104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB1330

 

Introduced , by Rep. Mary Beth Canty

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 105/4.02

    Amends the Illinois Act on the Aging. In provisions concerning the Community Care Program, provides that, subject to federal approval, on and after January 1, 2026, rates for in-home services shall be increased to $32.75 to sustain a minimum wage of $20 per hour for direct service workers. As a condition of their eligibility for the $32.75 in-home services rate, requires in-home services providers to (i) certify to the Department on Aging that they remain in compliance with the mandated wage increase for direct service workers and (ii) submit cost reports. Provides that fringe benefits shall not be reduced in relation to the rate increases. Provides that beginning January 1, 2028, the Department shall ensure that each in-home service provider spends a minimum of 80% of total payments the provider receives for homecare aide services it furnishes under the Community Care Program on total compensation for direct service workers who furnish those services. Requires the Department to adopt rules on financial reporting and minimum direct service worker costs. Authorizes the Department to sanction a provider that fails to meet the requirements of the amendatory Act. Defines terms.


LRB104 06107 KTG 16140 b

 

 

A BILL FOR

 

HB1330LRB104 06107 KTG 16140 b

1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Act on the Aging is amended by
5changing Section 4.02 as follows:
 
6    (20 ILCS 105/4.02)
7    Sec. 4.02. Community Care Program. The Department shall
8establish a program of services to prevent unnecessary
9institutionalization of persons age 60 and older in need of
10long term care or who are established as persons who suffer
11from Alzheimer's disease or a related disorder under the
12Alzheimer's Disease Assistance Act, thereby enabling them to
13remain in their own homes or in other living arrangements.
14Such preventive services, which may be coordinated with other
15programs for the aged, may include, but are not limited to, any
16or all of the following:
17        (a) (blank);
18        (b) (blank);
19        (c) home care aide services;
20        (d) personal assistant services;
21        (e) adult day services;
22        (f) home-delivered meals;
23        (g) education in self-care;

 

 

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1        (h) personal care services;
2        (i) adult day health services;
3        (j) habilitation services;
4        (k) respite care;
5        (k-5) community reintegration services;
6        (k-6) flexible senior services;
7        (k-7) medication management;
8        (k-8) emergency home response;
9        (l) other nonmedical social services that may enable
10    the person to become self-supporting; or
11        (m) (blank).
12    The Department shall establish eligibility standards for
13such services. In determining the amount and nature of
14services for which a person may qualify, consideration shall
15not be given to the value of cash, property, or other assets
16held in the name of the person's spouse pursuant to a written
17agreement dividing marital property into equal but separate
18shares or pursuant to a transfer of the person's interest in a
19home to his spouse, provided that the spouse's share of the
20marital property is not made available to the person seeking
21such services.
22    The Department shall require as a condition of eligibility
23that all new financially eligible applicants apply for and
24enroll in medical assistance under Article V of the Illinois
25Public Aid Code in accordance with rules promulgated by the
26Department.

 

 

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1    The Department shall, in conjunction with the Department
2of Public Aid (now Department of Healthcare and Family
3Services), seek appropriate amendments under Sections 1915 and
41924 of the Social Security Act. The purpose of the amendments
5shall be to extend eligibility for home and community based
6services under Sections 1915 and 1924 of the Social Security
7Act to persons who transfer to or for the benefit of a spouse
8those amounts of income and resources allowed under Section
91924 of the Social Security Act. Subject to the approval of
10such amendments, the Department shall extend the provisions of
11Section 5-4 of the Illinois Public Aid Code to persons who, but
12for the provision of home or community-based services, would
13require the level of care provided in an institution, as is
14provided for in federal law. Those persons no longer found to
15be eligible for receiving noninstitutional services due to
16changes in the eligibility criteria shall be given 45 days
17notice prior to actual termination. Those persons receiving
18notice of termination may contact the Department and request
19the determination be appealed at any time during the 45 day
20notice period. The target population identified for the
21purposes of this Section are persons age 60 and older with an
22identified service need. Priority shall be given to those who
23are at imminent risk of institutionalization. The services
24shall be provided to eligible persons age 60 and older to the
25extent that the cost of the services together with the other
26personal maintenance expenses of the persons are reasonably

 

 

