LONG-TERM CARE TRUST ACT

Illinois General Assembly - Full Text of HB4918

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HB4918 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB4918

Introduced , by Rep. Justin Cochran

SYNOPSIS AS INTRODUCED:

New Act

Creates the Long-Term Care Trust Act. Establishes the Long-Term
Services and Supports Trust Program (Trust Program) within the Department
on Aging to provide long-term services and supports funding benefits to
eligible employees through payroll deductions to be deposited into the
Long-Term Services and Supports Trust Fund created under the Act. Requires
the Department on Aging, an actuary contracted with the Department on
Aging, and the Department of Revenue to have the responsibilities of
implementing and administering the Trust Program. Sets forth the
Department on Aging's responsibilities, including, but not limited to: (i)
making determinations regarding an individual's status as an eligible
beneficiary; (ii) approving long-term services and supports eligible for
payment; (iii) registering long-term services and supports providers that
meet minimum qualifications; and (iv) disbursing payments of benefits to
registered long-term services and supports providers. Requires the
Department of Revenue to collect and assess employee premiums under the
program, make eligibility determinations, and other responsibilities.
Contains provisions on the responsibilities of the contracted actuary; the
establishment of a Long-Term Services and Supports Trust Commission and a
Long-Term Services and Supports Trust Council; qualifying beneficiary
requirements; payroll premiums and the disbursement of benefits; coverage
for self-employed individuals; the management of the Long-Term Services
and Supports Trust Fund; appeals of benefit determinations; federal waiver
requirements; reporting requirements; and other matters. Effective
immediately.
LRB104 17999 KTG 31436 b

A BILL FOR

HB4918
LRB104 17999 KTG 31436 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 1.
Short title.
This Act may be cited as the
5
Long-Term Care Trust Act.

6

Section 2.
Definitions.
As used in this Act:
7

"Approved service" means long-term services and supports,
8
including, but not limited to:
9

(1) Adult day services.
10

(2) Care transition coordination.
11

(3) Memory care.
12

(4) Adaptive equipment and technology.
13

(5) Environmental modification.
14

(6) Personal emergency response system.
15

(7) Home safety evaluation.
16

(8) Respite for family caregivers.
17

(9) Home delivered meals.
18

(10) Transportation.
19

(11) Dementia supports.
20

(12) Education and consultation.
21

(13) Eligible relative care.
22

(14) Professional services.
23

(15) Assisted living services.

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(16) Adult family home services.
2

(17) Nursing home services.
3

"Benefit unit" means up to $100 paid by the Department to a
4
long-term services and supports provider as reimbursement for
5
approved services provided to an eligible beneficiary on a
6
specific date.
7

"Commission" means the Long-Term Services and Supports
8
Trust Commission established under Section 4.
9

"Consumer Price Index" means the index published by the
10
Bureau of Labor Statistics of the United States Department of
11
Labor that measures the average change in prices of goods and
12
services purchased by all urban consumers, United States city
13
average, all items, 1982-84 = 100.
14

"Council" means the Long-Term Services and Supports Trust
15
Council established under Section 5.
16

"Department" means the Department on Aging.
17

"Eligible beneficiary" means a qualified individual who is
18
18 years of age or older, resides in this State, was not
19
disabled before 18 years of age, has been determined to meet
20
the minimum level of assistance with activities of daily
21
living necessary to receive benefits through the program and
22
who has not exhausted the lifetime limit of benefit units.
23

"Long-term services and supports provider" means a person
24
that meets the qualifications applicable under law to the
25
approved service that the person provides, including a
26
qualified or certified home care aide, licensed assisted

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living facility, licensed adult family home, licensed nursing
2
home, licensed in-home services agency, adult day services
3
program, vendor, instructor, qualified family member, or other
4
entities as registered by the Department.
5

"Medicaid" or "State's Medicaid program" means the medical
6
assistance program established and administered in Article V
7
of the Illinois Public Aid Code as authorized under Section
8
1902 of the Social Security Act.
9

