Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1182 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1182 Introduced 1/24/2025, by Sen. Doris Turner SYNOPSIS AS INTRODUCED: 20 ILCS 105/4.02 Amends the Illinois Act on the Aging. Provides that by January 1, 2026, the Department on Aging shall seek federal approval from the Centers for Medicare and Medicaid Services for any waiver or State Plan amendment necessary to provide monthly monitoring payments to care coordination units for each active participant enrolled in the Community Care Program who is receiving any allowable service and has not utilized services authorized by the care coordination unit or managed care organization for the month preceding the last month of services. Requires managed care organizations to remediate the full monthly monitoring payment to care coordination units that are providing services in accordance with the Act. Defines "active participant" to mean a person 60 years of age or older who has been found eligible to receive Community Care Program services. Provides that to receive administrative payments, a care coordination unit must provide documentation demonstrating that an effort has been made to contact the individual and confirm that the individual no longer needs services provided by the care coordination unit. Requires the Department to secure federal financial participation for expenditures made by the Department for State Fiscal Year 20265 and every State fiscal year thereafter. Effective immediately. LRB104 08421 KTG 18473 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1182 Introduced 1/24/2025, by Sen. Doris Turner SYNOPSIS AS INTRODUCED: 20 ILCS 105/4.02 20 ILCS 105/4.02 Amends the Illinois Act on the Aging. Provides that by January 1, 2026, the Department on Aging shall seek federal approval from the Centers for Medicare and Medicaid Services for any waiver or State Plan amendment necessary to provide monthly monitoring payments to care coordination units for each active participant enrolled in the Community Care Program who is receiving any allowable service and has not utilized services authorized by the care coordination unit or managed care organization for the month preceding the last month of services. Requires managed care organizations to remediate the full monthly monitoring payment to care coordination units that are providing services in accordance with the Act. Defines "active participant" to mean a person 60 years of age or older who has been found eligible to receive Community Care Program services. Provides that to receive administrative payments, a care coordination unit must provide documentation demonstrating that an effort has been made to contact the individual and confirm that the individual no longer needs services provided by the care coordination unit. Requires the Department to secure federal financial participation for expenditures made by the Department for State Fiscal Year 20265 and every State fiscal year thereafter. Effective immediately. LRB104 08421 KTG 18473 b LRB104 08421 KTG 18473 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1182 Introduced 1/24/2025, by Sen. Doris Turner SYNOPSIS AS INTRODUCED:
3	3	20 ILCS 105/4.02 20 ILCS 105/4.02
4	4	20 ILCS 105/4.02
5	5	Amends the Illinois Act on the Aging. Provides that by January 1, 2026, the Department on Aging shall seek federal approval from the Centers for Medicare and Medicaid Services for any waiver or State Plan amendment necessary to provide monthly monitoring payments to care coordination units for each active participant enrolled in the Community Care Program who is receiving any allowable service and has not utilized services authorized by the care coordination unit or managed care organization for the month preceding the last month of services. Requires managed care organizations to remediate the full monthly monitoring payment to care coordination units that are providing services in accordance with the Act. Defines "active participant" to mean a person 60 years of age or older who has been found eligible to receive Community Care Program services. Provides that to receive administrative payments, a care coordination unit must provide documentation demonstrating that an effort has been made to contact the individual and confirm that the individual no longer needs services provided by the care coordination unit. Requires the Department to secure federal financial participation for expenditures made by the Department for State Fiscal Year 20265 and every State fiscal year thereafter. Effective immediately.
6	6	LRB104 08421 KTG 18473 b LRB104 08421 KTG 18473 b
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8	8	A BILL FOR
9	9	SB1182LRB104 08421 KTG 18473 b SB1182 LRB104 08421 KTG 18473 b
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11	11	1 AN ACT concerning State government.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Illinois Act on the Aging is amended by
15	15	5 changing Section 4.02 as follows:
16	16	6 (20 ILCS 105/4.02)
17	17	7 Sec. 4.02. Community Care Program. The Department shall
18	18	8 establish a program of services to prevent unnecessary
19	19	9 institutionalization of persons age 60 and older in need of
20	20	10 long term care or who are established as persons who suffer
21	21	11 from Alzheimer's disease or a related disorder under the
22	22	12 Alzheimer's Disease Assistance Act, thereby enabling them to
23	23	13 remain in their own homes or in other living arrangements.
