AGING-DHS-DHFS-DON SCORES
One notable impact of HB1184 is the increase in the DON score threshold for individuals seeking institutional long term care from 29 to 37, effective July 1, 2025, contingent upon federal approval. This change is designed to narrow the criteria for institutionalization while promoting community-based alternatives. Furthermore, it allows for continuity of care for individuals with DON scores between 29 and 36 who are already in nursing facilities, provided they document that appropriate community services were offered and declined. This provision provides a safety net for those transitioning back into community living prior to the score change.
House Bill 1184 amends the Illinois Act on the Aging, the Rehabilitation of Persons with Disabilities Act, and the Illinois Public Aid Code. This bill stipulates that individuals who score 29 or higher on the determination of need (DON) assessment tool will be eligible for services provided through the Community Care Program. These services are intended to prevent unnecessary or premature institutionalization, thus allowing eligible individuals to remain in community settings rather than being placed in nursing facilities. The bill also establishes provisions to support medically fragile and technology-dependent children, ensuring they have access to necessary care options that are not overly restrictive compared to what existed on January 1, 2023.
The discussions around HB1184 may include concerns about the potential strain on community care resources as more individuals are eligible based on the revised DON assessment. Stakeholders may raise questions around funding for increased services and the capacity of community care providers to meet the demands of a wider population. Additionally, ensuring a smooth transition for existing nursing facility residents seeking to move to community-based services might lead to complexities in service delivery and eligibility verification.