"Premium" means the payments required under Section 9 and
10
paid to the Department of Revenue for deposit into the Trust
11
Fund.
12

"Program" means the Long-Term Services and Supports Trust
13
Program established under Section 3.
14

"Qualified family member" means a relative of an eligible
15
beneficiary qualified to meet the requirements established
16
under law for the approved service the relative provides that
17
would be required of any other long-term services and supports
18
provider to receive payments from the State.
19

"Qualified individual" means an individual who meets the
20
duration of payment requirements established under this Act.
21

"Trust Fund" means the Long-Term Services and Supports
22
Trust Fund established under Section 11.

23

Section 3.
Long-Term Services and Supports Trust Program.
24

(a) Establishment. The Long-Term Services and Supports
25
Trust Program is established within the Department on Aging.

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(b) Administration. The Department, an actuary contracted
2
by the Department, and the Department of Revenue shall have
3
the responsibilities of implementing and administering the
4
program as provided under this Section.
5

(c) Department on Aging. The Department shall:
6

(1) Make determinations regarding an individual's
7

status as an eligible beneficiary under Section 7.
8

(2) Approve long-term services and supports eligible
9

for payment as approved services under the program, as
10

informed by the Long-Term Services and Supports Trust
11

Commission established under Section 4.
12

(3) Register long-term services and supports providers
13

that meet minimum qualifications.
14

(4) Discontinue the registration of long-term services
15

and supports providers that:
16

(i) fail to meet the minimum qualifications
17

applicable in law to the approved service that the
18

long-term services and supports providers provide; or
19

(ii) violate the operational standards of the
20

program.
21

(5) Disburse payments of benefits to registered
22

long-term services and supports providers, utilizing and
23

leveraging existing payment systems for the provision of
24

approved services to eligible beneficiaries under Section
25

8.
26

(6) Prepare and distribute written or electronic

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materials to qualified individuals, eligible
2

beneficiaries, and the public as deemed necessary by the
3

Commission to inform the public of program design and
4

updates.
5

(7) Provide customer service and address questions and
6

complaints, including referring individuals to other
7

appropriate agencies.
8

(8) Provide administrative and operational support to
9

the Commission.
10

(9) Track data useful in monitoring and informing the
11

program, as identified by the Commission.
12

(10) Track the use of lifetime benefit units to verify
13

the individual's status as an eligible beneficiary.
14

(11) Ensure approved services are provided through
15

audits or service verification processes within the
16

service provider payment system for registered long-term
17

services and supports providers and recoup any
18

inappropriate payments.
19

(12) Establish criteria for the payment of benefits to
20

registered long-term services and supports providers under
21

Section 8.
22

(13) Establish rules and procedures for benefit
23

coordination when the eligible beneficiary is also funded
24

for Medicaid and other long-term services and supports,
25

including Medicare, workers' compensation, and private
26

long-term care coverage.

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(14) Adopt rules necessary to implement and administer
2

the activities specified under this Section related to the
3

program.
4

(d) Department of Revenue. The Department of Revenue
5
shall:
6

(1) Collect and assess employee premiums as provided
7

in Section 9.
8

(2) Assist the Commission, the Long-Term Services and
9

Supports Trust Council established under Section 5, and
10

the actuary contracted by the Department on Aging as
11

provided in subsection (e) in monitoring the solvency and
12

financial status of the program.
13

(3) Make determinations regarding an individual's
14

status as a qualified individual under Section 6.
15

(4) Adopt rules necessary to implement and administer
16

the activities specified under this Section.
17

(e) Actuary. The Department on Aging shall contract with
18
an actuary and the contract shall include that the actuary do
19
the following:
20

(1) Beginning January 1, 2029, and biennially
21

thereafter, perform an actuarial audit and valuation of
22

the Long-Term Services and Supports Trust Fund established
23

under Section 11. Additional or more frequent actuarial
24

audits and valuations may be performed at the request of
25

the Council.
26

(2) Make recommendations to the Council and the

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General Assembly on actions necessary to maintain fund
2

solvency. The recommendations shall include options to
3

redesign or reduce benefit units, approved services, or
4

both, to prevent or eliminate any unfunded actuarially
5

accrued liability in the trust or to maintain solvency.
6

(3) Select and contract for actuarial, research,
7

technical, and other consultants as the actuary deems
8

necessary to perform the actuary's duties under this Act.

