Public Act 095-0438
 
SB0765 Enrolled LRB095 05416 RCE 25506 b

    AN ACT concerning State government.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Disabilities Services Act of 2003 is amended
by adding a heading to Article 1 immediately before Section 1
of the Act, by adding a heading to Article 2 immediately before
Section 5 of the Act, by adding Article 3 and a heading to
Article 99 immediately before Section 90 of the Act as follows:
 
    (20 ILCS 2407/Art. 1 heading new)
ARTICLE 1. SHORT TITLE

 
    (20 ILCS 2407/Art. 2 heading new)
ARTICLE 2. DISABILITIES SERVICES ACT of 2003

 
    (20 ILCS 2407/Art. 3 heading new)
ARTICLE 3. MONEY FOLLOWS THE PERSON IMPLEMENTATION ACT

 
    (20 ILCS 2407/51 new)
    Sec. 51. Legislative intent. It is the intent of the
General Assembly to promote the civil rights of persons with
disabilities by providing community-based service for persons
with disabilities when such services are determined
appropriate and desired, as required by Title II of the
Americans with Disabilities Act under the United States Supreme
Court's decision in Olmstead v. L.C., 527 U.S. 581 (1999). In
accordance with Section 6071 of the Deficit Reduction Act of
2005 (P.L. 109-171), the purpose of this Act is (i) to identify
and reduce barriers or mechanisms, whether in State law, the
State Medicaid Plan, the State budget, or otherwise, that
prevent or restrict the flexible use of public funds to enable
individuals with disabilities to receive support for
appropriate and necessary long-term care services in settings
of their choice; (ii) to increase the use of home and
community-based long-term care services, rather than
institutions or long-term care facilities; (iii) to increase
the ability of the State Medicaid program to assure continued
provision of home and community-based long-term care services
to eligible individuals who choose to transition from an
institution or a long-term care facility to a community
setting; and (iv) to ensure that procedures are in place that
are at least comparable to those required under the qualified
home and community-based program to provide quality assurance
for eligible individuals receiving Medicaid home and
community-based long-term care services and to provide for
continuous quality improvement in such services. Utilizing the
framework created by the "Money Follows the Person"
demonstration project, approval received by the State on May
14, 2007, the purpose of this Act is to codify and reinforce
the State's commitment to promote individual choice and control
and increase utilization of home and community-based services
through:
        (a) Increased ability of the State Medicaid program to
    ensure continued provision of home and community-based
    long-term care services to eligible individuals who choose
    to transition from an institution to a community setting.
        (b) Assessment and removal of barriers to community
    reintegration, including development of a comprehensive
    housing strategy.
        (c) Expand availability of consumer self-directed
    service options.
        (d) Increased use of home and community-based
    long-term care services, rather than institutions or
    long-term care facilities, such that the percentage of the
    State long-term care budget expended for community-based
    services increases from its current 28.5% to at least 37%
    in the next 5 years.
        (e) Creation and implementation of interagency
    agreements or budgetary mechanisms to allow for the
    flexible movement of allocated dollars from institutional
    budget appropriations to appropriations supporting home
    and community-based services or Medicaid State Plan
    options.
        (f) Creation of an equitable, clinically sound and
    cost-effective system for identification and review of
    community transition candidates across all long-term care
    systems; including improvement of prescreening, assessment
    for rapid reintegration and targeted review of longer stay
    residents, training and outreach education for providers
    and consumers on community alternatives across all
    long-term care systems.
        (g) Development and implementation of data and
    information systems to track individuals across service
    systems and funding streams; support responsive
    eligibility determination; facilitate placement and care
    decisions; identify individuals with potential for
    transition; and drive planning for the development of
    community-based alternatives.
        (h) Establishment of procedures that are at least
    comparable to those required under the qualified home and
    community-based program to provide quality assurance for
    eligible individuals receiving Medicaid home and
    community-based long-term care services and to provide for
    continuous quality improvement in such services.
        (i) Nothing in this amendatory Act of the 95th General
    Assembly shall diminish or restrict the choice of an
    individual to reside in an institution or the quality of
    care they receive.
 
