State of Illinois
92nd General Assembly

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 1                    AMENDMENT TO SENATE BILL 608

 2        AMENDMENT NO.     .  Amend Senate Bill 608 on page 1,  by
 3    replacing line 1 with the following:
 4        "AN ACT in relation to human services."; and

 5    on page 1, after line 3, by inserting the following:

 6        "Section  2.  The Illinois Act on the Aging is amended by
 7    changing Section 4.02 as follows:

 8        (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
 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, thereby enabling them to remain in their own homes or in
15    other  living  arrangements.  Such preventive services, which
16    may be coordinated with  other  programs  for  the  aged  and
17    monitored  by  area agencies on aging in cooperation with the
18    Department, may include, but are not limited to, any  or  all
19    of the following:
20             (a)  home health services;
21             (b)  home nursing services;
                            -2-            LRB9203291DJgcam06
 1             (c)  homemaker services;
 2             (d)  chore and housekeeping services;
 3             (e)  day care services;
 4             (f)  home-delivered meals;
 5             (g)  education in self-care;
 6             (h)  personal care services;
 7             (i)  adult day health services;
 8             (j)  habilitation services;
 9             (k)  respite care;
10             (l)  other   nonmedical  social  services  that  may
11        enable the person to become self-supporting; or
12             (m)  clearinghouse  for  information   provided   by
13        senior  citizen  home owners who want to rent rooms to or
14        share living space with other senior citizens.
15        The Department shall establish eligibility standards  for
16    such  services  taking into consideration the unique economic
17    and social needs of the target population for whom  they  are
18    to  be  provided.  The  eligibility  standards must include a
19    provision that,  to  be  eligible  for  services  under  this
20    Section,   a   person   may   not  have  assets  (other  than
21    specifically exempt assets) totaling more than $20,000 if:
22             (1) the person is unmarried; or
23             (2)  the  person  is  married  and  the   Department
24        determines that:
25                  (A) the person's spouse receives services under
26             this Section; or
27                  (B)  the  person's  spouse resides in a skilled
28             nursing or intermediate long-term care facility that
29             is subject to licensure by the Department of  Public
30             Health under the Nursing Home Care Act; or
31                  (C)  the  person's  spouse does not reside on a
32             permanent basis with the person and does not receive
33             support from or give support to the person; or
34                  (D) the person has been abandoned by his or her
                            -3-            LRB9203291DJgcam06
 1             spouse; or
 2                  (E) the person has been the subject of a report
 3             of abuse (as defined in the Elder Abuse and  Neglect
 4             Act) by his or her spouse.
 5        Notwithstanding  the preceding paragraph, the eligibility
 6    standards must also include a provision that, to be  eligible
 7    for  services under this Section, a person who is married and
 8    whose spouse does not receive services under this Section may
 9    not have  assets  (other  than  specifically  exempt  assets)
10    totaling  more  than  the  asset disregard amount used by the
11    Department of  Public  Aid  in  determining  eligibility  for
12    medical assistance under Article V of the Illinois Public Aid
13    Code.
14        Such   eligibility   standards  shall  be  based  on  the
15    recipient's ability to pay for services;  provided,  however,
16    that  in  determining  the  amount and nature of services for
17    which a person may qualify, consideration shall not be  given
18    to  the  value  of cash, property or other assets held in the
19    name of the person's spouse pursuant to a  written  agreement
20    dividing  marital  property into equal but separate shares or
21    pursuant to a transfer of the person's interest in a home  to
22    his  spouse,  provided that the spouse's share of the marital
23    property is not made available to  the  person  seeking  such
24    services.  The  Department  shall,  in  conjunction  with the
25    Department of Public Aid, seek appropriate  amendments  under
26    Sections  1915  and  1924  of  the  Social Security Act.  The
27    purpose of the amendments shall be to extend eligibility  for
28    home  and  community  based  services under Sections 1915 and
29    1924 of the Social Security Act to persons who transfer to or
30    for the benefit of a  spouse  those  amounts  of  income  and
31    resources  allowed  under Section 1924 of the Social Security
32    Act.   Subject  to  the  approval  of  such  amendments,  the
33    Department shall extend the provisions of Section 5-4 of  the
34    Illinois  Public  Aid  Code  to  persons  who,  but  for  the
                            -4-            LRB9203291DJgcam06
 1    provision  of home or community-based services, would require
 2    the level of care provided in an institution, as is  provided
 3    for in federal law.
 4        Those   persons  no  longer  found  to  be  eligible  for
 5    receiving noninstitutional services due  to  changes  in  the
 6    eligibility  criteria  shall be given 60 days notice prior to
 7    actual  termination.  Those  persons  receiving   notice   of
 8    termination  may  contact  the  Department  and  request  the
 9    determination  be  appealed  at  any  time  during the 60 day
10    notice period. With the exception of  the  lengthened  notice
11    and  time  frame  for  the appeal request, the appeal process
12    shall follow the normal procedure. In addition,  each  person
13    affected  regardless  of  the  circumstances for discontinued
14    eligibility shall be given  notice  and  the  opportunity  to
15    purchase  the  necessary  services through the Community Care
16    Program.  If  the  individual  does  not  elect  to  purchase
