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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) (from Ch. 23, par. 6104.02)
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. Such
14preventive services, which may be coordinated with other
15programs for the aged and monitored by area agencies on aging
16in cooperation with the Department, may include, but are not
17limited to, any or all of the following:
18 (a) (blank);
19 (b) (blank);
20 (c) home care aide services;
21 (d) personal assistant services;
22 (e) adult day services;
23 (f) home-delivered meals;

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1 (g) education in self-care;
2 (h) personal care services;
3 (i) adult day health services;
4 (j) habilitation services;
5 (k) respite care;
6 (k-5) community reintegration services;
7 (k-6) flexible senior services;
8 (k-7) medication management;
9 (k-8) emergency home response;
10 (l) other nonmedical social services that may enable
11 the person to become self-supporting; or
12 (m) clearinghouse for information provided by senior
13 citizen home owners who want to rent rooms to or share
14 living space with other senior citizens.
15 The Department shall establish eligibility standards for
16such services. In determining the amount and nature of services
17for which a person may qualify, consideration shall not be
18given to the value of cash, property or other assets held in
19the name of the person's spouse pursuant to a written agreement
20dividing marital property into equal but separate shares or
21pursuant to a transfer of the person's interest in a home to
22his spouse, provided that the spouse's share of the marital
23property is not made available to the person seeking such
25 Beginning January 1, 2008, the Department shall require as
26a condition of eligibility that all new financially eligible

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1applicants apply for and enroll in medical assistance under
2Article V of the Illinois Public Aid Code in accordance with
3rules promulgated by the Department.
4 The Department shall, in conjunction with the Department of
5Public Aid (now Department of Healthcare and Family Services),
6seek appropriate amendments under Sections 1915 and 1924 of the
7Social Security Act. The purpose of the amendments shall be to
8extend eligibility for home and community based services under
9Sections 1915 and 1924 of the Social Security Act to persons
10who transfer to or for the benefit of a spouse those amounts of
11income and resources allowed under Section 1924 of the Social
12Security Act. Subject to the approval of such amendments, the
13Department shall extend the provisions of Section 5-4 of the
14Illinois Public Aid Code to persons who, but for the provision
15of home or community-based services, would require the level of
16care provided in an institution, as is provided for in federal
17law. Those persons no longer found to be eligible for receiving
18noninstitutional services due to changes in the eligibility
19criteria shall be given 45 days notice prior to actual
20termination. Those persons receiving notice of termination may
21contact the Department and request the determination be
22appealed at any time during the 45 day notice period. The
23target population identified for the purposes of this Section
24are persons age 60 and older with an identified service need.
25Priority shall be given to those who are at imminent risk of
26institutionalization. The services shall be provided to

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1eligible persons age 60 and older to the extent that the cost
2of the services together with the other personal maintenance
3expenses of the persons are reasonably related to the standards
4established for care in a group facility appropriate to the
5person's condition. These non-institutional services, pilot
6projects or experimental facilities may be provided as part of
7or in addition to those authorized by federal law or those
8funded and administered by the Department of Human Services.
9The Departments of Human Services, Healthcare and Family
10Services, Public Health, Veterans' Affairs, and Commerce and
11Economic Opportunity and other appropriate agencies of State,
12federal and local governments shall cooperate with the
13Department on Aging in the establishment and development of the
14non-institutional services. The Department shall require an
15annual audit from all personal assistant and home care aide
16vendors contracting with the Department under this Section. The
17annual audit shall assure that each audited vendor's procedures
18are in compliance with Department's financial reporting
19guidelines requiring an administrative and employee wage and
20benefits cost split as defined in administrative rules. The
21audit is a public record under the Freedom of Information Act.
22The Department shall execute, relative to the nursing home
23prescreening project, written inter-agency agreements with the
24Department of Human Services and the Department of Healthcare
25and Family Services, to effect the following: (1) intake
26procedures and common eligibility criteria for those persons

