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.