9

Section 4.
Long-Term Services and Supports Trust
10
Commission.
11

(a) Establishment. The Long-Term Services and Supports
12
Trust Commission is established. The Commission's
13
recommendations and decisions shall be guided by the joint
14
goals of maintaining benefit adequacy and maintaining fund
15
solvency and sustainability.
16

(b) Membership. The Commission shall include:
17

(1) The Director of Aging, or the Director's designee.
18

(2) The Director of Revenue or the Director's
19

designee.
20

(3) Two members of the Senate, appointed by the
21

President of the Senate.
22

(4) Two members of the House of Representatives,
23

appointed by the Speaker of the House of Representatives.
24

(5) One representative of an organization representing
25

Area Agencies on Aging.

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(6) One representative of a home care association that
2

represents caregivers who provide services to private pay
3

and Medicaid clients.
4

(7) One representative of a union representing
5

long-term care workers.
6

(8) One representative of an organization representing
7

retired individuals.
8

(9) One representative of an association representing
9

skilled nursing facilities and assisted living providers.
10

(10) One representative of an association representing
11

adult family home providers.
12

(11) Two individuals receiving long-term services and
13

supports, or their designees, or representatives of
14

consumers receiving long-term services and supports under
15

the program.
16

(12) One member who is a worker who is, or will likely
17

be, paying the premium established under Section 9 and who
18

is not employed by a long-term services and supports
19

provider.
20

(13) One representative of an organization of
21

employers whose members collect, or will likely be
22

collecting, the premium established under Section 9.
23

(c) Terms. Except for the members under paragraphs (1),
24
(2), (3), and (4) of subsection (b), members of the Commission
25
shall be appointed by the Governor for terms of 2 years, except
26
that the Governor shall appoint the initial members to

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staggered terms not to exceed 4 years.
2

(d) Chair. The Director of Aging, or the Director's
3
designee, shall serve as chair of the Commission.
4

(e) Meetings and quorum. Meetings of the Commission shall
5
be at the call of the chair. A majority of the voting members
6
of the Commission shall constitute a quorum for any votes of
7
the Commission. Approval of 60% of those voting members of the
8
Commission who are in attendance is required for the passage
9
of any vote.
10

(f) Recommendations. Beginning January 1, 2027, the
11
Commission shall propose recommendations to the Department
12
regarding:
13

(1) The establishment of criteria for determining that
14

an individual has met the requirements to be a qualified
15

individual as established under Section 6 or an eligible
16

beneficiary as established under Section 7.
17

(2) The establishment of criteria for minimum
18

qualifications for the registration of long-term services
19

and supports providers who provide approved services to
20

eligible beneficiaries.
21

(3) The establishment of payment maximums for approved
22

services consistent with actuarial soundness which may not
23

be lower than Medicaid payments for comparable services. A
24

service or supply may be limited by dollar amount,
25

duration, or number of visits. The Commission shall engage
26

affected stakeholders to develop this recommendation.

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(4) Changes to rules or policies to improve the
2

