PACE PROGRAM FLEXIBILITY

Illinois General Assembly - Full Text of HB4917

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HB4917 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4917

Introduced , by Rep. Anna Moeller

SYNOPSIS AS INTRODUCED:

320 ILCS 40/18 new

Amends the Program of All-Inclusive Care for the Elderly Act.
Provides that the Department of Healthcare and Family Services shall
coordinate with the Department on Aging and the Department of Human
Services to ensure the maximization of all available federal financial
participation and existing State revenue sources, which shall include, but
not be limited to, identifying and integrating funding streams currently
used for the Home and Community-Based Services (HCBS) waivers to support
PACE enrollment and developing a unified budgeting approach under which
appropriations for long-term services and supports are treated as a
fungible pool, allowing funding to transition seamlessly when a
participant chooses PACE over traditional waiver services. Provides that,
to ensure participant choice and program flexibility, the Department shall
establish a service-neutral enrollment mechanism. Provides that if an
individual is on a waiting list for a HCBS waiver and chooses to enroll in
PACE, the individual's status and slot value shall be preserved and
applied to the PACE capitation rate to ensure the State's budget
neutrality. Sets forth provisions concerning funding portability,
transitioning between PACE and traditional HCBS models, and the use of a
Unified Assessment Tool.
LRB104 18150 RPS 31589 b

A BILL FOR

HB4917
LRB104 18150 RPS 31589 b
1

AN ACT concerning aging.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Program of All-Inclusive Care for the
5
Elderly Act is amended by adding Section 18 as follows:

6

(320 ILCS 40/18 new)
7

Sec. 18.
Rate-setting, revenue maximization, and
8
participant flexibility.
9

(a) Revenue maximization and resource alignment. The
10
Department shall coordinate with the Department on Aging and
11
the Department of Human Services to ensure the maximization of
12
all available federal financial participation and existing
13
State revenue sources. This shall include, but not be limited
14
to:
15

(1) Identifying and integrating funding streams
16

currently used for the Home and Community-Based Services
17

(HCBS) waivers to support PACE enrollment.
18

(2) Developing a unified budgeting approach under
19

which appropriations for long-term services and supports
20

are treated as a fungible pool, allowing funding to
21

transition seamlessly when a participant chooses PACE over
22

traditional waiver services.
23

(b) Funding portability. To ensure participant choice and

HB4917
- 2 -
LRB104 18150 RPS 31589 b
1
program flexibility, the Department shall establish a
2
service-neutral enrollment mechanism.
3

(1) Preservation of eligibility. An individual found
4

eligible for a nursing facility level of care for the
5

purpose of a HCBS waiver shall be deemed clinically
6

eligible for the PACE program without a requirement for a
7

separate or additional medical assessment.
8

(2) Immediate fund transfer. Upon a participant's
9

voluntary election to enroll in a PACE program, the
10

Department shall facilitate the immediate transition of
11

the actuarially equivalent waiver dollar to the PACE
12

organization's capitated payment.
13

(3) Waitlist continuity. If an individual is on a
14

waiting list for a HCBS waiver and chooses to enroll in
15

PACE, the individual's status and slot value shall be
16

preserved and applied to the PACE capitation rate to
17

ensure the State's budget neutrality.
18

(c) Participant flexibility and reentry. To prevent an
19
inability to access resident-centered and resident-chosen
20
services, the Department shall ensure that:
21

(1) Participants may transition between PACE and
22

traditional HCBS models during any open enrollment period
23

or upon a change in medical necessity so long as the
24

transition does not result in a gap in care or loss of
25

Medicaid eligibility.
26

(2) The Department shall use a Unified Assessment Tool

HB4917
- 3 -
LRB104 18150 RPS 31589 b
1

to ensure that the participant's clinical profile is
2

portable between the managed care organization-waiver
3

system and the PACE delivery model.

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