State of Illinois
90th General Assembly
Legislation

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[ Engrossed ][ House Amendment 001 ]

90_HB1614

      20 ILCS 105/4.02          from Ch. 23, par. 6104.02
          Amends  the  Illinois  Act  on   the   Aging   concerning
      preventive services.  Adds a caption.
                                                     LRB9004323PTcw
                                               LRB9004323PTcw
 1        AN ACT to amend the Illinois Act on the Aging by amending
 2    Section 4.02.
 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:
 5        Section 5.  The Illinois Act on the Aging is  amended  by
 6    changing Section 4.02 as follows:
 7        (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
 8        (Text of Section before amendment by P.A. 89-507)
 9        Sec.  4.02.  The  Department shall establish a program of
10    services  to  prevent  unnecessary  institutionalization   of
11    persons age 60 and older in need of long term care or who are
12    established as persons who suffer from Alzheimer's disease or
13    a  related  disorder under the Alzheimer's Disease Assistance
14    Act, enacted by the 84th General Assembly,  thereby  enabling
15    them  to  remain  in  their  own  homes  or  in  other living
16    arrangements.   Such  preventive  services,  which   may   be
17    coordinated with other programs for the aged and monitored by
18    area  agencies  on  aging in cooperation with the Department,
19    may include, but are not  limited  to,  any  or  all  of  the
20    following:
21        (a)  home health services;
22        (b)  home nursing services;
23        (c)  homemaker services;
24        (d)  chore and housekeeping services;
25        (e)  day care services;
26        (f)  home-delivered meals;
27        (g)  education in self-care;
28        (h)  personal care services;
29        (i)  adult day health services;
30        (j)  habilitation services;
31        (k)  respite care; or
                            -2-                LRB9004323PTcw
 1        (l)  other nonmedical social services that may enable the
 2    person to become self-supporting.
 3        The  Department shall establish eligibility standards for
 4    such services taking into consideration the  unique  economic
 5    and  social  needs of the target population for whom they are
 6    to be provided. Such eligibility standards shall be based  on
 7    the  recipient's  ability  to  pay  for  services;  provided,
 8    however,  that  in  determining  the  amount  and  nature  of
 9    services  for which a person may qualify, consideration shall
10    not be given to the value of cash, property or  other  assets
11    held in the name of the person's spouse pursuant to a written
12    agreement  dividing  marital property into equal but separate
13    shares or pursuant to a transfer of the person's interest  in
14    a home to his spouse, provided that the spouse's share of the
15    marital  property is not made available to the person seeking
16    such services. The Department shall, in conjunction with  the
17    Department  of  Public Aid, seek appropriate amendments under
18    Sections 1915 and 1924  of  the  Social  Security  Act.   The
19    purpose  of the amendments shall be to extend eligibility for
20    home and community based services  under  Sections  1915  and
21    1924 of the Social Security Act to persons who transfer to or
22    for  the  benefit  of  a  spouse  those amounts of income and
23    resources allowed under Section 1924 of the  Social  Security
24    Act.   Subject  to  the  approval  of  such  amendments,  the
25    Department  shall extend the provisions of Section 5-4 of the
26    Illinois  Public  Aid  Code  to  persons  who,  but  for  the
27    provision of home or community-based services, would  require
28    the  level of care provided in an institution, as is provided
29    for in federal law. Those  persons  no  longer  found  to  be
30    eligible  for  receiving  noninstitutional  services  due  to
31    changes  in  the  eligibility criteria shall be given 60 days
32    notice prior to actual termination. Those  persons  receiving
33    notice  of termination may contact the Department and request
34    the determination be appealed at any time during the  60  day
                            -3-                LRB9004323PTcw
 1    notice  period.  With  the exception of the lengthened notice
 2    and time frame for the appeal  request,  the  appeal  process
 3    shall  follow  the normal procedure. In addition, each person
 4    affected regardless of  the  circumstances  for  discontinued
 5    eligibility  shall  be  given  notice  and the opportunity to
 6    purchase the necessary services through  the  Community  Care
 7    Program.  If  the  individual  does  not  elect  to  purchase
 8    services,  the  Department  shall  advise  the  individual of
 9    alternative services. The target  population  identified  for
10    the  purposes  of  this  Section are persons age 60 and older
11    with an identified service need. Priority shall be  given  to
12    those  who  are at imminent risk of institutionalization. The
13    services shall be provided to eligible  persons  age  60  and
14    older  to  the  extent that the cost of the services together
15    with the other personal maintenance expenses of  the  persons
16    are  reasonably related to the standards established for care
17    in a group facility appropriate to  the  person's  condition.