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1related to the standards established for care in a group
2facility appropriate to the person's condition. These
3noninstitutional non-institutional services, pilot projects,
4or experimental facilities may be provided as part of or in
5addition to those authorized by federal law or those funded
6and administered by the Department of Human Services. The
7Departments of Human Services, Healthcare and Family Services,
8Public Health, Veterans' Affairs, and Commerce and Economic
9Opportunity and other appropriate agencies of State, federal,
10and local governments shall cooperate with the Department on
11Aging in the establishment and development of the
12noninstitutional non-institutional services. The Department
13shall require an annual audit from all personal assistant and
14home care aide vendors contracting with the Department under
15this Section. The annual audit shall assure that each audited
16vendor's procedures are in compliance with Department's
17financial reporting guidelines requiring an administrative and
18employee wage and benefits cost split as defined in
19administrative rules. The audit is a public record under the
20Freedom of Information Act. The Department shall execute,
21relative to the nursing home prescreening project, written
22inter-agency agreements with the Department of Human Services
23and the Department of Healthcare and Family Services, to
24effect the following: (1) intake procedures and common
25eligibility criteria for those persons who are receiving
26noninstitutional non-institutional services; and (2) the

 

 

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1establishment and development of noninstitutional
2non-institutional services in areas of the State where they
3are not currently available or are undeveloped. On and after
4July 1, 1996, all nursing home prescreenings for individuals
560 years of age or older shall be conducted by the Department.
6    As part of the Department on Aging's routine training of
7case managers and case manager supervisors, the Department may
8include information on family futures planning for persons who
9are age 60 or older and who are caregivers of their adult
10children with developmental disabilities. The content of the
11training shall be at the Department's discretion.
12    The Department is authorized to establish a system of
13recipient copayment for services provided under this Section,
14such copayment to be based upon the recipient's ability to pay
15but in no case to exceed the actual cost of the services
16provided. Additionally, any portion of a person's income which
17is equal to or less than the federal poverty standard shall not
18be considered by the Department in determining the copayment.
19The level of such copayment shall be adjusted whenever
20necessary to reflect any change in the officially designated
21federal poverty standard.
22    The Department, or the Department's authorized
23representative, may recover the amount of moneys expended for
24services provided to or in behalf of a person under this
25Section by a claim against the person's estate or against the
26estate of the person's surviving spouse, but no recovery may

 

 

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1be had until after the death of the surviving spouse, if any,
2and then only at such time when there is no surviving child who
3is under age 21 or blind or who has a permanent and total
4disability. This paragraph, however, shall not bar recovery,
5at the death of the person, of moneys for services provided to
6the person or in behalf of the person under this Section to
7which the person was not entitled; provided that such recovery
8shall not be enforced against any real estate while it is
9occupied as a homestead by the surviving spouse or other
10dependent, if no claims by other creditors have been filed
11against the estate, or, if such claims have been filed, they
12remain dormant for failure of prosecution or failure of the
13claimant to compel administration of the estate for the
14purpose of payment. This paragraph shall not bar recovery from
15the estate of a spouse, under Sections 1915 and 1924 of the
16Social Security Act and Section 5-4 of the Illinois Public Aid
17Code, who precedes a person receiving services under this
18Section in death. All moneys for services paid to or in behalf
19of the person under this Section shall be claimed for recovery
20from the deceased spouse's estate. "Homestead", as used in
21this paragraph, means the dwelling house and contiguous real
22estate occupied by a surviving spouse or relative, as defined
23by the rules and regulations of the Department of Healthcare
24and Family Services, regardless of the value of the property.
25    The Department shall increase the effectiveness of the
26existing Community Care Program by:

 

 

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1        (1) ensuring that in-home services included in the
2    care plan are available on evenings and weekends;
3        (2) ensuring that care plans contain the services that
4    eligible participants need based on the number of days in
5    a month, not limited to specific blocks of time, as
6    identified by the comprehensive assessment tool selected
7    by the Department for use statewide, not to exceed the
8    total monthly service cost maximum allowed for each
9    service; the Department shall develop administrative rules
10    to implement this item (2);
11        (3) ensuring that the participants have the right to
12    choose the services contained in their care plan and to
13    direct how those services are provided, based on
14    administrative rules established by the Department;
15        (4)(blank);
16        (5) ensuring that homemakers can provide personal care
17    services that may or may not involve contact with clients,
18    including, but not limited to:
19            (A) bathing;
20            (B) grooming;
21            (C) toileting;
22            (D) nail care;
23            (E) transferring;
24            (F) respiratory services;
25            (G) exercise; or
26            (H) positioning;

