Bill Amendment: IL SB2929 | 2015-2016 | 99th General Assembly
NOTE: For additional amemendments please see the Bill Drafting List
Bill Title: MEDICAID-LONG TERM CARE SRVCES
Status: 2016-08-19 - Public Act . . . . . . . . . 99-0857 [SB2929 Detail]
Download: Illinois-2015-SB2929-Senate_Amendment_002.html
Bill Title: MEDICAID-LONG TERM CARE SRVCES
Status: 2016-08-19 - Public Act . . . . . . . . . 99-0857 [SB2929 Detail]
Download: Illinois-2015-SB2929-Senate_Amendment_002.html
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1 | AMENDMENT TO SENATE BILL 2929
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2 | AMENDMENT NO. ______. Amend Senate Bill 2929 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Act on the Aging is amended by | ||||||
5 | changing Section 4.03 as follows:
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6 | (20 ILCS 105/4.03) (from Ch. 23, par. 6104.03)
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7 | Sec. 4.03. The Department on Aging, in cooperation with the | ||||||
8 | Department of
Human Services and any other appropriate State, | ||||||
9 | local or
federal agency, shall, without regard to income | ||||||
10 | guidelines, establish a
nursing home prescreening program to | ||||||
11 | determine whether Alzheimer's Disease
and related disorders | ||||||
12 | victims, and persons who are deemed as blind or
as a person | ||||||
13 | with a disability as defined by the Social Security Act and who | ||||||
14 | are in need of long
term care, may be satisfactorily cared for | ||||||
15 | in their homes through the use
of home and community based | ||||||
16 | services. Responsibility for prescreening shall be vested with |
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1 | case coordination units.
Prescreening shall occur: (i) when | ||||||
2 | hospital discharge planners have advised the case coordination | ||||||
3 | unit of the imminent risk of nursing home placement of a | ||||||
4 | patient who meets the above criteria and in advance of | ||||||
5 | discharge of the patient; or (ii) when a case coordination unit | ||||||
6 | has been advised of the imminent risk of nursing home placement | ||||||
7 | of an individual in the community. The individual who is | ||||||
8 | prescreened shall be informed of all appropriate options, | ||||||
9 | including placement in a nursing home and the availability of | ||||||
10 | in-home and community-based services and shall be advised of | ||||||
11 | her or his right to refuse nursing home, in-home, | ||||||
12 | community-based, or all services. In addition, the individual | ||||||
13 | being prescreened shall be informed of spousal impoverishment | ||||||
14 | requirements, the need to submit financial information to | ||||||
15 | access services, and the consequences for failure to do so in a | ||||||
16 | form and manner developed jointly by the Department on Aging, | ||||||
17 | the Department of Human Services, and the Department of | ||||||
18 | Healthcare and Family Services. Case coordination units under
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19 | contract with the Department may charge a fee for the | ||||||
20 | prescreening provided
under this Section and the fee shall be | ||||||
21 | no greater than the cost of such
services to the case | ||||||
22 | coordination unit. At the time of each prescreening, case | ||||||
23 | coordination units shall provide information regarding the | ||||||
24 | Office of State Long Term Care Ombudsman's Residents Right to | ||||||
25 | Know database as authorized in subsection (c-5) of Section | ||||||
26 | 4.04. The case coordination units shall inquire if the |
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1 | individual who is being prescreened is in need of assistance | ||||||
2 | with the cost of nursing home care. The case coordination unit | ||||||
3 | shall provide assistance if the individual is unable to comply | ||||||
4 | in securing financial documents requested by the State to prove | ||||||
5 | financial eligibility and the individual's family is unable or | ||||||
6 | unwilling to secure the requested documents on the resident's | ||||||
7 | behalf. The case coordination unit providing these services | ||||||
8 | shall be reimbursed on a per client basis at a rate established | ||||||
9 | by the Department on Aging from federal Civil Monetary Funds | ||||||
10 | overseen by the Department on Public Health.