operation of the program.
3

(5) Providing a recommendation to the Council for the
4

annual adjustment of the benefit unit as provided under
5

this Act.
6

(6) Assisting the actuary contracted by the Department
7

with the preparation of regular actuarial reports on the
8

solvency and financial status of the program and advising
9

the General Assembly on actions necessary to maintain
10

trust solvency. The Commission shall provide the actuary
11

with all actuarial reports for review. The actuary shall
12

provide any recommendations to the Commission and the
13

General Assembly on actions necessary to maintain trust
14

solvency.
15

(7) Whether and how to extend coverage to individuals
16

who became disabled before 18 years of age, including the
17

impact on the financial status and solvency of the trust.
18

The Commission shall engage affected stakeholders to
19

develop this recommendation.
20

(8) Consultation with the actuary contracted by the
21

Department on the development of an actuarial report of
22

the projected solvency and financial status of the
23

program. The actuary shall provide any recommendations to
24

the Commission and the General Assembly on actions
25

necessary to achieve trust solvency.
26

(g) Expenses. The Commission shall monitor Department

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administrative expenses over time. Beginning November 15,
2
2027, the Commission shall annually report to the Governor and
3
the chairpersons and minority chairpersons of the Senate and
4
House Revenue Committees on Department spending for
5
administrative expenses and anticipated administrative
6
expenses as the program shifts into different phases of
7
implementation and operation. The November 15, 2030, report
8
shall include recommendations for a method of calculating
9
future Department administrative expenses to limit
10
administrative expenses while providing sufficient money to
11
adequately operate the program. The members under paragraphs
12
(1), (2), (3), and (4) of subsection (b) may advise the
13
Commission on the reports prepared under this subsection but
14
must recuse themselves from the Commission's process for
15
review, approval, and submission to the General Assembly.
16

(h) Investment strategy subcommittee. The Commission shall
17
establish an investment strategy subcommittee consisting of
18
the members under paragraphs (1), (2), (3), and (4) of
19
subsection (b) as voting members of the subcommittee. In
20
addition, 4 members appointed by the Governor who are
21
considered experienced and qualified in the field of
22
investment shall serve as nonvoting members. The subcommittee
23
shall provide guidance and advice to the State Treasurer on
24
investment strategies for the Trust Fund, including seeking
25
counsel and advice on the types of investments that are
26
constitutionally permitted.

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Section 5.
Long-Term Services and Supports Trust Council.
2

(a) Establishment. The Long-Term Services and Supports
3
Trust Council is established.
4

(b) Membership. The Council shall include:
5

(1) The Director of Aging, or the Director's designee.
6

(2) The Director of Revenue, or the Director's
7

designee.
8

(3) Two members of the Senate appointed by the
9

President of the Senate.
10

(4) Two members of the House of Representatives
11

appointed by the Speaker of the House of Representatives.
12

(5) A representative from the Governor's Office of
13

Management and Budget.
14

(c) Adjustments to benefit unit. On an annual basis, the
15
Council shall determine adjustments to the benefit unit to
16
ensure benefit adequacy and solvency of the Trust Fund. The
17
benefit unit shall be adjusted at a rate no greater than the
18
Consumer Price Index, as determined by the Council. In
19
determining adjustments to the benefit unit, the Council shall
20
review the actuary's actuarial audit and valuation of the
21
Trust Fund, any recommendations by the actuary and the
22
Commission, data on relevant economic indicators and program
23
costs and sustainability.
24

(d) Chair. The Director of Aging, or the Director's
25
designee, shall serve as chair of the Council.

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(e) Meetings and quorum. The Council shall meet at least
2
once annually to determine adjustments to the benefit unit
3
under subsection (c). Additional meetings of the Council shall
4
be at the call of the chair. A majority of the voting members
5
of the Council shall constitute a quorum for any votes of the
6
Council. Approval of 60% of the members of the Council who are
7
in attendance is required for the passage of any vote. The
8
Council may adopt rules for the conduct of meetings, including
9
provisions for meetings and voting to be conducted by
10
telephonic, video, or other conferencing process.

11

Section 6.
Qualifying beneficiaries.
12

(a) Determination. The Department of Revenue shall deem an
13
individual to be a qualified individual as provided under this
14
Act if the individual has paid the long-term services and
15
supports premiums required under Section 9 for the equivalent
16
of either:
17

(1) a total of 10 years without interruption of 5 or
18

more consecutive years; or
19

(2) 3 years within the last 6 years.
20

(b) Requirements. When deeming an individual to be a
21
qualified individual, the Department of Revenue shall require
22
that the individual have worked at least 500 hours during each
23
of the 10 years in paragraph (1) of subsection (a) and each of
24
the 3 years in paragraph (2) of subsection (a).