 

 

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1        (6) ensuring that homemaker program vendors are not
2    restricted from hiring homemakers who are family members
3    of clients or recommended by clients; the Department may
4    not, by rule or policy, require homemakers who are family
5    members of clients or recommended by clients to accept
6    assignments in homes other than the client;
7        (7) ensuring that the State may access maximum federal
8    matching funds by seeking approval for the Centers for
9    Medicare and Medicaid Services for modifications to the
10    State's home and community based services waiver and
11    additional waiver opportunities, including applying for
12    enrollment in the Balance Incentive Payment Program by May
13    1, 2013, in order to maximize federal matching funds; this
14    shall include, but not be limited to, modification that
15    reflects all changes in the Community Care Program
16    services and all increases in the services cost maximum;
17        (8) ensuring that the determination of need tool
18    accurately reflects the service needs of individuals with
19    Alzheimer's disease and related dementia disorders;
20        (9) ensuring that services are authorized accurately
21    and consistently for the Community Care Program (CCP); the
22    Department shall implement a Service Authorization policy
23    directive; the purpose shall be to ensure that eligibility
24    and services are authorized accurately and consistently in
25    the CCP program; the policy directive shall clarify
26    service authorization guidelines to Care Coordination

 

 

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1    Units and Community Care Program providers no later than
2    May 1, 2013;
3        (10) working in conjunction with Care Coordination
4    Units, the Department of Healthcare and Family Services,
5    the Department of Human Services, Community Care Program
6    providers, and other stakeholders to make improvements to
7    the Medicaid claiming processes and the Medicaid
8    enrollment procedures or requirements as needed,
9    including, but not limited to, specific policy changes or
10    rules to improve the up-front enrollment of participants
11    in the Medicaid program and specific policy changes or
12    rules to insure more prompt submission of bills to the
13    federal government to secure maximum federal matching
14    dollars as promptly as possible; the Department on Aging
15    shall have at least 3 meetings with stakeholders by
16    January 1, 2014 in order to address these improvements;
17        (11) requiring home care service providers to comply
18    with the rounding of hours worked provisions under the
19    federal Fair Labor Standards Act (FLSA) and as set forth
20    in 29 CFR 785.48(b) by May 1, 2013;
21        (12) implementing any necessary policy changes or
22    promulgating any rules, no later than January 1, 2014, to
23    assist the Department of Healthcare and Family Services in
24    moving as many participants as possible, consistent with
25    federal regulations, into coordinated care plans if a care
26    coordination plan that covers long term care is available

 

 

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1    in the recipient's area; and
2        (13) (blank).
3    By January 1, 2009 or as soon after the end of the Cash and
4Counseling Demonstration Project as is practicable, the
5Department may, based on its evaluation of the demonstration
6project, promulgate rules concerning personal assistant
7services, to include, but need not be limited to,
8qualifications, employment screening, rights under fair labor
9standards, training, fiduciary agent, and supervision
10requirements. All applicants shall be subject to the
11provisions of the Health Care Worker Background Check Act.
12    The Department shall develop procedures to enhance
13availability of services on evenings, weekends, and on an
14emergency basis to meet the respite needs of caregivers.
15Procedures shall be developed to permit the utilization of
16services in successive blocks of 24 hours up to the monthly
17maximum established by the Department. Workers providing these
18services shall be appropriately trained.
19    No September 23, 1991 (Public Act 87-729) person may
20perform chore/housekeeping and home care aide services under a
21program authorized by this Section unless that person has been
22issued a certificate of pre-service to do so by his or her
23employing agency. Information gathered to effect such
24certification shall include (i) the person's name, (ii) the
25date the person was hired by his or her current employer, and
26(iii) the training, including dates and levels. Persons

 

 

