois or the several
State's | 24 | | Attorneys.
| 25 | | (f) To carry out his or her duties as described in this | 26 | | Section, the
Inspector General and his or her designees shall |
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| 1 | | have the power to compel
by subpoena the attendance and | 2 | | testimony of witnesses and the production
of books, electronic | 3 | | records and papers as directly related to public
assistance | 4 | | programs administered by the Department of Healthcare and | 5 | | Family Services or
the Department of Human Services (as | 6 | | successor to the Department of Public
Aid). No medical provider | 7 | | shall be compelled, however, to provide individual
medical | 8 | | records of patients who are not clients of the Medical | 9 | | Assistance
Program.
| 10 | | (g) The Inspector General shall report all convictions, | 11 | | terminations, and
suspensions taken against vendors, | 12 | | contractors and medical providers to the
Department of | 13 | | Healthcare and Family Services and to any agency responsible | 14 | | for
licensing or regulating those persons or entities.
| 15 | | (h) The Inspector General shall make annual
reports, | 16 | | findings, and recommendations regarding the Office's | 17 | | investigations
into reports of fraud, waste, abuse, | 18 | | mismanagement, or misconduct relating to
any programs | 19 | | administered by the Department
of Healthcare and Family | 20 | | Services or the Department of Human Services (as successor to | 21 | | the
Department of Public Aid) to the General Assembly and the | 22 | | Governor. These
reports shall include, but not be limited to, | 23 | | the following information:
| 24 | | (1) Aggregate provider billing and payment | 25 | | information, including the
number of providers at various | 26 | | Medicaid earning levels.
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| 1 | | (2) The number of audits of the medical assistance
| 2 | | program and the dollar savings resulting from those audits.
| 3 | | (3) The number of prescriptions rejected annually | 4 | | under the
Department of Healthcare and Family Services' | 5 | | Refill Too Soon program and the
dollar savings resulting | 6 | | from that program.
| 7 | | (4) Provider sanctions, in the aggregate, including | 8 | | terminations and
suspensions.
| 9 | | (5) A detailed summary of the investigations | 10 | | undertaken in the previous
fiscal year. These summaries | 11 | | shall comply with all laws and rules regarding
maintaining | 12 | | confidentiality in the public aid programs.
| 13 | | (i) Nothing in this Section shall limit investigations by | 14 | | the
Department of Healthcare and Family Services or the | 15 | | Department of Human Services that may
otherwise be required by | 16 | | law or that may be necessary in their capacity as the
central | 17 | | administrative authorities responsible for administration of | 18 | | their agency's
programs in this
State.
| 19 | | (j) The Inspector General may issue shields or other | 20 | | distinctive identification to his or her employees not | 21 | | exercising the powers of a peace officer if the Inspector | 22 | | General determines that a shield or distinctive identification | 23 | | is needed by an employee to carry out his or her | 24 | | responsibilities. | 25 | | (Source: P.A. 96-555, eff. 8-18-09; 96-1316, eff. 1-1-11; | 26 | | 97-689, eff. 6-14-12.)
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| 1 | | (320 ILCS 50/15 rep.) | 2 | | Section 20. The Senior Pharmaceutical Assistance Act is | 3 | | amended by repealing Section 15.
| 4 | | Section 99. Effective date. This Act takes effect upon | 5 | | becoming law.".
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