18    These   non-institutional   services,   pilot   projects   or
19    experimental  facilities  may  be  provided  as part of or in
20    addition to those authorized by federal law or  those  funded
21    and   administered   by   the  Department  of  Rehabilitation
22    Services. The Departments of Rehabilitation Services,  Public
23    Aid,  Mental  Health  and  Developmental Disabilities, Public
24    Health, Veterans' Affairs, and Commerce and Community Affairs
25    and other appropriate agencies of State,  federal  and  local
26    governments  shall  cooperate with the Department on Aging in
27    the establishment and development  of  the  non-institutional
28    services.  The  Department shall require an annual audit from
29    all chore/housekeeping and homemaker vendors contracting with
30    the Department under this Section.  The  annual  audit  shall
31    assure   that   each   audited  vendor's  procedures  are  in
32    compliance with Department's financial  reporting  guidelines
33    requiring  a 27% administrative cost split and a 73% employee
34    wages and benefits cost split. The audit is a  public  record
                            -4-                LRB9004323PTcw
 1    under  the  Freedom  of Information Act. The Department shall
 2    execute, relative to the nursing home  prescreening  project,
 3    written   inter-agency  agreements  with  the  Department  of
 4    Rehabilitation Services and the Department of Public Aid,  to
 5    effect  the  following:   (1)  intake  procedures  and common
 6    eligibility criteria for  those  persons  who  are  receiving
 7    non-institutional  services;  and  (2)  the establishment and
 8    development of non-institutional services  in  areas  of  the
 9    State   where   they  are  not  currently  available  or  are
10    undeveloped. On and after July  1,  1996,  all  nursing  home
11    prescreenings  for individuals 60 years of age or older shall
12    be conducted by the Department.
13        The Department is authorized to  establish  a  system  of
14    recipient copayment for services provided under this Section,
15    such  copayment  to  be based upon the recipient's ability to
16    pay but in no case to exceed the actual cost of the  services
17    provided.  Additionally,  any  portion  of  a person's income
18    which is equal to or less than the federal  poverty  standard
19    shall  not be considered by the Department in determining the
20    copayment. The level of  such  copayment  shall  be  adjusted
21    whenever  necessary  to  reflect any change in the officially
22    designated federal poverty standard.
23        The   Department,   or   the   Department's    authorized
24    representative,  shall  recover the amount of moneys expended
25    for services provided to or in behalf of a person under  this
26    Section by a claim against the person's estate or against the
27    estate  of the person's surviving spouse, but no recovery may
28    be had until after the death of the surviving spouse, if any,
29    and then only at such time when there is no  surviving  child
30    who  is  under  age  21,  blind,  or  permanently and totally
31    disabled.  This paragraph, however, shall not  bar  recovery,
32    at  the  death of the person, of moneys for services provided
33    to the person or in behalf of the person under  this  Section
34    to  which  the  person  was  not entitled; provided that such
                            -5-                LRB9004323PTcw
 1    recovery shall not be enforced against any real estate  while
 2    it  is  occupied  as  a  homestead by the surviving spouse or
 3    other dependent, if no claims by other  creditors  have  been
 4    filed against the estate, or, if such claims have been filed,
 5    they  remain dormant for failure of prosecution or failure of
 6    the claimant to compel administration of the estate  for  the
 7    purpose  of  payment.   This paragraph shall not bar recovery
 8    from the estate of a spouse, under Sections 1915 and 1924  of
 9    the  Social  Security  Act  and  Section  5-4 of the Illinois
10    Public Aid Code, who precedes  a  person  receiving  services
11    under this Section in death.  All moneys for services paid to
12    or  in  behalf  of  the  person  under  this Section shall be
13    claimed for  recovery  from  the  deceased  spouse's  estate.