17    services,  the  Department  shall  advise  the  individual of
18    alternative services.
19        The target population identified for the purposes of this
20    Section are persons age  60  and  older  with  an  identified
21    service  need.   Priority  shall be given to those who are at
22    imminent risk of institutionalization.  The services shall be
23    provided to eligible persons age 60 and older to  the  extent
24    that  the  cost  of  the  services  together  with  the other
25    personal maintenance expenses of the persons  are  reasonably
26    related  to  the  standards  established  for care in a group
27    facility appropriate to the person's condition.
28        These  non-institutional  services,  pilot  projects   or
29    experimental  facilities  may  be  provided  as part of or in
30    addition to those authorized by federal law or  those  funded
31    and  administered  by  the Department of Human Services.  The
32    Departments of Human Services,  Public  Aid,  Public  Health,
33    Veterans'  Affairs,  and  Commerce  and Community Affairs and
34    other  appropriate  agencies  of  State,  federal  and  local
                            -5-            LRB9203291DJgcam06
 1    governments shall cooperate with the Department on  Aging  in
 2    the  establishment  and  development of the non-institutional
 3    services.
 4        The Department shall require an  annual  audit  from  all
 5    chore/housekeeping and homemaker vendors contracting with the
 6    Department under this Section.  The annual audit shall assure
 7    that  each audited vendor's procedures are in compliance with
 8    Department's financial reporting guidelines requiring  a  27%
 9    administrative  cost  split  and  a  73%  employee  wages and
10    benefits cost split.  The audit is a public record under  the
11    Freedom of Information Act.
12        The  Department  shall  execute,  relative to the nursing
13    home prescreening project,  written  inter-agency  agreements
14    with  the  Department of Human Services and the Department of
15    Public Aid, to effect the following:  (1)  intake  procedures
16    and  common  eligibility  criteria  for those persons who are
17    receiving   non-institutional   services;   and    (2)    the
18    establishment  and  development of non-institutional services
19    in areas of the State where they are not currently  available
20    or  are  undeveloped.  On and after July 1, 1996, all nursing
21    home prescreenings for individuals 60 years of age  or  older
22    shall be conducted by the Department.
23        The  Department  is  authorized  to establish a system of
24    recipient copayment for services provided under this Section,
25    such copayment to be based upon the  recipient's  ability  to
26    pay  but in no case to exceed the actual cost of the services
27    provided. Additionally, any  portion  of  a  person's  income
28    which  is  equal to or less than the federal poverty standard
29    shall not be considered by the Department in determining  the
30    copayment.  The  level  of  such  copayment shall be adjusted
31    whenever necessary to reflect any change  in  the  officially
32    designated federal poverty standard.
33        The    Department,   or   the   Department's   authorized
34    representative, shall recover the amount of  moneys  expended
                            -6-            LRB9203291DJgcam06
 1    for  services provided to or in behalf of a person under this
 2    Section by a claim against the person's estate or against the
 3    estate of the person's surviving spouse, but no recovery  may
 4    be had until after the death of the surviving spouse, if any,
 5    and  then  only at such time when there is no surviving child
 6    who is under  age  21,  blind,  or  permanently  and  totally
 7    disabled.   This  paragraph, however, shall not bar recovery,
 8    at the death of the person, of moneys for  services  provided
 9    to  the  person or in behalf of the person under this Section
10    to which the person was  not  entitled;  provided  that  such
11    recovery  shall not be enforced against any real estate while
12    it is occupied as a homestead  by  the  surviving  spouse  or
13    other  dependent,  if  no claims by other creditors have been
14    filed against the estate, or, if such claims have been filed,
15    they remain dormant for failure of prosecution or failure  of
16    the  claimant  to compel administration of the estate for the
17    purpose of payment.  This paragraph shall  not  bar  recovery
18    from  the estate of a spouse, under Sections 1915 and 1924 of
19    the Social Security Act  and  Section  5-4  of  the  Illinois
20    Public  Aid  Code,  who  precedes a person receiving services
21    under this Section in death.  All moneys for services paid to
22    or in behalf of  the  person  under  this  Section  shall  be
23    claimed  for  recovery  from  the  deceased  spouse's estate.
24    "Homestead", as used in this paragraph,  means  the  dwelling
25    house  and  contiguous  real  estate  occupied by a surviving
26    spouse or relative, as defined by the rules  and  regulations
27    of  the  Illinois Department of Public Aid, regardless of the
28    value of the property.
29        The  Department  shall  develop  procedures  to   enhance
30    availability  of  services  on  evenings, weekends, and on an
31    emergency basis to meet  the  respite  needs  of  caregivers.
32    Procedures  shall  be  developed to permit the utilization of
33    services in successive blocks of 24 hours up to  the  monthly
34    maximum  established  by  the Department.   Workers providing
                            -7-            LRB9203291DJgcam06
 1    these services shall be appropriately trained.
 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.
                            -8-            LRB9203291DJgcam06
 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. 91-303, eff. 1-1-00;  91-798,  eff.  7-9-00.)";
24    and

25    on page 4, by replacing lines 16 and 17 with the following:

26        "Section 99.  Effective date.  This Act takes effect upon
27    becoming  law,  except  that  the changes to Sec. 4.02 of the
28    Illinois Act on the Aging take effect January 1, 2002.".

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