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1who are receiving non-institutional services; and (2) the
2establishment and development of non-institutional services in
3areas of the State where they are not currently available or
4are undeveloped. On and after July 1, 1996, all nursing home
5prescreenings for individuals 60 years of age or older shall be
6conducted by the Department.
7 As part of the Department on Aging's routine training of
8case managers and case manager supervisors, the Department may
9include information on family futures planning for persons who
10are age 60 or older and who are caregivers of their adult
11children with developmental disabilities. The content of the
12training shall be at the Department's discretion.
13 The Department is authorized to establish a system of
14recipient copayment for services provided under this Section,
15such copayment to be based upon the recipient's ability to pay
16but in no case to exceed the actual cost of the services
17provided. Additionally, any portion of a person's income which
18is equal to or less than the federal poverty standard shall not
19be considered by the Department in determining the copayment.
20The level of such copayment shall be adjusted whenever
21necessary to reflect any change in the officially designated
22federal poverty standard.
23 The Department, or the Department's authorized
24representative, may recover the amount of moneys expended for
25services provided to or in behalf of a person under this
26Section by a claim against the person's estate or against the

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

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1existing Community Care Program by:
2 (1) ensuring that in-home services included in the care
3 plan are available on evenings and weekends;
4 (2) ensuring that care plans contain the services that
5 eligible participants need based on the number of days in a
6 month, not limited to specific blocks of time, as
7 identified by the comprehensive assessment tool selected
8 by the Department for use statewide, not to exceed the
9 total monthly service cost maximum allowed for each
10 service; the Department shall develop administrative rules
11 to implement this item (2);
12 (3) ensuring that the participants have the right to
13 choose the services contained in their care plan and to
14 direct how those services are provided, based on
15 administrative rules established by the Department;
16 (4) ensuring that the determination of need tool is
17 accurate in determining the participants' level of need; to
18 achieve this, the Department, in conjunction with the Older
19 Adult Services Advisory Committee, shall institute a study
20 of the relationship between the Determination of Need
21 scores, level of need, service cost maximums, and the
22 development and utilization of service plans no later than
23 May 1, 2008; findings and recommendations shall be
24 presented to the Governor and the General Assembly no later
25 than January 1, 2009; recommendations shall include all
26 needed changes to the service cost maximums schedule and

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1 additional covered services;
2 (5) ensuring that homemakers can provide personal care
3 services that may or may not involve contact with clients,
4 including but not limited to:
5 (A) bathing;
6 (B) grooming;
7 (C) toileting;
8 (D) nail care;
9 (E) transferring;
10 (F) respiratory services;
11 (G) exercise; or
12 (H) positioning;
13 (6) ensuring that homemaker program vendors are not
14 restricted from hiring homemakers who are family members of
15 clients or recommended by clients; the Department may not,
16 by rule or policy, require homemakers who are family
17 members of clients or recommended by clients to accept
18 assignments in homes other than the client;
19 (7) ensuring that the State may access maximum federal
20 matching funds by seeking approval for the Centers for
21 Medicare and Medicaid Services for modifications to the
22 State's home and community based services waiver and
23 additional waiver opportunities, including applying for
24 enrollment in the Balance Incentive Payment Program by May
25 1, 2013, in order to maximize federal matching funds; this
26 shall include, but not be limited to, modification that

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1 reflects all changes in the Community Care Program services
2 and all increases in the services cost maximum;
3 (8) ensuring that the determination of need tool
4 accurately reflects the service needs of individuals with
5 Alzheimer's disease and related dementia disorders;
6 (9) ensuring that services are authorized accurately
7 and consistently for the Community Care Program (CCP); the
8 Department shall implement a Service Authorization policy
9 directive; the purpose shall be to ensure that eligibility
10 and services are authorized accurately and consistently in
11 the CCP program; the policy directive shall clarify service
12 authorization guidelines to Care Coordination Units and
13 Community Care Program providers no later than May 1, 2013;
14 (10) working in conjunction with Care Coordination
15 Units, the Department of Healthcare and Family Services,
16 the Department of Human Services, Community Care Program
17 providers, and other stakeholders to make improvements to
18 the Medicaid claiming processes and the Medicaid
19 enrollment procedures or requirements as needed,
20 including, but not limited to, specific policy changes or
21 rules to improve the up-front enrollment of participants in
22 the Medicaid program and specific policy changes or rules
23 to insure more prompt submission of bills to the federal
24 government to secure maximum federal matching dollars as
25 promptly as possible; the Department on Aging shall have at
26 least 3 meetings with stakeholders by January 1, 2014 in