14    "Homestead",  as  used  in this paragraph, means the dwelling
15    house and contiguous real  estate  occupied  by  a  surviving
16    spouse  or  relative, as defined by the rules and regulations
17    of the Illinois Department of Public Aid, regardless  of  the
18    value of the property.
19        The   Department  shall  develop  procedures  to  enhance
20    availability of services on evenings,  weekends,  and  on  an
21    emergency  basis  to  meet  the  respite needs of caregivers.
22    Procedures shall be developed to permit  the  utilization  of
23    services  in  successive blocks of 24 hours up to the monthly
24    maximum established by the  Department.    Workers  providing
25    these services shall be appropriately trained.
26        The   Department  shall  work  in  conjunction  with  the
27    Alzheimer's  Task  Force  and  members  of  the   Alzheimer's
28    Association  and  other  senior  citizens'  organizations  in
29    developing these procedures by December 30, 1991.
30        Beginning on the effective date of this Amendatory Act of
31    1991,  no person may perform chore/housekeeping and homemaker
32    services under a program authorized by  this  Section  unless
33    that  person  has been issued a certificate of pre-service to
34    do so by his or her employing agency.   Information  gathered
                            -6-                LRB9004323PTcw
 1    to  effect  such certification shall include (i) the person's
 2    name, (ii) the date the  person  was  hired  by  his  or  her
 3    current employer, and (iii) the training, including dates and
 4    levels.   Persons  engaged  in the program authorized by this
 5    Section before the effective date of this Amendatory  Act  of
 6    1991 shall be issued a certificate of all pre- and in-service
 7    training  from  his  or  her  employer  upon  submitting  the
 8    necessary   information.    The  employing  agency  shall  be
 9    required to retain records of all staff pre-  and  in-service
10    training,  and  shall  provide such records to the Department
11    upon request and upon termination of the employer's  contract
12    with  the  Department.   In addition, the employing agency is
13    responsible for the issuance of certifications of  in-service
14    training completed to their employees.
15        The  Department is required to develop a system to ensure
16    that persons working as  homemakers  and  chore  housekeepers
17    receive  increases  in  their  wages when the federal minimum
18    wage is increased by requiring vendors to certify  that  they
19    are  meeting  the federal minimum wage statute for homemakers
20    and chore housekeepers.  An employer that cannot ensure  that
21    the  minimum  wage  increase is being given to homemakers and
22    chore  housekeepers  shall  be   denied   any   increase   in
23    reimbursement costs.
24        The   Department   on   Aging   and   the  Department  of
25    Rehabilitation Services shall cooperate  in  the  development
26    and  submission  of an annual report on programs and services
27    provided under this Section. Such joint report shall be filed
28    with the Governor and  the  General  Assembly  on  or  before
29    September 30 each year.
30        The  requirement  for  reporting  to the General Assembly
31    shall be satisfied by filing copies of the  report  with  the
32    Speaker,  the  Minority  Leader and the Clerk of the House of
33    Representatives and the President, the  Minority  Leader  and
34    the  Secretary  of  the  Senate  and the Legislative Research
                            -7-                LRB9004323PTcw
 1    Unit, as required by Section  3.1  of  the  General  Assembly
 2    Organization  Act  and filing such additional copies with the
 3    State Government Report Distribution Center for  the  General
 4    Assembly  as  is required under paragraph (t) of Section 7 of
 5    the State Library 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
 9    do  not  meet the eligibility standards in effect on or after
10    July 1, 1992, shall remain ineligible on and  after  July  1,
11    1992.   Those  persons  previously not required to cost-share
12    and who were required to cost-share effective March 1,  1992,
13    shall  continue  to meet cost-share requirements on and after
14    July 1, 1992.  Beginning July 1, 1992, all  clients  will  be
15    required   to   meet   eligibility,   cost-share,  and  other
16    requirements and will have services discontinued  or  altered
17    when they fail to meet these requirements.