24	24	14 Such preventive services, which may be coordinated with other
25	25	15 programs for the aged, may include, but are not limited to, any
26	26	16 or all of the following:
27	27	17 (a) (blank);
28	28	18 (b) (blank);
29	29	19 (c) home care aide services;
30	30	20 (d) personal assistant services;
31	31	21 (e) adult day services;
32	32	22 (f) home-delivered meals;
33	33	23 (g) education in self-care;
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37	37	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1182 Introduced 1/24/2025, by Sen. Doris Turner SYNOPSIS AS INTRODUCED:
38	38	20 ILCS 105/4.02 20 ILCS 105/4.02
39	39	20 ILCS 105/4.02
40	40	Amends the Illinois Act on the Aging. Provides that by January 1, 2026, the Department on Aging shall seek federal approval from the Centers for Medicare and Medicaid Services for any waiver or State Plan amendment necessary to provide monthly monitoring payments to care coordination units for each active participant enrolled in the Community Care Program who is receiving any allowable service and has not utilized services authorized by the care coordination unit or managed care organization for the month preceding the last month of services. Requires managed care organizations to remediate the full monthly monitoring payment to care coordination units that are providing services in accordance with the Act. Defines "active participant" to mean a person 60 years of age or older who has been found eligible to receive Community Care Program services. Provides that to receive administrative payments, a care coordination unit must provide documentation demonstrating that an effort has been made to contact the individual and confirm that the individual no longer needs services provided by the care coordination unit. Requires the Department to secure federal financial participation for expenditures made by the Department for State Fiscal Year 20265 and every State fiscal year thereafter. Effective immediately.
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43	43	A BILL FOR
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68	68	1 (h) personal care services;
69	69	2 (i) adult day health services;
70	70	3 (j) habilitation services;
71	71	4 (k) respite care;
72	72	5 (k-5) community reintegration services;
73	73	6 (k-6) flexible senior services;
74	74	7 (k-7) medication management;
75	75	8 (k-8) emergency home response;
76	76	9 (l) other nonmedical social services that may enable
77	77	10 the person to become self-supporting; or
78	78	11 (m) (blank).
79	79	12 The Department shall establish eligibility standards for
80	80	13 such services. In determining the amount and nature of
81	81	14 services for which a person may qualify, consideration shall
82	82	15 not be given to the value of cash, property, or other assets
83	83	16 held in the name of the person's spouse pursuant to a written
84	84	17 agreement dividing marital property into equal but separate
85	85	18 shares or pursuant to a transfer of the person's interest in a
86	86	19 home to his spouse, provided that the spouse's share of the
87	87	20 marital property is not made available to the person seeking
88	88	21 such services.
89	89	22 The Department shall require as a condition of eligibility
90	90	23 that all new financially eligible applicants apply for and
91	91	24 enroll in medical assistance under Article V of the Illinois
92	92	25 Public Aid Code in accordance with rules promulgated by the
93	93	26 Department.
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104	104	1 The Department shall, in conjunction with the Department
105	105	2 of Public Aid (now Department of Healthcare and Family
106	106	3 Services), seek appropriate amendments under Sections 1915 and
107	107	4 1924 of the Social Security Act. The purpose of the amendments
108	108	5 shall be to extend eligibility for home and community based
109	109	6 services under Sections 1915 and 1924 of the Social Security
110	110	7 Act to persons who transfer to or for the benefit of a spouse
111	111	8 those amounts of income and resources allowed under Section
112	112	9 1924 of the Social Security Act. Subject to the approval of
113	113	10 such amendments, the Department shall extend the provisions of
114	114	11 Section 5-4 of the Illinois Public Aid Code to persons who, but
115	115	12 for the provision of home or community-based services, would
116	116	13 require the level of care provided in an institution, as is
117	117	14 provided for in federal law. Those persons no longer found to
118	118	15 be eligible for receiving noninstitutional services due to
119	119	16 changes in the eligibility criteria shall be given 45 days
120	120	17 notice prior to actual termination. Those persons receiving
121	121	18 notice of termination may contact the Department and request
122	122	19 the determination be appealed at any time during the 45 day
123	123	20 notice period. The target population identified for the
124	124	21 purposes of this Section are persons age 60 and older with an
125	125	22 identified service need. Priority shall be given to those who
126	126	23 are at imminent risk of institutionalization. The services
127	127	24 shall be provided to eligible persons age 60 and older to the
128	128	25 extent that the cost of the services together with the other
129	129	26 personal maintenance expenses of the persons are reasonably
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140	140	1 related to the standards established for care in a group
141	141	2 facility appropriate to the person's condition. These
142	142	3 noninstitutional non-institutional services, pilot projects,
143	143	4 or experimental facilities may be provided as part of or in
144	144	5 addition to those authorized by federal law or those funded
145	145	6 and administered by the Department of Human Services. The
146	146	7 Departments of Human Services, Healthcare and Family Services,
147	147	8 Public Health, Veterans' Affairs, and Commerce and Economic
148	148	9 Opportunity and other appropriate agencies of State, federal,
149	149	10 and local governments shall cooperate with the Department on
150	150	11 Aging in the establishment and development of the
151	151	12 noninstitutional non-institutional services. The Department
152	152	13 shall require an annual audit from all personal assistant and
153	153	14 home care aide vendors contracting with the Department under
154	154	15 this Section. The annual audit shall assure that each audited
155	155	16 vendor's procedures are in compliance with Department's
156	156	17 financial reporting guidelines requiring an administrative and
157	157	18 employee wage and benefits cost split as defined in
158	158	19 administrative rules. The audit is a public record under the
159	159	20 Freedom of Information Act. The Department shall execute,
160	160	21 relative to the nursing home prescreening project, written
161	161	22 inter-agency agreements with the Department of Human Services
162	162	23 and the Department of Healthcare and Family Services, to
163	163	24 effect the following: (1) intake procedures and common
164	164	25 eligibility criteria for those persons who are receiving
165	165	26 noninstitutional non-institutional services; and (2) the
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176	176	1 establishment and development of noninstitutional
177	177	2 non-institutional services in areas of the State where they
178	178	3 are not currently available or are undeveloped. On and after
179	179	4 July 1, 1996, all nursing home prescreenings for individuals
180	180	5 60 years of age or older shall be conducted by the Department.
