Illinois General Assembly - Full Text of SB2781
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Full Text of SB2781  99th General Assembly


Sen. Kwame Raoul

Filed: 4/5/2016





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2    AMENDMENT NO. ______. Amend Senate Bill 2781 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.02 as follows:
6    (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)
7    Sec. 4.02. Community Care Program. The Department shall
8establish a program of services to prevent unnecessary
9institutionalization of persons age 60 and older in need of
10long term care or who are established as persons who suffer
11from Alzheimer's disease or a related disorder under the
12Alzheimer's Disease Assistance Act, thereby enabling them to
13remain in their own homes or in other living arrangements. Such
14preventive services, which may be coordinated with other
15programs for the aged and monitored by area agencies on aging
16in cooperation with the Department, may include, but are not



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1limited to, any or all of the following:
2        (a) (blank);
3        (b) (blank);
4        (c) home care aide services;
5        (d) personal assistant services;
6        (e) adult day services;
7        (f) home-delivered meals;
8        (g) education in self-care;
9        (h) personal care services;
10        (i) adult day health services;
11        (j) habilitation services;
12        (k) respite care;
13        (k-5) community reintegration services;
14        (k-6) flexible senior services;
15        (k-7) medication management;
16        (k-8) emergency home response;
17        (l) other nonmedical social services that may enable
18    the person to become self-supporting; or
19        (m) clearinghouse for information provided by senior
20    citizen home owners who want to rent rooms to or share
21    living space with other senior citizens.
22    The Department shall establish eligibility standards for
23such services. In determining the amount and nature of services
24for which a person may qualify, consideration shall not be
25given to the value of cash, property or other assets held in
26the name of the person's spouse pursuant to a written agreement



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1dividing marital property into equal but separate shares or
2pursuant to a transfer of the person's interest in a home to
3his spouse, provided that the spouse's share of the marital
4property is not made available to the person seeking such
6    Beginning January 1, 2008, the Department shall require as
7a condition of eligibility that all new financially eligible
8applicants apply for and enroll in medical assistance under
9Article V of the Illinois Public Aid Code in accordance with
10rules promulgated by the Department.
11    The Department shall, in conjunction with the Department of
12Public Aid (now Department of Healthcare and Family Services),
13seek appropriate amendments under Sections 1915 and 1924 of the
14Social Security Act. The purpose of the amendments shall be to
15extend eligibility for home and community based services under
16Sections 1915 and 1924 of the Social Security Act to persons
17who transfer to or for the benefit of a spouse those amounts of
18income and resources allowed under Section 1924 of the Social
19Security Act. Subject to the approval of such amendments, the
20Department shall extend the provisions of Section 5-4 of the
21Illinois Public Aid Code to persons who, but for the provision
22of home or community-based services, would require the level of
23care provided in an institution, as is provided for in federal
24law. Those persons no longer found to be eligible for receiving
25noninstitutional services due to changes in the eligibility
26criteria shall be given 45 days notice prior to actual



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1termination. Those persons receiving notice of termination may
2contact the Department and request the determination be
3appealed at any time during the 45 day notice period. The
4target population identified for the purposes of this Section
5are persons age 60 and older with an identified service need.
6Priority shall be given to those who are at imminent risk of
7institutionalization. The services shall be provided to
8eligible persons age 60 and older to the extent that the cost
9of the services together with the other personal maintenance
10expenses of the persons are reasonably related to the standards
11established for care in a group facility appropriate to the
12person's condition. These non-institutional services, pilot
13projects or experimental facilities may be provided as part of
14or in addition to those authorized by federal law or those
15funded and administered by the Department of Human Services.
16The Departments of Human Services, Healthcare and Family
17Services, Public Health, Veterans' Affairs, and Commerce and
18Economic Opportunity and other appropriate agencies of State,
19federal and local governments shall cooperate with the
20Department on Aging in the establishment and development of the
21non-institutional services. The Department shall require an
22annual audit from all personal assistant and home care aide
23vendors contracting with the Department under this Section. The
24annual audit shall assure that each audited vendor's procedures
25are in compliance with Department's financial reporting
26guidelines requiring an administrative and employee wage and