18    (Source: P.A. 89-21, eff. 7-1-95.)
19        (Text of Section after amendment by P.A. 89-507)
20        Sec.  4.02.  Preventive  services.   The Department shall
21    establish  a  program  of  services  to  prevent  unnecessary
22    institutionalization of persons age 60 and older in  need  of
23    long  term  care or who are established as persons who suffer
24    from Alzheimer's disease or  a  related  disorder  under  the
25    Alzheimer's  Disease Assistance Act, thereby enabling them to
26    remain in their own homes or in  other  living  arrangements.
27    Such preventive services, which may be coordinated with other
28    programs for the aged and monitored by area agencies on aging
29    in  cooperation with the Department, may include, but are not
30    limited to, any or all of the following:
31        (a)  home health services;
32        (b)  home nursing services;
33        (c)  homemaker services;
34        (d)  chore and housekeeping services;
                            -8-                LRB9004323PTcw
 1        (e)  day care services;
 2        (f)  home-delivered meals;
 3        (g)  education in self-care;
 4        (h)  personal care services;
 5        (i)  adult day health services;
 6        (j)  habilitation services;
 7        (k)  respite care; or
 8        (l)  other nonmedical social services that may enable the
 9    person to become self-supporting.
10        The Department shall establish eligibility standards  for
11    such  services  taking into consideration the unique economic
12    and social needs of the target population for whom  they  are
13    to  be provided. Such eligibility standards shall be based on
14    the  recipient's  ability  to  pay  for  services;  provided,
15    however,  that  in  determining  the  amount  and  nature  of
16    services for which a person may qualify, consideration  shall
17    not  be  given to the value of cash, property or other assets
18    held in the name of the person's spouse pursuant to a written
19    agreement dividing marital property into equal  but  separate
20    shares  or pursuant to a transfer of the person's interest in
21    a home to his spouse, provided that the spouse's share of the
22    marital property is not made available to the person  seeking
23    such  services. The Department shall, in conjunction with the
24    Department of Public Aid, seek appropriate  amendments  under
25    Sections  1915  and  1924  of  the  Social Security Act.  The
26    purpose of the amendments shall be to extend eligibility  for
27    home  and  community  based  services under Sections 1915 and
28    1924 of the Social Security Act to persons who transfer to or
29    for the benefit of a  spouse  those  amounts  of  income  and
30    resources  allowed  under Section 1924 of the Social Security
31    Act.   Subject  to  the  approval  of  such  amendments,  the
32    Department shall extend the provisions of Section 5-4 of  the
33    Illinois  Public  Aid  Code  to  persons  who,  but  for  the
34    provision  of home or community-based services, would require
                            -9-                LRB9004323PTcw
 1    the level of care provided in an institution, as is  provided
 2    for  in  federal  law.  Those  persons  no longer found to be
 3    eligible  for  receiving  noninstitutional  services  due  to
 4    changes in the eligibility criteria shall be  given  60  days
 5    notice  prior  to actual termination. Those persons receiving
 6    notice of termination may contact the Department and  request
 7    the  determination  be appealed at any time during the 60 day
 8    notice period. With the exception of  the  lengthened  notice
 9    and  time  frame  for  the appeal request, the appeal process
10    shall follow the normal procedure. In addition,  each  person
11    affected  regardless  of  the  circumstances for discontinued
12    eligibility shall be given  notice  and  the  opportunity  to
13    purchase  the  necessary  services through the Community Care
14    Program.  If  the  individual  does  not  elect  to  purchase
15    services,  the  Department  shall  advise  the  individual of
16    alternative services. The target  population  identified  for
17    the  purposes  of  this  Section are persons age 60 and older
18    with an identified service need.  Priority shall be given  to
19    those  who are at imminent risk of institutionalization.  The
20    services shall be provided to eligible  persons  age  60  and
21    older  to  the  extent that the cost of the services together
22    with the other personal maintenance expenses of  the  persons
23    are  reasonably related to the standards established for care
24    in a group facility appropriate to  the  person's  condition.