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Section 7.
Disbursement of benefits.
2

(a) General rule. Beginning January 1, 2030, approved
3
services shall be available and benefits payable to a
4
registered long-term services and supports provider on behalf
5
of an eligible beneficiary under this Section.
6

(b) Eligible beneficiary. A qualified individual may
7
become an eligible beneficiary by filing an application with
8
the Department and undergoing an eligibility determination
9
which includes an evaluation that the qualified individual
10
requires assistance with at least 3 activities of daily
11
living. The Department shall engage a qualified assessor so
12
that the determination may be made within 45 days from receipt
13
of the application by the qualified individual to use a
14
benefit.
15

(c) Receipt of services and benefits. An eligible
16
beneficiary:
17

(1) May receive approved services and benefits through
18

the program in the form of a benefit unit payable to a
19

registered long-term services and supports provider.
20

(2) May not receive more than the dollar equivalent of
21

365 benefit units over the course of the eligible
22

beneficiary's lifetime.
23

(d) Reimbursements. If the Department reimburses a
24
long-term services and supports provider for approved services
25
provided to an eligible beneficiary and the payment is less
26
than the benefit unit, only the portion of the benefit unit

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1
that is used shall be taken into consideration when
2
calculating the individual's remaining lifetime limit on
3
receipt of benefits.
4

(e) Combination of benefit units. Eligible beneficiaries
5
may combine benefit units to receive more approved services
6
per day as long as the total number of lifetime benefit units
7
has not been exceeded.

8

Section 8.
Benefits.
9

(a) Payment. Benefits provided under this Act shall be
10
paid periodically and promptly to registered long-term
11
services and supports providers.
12

(b) Qualified family members. Qualified family members may
13
be paid for approved personal care services in the same way as
14
individual providers, through a licensed home care agency or
15
through a third option if recommended by the Commission and
16
adopted by the Department.

17

Section 9.
Payroll premium.
18

(a) General rule. Beginning January 1, 2027, the
19
Department of Revenue shall assess for each individual in
20
employment with an employer a premium based on the amount of
21
the individual's wages. The initial premium rate shall be
22
0.58% of the individual's wages. Beginning January 1, 2029,
23
and biennially thereafter, the premium rate shall be set by
24
the Illinois Commission on Government Forecasting and

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Accountability at a rate no greater than 0.58%. In addition,
2
the Illinois Commission on Government Forecasting and
3
Accountability shall set the premium rate at the lowest amount
4
necessary to maintain the actuarial solvency of the Trust Fund
5
in accordance with recognized insurance principles and
6
designed to attempt to limit fluctuations in the premium rate.
7
To facilitate the premium rate setting the actuary contracted
8
by the Department shall perform a biennial actuarial audit and
9
valuation of the Trust Fund and make recommendations to the
10
Illinois Commission on Government Forecasting and
11
Accountability.
12

(b) Duties of employers. An employer shall:
13

(1) Collect from employees the premiums provided under
14

subsection (a) through payroll deductions and remit the
15

amounts collected to the Department of Revenue.
16

(2) In collecting employee premiums through payroll
17

deductions, act as the agent of the employees and shall
18

remit the amounts to the Department of Revenue as required
19

by this Act.
20

(c) Collective bargaining agreements. Nothing in this Act
21
shall require a party to a collective bargaining agreement
22
taking effect within 24 months or less of the effective date of
23
this Act to reopen negotiations of the agreement or to apply
24
any of the responsibilities under this Act unless and until
25
the existing agreement is reopened or renegotiated by the
26
parties or expires.