181	181	6 As part of the Department on Aging's routine training of
182	182	7 case managers and case manager supervisors, the Department may
183	183	8 include information on family futures planning for persons who
184	184	9 are age 60 or older and who are caregivers of their adult
185	185	10 children with developmental disabilities. The content of the
186	186	11 training shall be at the Department's discretion.
187	187	12 The Department is authorized to establish a system of
188	188	13 recipient copayment for services provided under this Section,
189	189	14 such copayment to be based upon the recipient's ability to pay
190	190	15 but in no case to exceed the actual cost of the services
191	191	16 provided. Additionally, any portion of a person's income which
192	192	17 is equal to or less than the federal poverty standard shall not
193	193	18 be considered by the Department in determining the copayment.
194	194	19 The level of such copayment shall be adjusted whenever
195	195	20 necessary to reflect any change in the officially designated
196	196	21 federal poverty standard.
197	197	22 The Department, or the Department's authorized
198	198	23 representative, may recover the amount of moneys expended for
199	199	24 services provided to or in behalf of a person under this
200	200	25 Section by a claim against the person's estate or against the
201	201	26 estate of the person's surviving spouse, but no recovery may
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212	212	1 be had until after the death of the surviving spouse, if any,
213	213	2 and then only at such time when there is no surviving child who
214	214	3 is under age 21 or blind or who has a permanent and total
215	215	4 disability. This paragraph, however, shall not bar recovery,
216	216	5 at the death of the person, of moneys for services provided to
217	217	6 the person or in behalf of the person under this Section to
218	218	7 which the person was not entitled; provided that such recovery
219	219	8 shall not be enforced against any real estate while it is
220	220	9 occupied as a homestead by the surviving spouse or other
221	221	10 dependent, if no claims by other creditors have been filed
222	222	11 against the estate, or, if such claims have been filed, they
223	223	12 remain dormant for failure of prosecution or failure of the
224	224	13 claimant to compel administration of the estate for the
225	225	14 purpose of payment. This paragraph shall not bar recovery from
226	226	15 the estate of a spouse, under Sections 1915 and 1924 of the
227	227	16 Social Security Act and Section 5-4 of the Illinois Public Aid
228	228	17 Code, who precedes a person receiving services under this
229	229	18 Section in death. All moneys for services paid to or in behalf
230	230	19 of the person under this Section shall be claimed for recovery
231	231	20 from the deceased spouse's estate. "Homestead", as used in
232	232	21 this paragraph, means the dwelling house and contiguous real
233	233	22 estate occupied by a surviving spouse or relative, as defined
234	234	23 by the rules and regulations of the Department of Healthcare
235	235	24 and Family Services, regardless of the value of the property.