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1benefits cost split as defined in administrative rules. The
2audit is a public record under the Freedom of Information Act.
3The Department shall execute, relative to the nursing home
4prescreening project, written inter-agency agreements with the
5Department of Human Services and the Department of Healthcare
6and Family Services, to effect the following: (1) intake
7procedures and common eligibility criteria for those persons
8who are receiving non-institutional services; and (2) the
9establishment and development of non-institutional services in
10areas of the State where they are not currently available or
11are undeveloped. On and after July 1, 1996, all nursing home
12prescreenings for individuals 60 years of age or older shall be
13conducted by the Department.
14    As part of the Department on Aging's routine training of
15case managers and case manager supervisors, the Department may
16include information on family futures planning for persons who
17are age 60 or older and who are caregivers of their adult
18children with developmental disabilities. The content of the
19training shall be at the Department's discretion.
20    The Department is authorized to establish a system of
21recipient copayment for services provided under this Section,
22such copayment to be based upon the recipient's ability to pay
23but in no case to exceed the actual cost of the services
24provided. Additionally, any portion of a person's income which
25is equal to or less than the federal poverty standard shall not
26be considered by the Department in determining the copayment.



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1The level of such copayment shall be adjusted whenever
2necessary to reflect any change in the officially designated
3federal poverty standard.
4    The Department, or the Department's authorized
5representative, may recover the amount of moneys expended for
6services provided to or in behalf of a person under this
7Section by a claim against the person's estate or against the
8estate of the person's surviving spouse, but no recovery may be
9had until after the death of the surviving spouse, if any, and
10then only at such time when there is no surviving child who is
11under age 21 or blind or who has a permanent and total
12disability. This paragraph, however, shall not bar recovery, at
13the death of the person, of moneys for services provided to the
14person or in behalf of the person under this Section to which
15the person was not entitled; provided that such recovery shall
16not be enforced against any real estate while it is occupied as
17a homestead by the surviving spouse or other dependent, if no
18claims by other creditors have been filed against the estate,
19or, if such claims have been filed, they remain dormant for
20failure of prosecution or failure of the claimant to compel
21administration of the estate for the purpose of payment. This
22paragraph shall not bar recovery from the estate of a spouse,
23under Sections 1915 and 1924 of the Social Security Act and
24Section 5-4 of the Illinois Public Aid Code, who precedes a
25person receiving services under this Section in death. All
26moneys for services paid to or in behalf of the person under



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1this Section shall be claimed for recovery from the deceased
2spouse's estate. "Homestead", as used in this paragraph, means
3the dwelling house and contiguous real estate occupied by a
4surviving spouse or relative, as defined by the rules and
5regulations of the Department of Healthcare and Family
6Services, regardless of the value of the property.
7    The Department shall increase the effectiveness of the
8existing Community Care Program by:
9        (1) ensuring that in-home services included in the care
10    plan are available on evenings and weekends;
11        (2) ensuring that care plans contain the services that
12    eligible participants need based on the number of days in a
13    month, not limited to specific blocks of time, as
14    identified by the comprehensive assessment tool selected
15    by the Department for use statewide, not to exceed the
16    total monthly service cost maximum allowed for each
17    service; the Department shall develop administrative rules
18    to implement this item (2);
19        (3) ensuring that the participants have the right to
20    choose the services contained in their care plan and to
21    direct how those services are provided, based on
22    administrative rules established by the Department;
23        (4) ensuring that the determination of need tool is
24    accurate in determining the participants' level of need; to
25    achieve this, the Department, in conjunction with the Older
26    Adult Services Advisory Committee, shall institute a study



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1    of the relationship between the Determination of Need
2    scores, level of need, service cost maximums, and the
3    development and utilization of service plans no later than
4    May 1, 2008; findings and recommendations shall be
5    presented to the Governor and the General Assembly no later
6    than January 1, 2009; recommendations shall include all
7    needed changes to the service cost maximums schedule and
8    additional covered services;
9        (5) ensuring that homemakers can provide personal care
10    services that may or may not involve contact with clients,
11    including but not limited to:
12            (A) bathing;
13            (B) grooming;
14            (C) toileting;
15            (D) nail care;
16            (E) transferring;
17            (F) respiratory services;
18            (G) exercise; or
19            (H) positioning;
20        (6) ensuring that homemaker program vendors are not
21    restricted from hiring homemakers who are family members of
22    clients or recommended by clients; the Department may not,
23    by rule or policy, require homemakers who are family
24    members of clients or recommended by clients to accept
25    assignments in homes other than the client;
26        (7) ensuring that the State may access maximum federal