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(d) Collection. Premiums shall be collected in the manner
2
and at such intervals as provided by the Department of
3
Revenue.
4

(e) Deposit of premiums. The Department of Revenue shall
5
deposit all premiums collected under this Section into the
6
Trust Fund.
7

(f) Increase of premiums. If the premiums under this
8
Section are increased, the Department of Revenue shall notify
9
each qualified individual by mail that the individual's
10
premiums have been increased, describe the reason for
11
increasing the premiums and describe the plan for restoring
12
the money so that premiums are returned to 0.58% of the
13
individual's wages.
14

(g) Exemption. An employee who demonstrates that the
15
employee has long-term care insurance is exempt from the
16
premium assessment under this Section.

17

Section 10.
Self-employed individuals.
18

(a) Electing coverage. Beginning January 1, 2027, a
19
self-employed individual, including a sole proprietor,
20
independent contractor, partner, or joint venturer may elect
21
coverage under this Act. An individual electing coverage under
22
this subsection is responsible for payment of all premiums
23
assessed to an employee under Section 9. The individual shall
24
file a notice of election in writing with the Department of
25
Revenue, in a manner prescribed by the Department of Revenue.

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The individual shall be eligible for benefits after paying the
2
long-term services and supports premium for the time required
3
under Section 6.
4

(b) Withdraw from coverage. A self-employed individual who
5
has elected coverage may withdraw from coverage at times
6
prescribed by the Department of Revenue by filing a notice of
7
withdrawal in writing with the Department of Revenue, with the
8
withdrawal to take effect no sooner than 30 days after filing
9
the notice with the Department of Revenue.
10

(c) Cancellation. The Department of Revenue may cancel
11
elective coverage if the self-employed individual fails to
12
make required payments or file reports. The Department of
13
Revenue may collect due and unpaid premiums and may levy an
14
additional premium for the remainder of the period of
15
coverage. The cancellation shall be effective no later than 30
16
days from the date of the notice in writing advising the
17
self-employed individual of the cancellation.
18

(d) Rules. The Department of Revenue shall adopt rules for
19
determining the hours worked and the wages of individuals who
20
elect coverage under this Section and for the enforcement of
21
this Section.

22

Section 11.
Long-Term Services and Supports Trust Fund.
23

(a) Establishment. The Long-Term Services and Supports
24
Trust Fund is created as a trust fund in the State treasury.
25
The Trust Fund shall be held separate and apart from all public

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1
moneys or funds of this State. The Trust Fund shall consist of
2
all receipts from employers as provided under Section 9 as
3
well as any moneys appropriated to the Department for the
4
purposes of this Act. Interest earned on moneys in the Trust
5
Fund shall be deposited into the Trust Fund.
6

(b) Trust Fund Administration.
7

(1) All receipts from employers under Section 9 shall
8

be deposited into the Trust Fund.
9

(2) Expenditures from the Trust Fund may be used for
10

the administrative activities of the Department and the
11

Department of Revenue.
12

(3) Benefits associated with the program shall be
13

disbursed from the Trust Fund by the Department. Only the
14

Director of Aging, or the Director's designee, may
15

authorize disbursements from the Trust Fund.
16

(4) The Trust Fund shall provide reimbursement of any
17

amounts from other sources that may have been used for the
18

initial establishment of the program.
19

(c) Utilization of revenue. The revenue generated under
20
this Act shall be utilized to expand long-term care in this
21
State. The money may not be used either in whole or in part to
22
supplant existing State or county money for programs that meet
23
the definition of approved services.
24

(d) Money expended for other purposes. Money deposited
25
into the Trust Fund shall remain in the Trust Fund until
26
expended in accordance with the requirements of this Act. If

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1
money is expended for any purpose other than supporting the
2
long-term services and supports program, the Department of
3
Revenue shall notify each qualified individual by mail that
4
the individual's premiums have been expended for an alternate
5
use, describe the alternate use and state the Department of
6
Revenue's plan for restoring the money so that premiums are
7
not increased and benefits are not reduced.