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1engaged in the program authorized by this Section before the
2effective date of this amendatory Act of 1991 shall be issued a
3certificate of all pre-service and in-service training from
4his or her employer upon submitting the necessary information.
5The employing agency shall be required to retain records of
6all staff pre-service and in-service training, and shall
7provide such records to the Department upon request and upon
8termination of the employer's contract with the Department. In
9addition, the employing agency is responsible for the issuance
10of certifications of in-service training completed to their
11employees.
12    The Department is required to develop a system to ensure
13that persons working as home care aides and personal
14assistants receive increases in their wages when the federal
15minimum wage is increased by requiring vendors to certify that
16they are meeting the federal minimum wage statute for home
17care aides and personal assistants. An employer that cannot
18ensure that the minimum wage increase is being given to home
19care aides and personal assistants shall be denied any
20increase in reimbursement costs.
21    The Community Care Program Advisory Committee is created
22in the Department on Aging. The Director shall appoint
23individuals to serve in the Committee, who shall serve at
24their own expense. Members of the Committee must abide by all
25applicable ethics laws. The Committee shall advise the
26Department on issues related to the Department's program of

 

 

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1services to prevent unnecessary institutionalization. The
2Committee shall meet on a bi-monthly basis and shall serve to
3identify and advise the Department on present and potential
4issues affecting the service delivery network, the program's
5clients, and the Department and to recommend solution
6strategies. Persons appointed to the Committee shall be
7appointed on, but not limited to, their own and their agency's
8experience with the program, geographic representation, and
9willingness to serve. The Director shall appoint members to
10the Committee to represent provider, advocacy, policy
11research, and other constituencies committed to the delivery
12of high quality home and community-based services to older
13adults. Representatives shall be appointed to ensure
14representation from community care providers, including, but
15not limited to, adult day service providers, homemaker
16providers, case coordination and case management units,
17emergency home response providers, statewide trade or labor
18unions that represent home care aides and direct care staff,
19area agencies on aging, adults over age 60, membership
20organizations representing older adults, and other
21organizational entities, providers of care, or individuals
22with demonstrated interest and expertise in the field of home
23and community care as determined by the Director.
24    Nominations may be presented from any agency or State
25association with interest in the program. The Director, or his
26or her designee, shall serve as the permanent co-chair of the

 

 

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1advisory committee. One other co-chair shall be nominated and
2approved by the members of the committee on an annual basis.
3Committee members' terms of appointment shall be for 4 years
4with one-quarter of the appointees' terms expiring each year.
5A member shall continue to serve until his or her replacement
6is named. The Department shall fill vacancies that have a
7remaining term of over one year, and this replacement shall
8occur through the annual replacement of expiring terms. The
9Director shall designate Department staff to provide technical
10assistance and staff support to the committee. Department
11representation shall not constitute membership of the
12committee. All Committee papers, issues, recommendations,
13reports, and meeting memoranda are advisory only. The
14Director, or his or her designee, shall make a written report,
15as requested by the Committee, regarding issues before the
16Committee.
17    The Department on Aging and the Department of Human
18Services shall cooperate in the development and submission of
19an annual report on programs and services provided under this
20Section. Such joint report shall be filed with the Governor
21and the General Assembly on or before March 31 of the following
22fiscal year.
23    The requirement for reporting to the General Assembly
24shall be satisfied by filing copies of the report as required
25by Section 3.1 of the General Assembly Organization Act and
26filing such additional copies with the State Government Report

 

 

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1Distribution Center for the General Assembly as is required
2under paragraph (t) of Section 7 of the State Library Act.
3    Those persons previously found eligible for receiving
4noninstitutional non-institutional services whose services
5were discontinued under the Emergency Budget Act of Fiscal
6Year 1992, and who do not meet the eligibility standards in
7effect on or after July 1, 1992, shall remain ineligible on and
8after July 1, 1992. Those persons previously not required to
9cost-share and who were required to cost-share effective March
101, 1992, shall continue to meet cost-share requirements on and
11after July 1, 1992. Beginning July 1, 1992, all clients will be
12required to meet eligibility, cost-share, and other
13requirements and will have services discontinued or altered
14when they fail to meet these requirements.
15    For the purposes of this Section, "flexible senior
16services" refers to services that require one-time or periodic
17expenditures, including, but not limited to, respite care,
18home modification, assistive technology, housing assistance,
19and transportation.
20    The Department shall implement an electronic service
21verification based on global positioning systems or other
22cost-effective technology for the Community Care Program no
23later than January 1, 2014.
24    The Department shall require, as a condition of
25eligibility, application for the medical assistance program
26under Article V of the Illinois Public Aid Code.