25    These   non-institutional   services,   pilot   projects   or
26    experimental  facilities  may  be  provided  as part of or in
27    addition to those authorized by federal law or  those  funded
28    and  administered  by  the Department of Human Services.  The
29    Departments of Human Services,  Public  Aid,  Public  Health,
30    Veterans'  Affairs,  and  Commerce  and Community Affairs and
31    other  appropriate  agencies  of  State,  federal  and  local
32    governments shall cooperate with the Department on  Aging  in
33    the  establishment  and  development of the non-institutional
34    services.  The Department shall require an annual audit  from
                            -10-               LRB9004323PTcw
 1    all chore/housekeeping and homemaker vendors contracting with
 2    the  Department  under  this Section.  The annual audit shall
 3    assure  that  each  audited  vendor's   procedures   are   in
 4    compliance  with  Department's financial reporting guidelines
 5    requiring a 27% administrative cost split and a 73%  employee
 6    wages  and benefits cost split.  The audit is a public record
 7    under the Freedom of Information Act.  The  Department  shall
 8    execute,  relative  to the nursing home prescreening project,
 9    written inter-agency agreements with the Department of  Human
10    Services  and  the  Department  of  Public Aid, to effect the
11    following:  (1)  intake  procedures  and  common  eligibility
12    criteria    for    those    persons    who    are   receiving
13    non-institutional services; and  (2)  the  establishment  and
14    development  of  non-institutional  services  in areas of the
15    State  where  they  are  not  currently  available   or   are
16    undeveloped.  On  and  after  July  1, 1996, all nursing home
17    prescreenings for individuals 60 years of age or older  shall
18    be conducted by the Department.
19        The  Department  is  authorized  to establish a system of
20    recipient copayment for services provided under this Section,
21    such copayment to be based upon the  recipient's  ability  to
22    pay  but in no case to exceed the actual cost of the services
23    provided. Additionally, any  portion  of  a  person's  income
24    which  is  equal to or less than the federal poverty standard
25    shall not be considered by the Department in determining  the
26    copayment.  The  level  of  such  copayment shall be adjusted
27    whenever necessary to reflect any change  in  the  officially
28    designated federal poverty standard.
29        The    Department,   or   the   Department's   authorized
30    representative, shall recover the amount of  moneys  expended
31    for  services provided to or in behalf of a person under this
32    Section by a claim against the person's estate or against the
33    estate of the person's surviving spouse, but no recovery  may
34    be had until after the death of the surviving spouse, if any,
                            -11-               LRB9004323PTcw
 1    and  then  only at such time when there is no surviving child
 2    who is under  age  21,  blind,  or  permanently  and  totally
 3    disabled.   This  paragraph, however, shall not bar recovery,
 4    at the death of the person, of moneys for  services  provided
 5    to  the  person or in behalf of the person under this Section
 6    to which the person was  not  entitled;  provided  that  such
 7    recovery  shall not be enforced against any real estate while
 8    it is occupied as a homestead  by  the  surviving  spouse  or
 9    other  dependent,  if  no claims by other creditors have been
10    filed against the estate, or, if such claims have been filed,
11    they remain dormant for failure of prosecution or failure  of
12    the  claimant  to compel administration of the estate for the
13    purpose of payment.  This paragraph shall  not  bar  recovery
14    from  the estate of a spouse, under Sections 1915 and 1924 of
15    the Social Security Act  and  Section  5-4  of  the  Illinois
16    Public  Aid  Code,  who  precedes a person receiving services
17    under this Section in death.  All moneys for services paid to
18    or in behalf of  the  person  under  this  Section  shall  be
19    claimed  for  recovery  from  the  deceased  spouse's estate.
20    "Homestead", as used in this paragraph,  means  the  dwelling
21    house  and  contiguous  real  estate  occupied by a surviving
22    spouse or relative, as defined by the rules  and  regulations
23    of  the  Illinois Department of Public Aid, regardless of the
24    value of the property.
25        The  Department  shall  develop  procedures  to   enhance
26    availability  of  services  on  evenings, weekends, and on an
27    emergency basis to meet  the  respite  needs  of  caregivers.