236	236	25 The Department shall increase the effectiveness of the
237	237	26 existing Community Care Program by:
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248	248	1 (1) ensuring that in-home services included in the
249	249	2 care plan are available on evenings and weekends;
250	250	3 (2) ensuring that care plans contain the services that
251	251	4 eligible participants need based on the number of days in
252	252	5 a month, not limited to specific blocks of time, as
253	253	6 identified by the comprehensive assessment tool selected
254	254	7 by the Department for use statewide, not to exceed the
255	255	8 total monthly service cost maximum allowed for each
256	256	9 service; the Department shall develop administrative rules
257	257	10 to implement this item (2);
258	258	11 (3) ensuring that the participants have the right to
259	259	12 choose the services contained in their care plan and to
260	260	13 direct how those services are provided, based on
261	261	14 administrative rules established by the Department;
262	262	15 (4)(blank);
263	263	16 (5) ensuring that homemakers can provide personal care
264	264	17 services that may or may not involve contact with clients,
265	265	18 including, but not limited to:
266	266	19 (A) bathing;
267	267	20 (B) grooming;
268	268	21 (C) toileting;
269	269	22 (D) nail care;
270	270	23 (E) transferring;
271	271	24 (F) respiratory services;
272	272	25 (G) exercise; or
273	273	26 (H) positioning;
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284	284	1 (6) ensuring that homemaker program vendors are not
285	285	2 restricted from hiring homemakers who are family members
286	286	3 of clients or recommended by clients; the Department may
287	287	4 not, by rule or policy, require homemakers who are family
288	288	5 members of clients or recommended by clients to accept
289	289	6 assignments in homes other than the client;
290	290	7 (7) ensuring that the State may access maximum federal
291	291	8 matching funds by seeking approval for the Centers for
292	292	9 Medicare and Medicaid Services for modifications to the
293	293	10 State's home and community based services waiver and
294	294	11 additional waiver opportunities, including applying for
295	295	12 enrollment in the Balance Incentive Payment Program by May
296	296	13 1, 2013, in order to maximize federal matching funds; this
297	297	14 shall include, but not be limited to, modification that
298	298	15 reflects all changes in the Community Care Program
299	299	16 services and all increases in the services cost maximum;
300	300	17 (8) ensuring that the determination of need tool
301	301	18 accurately reflects the service needs of individuals with
302	302	19 Alzheimer's disease and related dementia disorders;
303	303	20 (9) ensuring that services are authorized accurately
304	304	21 and consistently for the Community Care Program (CCP); the
305	305	22 Department shall implement a Service Authorization policy
306	306	23 directive; the purpose shall be to ensure that eligibility
307	307	24 and services are authorized accurately and consistently in
308	308	25 the CCP program; the policy directive shall clarify
309	309	26 service authorization guidelines to Care Coordination
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320	320	1 Units and Community Care Program providers no later than
321	321	2 May 1, 2013;
322	322	3 (10) working in conjunction with Care Coordination
323	323	4 Units, the Department of Healthcare and Family Services,
324	324	5 the Department of Human Services, Community Care Program
325	325	6 providers, and other stakeholders to make improvements to
326	326	7 the Medicaid claiming processes and the Medicaid
327	327	8 enrollment procedures or requirements as needed,
328	328	9 including, but not limited to, specific policy changes or
329	329	10 rules to improve the up-front enrollment of participants
330	330	11 in the Medicaid program and specific policy changes or
331	331	12 rules to insure more prompt submission of bills to the
332	332	13 federal government to secure maximum federal matching
333	333	14 dollars as promptly as possible; the Department on Aging
334	334	15 shall have at least 3 meetings with stakeholders by
335	335	16 January 1, 2014 in order to address these improvements;
336	336	17 (11) requiring home care service providers to comply
337	337	18 with the rounding of hours worked provisions under the
338	338	19 federal Fair Labor Standards Act (FLSA) and as set forth
339	339	20 in 29 CFR 785.48(b) by May 1, 2013;
340	340	21 (12) implementing any necessary policy changes or
341	341	22 promulgating any rules, no later than January 1, 2014, to
342	342	23 assist the Department of Healthcare and Family Services in
343	343	24 moving as many participants as possible, consistent with
344	344	25 federal regulations, into coordinated care plans if a care
345	345	26 coordination plan that covers long term care is available
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356	356	1 in the recipient's area; and
357	357	2 (13) (blank).
358	358	3 By January 1, 2009 or as soon after the end of the Cash and
359	359	4 Counseling Demonstration Project as is practicable, the
360	360	5 Department may, based on its evaluation of the demonstration
361	361	6 project, promulgate rules concerning personal assistant
362	362	7 services, to include, but need not be limited to,
363	363	8 qualifications, employment screening, rights under fair labor
364	364	9 standards, training, fiduciary agent, and supervision
365	365	10 requirements. All applicants shall be subject to the
366	366	11 provisions of the Health Care Worker Background Check Act.
367	367	12 The Department shall develop procedures to enhance
368	368	13 availability of services on evenings, weekends, and on an
369	369	14 emergency basis to meet the respite needs of caregivers.
370	370	15 Procedures shall be developed to permit the utilization of
371	371	16 services in successive blocks of 24 hours up to the monthly
372	372	17 maximum established by the Department. Workers providing these
373	373	18 services shall be appropriately trained.
374	374	19 No September 23, 1991 (Public Act 87-729) person may
375	375	20 perform chore/housekeeping and home care aide services under a
376	376	21 program authorized by this Section unless that person has been
377	377	22 issued a certificate of pre-service to do so by his or her
378	378	23 employing agency. Information gathered to effect such
379	379	24 certification shall include (i) the person's name, (ii) the
380	380	25 date the person was hired by his or her current employer, and
381	381	26 (iii) the training, including dates and levels. Persons
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392	392	1 engaged in the program authorized by this Section before the
393	393	2 effective date of this amendatory Act of 1991 shall be issued a
394	394	3 certificate of all pre-service and in-service training from
395	395	4 his or her employer upon submitting the necessary information.
396	396	5 The employing agency shall be required to retain records of
397	397	6 all staff pre-service and in-service training, and shall
398	398	7 provide such records to the Department upon request and upon
399	399	8 termination of the employer's contract with the Department. In
400	400	9 addition, the employing agency is responsible for the issuance
401	401	10 of certifications of in-service training completed to their
402	402	11 employees.