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1    matching funds by seeking approval for the Centers for
2    Medicare and Medicaid Services for modifications to the
3    State's home and community based services waiver and
4    additional waiver opportunities, including applying for
5    enrollment in the Balance Incentive Payment Program by May
6    1, 2013, in order to maximize federal matching funds; this
7    shall include, but not be limited to, modification that
8    reflects all changes in the Community Care Program services
9    and all increases in the services cost maximum;
10        (8) ensuring that the determination of need tool
11    accurately reflects the service needs of individuals with
12    Alzheimer's disease and related dementia disorders;
13        (9) ensuring that services are authorized accurately
14    and consistently for the Community Care Program (CCP); the
15    Department shall implement a Service Authorization policy
16    directive; the purpose shall be to ensure that eligibility
17    and services are authorized accurately and consistently in
18    the CCP program; the policy directive shall clarify service
19    authorization guidelines to Care Coordination Units and
20    Community Care Program providers no later than May 1, 2013;
21        (10) working in conjunction with Care Coordination
22    Units, the Department of Healthcare and Family Services,
23    the Department of Human Services, Community Care Program
24    providers, and other stakeholders to make improvements to
25    the Medicaid claiming processes and the Medicaid
26    enrollment procedures or requirements as needed,



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1    including, but not limited to, specific policy changes or
2    rules to improve the up-front enrollment of participants in
3    the Medicaid program and specific policy changes or rules
4    to insure more prompt submission of bills to the federal
5    government to secure maximum federal matching dollars as
6    promptly as possible; the Department on Aging shall have at
7    least 3 meetings with stakeholders by January 1, 2014 in
8    order to address these improvements;
9        (11) requiring home care service providers to comply
10    with the rounding of hours worked provisions under the
11    federal Fair Labor Standards Act (FLSA) and as set forth in
12    29 CFR 785.48(b) by May 1, 2013;
13        (12) implementing any necessary policy changes or
14    promulgating any rules, no later than January 1, 2014, to
15    assist the Department of Healthcare and Family Services in
16    moving as many participants as possible, consistent with
17    federal regulations, into coordinated care plans if a care
18    coordination plan that covers long term care is available
19    in the recipient's area; and
20        (13) maintaining fiscal year 2014 rates at the same
21    level established on January 1, 2013.
22    By January 1, 2009 or as soon after the end of the Cash and
23Counseling Demonstration Project as is practicable, the
24Department may, based on its evaluation of the demonstration
25project, promulgate rules concerning personal assistant
26services, to include, but need not be limited to,



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1qualifications, employment screening, rights under fair labor
2standards, training, fiduciary agent, and supervision
3requirements. All applicants shall be subject to the provisions
4of the Health Care Worker Background Check Act.
5    The Department shall develop procedures to enhance
6availability of services on evenings, weekends, and on an
7emergency basis to meet the respite needs of caregivers.
8Procedures shall be developed to permit the utilization of
9services in successive blocks of 24 hours up to the monthly
10maximum established by the Department. Workers providing these
11services shall be appropriately trained.
12    Beginning on the effective date of this amendatory Act of
131991, no person may perform chore/housekeeping and home care
14aide services under a program authorized by this Section unless
15that person has been issued a certificate of pre-service to do
16so by his or her employing agency. Information gathered to
17effect such certification shall include (i) the person's name,
18(ii) the date the person was hired by his or her current
19employer, and (iii) the training, including dates and levels.
20Persons engaged in the program authorized by this Section
21before the effective date of this amendatory Act of 1991 shall
22be issued a certificate of all pre- and in-service training
23from his or her employer upon submitting the necessary
24information. The employing agency shall be required to retain
25records of all staff pre- and in-service training, and shall
26provide such records to the Department upon request and upon



