Public Act 096-1129
 
SB3590 EnrolledLRB096 19140 KTG 34531 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 Illinois Act on the Aging is amended  by 
changing Section 4.02 as follows:
 



    (20 ILCS 105/4.02)  (from Ch. 23, par. 6104.02)


    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

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:


        (a) (blank);


        (b) (blank);


        (c) home care aide services;


        (d) personal assistant services;


        (e) adult day services;


        (f) home-delivered meals;


        (g) education in self-care;


        (h) personal care services;


        (i) adult day health services;


        (j) habilitation services;


        (k) respite care;

        (k-5) community reintegration services;

        (k-6) flexible senior services;
        (k-7) medication management;
        (k-8) emergency home response;


        (l) other nonmedical social services that may enable 
    the person
to become self-supporting; or


        (m) clearinghouse for information provided by senior 
    citizen home owners
who want to rent rooms to or share 
    living space with other senior citizens.

    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

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.

    Beginning July 1, 2002, the Department shall require as a 
condition of
eligibility that all financially eligible 
applicants apply
for medical assistance
under Article V of the 
Illinois Public Aid Code in accordance with rules
promulgated 
by the Department.

    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.

    The Department shall, in conjunction with the Department of 
Public Aid (now Department of Healthcare and Family Services),

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

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

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

procedure.  In addition, each person affected regardless of the

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

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

of the services together with the other personal maintenance

expenses of the persons are reasonably related to the standards

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 personal assistant
 and home care aide 
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
individuals 60 years of age or older shall be 
conducted by the Department.

    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

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.

    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

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

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

Illinois Public Aid Code, who precedes a person receiving 
services under this
Section in death.  All moneys for services

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

or relative, as defined by the rules and regulations of the 
Department of Healthcare and Family Services, regardless of the 
value of the property.

    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; and .
        (8) ensuring that the determination of need tool 
    accurately reflects the service needs of individuals with 
    Alzheimer's disease and related dementia disorders. 
    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.

    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

maximum established by the Department.   Workers providing these 
services
shall be appropriately trained.

    Beginning on the effective date of this Amendatory Act of 
1991, no person
may perform chore/housekeeping and home care 
aide 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

employees.

    The Department is required to develop a system to ensure 
that persons
working as home care aides and personal assistants
 
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 home care aides


and personal assistants.  An employer that cannot ensure that 
the minimum
wage increase is being given to home care aides and 
personal assistants

shall be denied any increase in 
reimbursement costs.

    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 Director shall appoint members to the Committee to 
represent provider, advocacy, policy research, and other 
constituencies committed to the delivery of high quality home 
and community-based services to older adults. Representatives 
shall be appointed to ensure representation from community care 
providers including, but not limited to, adult day service 
providers, homemaker providers, case coordination and case 
management units, emergency home response providers, statewide 
trade or labor unions that represent home care
 aides and direct 
care staff, area agencies on aging, adults over age 60, 
membership organizations representing older adults, and other 
organizational entities, providers of care, or individuals 
with demonstrated interest and expertise in the field of home 
and community care as determined by the Director.
    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. A 
member shall continue to serve until his or her replacement is 
named. 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.

    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.

    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.

    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.
    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.

(Source: P.A. 94-48, eff. 7-1-05; 94-269, eff. 7-19-05; 94-336, 
eff. 7-26-05; 94-954, eff. 6-27-06; 95-298, eff. 8-20-07; 
95-473, eff. 8-27-07; 95-565, eff. 6-1-08; 95-876, eff. 
8-21-08.)
 
 
    Section 99. Effective date. This Act takes effect upon 
becoming law. 
  


Effective Date:  7/20/2010