403	403	12 The Department is required to develop a system to ensure
404	404	13 that persons working as home care aides and personal
405	405	14 assistants receive increases in their wages when the federal
406	406	15 minimum wage is increased by requiring vendors to certify that
407	407	16 they are meeting the federal minimum wage statute for home
408	408	17 care aides and personal assistants. An employer that cannot
409	409	18 ensure that the minimum wage increase is being given to home
410	410	19 care aides and personal assistants shall be denied any
411	411	20 increase in reimbursement costs.
412	412	21 The Community Care Program Advisory Committee is created
413	413	22 in the Department on Aging. The Director shall appoint
414	414	23 individuals to serve in the Committee, who shall serve at
415	415	24 their own expense. Members of the Committee must abide by all
416	416	25 applicable ethics laws. The Committee shall advise the
417	417	26 Department on issues related to the Department's program of
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428	428	1 services to prevent unnecessary institutionalization. The
429	429	2 Committee shall meet on a bi-monthly basis and shall serve to
430	430	3 identify and advise the Department on present and potential
431	431	4 issues affecting the service delivery network, the program's
432	432	5 clients, and the Department and to recommend solution
433	433	6 strategies. Persons appointed to the Committee shall be
434	434	7 appointed on, but not limited to, their own and their agency's
435	435	8 experience with the program, geographic representation, and
436	436	9 willingness to serve. The Director shall appoint members to
437	437	10 the Committee to represent provider, advocacy, policy
438	438	11 research, and other constituencies committed to the delivery
439	439	12 of high quality home and community-based services to older
440	440	13 adults. Representatives shall be appointed to ensure
441	441	14 representation from community care providers, including, but
442	442	15 not limited to, adult day service providers, homemaker
443	443	16 providers, case coordination and case management units,
444	444	17 emergency home response providers, statewide trade or labor
445	445	18 unions that represent home care aides and direct care staff,
446	446	19 area agencies on aging, adults over age 60, membership
447	447	20 organizations representing older adults, and other
448	448	21 organizational entities, providers of care, or individuals
449	449	22 with demonstrated interest and expertise in the field of home
450	450	23 and community care as determined by the Director.
451	451	24 Nominations may be presented from any agency or State
452	452	25 association with interest in the program. The Director, or his
453	453	26 or her designee, shall serve as the permanent co-chair of the
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464	464	1 advisory committee. One other co-chair shall be nominated and
465	465	2 approved by the members of the committee on an annual basis.
466	466	3 Committee members' terms of appointment shall be for 4 years
467	467	4 with one-quarter of the appointees' terms expiring each year.
468	468	5 A member shall continue to serve until his or her replacement
469	469	6 is named. The Department shall fill vacancies that have a
470	470	7 remaining term of over one year, and this replacement shall
471	471	8 occur through the annual replacement of expiring terms. The
472	472	9 Director shall designate Department staff to provide technical
473	473	10 assistance and staff support to the committee. Department
474	474	11 representation shall not constitute membership of the
475	475	12 committee. All Committee papers, issues, recommendations,
476	476	13 reports, and meeting memoranda are advisory only. The
477	477	14 Director, or his or her designee, shall make a written report,
478	478	15 as requested by the Committee, regarding issues before the
479	479	16 Committee.
480	480	17 The Department on Aging and the Department of Human
481	481	18 Services shall cooperate in the development and submission of
482	482	19 an annual report on programs and services provided under this
483	483	20 Section. Such joint report shall be filed with the Governor
484	484	21 and the General Assembly on or before March 31 of the following
485	485	22 fiscal year.
486	486	23 The requirement for reporting to the General Assembly
487	487	24 shall be satisfied by filing copies of the report as required
488	488	25 by Section 3.1 of the General Assembly Organization Act and
489	489	26 filing such additional copies with the State Government Report
490	490
491	491
492	492
493	493
494	494
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496	496
497	497
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500	500	1 Distribution Center for the General Assembly as is required
501	501	2 under paragraph (t) of Section 7 of the State Library Act.
502	502	3 Those persons previously found eligible for receiving
503	503	4 noninstitutional non-institutional services whose services
504	504	5 were discontinued under the Emergency Budget Act of Fiscal
505	505	6 Year 1992, and who do not meet the eligibility standards in
506	506	7 effect on or after July 1, 1992, shall remain ineligible on and
507	507	8 after July 1, 1992. Those persons previously not required to
508	508	9 cost-share and who were required to cost-share effective March
509	509	10 1, 1992, shall continue to meet cost-share requirements on and
510	510	11 after July 1, 1992. Beginning July 1, 1992, all clients will be
511	511	12 required to meet eligibility, cost-share, and other
512	512	13 requirements and will have services discontinued or altered
513	513	14 when they fail to meet these requirements.