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1termination of the employer's contract with the Department. In
2addition, the employing agency is responsible for the issuance
3of certifications of in-service training completed to their
5    The Department is required to develop a system to ensure
6that persons working as home care aides and personal assistants
7receive increases in their wages when the federal minimum wage
8is increased by requiring vendors to certify that they are
9meeting the federal minimum wage statute for home care aides
10and personal assistants. An employer that cannot ensure that
11the minimum wage increase is being given to home care aides and
12personal assistants shall be denied any increase in
13reimbursement costs. On July 1, 2016, rates shall be increased
14to $19.23 per hour, for the purpose of increasing, by at least
15$1.25 per hour, the wages paid by those vendors to their
16employees who provide homemaker services. On July 1, 2017,
17rates shall be increased to $21.32 per hour, for the purpose of
18increasing, by at least $1.25 per hour, the wages paid by those
19vendors to their employees who provide homemaker services. On
20July 1, 2018, rates shall be increased to $23.41 per hour, for
21the purpose of increasing, by at least $1.25 per hour, the
22wages paid by those vendors to their employees who provide
23homemaker services. On July 1, 2019, rates shall be increased
24to $25.08 per hour, for the purpose of increasing, by at least
25$1 per hour, the wages paid by those vendors to their employees
26who provide homemaker services. The Department shall pay an



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1enhanced rate under the Community Care Program to those in-home
2service provider agencies that offer health insurance coverage
3as a benefit to their direct service worker employees
4consistent with the mandates of Public Act 95-713. For State
5fiscal year 2017, the enhanced rate shall be $1.77 per hour.
6The rate shall be adjusted using actuarial analysis based on
7the cost of care, but shall not be set below $1.77 per hour.
8    The Community Care Program Advisory Committee is created in
9the Department on Aging. The Director shall appoint individuals
10to serve in the Committee, who shall serve at their own
11expense. Members of the Committee must abide by all applicable
12ethics laws. The Committee shall advise the Department on
13issues related to the Department's program of services to
14prevent unnecessary institutionalization. The Committee shall
15meet on a bi-monthly basis and shall serve to identify and
16advise the Department on present and potential issues affecting
17the service delivery network, the program's clients, and the
18Department and to recommend solution strategies. Persons
19appointed to the Committee shall be appointed on, but not
20limited to, their own and their agency's experience with the
21program, geographic representation, and willingness to serve.
22The Director shall appoint members to the Committee to
23represent provider, advocacy, policy research, and other
24constituencies committed to the delivery of high quality home
25and community-based services to older adults. Representatives
26shall be appointed to ensure representation from community care



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1providers including, but not limited to, adult day service
2providers, homemaker providers, case coordination and case
3management units, emergency home response providers, statewide
4trade or labor unions that represent home care aides and direct
5care staff, area agencies on aging, adults over age 60,
6membership organizations representing older adults, and other
7organizational entities, providers of care, or individuals
8with demonstrated interest and expertise in the field of home
9and community care as determined by the Director.
10    Nominations may be presented from any agency or State
11association with interest in the program. The Director, or his
12or her designee, shall serve as the permanent co-chair of the
13advisory committee. One other co-chair shall be nominated and
14approved by the members of the committee on an annual basis.
15Committee members' terms of appointment shall be for 4 years
16with one-quarter of the appointees' terms expiring each year. A
17member shall continue to serve until his or her replacement is
18named. The Department shall fill vacancies that have a
19remaining term of over one year, and this replacement shall
20occur through the annual replacement of expiring terms. The
21Director shall designate Department staff to provide technical
22assistance and staff support to the committee. Department
23representation shall not constitute membership of the
24committee. All Committee papers, issues, recommendations,
25reports, and meeting memoranda are advisory only. The Director,
26or his or her designee, shall make a written report, as



