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| Public Act 095-0565 |
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AN ACT concerning State government.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Act on the Aging is amended by | ||||
changing Section 4.02 as follows:
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(20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
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Sec. 4.02. Community Care Program.
The Department shall | ||||
establish a program of services to
prevent unnecessary | ||||
institutionalization of persons age 60 and older in
need of | ||||
long term care or who are established as persons who suffer | ||||
from
Alzheimer's disease or a related disorder under the | ||||
Alzheimer's Disease
Assistance Act, thereby enabling them
to | ||||
remain in their own homes or in other living arrangements. Such
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preventive services, which may be coordinated with other | ||||
programs for the
aged and monitored by area agencies on aging | ||||
in cooperation with the
Department, may include, but are not | ||||
limited to, any or all of the following:
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(a) (blank);
home health services;
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(b) (blank);
home nursing services;
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(c) homemaker services;
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(d) personal assistant services
chore and housekeeping | ||||
services;
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(e) adult day services;
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(f) home-delivered meals;
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(g) education in self-care;
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(h) personal care services;
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(i) adult day health services;
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(j) habilitation services;
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(k) respite care;
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(k-5) community reintegration services;
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(k-6) flexible senior services; | ||
(k-7) medication management; | ||
(k-8) emergency home response;
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(l) other nonmedical social services that may enable | ||
the person
to become self-supporting; or
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(m) clearinghouse for information provided by senior | ||
citizen home owners
who want to rent rooms to or share | ||
living space with other senior citizens.
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The Department shall establish eligibility standards for | ||
such
services taking into consideration the unique economic and | ||
social needs
of the target population for whom they are to be | ||
provided. Such eligibility
standards shall be based on the | ||
recipient's ability to pay for services;
provided, however, | ||
that in determining the amount and nature of services
for which | ||
a person may qualify, consideration shall not be given to the
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value of cash, property or other assets held in the name of the | ||
person's
spouse pursuant to a written agreement dividing | ||
marital property into equal
but separate shares or pursuant to | ||
a transfer of the person's interest in a
home to his spouse, | ||
provided that the spouse's share of the marital
property is not | ||
made available to the person seeking such services.
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Beginning July 1, 2002, the Department shall require as a | ||
condition of
eligibility that all financially eligible | ||
applicants and recipients apply
for medical assistance
under | ||
Article V of the Illinois Public Aid Code in accordance with | ||
rules
promulgated by the Department.
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Beginning January 1, 2008, the Department shall require as | ||
a condition of eligibility that all new financially eligible | ||
applicants apply for and enroll in medical assistance under | ||
Article V of the Illinois Public Aid Code in accordance with | ||
rules promulgated by the Department.
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The Department shall, in conjunction with the Department of | ||
Public Aid (now Department of Healthcare and Family Services),
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seek appropriate amendments under Sections 1915 and 1924 of the | ||
Social
Security Act. The purpose of the amendments shall be to | ||
extend eligibility
for home and community based services under | ||
Sections 1915 and 1924 of the
Social Security Act to persons | ||
who transfer to or for the benefit of a
spouse those amounts of | ||
income and resources allowed under Section 1924 of
the Social | ||
Security Act. Subject to the approval of such amendments, the
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Department shall extend the provisions of Section 5-4 of the | ||
Illinois
Public Aid Code to persons who, but for the provision | ||
of home or
community-based services, would require the level of | ||
care provided in an
institution, as is provided for in federal | ||
law. Those persons no longer
found to be eligible for receiving | ||
noninstitutional services due to changes
in the eligibility | ||
criteria shall be given 60 days notice prior to actual
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termination. Those persons receiving notice of termination may | ||
contact the
Department and request the determination be | ||
appealed at any time during the
60 day notice period. With the | ||
exception of the lengthened notice and time
frame for the | ||
appeal request, the appeal process shall follow the normal
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procedure. In addition, each person affected regardless of the