 

 

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1    The Department may authorize Community Care Program
2services until an applicant is determined eligible for medical
3assistance under Article V of the Illinois Public Aid Code.
4    The Department shall continue to provide Community Care
5Program reports as required by statute, which shall include an
6annual report on Care Coordination Unit performance and
7adherence to service guidelines and a 6-month supplemental
8report.
9    In regard to community care providers, failure to comply
10with Department on Aging policies shall be cause for
11disciplinary action, including, but not limited to,
12disqualification from serving Community Care Program clients.
13Each provider, upon submission of any bill or invoice to the
14Department for payment for services rendered, shall include a
15notarized statement, under penalty of perjury pursuant to
16Section 1-109 of the Code of Civil Procedure, that the
17provider has complied with all Department policies.
18    The Director of the Department on Aging shall make
19information available to the State Board of Elections as may
20be required by an agreement the State Board of Elections has
21entered into with a multi-state voter registration list
22maintenance system.
23    The Department shall pay an enhanced rate of at least
24$1.77 per unit under the Community Care Program to those
25in-home service provider agencies that offer health insurance
26coverage as a benefit to their direct service worker employees

 

 

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1pursuant to rules adopted by the Department. The Department
2shall review the enhanced rate as part of its process to rebase
3in-home service provider reimbursement rates pursuant to
4federal waiver requirements. Subject to federal approval,
5beginning on January 1, 2024, rates for adult day services
6shall be increased to $16.84 per hour and rates for each way
7transportation services for adult day services shall be
8increased to $12.44 per unit transportation.
9    Subject to federal approval, on and after January 1, 2024,
10rates for homemaker services shall be increased to $28.07 to
11sustain a minimum wage of $17 per hour for direct service
12workers. Rates in subsequent State fiscal years shall be no
13lower than the rates put into effect upon federal approval.
14Providers of in-home services shall be required to certify to
15the Department that they remain in compliance with the
16mandated wage increase for direct service workers. Fringe
17benefits, including, but not limited to, paid time off and
18payment for training, health insurance, travel, or
19transportation, shall not be reduced in relation to the rate
20increases described in this paragraph.
21    Subject to and upon federal approval, on and after January
221, 2025, rates for homemaker services shall be increased to
23$29.63 to sustain a minimum wage of $18 per hour for direct
24service workers. Rates in subsequent State fiscal years shall
25be no lower than the rates put into effect upon federal
26approval. Providers of in-home services shall be required to

 

 

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1certify to the Department that they remain in compliance with
2the mandated wage increase for direct service workers. Fringe
3benefits, including, but not limited to, paid time off and
4payment for training, health insurance, travel, or
5transportation, shall not be reduced in relation to the rate
6increases described in this paragraph.
7    Subject to federal approval, on and after January 1, 2026,
8rates for in-home services shall be increased to $32.75 to
9sustain a minimum wage of $20 per hour for direct service
10workers. Rates in subsequent State fiscal years shall be no
11lower than the rates put into effect upon federal approval. In
12order for a provider of in-home services to be eligible to
13receive the $32.75 rate, the provider must pay a minimum wage
14of $20 per hour to all direct service workers employed by the
15provider. Providers of in-home services shall be required to
16certify to the Department that they remain in compliance with
17the mandated wage increase for direct service workers. By no
18more than 60 days after issuing notification of the rate
19increase, the Department shall require providers of in-home
20services to submit such certification to the Department in
21order for the provider to be eligible for the $32.75 rate for
22in-home services. The Department shall also require each
23provider of in-home services to submit cost reports to the
24Department consistent with Section 240.2023 of Title 89 of the
25Illinois Administrative Code in order for the provider to be
26eligible for the $32.75 rate for in-home services. Fringe

 

 