514	514	15 For the purposes of this Section, "flexible senior
515	515	16 services" refers to services that require one-time or periodic
516	516	17 expenditures, including, but not limited to, respite care,
517	517	18 home modification, assistive technology, housing assistance,
518	518	19 and transportation.
519	519	20 The Department shall implement an electronic service
520	520	21 verification based on global positioning systems or other
521	521	22 cost-effective technology for the Community Care Program no
522	522	23 later than January 1, 2014.
523	523	24 The Department shall require, as a condition of
524	524	25 eligibility, application for the medical assistance program
525	525	26 under Article V of the Illinois Public Aid Code.
526	526
527	527
528	528
529	529
530	530
531	531	SB1182 - 14 - LRB104 08421 KTG 18473 b
532	532
533	533
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535	535	SB1182 - 15 - LRB104 08421 KTG 18473 b
536	536	1 The Department may authorize Community Care Program
537	537	2 services until an applicant is determined eligible for medical
538	538	3 assistance under Article V of the Illinois Public Aid Code.
539	539	4 The Department shall continue to provide Community Care
540	540	5 Program reports as required by statute, which shall include an
541	541	6 annual report on Care Coordination Unit performance and
542	542	7 adherence to service guidelines and a 6-month supplemental
543	543	8 report.
544	544	9 In regard to community care providers, failure to comply
545	545	10 with Department on Aging policies shall be cause for
546	546	11 disciplinary action, including, but not limited to,
547	547	12 disqualification from serving Community Care Program clients.
548	548	13 Each provider, upon submission of any bill or invoice to the
549	549	14 Department for payment for services rendered, shall include a
550	550	15 notarized statement, under penalty of perjury pursuant to
551	551	16 Section 1-109 of the Code of Civil Procedure, that the
552	552	17 provider has complied with all Department policies.
553	553	18 The Director of the Department on Aging shall make
554	554	19 information available to the State Board of Elections as may
555	555	20 be required by an agreement the State Board of Elections has
556	556	21 entered into with a multi-state voter registration list
557	557	22 maintenance system.
558	558	23 The Department shall pay an enhanced rate of at least
559	559	24 $1.77 per unit under the Community Care Program to those
560	560	25 in-home service provider agencies that offer health insurance
561	561	26 coverage as a benefit to their direct service worker employees
562	562
563	563
564	564
565	565
566	566
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568	568
569	569
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572	572	1 pursuant to rules adopted by the Department. The Department
573	573	2 shall review the enhanced rate as part of its process to rebase
574	574	3 in-home service provider reimbursement rates pursuant to
575	575	4 federal waiver requirements. Subject to federal approval,
576	576	5 beginning on January 1, 2024, rates for adult day services
577	577	6 shall be increased to $16.84 per hour and rates for each way
578	578	7 transportation services for adult day services shall be
579	579	8 increased to $12.44 per unit transportation.
580	580	9 Subject to federal approval, on and after January 1, 2024,
581	581	10 rates for homemaker services shall be increased to $28.07 to
582	582	11 sustain a minimum wage of $17 per hour for direct service
583	583	12 workers. Rates in subsequent State fiscal years shall be no
584	584	13 lower than the rates put into effect upon federal approval.
585	585	14 Providers of in-home services shall be required to certify to
586	586	15 the Department that they remain in compliance with the
587	587	16 mandated wage increase for direct service workers. Fringe
588	588	17 benefits, including, but not limited to, paid time off and
589	589	18 payment for training, health insurance, travel, or
590	590	19 transportation, shall not be reduced in relation to the rate
591	591	20 increases described in this paragraph.
592	592	21 Subject to and upon federal approval, on and after January
593	593	22 1, 2025, rates for homemaker services shall be increased to
594	594	23 $29.63 to sustain a minimum wage of $18 per hour for direct
595	595	24 service workers. Rates in subsequent State fiscal years shall
596	596	25 be no lower than the rates put into effect upon federal
597	597	26 approval. Providers of in-home services shall be required to
598	598
599	599
600	600
601	601
602	602
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604	604
605	605
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607	607	SB1182 - 17 - LRB104 08421 KTG 18473 b
608	608	1 certify to the Department that they remain in compliance with
609	609	2 the mandated wage increase for direct service workers. Fringe
610	610	3 benefits, including, but not limited to, paid time off and
611	611	4 payment for training, health insurance, travel, or
612	612	5 transportation, shall not be reduced in relation to the rate
613	613	6 increases described in this paragraph.