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1 order to address these improvements;
2 (11) requiring home care service providers to comply
3 with the rounding of hours worked provisions under the
4 federal Fair Labor Standards Act (FLSA) and as set forth in
5 29 CFR 785.48(b) by May 1, 2013;
6 (12) implementing any necessary policy changes or
7 promulgating any rules, no later than January 1, 2014, to
8 assist the Department of Healthcare and Family Services in
9 moving as many participants as possible, consistent with
10 federal regulations, into coordinated care plans if a care
11 coordination plan that covers long term care is available
12 in the recipient's area; and
13 (13) maintaining fiscal year 2014 rates at the same
14 level established on January 1, 2013.
15 By January 1, 2009 or as soon after the end of the Cash and
16Counseling Demonstration Project as is practicable, the
17Department may, based on its evaluation of the demonstration
18project, promulgate rules concerning personal assistant
19services, to include, but need not be limited to,
20qualifications, employment screening, rights under fair labor
21standards, training, fiduciary agent, and supervision
22requirements. All applicants shall be subject to the provisions
23of the Health Care Worker Background Check Act.
24 The Department shall develop procedures to enhance
25availability of services on evenings, weekends, and on an
26emergency basis to meet the respite needs of caregivers.

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1Procedures shall be developed to permit the utilization of
2services in successive blocks of 24 hours up to the monthly
3maximum established by the Department. Workers providing these
4services shall be appropriately trained.
5 Beginning on the effective date of this amendatory Act of
61991, no person may perform chore/housekeeping and home care
7aide services under a program authorized by this Section unless
8that person has been issued a certificate of pre-service to do
9so by his or her employing agency. Information gathered to
10effect such certification shall include (i) the person's name,
11(ii) the date the person was hired by his or her current
12employer, and (iii) the training, including dates and levels.
13Persons engaged in the program authorized by this Section
14before the effective date of this amendatory Act of 1991 shall
15be issued a certificate of all pre- and in-service training
16from his or her employer upon submitting the necessary
17information. The employing agency shall be required to retain
18records of all staff pre- and in-service training, and shall
19provide such records to the Department upon request and upon
20termination of the employer's contract with the Department. In
21addition, the employing agency is responsible for the issuance
22of certifications of in-service training completed to their
24 The Department is required to develop a system to ensure
25that persons working as home care aides and personal assistants
26receive increases in their wages when the federal minimum wage

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1is increased by requiring vendors to certify that they are
2meeting the federal minimum wage statute for home care aides
3and personal assistants. An employer that cannot ensure that
4the minimum wage increase is being given to home care aides and
5personal assistants shall be denied any increase in
6reimbursement costs. On July 1, 2018, rates shall be increased
7to $19.89 per hour, for the purpose of increasing, by at least
8$1 per hour, the wages paid by those vendors to their employees
9who provide homemaker services. This wage increase shall be a
10new wage increase implemented on July 1, 2018. On July 1, 2019,
11rates shall be increased to $21.49 per hour, for the purpose of
12increasing, by at least $1 per hour, the wages paid by those
13vendors to their employees who provide homemaker services. This
14wage increase shall be a new wage increase implemented on July
151, 2019. On July 1, 2020, rates shall be increased to $23.09
16per hour, for the purpose of increasing, by at least $1 per
17hour, the wages paid by those vendors to their employees who
18provide homemaker services. This wage increase shall be a new
19wage increase implemented on July 1, 2020. On July 1, 2021,
20rates shall be increased to $24.69 per hour, for the purpose of
21increasing, by at least $1 per hour, the wages paid by those
22vendors to their employees who provide homemaker services. This
23wage increase shall be a new wage increase implemented on July
241, 2021. Fringe benefits, including, but not limited to, any
25paid time off or payments for training, health insurance,
26travel, or transportation shall not be reduced in relation to