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1benefits, including, but not limited to, paid time off and
2payment for training, health insurance, travel, or
3transportation, shall not be reduced in relation to the rate
4increases described in this paragraph.
5    To ensure that in-home service payment rates are adequate
6to maintain a sufficient direct care workforce to meet the
7needs of Community Care Program beneficiaries and provide
8access to services in the amount, duration, and scope
9specified in beneficiaries' person-centered service plans,
10beginning January 1, 2028, the Department shall ensure that
11each in-home service provider spends a minimum of 80% of total
12payments the provider receives for homecare aide services it
13furnishes under the Community Care Program on total
14compensation for direct service workers who furnish those
15services. "Compensation" means salary, wages, and other
16remuneration as defined by the Fair Labor Standards Act and
17implementing regulations (29 U.S.C. 201 et seq., 29 CFR Parts
18531 and 778); benefits (such as health and dental benefits,
19life and disability insurance, paid leave, retirement, and
20tuition reimbursement); and the employer share of payroll
21taxes for direct service workers delivering services
22authorized under this Section. This calculation shall not
23include excluded costs as defined in this paragraph. The
24Department shall require each provider annually to submit a
25direct service worker cost report certifying that the provider
26has met the minimum spending requirement. The report must be

 

 

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1based upon actual, documented expenditures, attested to by an
2authorized representative of the provider, and submitted
3within 6 months after the end of the reporting period. The
4Department shall adopt rules amending current rules on
5financial reporting and minimum direct service worker costs to
6implement this paragraph. If a provider fails to meet the
7requirements of this paragraph, the Department may sanction
8the provider by closing intake of Community Care Program
9participants on some or all of the provider's contracts for a
10period of time, or by terminating some or all of the provider's
11contracts under the Community Care Program. For purposes of
12this paragraph, "excluded costs" mean costs of administering
13required trainings for direct service workers (such as costs
14for qualified trainers and training materials); travel costs
15for direct service workers (such as mileage reimbursement or
16public transportation subsidies); costs of personal protective
17equipment for direct service workers; and the cost of health
18insurance coverage for direct service workers not exceeding
19the value of an enhanced rate paid under the Community Care
20Program to in-home service provider agencies that offer health
21insurance coverage as a benefit to direct service workers
22consistent with the mandates of Public Act 95-713.
23    The General Assembly finds it necessary to authorize an
24aggressive Medicaid enrollment initiative designed to maximize
25federal Medicaid funding for the Community Care Program which
26produces significant savings for the State of Illinois. The

 

 

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1Department on Aging shall establish and implement a Community
2Care Program Medicaid Initiative. Under the Initiative, the
3Department on Aging shall, at a minimum: (i) provide an
4enhanced rate to adequately compensate care coordination units
5to enroll eligible Community Care Program clients into
6Medicaid; (ii) use recommendations from a stakeholder
7committee on how best to implement the Initiative; and (iii)
8establish requirements for State agencies to make enrollment
9in the State's Medical Assistance program easier for seniors.
10    The Community Care Program Medicaid Enrollment Oversight
11Subcommittee is created as a subcommittee of the Older Adult
12Services Advisory Committee established in Section 35 of the
13Older Adult Services Act to make recommendations on how best
14to increase the number of medical assistance recipients who
15are enrolled in the Community Care Program. The Subcommittee
16shall consist of all of the following persons who must be
17appointed within 30 days after June 4, 2018 (the effective
18date of Public Act 100-587):
19        (1) The Director of Aging, or his or her designee, who
20    shall serve as the chairperson of the Subcommittee.
21        (2) One representative of the Department of Healthcare
22    and Family Services, appointed by the Director of
23    Healthcare and Family Services.
24        (3) One representative of the Department of Human
25    Services, appointed by the Secretary of Human Services.
26        (4) One individual representing a care coordination

 

 

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1    unit, appointed by the Director of Aging.
2        (5) One individual from a non-governmental statewide
3    organization that advocates for seniors, appointed by the
4    Director of Aging.
5        (6) One individual representing Area Agencies on
6    Aging, appointed by the Director of Aging.
7        (7) One individual from a statewide association
8    dedicated to Alzheimer's care, support, and research,
9    appointed by the Director of Aging.
10        (8) One individual from an organization that employs
11    persons who provide services under the Community Care
12    Program, appointed by the Director of Aging.
13        (9) One member of a trade or labor union representing
14    persons who provide services under the Community Care
15    Program, appointed by the Director of Aging.
16        (10) One member of the Senate, who shall serve as
17    co-chairperson, appointed by the President of the Senate.
18        (11) One member of the Senate, who shall serve as
19    co-chairperson, appointed by the Minority Leader of the
20    Senate.
21        (12) One member of the House of Representatives, who
22    shall serve as co-chairperson, appointed by the Speaker of
23    the House of Representatives.
24        (13) One member of the House of Representatives, who
25    shall serve as co-chairperson, appointed by the Minority
26    Leader of the House of Representatives.