614	614	7 The General Assembly finds it necessary to authorize an
615	615	8 aggressive Medicaid enrollment initiative designed to maximize
616	616	9 federal Medicaid funding for the Community Care Program which
617	617	10 produces significant savings for the State of Illinois. The
618	618	11 Department on Aging shall establish and implement a Community
619	619	12 Care Program Medicaid Initiative. Under the Initiative, the
620	620	13 Department on Aging shall, at a minimum: (i) provide an
621	621	14 enhanced rate to adequately compensate care coordination units
622	622	15 to enroll eligible Community Care Program clients into
623	623	16 Medicaid; (ii) use recommendations from a stakeholder
624	624	17 committee on how best to implement the Initiative; and (iii)
625	625	18 establish requirements for State agencies to make enrollment
626	626	19 in the State's Medical Assistance program easier for seniors.
627	627	20 The Community Care Program Medicaid Enrollment Oversight
628	628	21 Subcommittee is created as a subcommittee of the Older Adult
629	629	22 Services Advisory Committee established in Section 35 of the
630	630	23 Older Adult Services Act to make recommendations on how best
631	631	24 to increase the number of medical assistance recipients who
632	632	25 are enrolled in the Community Care Program. The Subcommittee
633	633	26 shall consist of all of the following persons who must be
634	634
635	635
636	636
637	637
638	638
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640	640
641	641
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643	643	SB1182 - 18 - LRB104 08421 KTG 18473 b
644	644	1 appointed within 30 days after June 4, 2018 (the effective
645	645	2 date of Public Act 100-587):
646	646	3 (1) The Director of Aging, or his or her designee, who
647	647	4 shall serve as the chairperson of the Subcommittee.
648	648	5 (2) One representative of the Department of Healthcare
649	649	6 and Family Services, appointed by the Director of
650	650	7 Healthcare and Family Services.
651	651	8 (3) One representative of the Department of Human
652	652	9 Services, appointed by the Secretary of Human Services.
653	653	10 (4) One individual representing a care coordination
654	654	11 unit, appointed by the Director of Aging.
655	655	12 (5) One individual from a non-governmental statewide
656	656	13 organization that advocates for seniors, appointed by the
657	657	14 Director of Aging.
658	658	15 (6) One individual representing Area Agencies on
659	659	16 Aging, appointed by the Director of Aging.
660	660	17 (7) One individual from a statewide association
661	661	18 dedicated to Alzheimer's care, support, and research,
662	662	19 appointed by the Director of Aging.
663	663	20 (8) One individual from an organization that employs
664	664	21 persons who provide services under the Community Care
665	665	22 Program, appointed by the Director of Aging.
666	666	23 (9) One member of a trade or labor union representing
667	667	24 persons who provide services under the Community Care
668	668	25 Program, appointed by the Director of Aging.
669	669	26 (10) One member of the Senate, who shall serve as
670	670
671	671
672	672
673	673
674	674
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676	676
677	677
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679	679	SB1182 - 19 - LRB104 08421 KTG 18473 b
680	680	1 co-chairperson, appointed by the President of the Senate.
681	681	2 (11) One member of the Senate, who shall serve as
682	682	3 co-chairperson, appointed by the Minority Leader of the
683	683	4 Senate.
684	684	5 (12) One member of the House of Representatives, who
685	685	6 shall serve as co-chairperson, appointed by the Speaker of
686	686	7 the House of Representatives.
687	687	8 (13) One member of the House of Representatives, who
688	688	9 shall serve as co-chairperson, appointed by the Minority
689	689	10 Leader of the House of Representatives.
690	690	11 (14) One individual appointed by a labor organization
691	691	12 representing frontline employees at the Department of
692	692	13 Human Services.
693	693	14 The Subcommittee shall provide oversight to the Community
694	694	15 Care Program Medicaid Initiative and shall meet quarterly. At
695	695	16 each Subcommittee meeting the Department on Aging shall
696	696	17 provide the following data sets to the Subcommittee: (A) the
697	697	18 number of Illinois residents, categorized by planning and
698	698	19 service area, who are receiving services under the Community
699	699	20 Care Program and are enrolled in the State's Medical
700	700	21 Assistance Program; (B) the number of Illinois residents,
701	701	22 categorized by planning and service area, who are receiving
702	702	23 services under the Community Care Program, but are not
703	703	24 enrolled in the State's Medical Assistance Program; and (C)
704	704	25 the number of Illinois residents, categorized by planning and
705	705	26 service area, who are receiving services under the Community
706	706
707	707
708	708
709	709
710	710
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712	712
713	713
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716	716	1 Care Program and are eligible for benefits under the State's
717	717	2 Medical Assistance Program, but are not enrolled in the
718	718	3 State's Medical Assistance Program. In addition to this data,
719	719	4 the Department on Aging shall provide the Subcommittee with
720	720	5 plans on how the Department on Aging will reduce the number of
721	721	6 Illinois residents who are not enrolled in the State's Medical
722	722	7 Assistance Program but who are eligible for medical assistance
723	723	8 benefits. The Department on Aging shall enroll in the State's
724	724	9 Medical Assistance Program those Illinois residents who
725	725	10 receive services under the Community Care Program and are
726	726	11 eligible for medical assistance benefits but are not enrolled
727	727	12 in the State's Medicaid Assistance Program. The data provided
728	728	13 to the Subcommittee shall be made available to the public via
729	729	14 the Department on Aging's website.
