Public Act 096-0248
 		





HB0752 Enrolled
LRB096 04648 DRJ 14707 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 on Aging and the Departments 
of Public Health and Healthcare and Family Services shall 
develop a plan to restructure the State's service delivery 
system for older adults pursuant to this Act no later than 
September 30, 2010.  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 and shall protect the rights 
of all older Illinoisans to services based on their health 
circumstances and functioning level, regardless of whether 
they receive their  care in their homes, in a community setting, 
or in a residential facility.   Financing for older adult 
services shall be based on the principle that "money follows 
the individual" taking into account individual preference, but 
shall not jeopardize the health, safety, or level of care of 
nursing home residents. 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 Healthcare and Family Services 
(formerly 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 Healthcare and Family Services 
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.


    The Older Adult Services Advisory Committee shall 
investigate innovative and promising practices operating as 
demonstration or pilot projects in Illinois and in other 
states. The Department on Aging shall provide the Older Adult 
Services Advisory Committee with a list of all demonstration or 
pilot projects funded by the Department on Aging, including 
those specified by rule, law, policy memorandum, or funding 
arrangement. The Committee shall work with the Department on 
Aging to evaluate the viability of expanding these programs 
into other areas of the State.

(Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05; 
94-766, eff. 1-1-07.)
 

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