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circumstances for discontinued eligibility shall be given | ||
notice and the
opportunity to purchase the necessary services | ||
through the Community Care
Program. If the individual does not | ||
elect to purchase services, the
Department shall advise the | ||
individual of alternative services. The target
population | ||
identified for the purposes of this Section are persons age 60
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and older with an identified service need. Priority shall be | ||
given to those
who are at imminent risk of | ||
institutionalization. The services shall be
provided to | ||
eligible persons age 60 and older to the extent that the cost
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of the services together with the other personal maintenance
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expenses of the persons are reasonably related to the standards
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established for care in a group facility appropriate to the | ||
person's
condition. These non-institutional services, pilot | ||
projects or
experimental facilities may be provided as part of | ||
or in addition to
those authorized by federal law or those | ||
funded and administered by the
Department of Human Services. | ||
The Departments of Human Services, Healthcare and Family | ||
Services,
Public Health, Veterans' Affairs, and Commerce and | ||
Economic Opportunity and
other appropriate agencies of State, | ||
federal and local governments shall
cooperate with the | ||
Department on Aging in the establishment and development
of the | ||
non-institutional services. The Department shall require an | ||
annual
audit from all chore/housekeeping and homemaker vendors | ||
contracting with
the Department under this Section. The annual | ||
audit shall assure that each
audited vendor's procedures are in | ||
compliance with Department's financial
reporting guidelines | ||
requiring an administrative and employee wage and benefits cost | ||
split as defined in administrative rules. The audit is a public | ||
record under
the Freedom of Information Act. The Department | ||
shall execute, relative to
the nursing home prescreening | ||
project, written inter-agency
agreements with the Department | ||
of Human Services and the Department
of Healthcare and Family | ||
Services, to effect the following: (1) intake procedures and | ||
common
eligibility criteria for those persons who are receiving | ||
non-institutional
services; and (2) the establishment and | ||
development of non-institutional
services in areas of the State | ||
where they are not currently available or are
undeveloped. On | ||
and after July 1, 1996, all nursing home prescreenings for
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individuals 60 years of age or older shall be conducted by the | ||
Department.
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As part of the Department on Aging's routine training of | ||
case managers and case manager supervisors, the Department may | ||
include information on family futures planning for persons who | ||
are age 60 or older and who are caregivers of their adult | ||
children with developmental disabilities. The content of the | ||
training shall be at the Department's discretion. | ||
The Department is authorized to establish a system of | ||
recipient copayment
for services provided under this Section, | ||
such copayment to be based upon
the recipient's ability to pay | ||
but in no case to exceed the actual cost of
the services | ||
provided. Additionally, any portion of a person's income which
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is equal to or less than the federal poverty standard shall not | ||
be
considered by the Department in determining the copayment. | ||
The level of
such copayment shall be adjusted whenever | ||
necessary to reflect any change
in the officially designated | ||
federal poverty standard.
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The Department, or the Department's authorized | ||
representative, shall
recover the amount of moneys expended for | ||
services provided to or in
behalf of a person under this | ||
Section by a claim against the person's
estate or against the | ||
estate of the person's surviving spouse, but no
recovery may be | ||
had until after the death of the surviving spouse, if
any, and | ||
then only at such time when there is no surviving child who
is | ||
under age 21, blind, or permanently and totally disabled. This
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paragraph, however, shall not bar recovery, at the death of the | ||
person, of
moneys for services provided to the person or in | ||
behalf of the person under
this Section to which the person was | ||
not entitled;
provided that such recovery shall not be enforced | ||
against any real estate while
it is occupied as a homestead by | ||
the surviving spouse or other dependent, if no
claims by other | ||
creditors have been filed against the estate, or, if such
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claims have been filed, they remain dormant for failure of | ||
prosecution or
failure of the claimant to compel administration | ||
of the estate for the purpose
of payment. This paragraph shall | ||
not bar recovery from the estate of a spouse,
under Sections | ||
1915 and 1924 of the Social Security Act and Section 5-4 of the
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Illinois Public Aid Code, who precedes a person receiving | ||
services under this
Section in death. All moneys for services
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paid to or in behalf of the person under this Section shall be | ||
claimed for
recovery from the deceased spouse's estate. | ||
"Homestead", as used
in this paragraph, means the dwelling | ||
house and
contiguous real estate occupied by a surviving spouse
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or relative, as defined by the rules and regulations of the | ||
Department of Healthcare and Family Services, regardless of the | ||
value of the property.