730	730	15 The Department on Aging, with the involvement of the
731	731	16 Subcommittee, shall collaborate with the Department of Human
732	732	17 Services and the Department of Healthcare and Family Services
733	733	18 on how best to achieve the responsibilities of the Community
734	734	19 Care Program Medicaid Initiative.
735	735	20 The Department on Aging, the Department of Human Services,
736	736	21 and the Department of Healthcare and Family Services shall
737	737	22 coordinate and implement a streamlined process for seniors to
738	738	23 access benefits under the State's Medical Assistance Program.
739	739	24 The Subcommittee shall collaborate with the Department of
740	740	25 Human Services on the adoption of a uniform application
741	741	26 submission process. The Department of Human Services and any
742	742
743	743
744	744
745	745
746	746
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748	748
749	749
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752	752	1 other State agency involved with processing the medical
753	753	2 assistance application of any person enrolled in the Community
754	754	3 Care Program shall include the appropriate care coordination
755	755	4 unit in all communications related to the determination or
756	756	5 status of the application.
757	757	6 The Community Care Program Medicaid Initiative shall
758	758	7 provide targeted funding to care coordination units to help
759	759	8 seniors complete their applications for medical assistance
760	760	9 benefits. On and after July 1, 2019, care coordination units
761	761	10 shall receive no less than $200 per completed application,
762	762	11 which rate may be included in a bundled rate for initial intake
763	763	12 services when Medicaid application assistance is provided in
764	764	13 conjunction with the initial intake process for new program
765	765	14 participants.
766	766	15 The Community Care Program Medicaid Initiative shall cease
767	767	16 operation 5 years after June 4, 2018 (the effective date of
768	768	17 Public Act 100-587), after which the Subcommittee shall
769	769	18 dissolve.
770	770	19 Effective July 1, 2023, subject to federal approval, the
771	771	20 Department on Aging shall reimburse Care Coordination Units at
772	772	21 the following rates for case management services: $252.40 for
773	773	22 each initial assessment; $366.40 for each initial assessment
774	774	23 with translation; $229.68 for each redetermination assessment;
775	775	24 $313.68 for each redetermination assessment with translation;
776	776	25 $200.00 for each completed application for medical assistance
777	777	26 benefits; $132.26 for each face-to-face, choices-for-care
778	778
779	779
780	780
781	781
782	782
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784	784
785	785
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787	787	SB1182 - 22 - LRB104 08421 KTG 18473 b
788	788	1 screening; $168.26 for each face-to-face, choices-for-care
789	789	2 screening with translation; $124.56 for each 6-month,
790	790	3 face-to-face visit; $132.00 for each MCO participant
791	791	4 eligibility determination; and $157.00 for each MCO
792	792	5 participant eligibility determination with translation.
793	793	6 By January 1, 2026, the Department shall seek federal
794	794	7 approval from the Centers for Medicare and Medicaid Services
795	795	8 for any waiver or State Plan amendment necessary to provide
796	796	9 monthly monitoring payments to care coordination units for
797	797	10 each active participant enrolled in the Community Care Program
798	798	11 who is receiving any allowable service under this Section and
799	799	12 has not utilized services authorized by the care coordination
800	800	13 unit or managed care organization for the month preceding the
801	801	14 last month of services. Managed care organizations shall
802	802	15 remediate the full monthly monitoring payment to care
803	803	16 coordination units that are providing services in accordance
804	804	17 with this Section. As used in this paragraph, "active
805	805	18 participant" means a person 60 years of age or older who has
806	806	19 been found eligible to receive Community Care Program
807	807	20 services. To receive administrative payments under this
808	808	21 paragraph, a care coordination unit must provide documentation
809	809	22 demonstrating that an effort has been made to contact the
810	810	23 individual and confirm that the individual no longer needs
811	811	24 services provided by the care coordination unit. The
812	812	25 Department shall secure federal financial participation for
813	813	26 expenditures made by the Department in accordance with this
814	814
815	815
816	816
817	817
818	818
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820	820
821	821
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823	823	SB1182 - 23 - LRB104 08421 KTG 18473 b
824	824	1 paragraph for State Fiscal Year 2026 and every State fiscal
825	825	2 year thereafter.
826	826	3 (Source: P.A. 102-1071, eff. 6-10-22; 103-8, eff. 6-7-23;
827	827	4 103-102, Article 45, Section 45-5, eff. 1-1-24; 103-102,
828	828	5 Article 85, Section 85-5, eff. 1-1-24; 103-102, Article 90,
829	829	6 Section 90-5, eff. 1-1-24; 103-588, eff. 6-5-24; 103-605, eff.
830	830	7 7-1-24; 103-670, eff. 1-1-25; revised 11-26-24.)
831	831
832	832
833	833
834	834
835	835
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