 

 

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1        (14) One individual appointed by a labor organization
2    representing frontline employees at the Department of
3    Human Services.
4    The Subcommittee shall provide oversight to the Community
5Care Program Medicaid Initiative and shall meet quarterly. At
6each Subcommittee meeting the Department on Aging shall
7provide the following data sets to the Subcommittee: (A) the
8number of Illinois residents, categorized by planning and
9service area, who are receiving services under the Community
10Care Program and are enrolled in the State's Medical
11Assistance Program; (B) the number of Illinois residents,
12categorized by planning and service area, who are receiving
13services under the Community Care Program, but are not
14enrolled in the State's Medical Assistance Program; and (C)
15the number of Illinois residents, categorized by planning and
16service area, who are receiving services under the Community
17Care Program and are eligible for benefits under the State's
18Medical Assistance Program, but are not enrolled in the
19State's Medical Assistance Program. In addition to this data,
20the Department on Aging shall provide the Subcommittee with
21plans on how the Department on Aging will reduce the number of
22Illinois residents who are not enrolled in the State's Medical
23Assistance Program but who are eligible for medical assistance
24benefits. The Department on Aging shall enroll in the State's
25Medical Assistance Program those Illinois residents who
26receive services under the Community Care Program and are

 

 

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1eligible for medical assistance benefits but are not enrolled
2in the State's Medicaid Assistance Program. The data provided
3to the Subcommittee shall be made available to the public via
4the Department on Aging's website.
5    The Department on Aging, with the involvement of the
6Subcommittee, shall collaborate with the Department of Human
7Services and the Department of Healthcare and Family Services
8on how best to achieve the responsibilities of the Community
9Care Program Medicaid Initiative.
10    The Department on Aging, the Department of Human Services,
11and the Department of Healthcare and Family Services shall
12coordinate and implement a streamlined process for seniors to
13access benefits under the State's Medical Assistance Program.
14    The Subcommittee shall collaborate with the Department of
15Human Services on the adoption of a uniform application
16submission process. The Department of Human Services and any
17other State agency involved with processing the medical
18assistance application of any person enrolled in the Community
19Care Program shall include the appropriate care coordination
20unit in all communications related to the determination or
21status of the application.
22    The Community Care Program Medicaid Initiative shall
23provide targeted funding to care coordination units to help
24seniors complete their applications for medical assistance
25benefits. On and after July 1, 2019, care coordination units
26shall receive no less than $200 per completed application,

 

 

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1which rate may be included in a bundled rate for initial intake
2services when Medicaid application assistance is provided in
3conjunction with the initial intake process for new program
4participants.
5    The Community Care Program Medicaid Initiative shall cease
6operation 5 years after June 4, 2018 (the effective date of
7Public Act 100-587), after which the Subcommittee shall
8dissolve.
9    Effective July 1, 2023, subject to federal approval, the
10Department on Aging shall reimburse Care Coordination Units at
11the following rates for case management services: $252.40 for
12each initial assessment; $366.40 for each initial assessment
13with translation; $229.68 for each redetermination assessment;
14$313.68 for each redetermination assessment with translation;
15$200.00 for each completed application for medical assistance
16benefits; $132.26 for each face-to-face, choices-for-care
17screening; $168.26 for each face-to-face, choices-for-care
18screening with translation; $124.56 for each 6-month,
19face-to-face visit; $132.00 for each MCO participant
20eligibility determination; and $157.00 for each MCO
21participant eligibility determination with translation.
22(Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23;
23103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102,
24Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90,
25Section 90-5, eff. 1-1-24; 103-588, eff. 6-5-24; 103-605, eff.
267-1-24; 103-670, eff. 1-1-25; revised 11-26-24.)