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1requested by the Committee, regarding issues before the
3    The Department on Aging and the Department of Human
4Services shall cooperate in the development and submission of
5an annual report on programs and services provided under this
6Section. Such joint report shall be filed with the Governor and
7the General Assembly on or before September 30 each year.
8    The requirement for reporting to the General Assembly shall
9be satisfied by filing copies of the report with the Speaker,
10the Minority Leader and the Clerk of the House of
11Representatives and the President, the Minority Leader and the
12Secretary of the Senate and the Legislative Research Unit, as
13required by Section 3.1 of the General Assembly Organization
14Act and filing such additional copies with the State Government
15Report Distribution Center for the General Assembly as is
16required under paragraph (t) of Section 7 of the State Library
18    Those persons previously found eligible for receiving
19non-institutional services whose services were discontinued
20under the Emergency Budget Act of Fiscal Year 1992, and who do
21not meet the eligibility standards in effect on or after July
221, 1992, shall remain ineligible on and after July 1, 1992.
23Those persons previously not required to cost-share and who
24were required to cost-share effective March 1, 1992, shall
25continue to meet cost-share requirements on and after July 1,
261992. Beginning July 1, 1992, all clients will be required to



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1meet eligibility, cost-share, and other requirements and will
2have services discontinued or altered when they fail to meet
3these requirements.
4    For the purposes of this Section, "flexible senior
5services" refers to services that require one-time or periodic
6expenditures including, but not limited to, respite care, home
7modification, assistive technology, housing assistance, and
9    The Department shall implement an electronic service
10verification based on global positioning systems or other
11cost-effective technology for the Community Care Program no
12later than January 1, 2014.
13    The Department shall require, as a condition of
14eligibility, enrollment in the medical assistance program
15under Article V of the Illinois Public Aid Code (i) beginning
16August 1, 2013, if the Auditor General has reported that the
17Department has failed to comply with the reporting requirements
18of Section 2-27 of the Illinois State Auditing Act; or (ii)
19beginning June 1, 2014, if the Auditor General has reported
20that the Department has not undertaken the required actions
21listed in the report required by subsection (a) of Section 2-27
22of the Illinois State Auditing Act.
23    The Department shall delay Community Care Program services
24until an applicant is determined eligible for medical
25assistance under Article V of the Illinois Public Aid Code (i)
26beginning August 1, 2013, if the Auditor General has reported



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1that the Department has failed to comply with the reporting
2requirements of Section 2-27 of the Illinois State Auditing
3Act; or (ii) beginning June 1, 2014, if the Auditor General has
4reported that the Department has not undertaken the required
5actions listed in the report required by subsection (a) of
6Section 2-27 of the Illinois State Auditing Act.
7    The Department shall implement co-payments for the
8Community Care Program at the federally allowable maximum level
9(i) beginning August 1, 2013, if the Auditor General has
10reported that the Department has failed to comply with the
11reporting requirements of Section 2-27 of the Illinois State
12Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
13General has reported that the Department has not undertaken the
14required actions listed in the report required by subsection
15(a) of Section 2-27 of the Illinois State Auditing Act.
16    The Department shall provide a bi-monthly report on the
17progress of the Community Care Program reforms set forth in
18this amendatory Act of the 98th General Assembly to the
19Governor, the Speaker of the House of Representatives, the
20Minority Leader of the House of Representatives, the President
21of the Senate, and the Minority Leader of the Senate.
22    The Department shall conduct a quarterly review of Care
23Coordination Unit performance and adherence to service
24guidelines. The quarterly review shall be reported to the
25Speaker of the House of Representatives, the Minority Leader of
26the House of Representatives, the President of the Senate, and



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1the Minority Leader of the Senate. The Department shall collect
2and report longitudinal data on the performance of each care
3coordination unit. Nothing in this paragraph shall be construed
4to require the Department to identify specific care
5coordination units.
6    In regard to community care providers, failure to comply
7with Department on Aging policies shall be cause for
8disciplinary action, including, but not limited to,
9disqualification from serving Community Care Program clients.
10Each provider, upon submission of any bill or invoice to the
11Department for payment for services rendered, shall include a
12notarized statement, under penalty of perjury pursuant to
13Section 1-109 of the Code of Civil Procedure, that the provider
14has complied with all Department policies.
15    The Director of the Department on Aging shall make
16information available to the State Board of Elections as may be
17required by an agreement the State Board of Elections has
18entered into with a multi-state voter registration list
19maintenance system.
20(Source: P.A. 98-8, eff. 5-3-13; 98-1171, eff. 6-1-15; 99-143,
21eff. 7-27-15.)
22    Section 99. Effective date. This Act takes effect July 1,