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1the rate increases established in this paragraph.
2 The Community Care Program Advisory Committee is created in
3the Department on Aging. The Director shall appoint individuals
4to serve in the Committee, who shall serve at their own
5expense. Members of the Committee must abide by all applicable
6ethics laws. The Committee shall advise the Department on
7issues related to the Department's program of services to
8prevent unnecessary institutionalization. The Committee shall
9meet on a bi-monthly basis and shall serve to identify and
10advise the Department on present and potential issues affecting
11the service delivery network, the program's clients, and the
12Department and to recommend solution strategies. Persons
13appointed to the Committee shall be appointed on, but not
14limited to, their own and their agency's experience with the
15program, geographic representation, and willingness to serve.
16The Director shall appoint members to the Committee to
17represent provider, advocacy, policy research, and other
18constituencies committed to the delivery of high quality home
19and community-based services to older adults. Representatives
20shall be appointed to ensure representation from community care
21providers including, but not limited to, adult day service
22providers, homemaker providers, case coordination and case
23management units, emergency home response providers, statewide
24trade or labor unions that represent home care aides and direct
25care staff, area agencies on aging, adults over age 60,
26membership organizations representing older adults, and other

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1organizational entities, providers of care, or individuals
2with demonstrated interest and expertise in the field of home
3and community care as determined by the Director.
4 Nominations may be presented from any agency or State
5association with interest in the program. The Director, or his
6or her designee, shall serve as the permanent co-chair of the
7advisory committee. One other co-chair shall be nominated and
8approved by the members of the committee on an annual basis.
9Committee members' terms of appointment shall be for 4 years
10with one-quarter of the appointees' terms expiring each year. A
11member shall continue to serve until his or her replacement is
12named. The Department shall fill vacancies that have a
13remaining term of over one year, and this replacement shall
14occur through the annual replacement of expiring terms. The
15Director shall designate Department staff to provide technical
16assistance and staff support to the committee. Department
17representation shall not constitute membership of the
18committee. All Committee papers, issues, recommendations,
19reports, and meeting memoranda are advisory only. The Director,
20or his or her designee, shall make a written report, as
21requested by the Committee, regarding issues before the
23 The Department on Aging and the Department of Human
24Services shall cooperate in the development and submission of
25an annual report on programs and services provided under this
26Section. Such joint report shall be filed with the Governor and

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1the General Assembly on or before September 30 each year.
2 The requirement for reporting to the General Assembly shall
3be satisfied by filing copies of the report with the Speaker,
4the Minority Leader and the Clerk of the House of
5Representatives and the President, the Minority Leader and the
6Secretary of the Senate and the Legislative Research Unit, as
7required by Section 3.1 of the General Assembly Organization
8Act and filing such additional copies with the State Government
9Report Distribution Center for the General Assembly as is
10required under paragraph (t) of Section 7 of the State Library
12 Those persons previously found eligible for receiving
13non-institutional services whose services were discontinued
14under the Emergency Budget Act of Fiscal Year 1992, and who do
15not meet the eligibility standards in effect on or after July
161, 1992, shall remain ineligible on and after July 1, 1992.
17Those persons previously not required to cost-share and who
18were required to cost-share effective March 1, 1992, shall
19continue to meet cost-share requirements on and after July 1,
201992. Beginning July 1, 1992, all clients will be required to
21meet eligibility, cost-share, and other requirements and will
22have services discontinued or altered when they fail to meet
23these requirements.
24 For the purposes of this Section, "flexible senior
25services" refers to services that require one-time or periodic
26expenditures including, but not limited to, respite care, home

