Public Act 094-0236
 		





SB1967 Enrolled
LRB094 08053 DRJ 38236 b






    AN ACT concerning aging.

 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:


 
    Section 5. The Older Adult Services Act is amended  by 
changing Section 25 as follows:
 
    (320 ILCS 42/25)

    Sec. 25. Older adult services restructuring. No later than 
January 1, 2005, the Department shall commence the process of 
restructuring the older adult services delivery system.  
Priority shall be given to both the expansion of services and 
the development of new services in priority service areas.  
Subject to the availability of funding, the restructuring shall 
include, but not be limited to, the following:


    (1) Planning.  The Department shall develop a plan to 
restructure the State's service delivery system for older 
adults.  The plan shall include a schedule for the 
implementation of the initiatives outlined in this Act and all 
other initiatives identified by the participating agencies to 
fulfill the purposes of this Act.   Financing for older adult 
services shall be based on the principle that "money follows 
the individual". The plan shall also identify potential 
impediments to delivery system restructuring and include any 
known regulatory or statutory barriers.
    (2)  Comprehensive case management.  The Department shall 
implement a statewide system of holistic comprehensive case 
management.   The system shall include the identification and 
implementation of a universal, comprehensive assessment tool 
to be used statewide to determine the level of functional, 
cognitive, socialization, and financial needs of older adults.  
This tool shall be supported by an electronic intake, 
assessment, and care planning system linked to a central 
location.   "Comprehensive case management" includes services 
and coordination such as (i) comprehensive assessment of the 
older adult (including the physical, functional, cognitive, 
psycho-social, and social needs of the individual); (ii) 
development and implementation of a service plan with the older 
adult to mobilize the formal and family resources and services 
identified in the assessment to meet the needs of the older 
adult, including coordination of the resources and services 
with any other plans that exist for various formal services, 
such as hospital discharge plans, and with the information and 
assistance services; (iii) coordination and monitoring of 
formal and family service delivery, including coordination and 
monitoring to ensure that services specified in the plan are 
being provided; (iv) periodic reassessment and revision of the 
status of the older adult with the older adult or, if 
necessary, the older adult's designated representative; and 
(v) in accordance with the wishes of the older adult, advocacy 
on behalf of the older adult for needed services or resources.
    (3) Coordinated point of entry. The Department shall 
implement and publicize a statewide coordinated point of entry 
using a uniform name, identity, logo, and toll-free number.
    (4)  Public web site.  The Department shall develop a public 
web site that provides links to available services, resources, 
and reference materials concerning caregiving, diseases, and 
best practices for use by professionals, older adults, and 
family caregivers.
    (5)  Expansion of older adult services. The Department shall 
expand older adult services that promote independence and 
permit older adults to remain in their own homes and 
communities.
    (6)  Consumer-directed home and community-based services.  
The Department shall expand the range of service options 
available to permit older adults to exercise maximum choice and 
control over their care.
    (7)  Comprehensive delivery system.  The Department shall 
expand opportunities for older adults to receive services in 
systems that integrate acute and chronic care.
    (8)  Enhanced transition and follow-up services.  The 
Department shall implement a program of transition from one 
residential setting to another and follow-up services, 
regardless of residential setting, pursuant to rules with 
respect to (i) resident eligibility, (ii) assessment of the 
resident's health, cognitive, social, and financial needs, 
(iii) development of transition plans, and (iv) the level of 
services that must be available before transitioning a resident 
from one setting to another.
    (9)  Family caregiver support.  The Department shall develop 
strategies for public and private financing of services that 
supplement and support family caregivers.


    (10)  Quality standards and quality improvement.  The 
Department shall establish a core set of uniform quality 
standards for all providers that focus on outcomes and take 
into consideration consumer choice and satisfaction, and the 
Department shall require each provider to implement a 
continuous quality improvement process to address consumer 
issues.  The continuous quality improvement process must 
benchmark performance, be person-centered and  data-driven, and 
focus on consumer satisfaction.