28    Procedures  shall  be  developed to permit the utilization of
29    services in successive blocks of 24 hours up to  the  monthly
30    maximum  established  by  the Department.   Workers providing
31    these services shall be appropriately trained.
32        The  Department  shall  work  in  conjunction  with   the
33    Alzheimer's   Task  Force  and  members  of  the  Alzheimer's
34    Association  and  other  senior  citizens'  organizations  in
                            -12-               LRB9004323PTcw
 1    developing these procedures by December 30, 1991.
 2        Beginning on the effective date of this Amendatory Act of
 3    1991, no person may perform chore/housekeeping and  homemaker
 4    services  under  a  program authorized by this Section unless
 5    that person has been issued a certificate of  pre-service  to
 6    do  so  by his or her employing agency.  Information gathered
 7    to effect such certification shall include (i)  the  person's
 8    name,  (ii)  the  date  the  person  was  hired by his or her
 9    current employer, and (iii) the training, including dates and
10    levels.  Persons engaged in the program  authorized  by  this
11    Section  before  the effective date of this amendatory Act of
12    1991 shall be issued a certificate of all pre- and in-service
13    training  from  his  or  her  employer  upon  submitting  the
14    necessary  information.   The  employing  agency   shall   be
15    required  to  retain records of all staff pre- and in-service
16    training, and shall provide such records  to  the  Department
17    upon  request and upon termination of the employer's contract
18    with the Department.  In addition, the  employing  agency  is
19    responsible  for the issuance of certifications of in-service
20    training completed to their employees.
21        The Department is required to develop a system to  ensure
22    that  persons  working  as  homemakers and chore housekeepers
23    receive increases in their wages  when  the  federal  minimum
24    wage  is  increased by requiring vendors to certify that they
25    are meeting the federal minimum wage statute  for  homemakers
26    and  chore housekeepers.  An employer that cannot ensure that
27    the minimum wage increase is being given  to  homemakers  and
28    chore   housekeepers   shall   be   denied  any  increase  in
29    reimbursement costs.
30        The Department on  Aging  and  the  Department  of  Human
31    Services shall cooperate in the development and submission of
32    an annual report on programs and services provided under this
33    Section.   Such joint report shall be filed with the Governor
34    and the General Assembly on or before September 30 each year.
                            -13-               LRB9004323PTcw
 1        The requirement for reporting  to  the  General  Assembly
 2    shall  be  satisfied  by filing copies of the report with the
 3    Speaker, the Minority Leader and the Clerk of  the  House  of
 4    Representatives  and  the  President, the Minority Leader and
 5    the Secretary of the  Senate  and  the  Legislative  Research
 6    Unit,  as  required  by  Section  3.1 of the General Assembly
 7    Organization Act  and filing such additional copies with  the
 8    State  Government  Report Distribution Center for the General
 9    Assembly as is required under paragraph (t) of Section  7  of
10    the State Library Act.
11        Those  persons  previously  found  eligible for receiving
12    non-institutional services whose services  were  discontinued
13    under  the  Emergency Budget Act of Fiscal Year 1992, and who
14    do not meet the eligibility standards in effect on  or  after
15    July  1,  1992,  shall remain ineligible on and after July 1,
16    1992.  Those persons previously not  required  to  cost-share
17    and  who were required to cost-share effective March 1, 1992,
18    shall continue to meet cost-share requirements on  and  after
19    July  1,  1992.   Beginning July 1, 1992, all clients will be
20    required  to  meet   eligibility,   cost-share,   and   other
21    requirements  and  will have services discontinued or altered
22    when they fail to meet these requirements.
23    (Source: P.A. 89-21, eff. 7-1-95; 89-507, eff. 7-1-97.)
24        Section 95.  No acceleration or delay.   Where  this  Act
25    makes changes in a statute that is represented in this Act by
26    text  that  is not yet or no longer in effect (for example, a
27    Section represented by multiple versions), the  use  of  that
28    text  does  not  accelerate or delay the taking effect of (i)
29    the changes made by this Act or (ii) provisions derived  from
30    any other Public Act.

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