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1modification, assistive technology, housing assistance, and
3 The Department shall implement an electronic service
4verification based on global positioning systems or other
5cost-effective technology for the Community Care Program no
6later than January 1, 2014.
7 The Department shall require, as a condition of
8eligibility, enrollment in the medical assistance program
9under Article V of the Illinois Public Aid Code (i) beginning
10August 1, 2013, if the Auditor General has reported that the
11Department has failed to comply with the reporting requirements
12of Section 2-27 of the Illinois State Auditing Act; or (ii)
13beginning June 1, 2014, if the Auditor General has reported
14that the Department has not undertaken the required actions
15listed in the report required by subsection (a) of Section 2-27
16of the Illinois State Auditing Act.
17 The Department shall delay Community Care Program services
18until an applicant is determined eligible for medical
19assistance under Article V of the Illinois Public Aid Code (i)
20beginning August 1, 2013, if the Auditor General has reported
21that the Department has failed to comply with the reporting
22requirements of Section 2-27 of the Illinois State Auditing
23Act; or (ii) beginning June 1, 2014, if the Auditor General has
24reported that the Department has not undertaken the required
25actions listed in the report required by subsection (a) of
26Section 2-27 of the Illinois State Auditing Act.

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1 The Department shall implement co-payments for the
2Community Care Program at the federally allowable maximum level
3(i) beginning August 1, 2013, if the Auditor General has
4reported that the Department has failed to comply with the
5reporting requirements of Section 2-27 of the Illinois State
6Auditing Act; or (ii) beginning June 1, 2014, if the Auditor
7General has reported that the Department has not undertaken the
8required actions listed in the report required by subsection
9(a) of Section 2-27 of the Illinois State Auditing Act.
10 The Department shall provide a bi-monthly report on the
11progress of the Community Care Program reforms set forth in
12this amendatory Act of the 98th General Assembly to the
13Governor, the Speaker of the House of Representatives, the
14Minority Leader of the House of Representatives, the President
15of the Senate, and the Minority Leader of the Senate.
16 The Department shall conduct a quarterly review of Care
17Coordination Unit performance and adherence to service
18guidelines. The quarterly review shall be reported to the
19Speaker of the House of Representatives, the Minority Leader of
20the House of Representatives, the President of the Senate, and
21the Minority Leader of the Senate. The Department shall collect
22and report longitudinal data on the performance of each care
23coordination unit. Nothing in this paragraph shall be construed
24to require the Department to identify specific care
25coordination units.
26 In regard to community care providers, failure to comply

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1with Department on Aging policies shall be cause for
2disciplinary action, including, but not limited to,
3disqualification from serving Community Care Program clients.
4Each provider, upon submission of any bill or invoice to the
5Department for payment for services rendered, shall include a
6notarized statement, under penalty of perjury pursuant to
7Section 1-109 of the Code of Civil Procedure, that the provider
8has complied with all Department policies.
9 The Director of the Department on Aging shall make
10information available to the State Board of Elections as may be
11required by an agreement the State Board of Elections has
12entered into with a multi-state voter registration list
13maintenance system.
14 Within 30 days after the effective date of this amendatory
15Act of the 100th General Assembly, rates shall be increased to
16$18.29 per hour, for the purpose of increasing, by at least
17$.72 per hour, the wages paid by those vendors to their
18employees who provide homemaker services. The Department shall
19pay an enhanced rate under the Community Care Program to those
20in-home service provider agencies that offer health insurance
21coverage as a benefit to their direct service worker employees
22consistent with the mandates of Public Act 95-713. For State
23fiscal year 2018, the enhanced rate shall be $1.77 per hour.
24The rate shall be adjusted using actuarial analysis based on
25the cost of care, but shall not be set below $1.77 per hour.
26The Department shall adopt rules, including emergency rules

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1under subsection (y) of Section 5-45 of the Illinois
2Administrative Procedure Act, to implement the provisions of
3this paragraph.
4(Source: P.A. 99-143, eff. 7-27-15; 100-23, eff. 7-6-17.)
5 Section 99. Effective date. This Act takes effect July 1,