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11 | (Source: P.A. 98-255, eff. 8-9-13; 99-143, eff. 7-27-15.)
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12 | Section 10. The Hospital Licensing Act is amended by | ||||||
13 | changing Section 6.09 as follows:
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14 | (210 ILCS 85/6.09) (from Ch. 111 1/2, par. 147.09) | ||||||
15 | Sec. 6.09. (a) In order to facilitate the orderly | ||||||
16 | transition of aged
patients and patients with disabilities from | ||||||
17 | hospitals to post-hospital care, whenever a
patient who | ||||||
18 | qualifies for the
federal Medicare program is hospitalized, the | ||||||
19 | patient shall be notified
of discharge at least
24 hours prior | ||||||
20 | to discharge from
the hospital. With regard to pending | ||||||
21 | discharges to a skilled nursing facility, the hospital must | ||||||
22 | notify the case coordination unit, as defined in 89 Ill. Adm. | ||||||
23 | Code 240.260, at least 24 hours prior to discharge. When the | ||||||
24 | assessment is completed in the hospital, the case coordination |
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1 | unit shall provide the discharge planner with a copy of the | ||||||
2 | prescreening information and accompanying materials, which the | ||||||
3 | discharge planner shall transmit when the patient is discharged | ||||||
4 | to a skilled nursing facility. When a case coordination unit is | ||||||
5 | unable to complete an assessment in the hospital prior to the | ||||||
6 | discharge of a patient to a nursing home, the case coordination | ||||||
7 | unit shall notify the Department on Aging, which shall notify | ||||||
8 | the Department of Healthcare and Family Services. The | ||||||
9 | Department of Healthcare and Family Services and the Department | ||||||
10 | on Aging shall adopt rules to address these instances that | ||||||
11 | ensure that the patient is able to access nursing home care and | ||||||
12 | that the nursing home is not penalized for accepting the | ||||||
13 | admission. If home health services are ordered, the hospital | ||||||
14 | must inform its designated case coordination unit, as defined | ||||||
15 | in 89 Ill. Adm. Code 240.260, of the pending discharge and must | ||||||
16 | provide the patient with the case coordination unit's telephone | ||||||
17 | number and other contact information.
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18 | (b) Every hospital shall develop procedures for a physician | ||||||
19 | with medical
staff privileges at the hospital or any | ||||||
20 | appropriate medical staff member to
provide the discharge | ||||||
21 | notice prescribed in subsection (a) of this Section. The | ||||||
22 | procedures must include prohibitions against discharging or | ||||||
23 | referring a patient to any of the following if unlicensed, | ||||||
24 | uncertified, or unregistered: (i) a board and care facility, as | ||||||
25 | defined in the Board and Care Home Act; (ii) an assisted living | ||||||
26 | and shared housing establishment, as defined in the Assisted |
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1 | Living and Shared Housing Act; (iii) a facility licensed under | ||||||
2 | the Nursing Home Care Act, the Specialized Mental Health | ||||||
3 | Rehabilitation Act of 2013, the ID/DD Community Care Act, or | ||||||
4 | the MC/DD Act; (iv) a supportive living facility, as defined in | ||||||
5 | Section 5-5.01a of the Illinois Public Aid Code; or (v) a | ||||||
6 | free-standing hospice facility licensed under the Hospice | ||||||
7 | Program Licensing Act if licensure, certification, or | ||||||
8 | registration is required. The Department of Public Health shall | ||||||
9 | annually provide hospitals with a list of licensed, certified, | ||||||
10 | or registered board and care facilities, assisted living and | ||||||
11 | shared housing establishments, nursing homes, supportive | ||||||
12 | living facilities, facilities licensed under the ID/DD | ||||||
13 | Community Care Act, the MC/DD Act, or the Specialized Mental | ||||||
14 | Health Rehabilitation Act of 2013, and hospice facilities. | ||||||
15 | Reliance upon this list by a hospital shall satisfy compliance | ||||||
16 | with this requirement.