    (11)  Workforce.  The Department shall develop strategies to 
attract and retain a qualified and stable worker pool, provide 
living wages and benefits, and create a work environment that 
is conducive to long-term employment and career development.  
Resources such as grants, education, and promotion of career 
opportunities may be used.
    (12)  Coordination of services. The Department shall 
identify methods to better coordinate service networks to 
maximize resources and minimize duplication of services and 
ease of application.
    (13)  Barriers to services.  The Department shall identify 
barriers to the provision, availability, and accessibility of 
services and shall implement a plan to address those barriers.  
The plan shall: (i) identify barriers, including but not 
limited to, statutory and regulatory complexity, reimbursement 
issues, payment issues, and labor force issues; (ii) recommend 
changes to State or federal laws or administrative rules or 
regulations; (iii) recommend application for federal waivers 
to improve efficiency and reduce cost and paperwork; (iv) 
develop innovative service delivery models; and (v) recommend 
application for federal or private service grants.
    (14)  Reimbursement and funding.  The Department shall 
investigate and evaluate costs and payments by defining costs 
to implement a uniform, audited provider cost reporting system 
to be considered by all Departments in establishing payments.  
To the extent possible, multiple cost reporting mandates shall 
not be imposed.
    (15)  Medicaid nursing home cost containment and Medicare 
utilization.  The Department of Public Aid, in collaboration 
with the Department on Aging and the Department of Public 
Health and in consultation with the Advisory Committee, shall 
propose a plan to contain Medicaid nursing home costs and 
maximize Medicare utilization.   The plan must not impair the 
ability of an older adult to choose among available services.  
The plan shall include, but not be limited to, (i) techniques 
to maximize the use of the most cost-effective services without 
sacrificing quality and (ii) methods to identify and serve 
older adults in need of minimal services to remain independent, 
but who are likely to develop a need for more extensive 
services in the absence of those minimal services.
    (16)  Bed reduction.  The Department of Public Health shall 
implement a nursing home conversion program to reduce the 
number of Medicaid-certified nursing home beds in areas with 
excess beds.  The Department of Public Aid shall investigate 
changes to the Medicaid nursing facility reimbursement system 
in order to reduce beds. Such changes may include, but are not 
limited to, incentive payments that will enable facilities to 
adjust to the restructuring and expansion of services required 
by the Older Adult Services Act, including adjustments for the 
voluntary closure or layaway of nursing home beds certified 
under Title XIX of the federal Social Security Act. Any savings 
shall be reallocated to fund home-based  or community-based 
older adult services pursuant to Section 20.
    (17)  Financing.  The Department shall investigate and 
evaluate financing options for older adult services and shall 
make recommendations in the report required by Section 15 
concerning the feasibility of these financing arrangements. 
These arrangements shall include, but are not limited to:
        (A)  private long-term care insurance coverage for 
    older adult services;
        (B)  enhancement of federal long-term care financing 
    initiatives;
        (C)  employer benefit programs such as medical savings 
    accounts for long-term care;
        (D)  individual and family cost-sharing options;
        (E)  strategies to reduce reliance on government 
    programs;
        (F)  fraudulent asset divestiture and financial 
    planning prevention; and
        (G)  methods to supplement and support family and 
    community caregiving.
    (18) Older Adult Services Demonstration Grants.  The 
Department shall implement a program of demonstration grants 
that will assist in the restructuring of the older adult 
services delivery system, and shall provide funding for 
innovative service delivery models and system change and 
integration initiatives pursuant to subsection (g) of Section 
20.
    (19)  Bed need methodology update.    For the purposes of 
determining areas with excess beds, the Departments shall 
provide information and assistance to the Health Facilities 
Planning Board to update the Bed Need Methodology for Long-Term 
Care to update the assumptions used to establish the 
methodology to make them consistent with modern older adult 
services.

    (20) Affordable housing. The Departments shall utilize the 
recommendations of Illinois' Annual Comprehensive Housing 
Plan, as developed by the Affordable Housing Task Force through 
the Governor's Executive Order 2003-18, in their efforts to 
address the affordable housing needs of older adults.


(Source: P.A. 93-1031, eff. 8-27-04.)
 

    Section 99. Effective date. This Act takes effect upon 
becoming law.