    (20 ILCS 2407/52 new)
    Sec. 52. Applicability; definitions. In accordance with
Section 6071 of the Deficit Reduction Act of 2005 (P.L.
109-171), as used in this Article:
    "Departments". The term "Departments" means for the
purposes of this Act, the Department of Human Services, the
Department on Aging, Department of Healthcare and Family
Services and Department of Public Health, unless otherwise
noted.
    "Home and community-based long-term care services". The
term "home and community-based long-term care services" means,
with respect to the State Medicaid program, a service aid, or
benefit, home and community-based services, including but not
limited to home health and personal care services, that are
provided to a person with a disability, and are voluntarily
accepted, as part of his or her long-term care that: (i) is
provided under the State's qualified home and community-based
program or that could be provided under such a program but is
otherwise provided under the Medicaid program; (ii) is
delivered in a qualified residence; and (iii) is necessary for
the person with a disability to live in the community.
    "Long-term care facility". The term "long-term care
facility", for the purposes of this Article, means a skilled
nursing or intermediate long-term care facility subject to
licensure by the Department of Public Health under the Nursing
Home Care Act, an intermediate care facility for the
developmentally disabled (ICF-DDs), and a State-operated
developmental center or mental health center, whether publicly
or privately owned.
    "Money Follows the Person" Demonstration. Enacted by the
Deficit Reduction Act of 2005, the Money Follows the Person
(MFP) Rebalancing Demonstration is part of a comprehensive,
coordinated strategy to assist states, in collaboration with
stakeholders, to make widespread changes to their long-term
care support systems. This initiative will assist states in
their efforts to reduce their reliance on institutional care
while developing community-based long-term care opportunities,
enabling the elderly and people with disabilities to fully
participate in their communities.
    "Public funds" mean any funds appropriated by the General
Assembly to the Departments of Human Services, on Aging, of
Healthcare and Family Services and of Public Health for
settings and services as defined in this Article.
    "Qualified residence". The term "qualified residence"
means, with respect to an eligible individual: (i) a home owned
or leased by the individual or the individual's authorized
representative (as defined by P.L. 109-171); (ii) an apartment
with an individual lease, with lockable access and egress, and
which includes living, sleeping, bathing, and cooking areas
over which the individual or the individual's family has domain
and control; or (iii) a residence, in a community-based
residential setting, in which no more than 4 unrelated
individuals reside. Where qualified residences are not
sufficient to meet the demand of eligible individuals,
time-limited exceptions to this definition may be developed
through administrative rule.
    "Self-directed services". The term "self-directed
services" means, with respect to home and community-based
long-term services for an eligible individual, those services
for the individual that are planned and purchased under the
direction and control of the individual or the individual's
authorized representative, including the amount, duration,
scope, provider, and location of such services, under the State
Medicaid program consistent with the following requirements:
        (a) Assessment: there is an assessment of the needs,
    capabilities, and preference of the individual with
    respect to such services.
        (b) Individual service care or treatment plan: based on
    the assessment, there is development jointly with such
    individual or individual's authorized representative, a
    plan for such services for the individual that (i)
    specifies those services, if any, that the individual or
    the individual's authorized representative would be
    responsible for directing; (ii) identifies the methods by
    which the individual or the individual's authorized
    representative or an agency designated by an individual or
    representative will select, manage, and dismiss providers
    of such services.
 
    (20 ILCS 2407/53 new)
    Sec. 53. Rebalancing benchmarks.
    (a) Illinois' long-term care system is in a state of
transformation, as evidenced by the creation and subsequent
work products of the Disability Services Advisory Committee,
Older Adult Services Advisory Committee, Housing Task Force and
other executive and legislative branch initiatives.
    (b) Illinois' Money Follows the Person demonstration
approval capitalizes on this progress and commits the State to
transition approximately 3,357 older persons and persons with
developmental, physical or psychiatric disabilities from
institutional to home and community-based settings, resulting
in an increased percentage of long-term care community spending
over the next 5 years.
    (c) The State will endeavor to increase the percentage of
community-based long-term care spending over the next 5 years
according to the following timeline:
        Estimated baseline: 28.5%
        Year 1: 30%
        Year 2: 31%
        Year 3: 32%
        Year 4: 35%
        Year 5: 37%
    (d) The Departments will utilize interagency agreements
and will seek legislative authority to implement a Money
Follows the Person budgetary mechanism to allocate or
reallocate funds for the purpose of expanding the availability,
quality or stability of home and community-based long-term care
services and supports for persons with disabilities.
    (e) The allocation of public funds for home and
community-based long-term care services shall not have the
effect of: (i) diminishing or reducing the quality of services
available to residents of long-term care facilities; (ii)
forcing any residents of long-term care facilities to
involuntarily accept home and community-based long-term care
services, or causing any residents of long-term care facilities
to be involuntarily transferred or discharged; (iii) causing
reductions in long-term care facility reimbursement rates in
effect as of July 1, 2008; or (iv) diminishing access to a full
array of long-term care options.
 
    (20 ILCS 2407/54 new)
    Sec. 54. Quality assurance and quality improvement.
    (a) In accordance with subsection (11) of Section 6071 of
the Deficit Reduction Act of 2005 (P.L. 109-171), the
Departments shall develop a plan for quality assurance and
quality improvement for home and community-based long-term
care services under the State Medicaid program, including a
plan to assure the health and welfare of eligible individuals
under this Act.
    (b) This plan shall require the Departments to apply for
any available funding to support the intent of this
legislation, and to seek any appropriate federal Medicaid
approval.
 
    (20 ILCS 2407/55 new)
    Sec. 55. Dissemination of reports.
    (a) On or before April 1 of each year, in conjunction with
their annual report, the Department of Healthcare and Family
Services, in cooperation with the other involved agencies,
shall report to the Governor and the General Assembly on the
implementation of this Act and include, at a minimum, the
following data: (i) a description of any interagency
agreements, fiscal payment mechanisms or methodologies
developed under this Act that effectively support choice; (ii)
information concerning the dollar amounts of State Medicaid
long-term care expenditures and the percentage of such
expenditures that were for institutional long-term care
services or were for home and community-based long-term care
services; and (iii) documentation that the Departments have met
the requirements under Section 54(a) to assure the health and
welfare of eligible individuals receiving home and
community-based long-term care services. This report must be
made available to the general public, including via the
Departmental websites.
 
    (20 ILCS 2407/56 new)
    Sec. 56. Effect on existing rights.
    (a) This Article does not alter or affect the manner in
which persons with disabilities are determined eligible or
appropriate for home and community-based long-term care
services.
    (b) This Article shall not be read to limit in any way the
rights of persons with disabilities under the U.S.
Constitution, the Americans with Disabilities Act, Section 504
of the Rehabilitation Act, the Social Security Act, or any
other federal or State law.
 
    (20 ILCS 2407/57 new)
    Sec. 57. Rules. The Departments of Human Services, on
Aging, of Healthcare and Family Services and of Public Health
shall adopt any rules necessary for the implementation and
administration of this Act.