8

Section 12.
Management of Trust Fund.
9

(a) Investment of money in Trust Fund. The Department
10
shall have the State Treasurer invest the money in the Trust
11
Fund. The State Treasurer shall have full power to invest,
12
reinvest, manage, contract, sell, or exchange investment money
13
in the Trust Fund.
14

(b) Investment policy. All investments made by the State
15
Treasurer shall be made with the degree of judgment and care
16
required and the investment policy established by the State
17
Treasury.
18

(c) Investment with other funds. As deemed appropriate by
19
the State Treasurer, money in the Trust Fund may be commingled
20
for investment with other funds subject to investment by the
21
State Treasurer.
22

(d) Policies. The Department shall establish all policies
23
relating to the Trust Fund, other than the investment policies
24
as provided under this Section.
25

(e) Disbursement. With the exception of expenses of the

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1
State Treasurer under this Section, disbursements from the
2
Trust Fund shall be made only on the authorization of the
3
Director of Aging, or the Director's designee, and money in
4
the Trust Fund may be spent only for the purposes specified
5
under this Act.
6

(f) Consultation. The State Treasurer shall routinely
7
consult and communicate with the Department on the investment
8
policy, earnings of the Trust Fund, and related needs of the
9
program.

10

Section 13.
Appeals.
Determinations made by the Department
11
under this Act, including determinations regarding functional
12
eligibility or related to registration of long-term services
13
and support providers, are subject to judicial review in
14
accordance with the provisions of the Administrative Review
15
Law. In addition, the standards and procedures adopted for
16
judicial review under this Section shall address the
17
following:
18

(1) Timelines.
19

(2) Eligibility and benefit determination.
20

(3) Fees.

21

Section 14.
Information sharing.
The Department shall:
22

(1) Seek access to Medicare data from the Centers for
23

Medicare and Medicaid Services of the United States
24

Department of Health and Human Services to analyze the

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1

potential savings in Medicare expenditures due to the
2

operation of the program.
3

(2) Apply for a demonstration waiver from the Centers
4

for Medicare and Medicaid Services of the United States
5

Department of Health and Human Services to allow for the
6

State to share in the savings generated in the federal
7

match for Medicaid long-term services and supports and
8

Medicare due to the operation of the program.
9

(3) Submit a report on the status of the waiver to
10

General Assembly by December 1, 2027.

11

Section 15.
Report.
Beginning December 1, 2031, and
12
annually thereafter, the Commission shall report to the
13
General Assembly on the program, including:
14

(1) Projected and actual program participation.
15

(2) Adequacy of premium rates.
16

(3) Trust Fund balances.
17

(4) Benefits paid.
18

(5) Demographic information on program participants,
19

including age, gender, race, ethnicity, geographic
20

distribution by county, legislative district, and
21

employment sector.
22

(6) The extent to which the operation of the program
23

has resulted in savings to the State's Medicaid program by
24

avoiding costs that would have otherwise been the
25

responsibility of the State.

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1

Section 16.
Auditor General audits.
By December 1, 2031,
2
the Auditor General must conduct, in accordance with the
3
Illinois State Auditing Act, a financial, compliance, and
4
performance audit of the Long-Term Services and Supports Trust
5
Program and deliver a report, including a conclusion and
6
recommendations for improvement to the General Assembly
7
regarding:
8

(1) Program operations, including the performance of
9

the Commission established in Section 4;
10

(2) Program financial status, including solvency, the
11

value of the benefit provided, and the financial balance
12

of program benefits to costs.
13

(3) The overall efficacy of the program, based on the
14

established goals under this Act including, but not
15

limited to:
16

(i) delaying middle class families' need to spend
17

to poverty to receive Medicaid-funded long-term care;
18

(ii) strengthening the State economy through
19

improving workforce participation;
20

(iii) reducing the caseload and expenditures of
21

the State Medicaid program on long-term care; and
22

(iv) obtaining shared savings through a Medicaid
23

demonstration waiver.

24

Section 17.
Exclusions.
Any benefits used by an individual

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1
under this Act are not income or resources for any
2
determinations of eligibility for any other State program or
3
benefit, Medicaid, a State-federal program, or for any other
4
means-tested program.

5

Section 99.
Effective date.
This Act takes effect upon
6
becoming law.

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