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The Department shall increase the effectiveness of the | ||
existing Community Care Program by: | ||
(1) ensuring that in-home services included in the care | ||
plan are available on evenings and weekends; | ||
(2) ensuring that care plans contain the services that | ||
eligible participants' need based on the number of days in | ||
a month, not limited to specific blocks of time, as | ||
identified by the comprehensive assessment tool selected | ||
by the Department for use statewide, not to exceed the | ||
total monthly service cost maximum allowed for each | ||
service. The Department shall develop administrative rules | ||
to implement this item (2); | ||
(3) ensuring that the participants have the right to | ||
choose the services contained in their care plan and to | ||
direct how those services are provided, based on | ||
administrative rules established by the Department; | ||
(4) ensuring that the determination of need tool is | ||
accurate in determining the participants' level of need; to | ||
achieve this, the Department, in conjunction with the Older | ||
Adult Services Advisory Committee, shall institute a study | ||
of the relationship between the Determination of Need | ||
scores, level of need, Service Cost Maximums and the | ||
development and utilization of service plans no later than | ||
May 1, 2008; findings and recommendations shall be | ||
presented to the Governor and the General Assembly no later | ||
than January 1, 2009; recommendations shall include all | ||
needed changes to the service cost maximums schedule and | ||
additional covered services; | ||
(5) ensuring that homemakers can provide personal care | ||
services that may or may not involve contact with clients, | ||
including but not limited to: | ||
(A) bathing; | ||
(B) grooming; | ||
(C) toileting; | ||
(D) nail care; | ||
(E) transferring; | ||
(F) respiratory services; | ||
(G) exercise; or | ||
(H) positioning; | ||
(6) ensuring that homemaker program vendors are not | ||
restricted from hiring homemakers who are family members of | ||
clients or recommended by clients; the Department may not, | ||
by rule or policy, require homemakers who are family | ||
members of clients or recommended by clients to accept | ||
assignments in homes other than the client; and | ||
(7) ensuring that the State may access maximum federal | ||
matching funds by seeking approval for the Centers for | ||
Medicare and Medicaid Services for modifications to the | ||
State's home and community based services waiver and | ||
additional waiver opportunities in order to maximize | ||
federal matching funds; this shall include, but not be | ||
limited to, modification that reflects all changes in the | ||
Community Care Program services and all increases in the | ||
Services Cost Maximum. | ||
By January 1, 2009 or as soon after the end of the Cash and | ||
Counseling Demonstration Project as is practicable, the | ||
Department may, based on its evaluation of the demonstration | ||
project, promulgate rules concerning personal assistant | ||
services to include, but need not be limited to, | ||
qualifications, employment screening, rights under fair labor | ||
standards, training, fiduciary agent, and supervision | ||
requirements. All applicants shall be subject to the provisions | ||
of the Health Care Worker Background Check Act.
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The Department shall develop procedures to enhance | ||
availability of
services on evenings, weekends, and on an | ||
emergency basis to meet the
respite needs of caregivers. | ||
Procedures shall be developed to permit the
utilization of | ||
services in successive blocks of 24 hours up to the monthly
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maximum established by the Department. Workers providing these | ||
services
shall be appropriately trained.
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Beginning on the effective date of this Amendatory Act of | ||
1991, no person
may perform chore/housekeeping and homemaker | ||
services under a program
authorized by this Section unless that | ||
person has been issued a certificate
of pre-service to do so by | ||
his or her employing agency. Information
gathered to effect | ||
such certification shall include (i) the person's name,
(ii) | ||
the date the person was hired by his or her current employer, | ||
and
(iii) the training, including dates and levels. Persons | ||
engaged in the
program authorized by this Section before the | ||
effective date of this
amendatory Act of 1991 shall be issued a | ||
certificate of all pre- and
in-service training from his or her | ||
employer upon submitting the necessary
information. The | ||
employing agency shall be required to retain records of
all | ||
staff pre- and in-service training, and shall provide such | ||
records to
the Department upon request and upon termination of | ||
the employer's contract
with the Department. In addition, the | ||
employing agency is responsible for
the issuance of | ||
certifications of in-service training completed to their
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employees.
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The Department is required to develop a system to ensure | ||
that persons
working as homemakers and chore housekeepers | ||
receive increases in their
wages when the federal minimum wage | ||
is increased by requiring vendors to
certify that they are | ||
meeting the federal minimum wage statute for homemakers
and | ||
chore housekeepers. An employer that cannot ensure that the | ||
minimum
wage increase is being given to homemakers and chore | ||
housekeepers
shall be denied any increase in reimbursement | ||
costs.