The procedure may also include a waiver | ||||||
17 | for any case in which a discharge
notice is not feasible due to | ||||||
18 | a short length of stay in the hospital by the patient,
or for | ||||||
19 | any case in which the patient voluntarily desires to leave the
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20 | hospital before the expiration of the
24 hour period. | ||||||
21 | (c) At least
24 hours prior to discharge from the hospital, | ||||||
22 | the
patient shall receive written information on the patient's | ||||||
23 | right to appeal the
discharge pursuant to the
federal Medicare | ||||||
24 | program, including the steps to follow to appeal
the discharge | ||||||
25 | and the appropriate telephone number to call in case the
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26 | patient intends to appeal the discharge. |
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1 | (d) Before transfer of a patient to a long term care | ||||||
2 | facility licensed under the Nursing Home Care Act where elderly | ||||||
3 | persons reside, a hospital shall as soon as practicable | ||||||
4 | initiate a name-based criminal history background check by | ||||||
5 | electronic submission to the Department of State Police for all | ||||||
6 | persons between the ages of 18 and 70 years; provided, however, | ||||||
7 | that a hospital shall be required to initiate such a background | ||||||
8 | check only with respect to patients who: | ||||||
9 | (1) are transferring to a long term care facility for | ||||||
10 | the first time; | ||||||
11 | (2) have been in the hospital more than 5 days; | ||||||
12 | (3) are reasonably expected to remain at the long term | ||||||
13 | care facility for more than 30 days; | ||||||
14 | (4) have a known history of serious mental illness or | ||||||
15 | substance abuse; and | ||||||
16 | (5) are independently ambulatory or mobile for more | ||||||
17 | than a temporary period of time. | ||||||
18 | A hospital may also request a criminal history background | ||||||
19 | check for a patient who does not meet any of the criteria set | ||||||
20 | forth in items (1) through (5). | ||||||
21 | A hospital shall notify a long term care facility if the | ||||||
22 | hospital has initiated a criminal history background check on a | ||||||
23 | patient being discharged to that facility. In all circumstances | ||||||
24 | in which the hospital is required by this subsection to | ||||||
25 | initiate the criminal history background check, the transfer to | ||||||
26 | the long term care facility may proceed regardless of the |
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1 | availability of criminal history results. Upon receipt of the | ||||||
2 | results, the hospital shall promptly forward the results to the | ||||||
3 | appropriate long term care facility. If the results of the | ||||||
4 | background check are inconclusive, the hospital shall have no | ||||||
5 | additional duty or obligation to seek additional information | ||||||
6 | from, or about, the patient. | ||||||
7 | (Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14; | ||||||
8 | 99-143, eff. 7-27-15; 99-180, eff. 7-29-15; revised 10-14-15.)
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9 | Section 15. The Illinois Public Aid Code is amended by | ||||||
10 | changing Section 5-6 as follows:
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11 | (305 ILCS 5/5-6) (from Ch. 23, par. 5-6)
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12 | Sec. 5-6. Obligations incurred prior to death of a | ||||||
13 | recipient or during the pendency of an individual's application | ||||||
14 | for benefits . Obligations incurred but not paid for at the time | ||||||
15 | of the death of a recipient or during the pendency of an | ||||||
16 | individual's application for benefits recipient's death
for | ||||||
17 | services authorized under Section 5-5, including medical and | ||||||
18 | other
care in facilities as defined in the Nursing Home Care
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19 | Act, the Specialized Mental Health Rehabilitation Act of 2013, | ||||||
20 | the ID/DD Community Care Act, or the MC/DD Act, or in like | ||||||
21 | facilities
not required to be licensed under that Act, may be | ||||||
22 | paid, subject to the
rules and regulations of the Illinois | ||||||
23 | Department, after the death of the recipient or during the | ||||||
24 | pendency of the individual's application for benefits .
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1 | (Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)".
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