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The Community Care Program Advisory Committee is created in | ||
the Department on Aging. The Director shall appoint individuals | ||
to serve in the Committee, who shall serve at their own | ||
expense. Members of the Committee must abide by all applicable | ||
ethics laws. The Committee shall advise the Department on | ||
issues related to the Department's program of services to | ||
prevent unnecessary institutionalization. The Committee shall | ||
meet on a bi-monthly basis and shall serve to identify and | ||
advise the Department on present and potential issues affecting | ||
the service delivery network, the program's clients, and the | ||
Department and to recommend solution strategies. Persons | ||
appointed to the Committee shall be appointed on, but not | ||
limited to, their own and their agency's experience with the | ||
program, geographic representation, and willingness to serve. | ||
The Committee shall include, but not be limited to, | ||
representatives from the following agencies and organizations: | ||
(a) at least 4 adult day service representatives; | ||
(b) at least 4 case coordination unit representatives; | ||
(c) at least 4 representatives from in-home direct care | ||
service agencies; | ||
(d) at least 2 representatives of statewide trade or | ||
labor unions that represent in-home direct care service | ||
staff;
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(e) at least 2 representatives of Area Agencies on | ||
Aging; | ||
(f) at least 2 non-provider representatives from a | ||
policy, advocacy, research, or other service organization; | ||
(g) at least 2 representatives from a statewide | ||
membership organization for senior citizens; and | ||
(h) at least 2 citizen members 60 years of age or | ||
older. | ||
Nominations may be presented from any agency or State | ||
association with interest in the program. The Director, or his | ||
or her designee, shall serve as the permanent co-chair of the | ||
advisory committee. One other co-chair shall be nominated and | ||
approved by the members of the committee on an annual basis. | ||
Committee members' terms of appointment shall be for 4 years | ||
with one-quarter of the appointees' terms expiring each year. | ||
At no time may a member serve more than one consecutive term in | ||
any capacity on the committee. The Department shall fill | ||
vacancies that have a remaining term of over one year, and this | ||
replacement shall occur through the annual replacement of | ||
expiring terms. The Director shall designate Department staff | ||
to provide technical assistance and staff support to the | ||
committee. Department representation shall not constitute | ||
membership of the committee. All Committee papers, issues, | ||
recommendations, reports, and meeting memoranda are advisory | ||
only. The Director, or his or her designee, shall make a | ||
written report, as requested by the Committee, regarding issues | ||
before the Committee.
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The Department on Aging and the Department of Human | ||
Services
shall cooperate in the development and submission of | ||
an annual report on
programs and services provided under this | ||
Section. Such joint report
shall be filed with the Governor and | ||
the General Assembly on or before
September 30 each year.
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The requirement for reporting to the General Assembly shall | ||
be satisfied
by filing copies of the report with the Speaker, | ||
the Minority Leader and
the Clerk of the House of | ||
Representatives and the President, the Minority
Leader and the | ||
Secretary of the Senate and the Legislative Research Unit,
as | ||
required by Section 3.1 of the General Assembly Organization | ||
Act and
filing such additional copies with the State Government | ||
Report Distribution
Center for the General Assembly as is | ||
required under paragraph (t) of
Section 7 of the State Library | ||
Act.
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Those persons previously found eligible for receiving | ||
non-institutional
services whose services were discontinued | ||
under the Emergency Budget Act of
Fiscal Year 1992, and who do | ||
not meet the eligibility standards in effect
on or after July | ||
1, 1992, shall remain ineligible on and after July 1,
1992. | ||
Those persons previously not required to cost-share and who | ||
were
required to cost-share effective March 1, 1992, shall | ||
continue to meet
cost-share requirements on and after July 1, | ||
1992. Beginning July 1, 1992,
all clients will be required to | ||
meet
eligibility, cost-share, and other requirements and will | ||
have services
discontinued or altered when they fail to meet | ||
these requirements.
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For the purposes of this Section, "flexible senior | ||
services" refers to services that require one-time or periodic | ||
expenditures including, but not limited to, respite care, home | ||
modification, assistive technology, housing assistance, and | ||
transportation.
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(Source: P.A. 93-85, eff. 1-1-04; 93-902, eff. 8-10-04; 94-48, | ||
eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, eff. 7-26-05; | ||
94-954, eff. 6-27-06.)
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