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Bill

HB 4918

LONG-TERM CARE TRUST ACT

104th Regular Session

Creates a dedicated Long-Term Care Trust Fund to finance broad long-term care services for eligible Illinois residents, with governance, eligibility, and sustainability rules.

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Bill Summary · HB 4918

Overview

HB 4918 (104th Illinois General Assembly) enacts the Long-Term Care Trust Act. The bill creates a state trust fund and associated program to finance long-term care services for eligible Illinois residents. It establishes funding mechanisms, eligibility criteria, benefits, administration, and oversight to provide comprehensive long-term care supports beyond traditional Medicaid structures.

Purpose and intent

  • Establish a dedicated Long-Term Care Trust Fund to pool resources for long-term care services.
  • Provide funds for paid long-term care services and supports to qualified residents, reducing reliance on out-of-pocket spending and heterogeneous funding sources.
  • Create a unified framework for access to institutional and home-and-community-based services (HCBS) for eligible participants.
  • Ensure program integrity, financial sustainability, and transparent governance.

Key provisions and changes

  • Fund creation and administration

    • Establishment of the Long-Term Care Trust Fund as a financing mechanism for long-term care services.
    • Designation of administering agency and a governing board or oversight body to manage revenues, expenditures, and program policies.
    • Provisions for ongoing funding sources (e.g., earmarked taxes, premiums, or other state/employee contributions as specified in the bill).

  • Eligibility and enrollment

    • Criteria for qualifying for long-term care benefits (age, disability, or functional status thresholds; residency requirements; and other eligibility determinants).
    • Enrollment processes, including any waiting periods, premium contributions, or income/asset testing if applicable.
    • Coordination with existing programs (e.g., Medicaid) to prevent duplication of benefits and to determine concurrent eligibility where appropriate.

  • Benefits and coverage

    • Scope of covered services, including institutional care (nursing facility, intermediate care) and HCBS (in-home care, adult day services, care coordination, respite, and support for caregivers).
    • Benefit limits, caps, and cost-sharing requirements (premiums, copayments, or deductibles), if any.
    • Standards for quality of care, provider eligibility, and service delivery models.

  • Administration and governance

    • Establishment of program rules, eligibility verification, and utilization management.
    • Creation of advisory councils or stakeholder participation mechanisms.
    • Reporting, auditing, and performance metrics to ensure accountability and fiscal responsibility.

  • Funding mechanisms and sustainability

    • Detailed description of revenue sources (potential payroll, premium payments, state contributions, or other assessments).
    • Provisions to ensure long-term solvency and periodic actuarial analyses.

  • Protections and consumer safeguards

    • Protections for beneficiaries against fraud, abuse, and improper billing.
    • Continuity of care provisions and appeals/processes for disputes.

  • Implementation timeline

    • Phased implementation schedule, including initial enrollment windows, pilot phases (if any), and full program rollout.
    • Interim measures to align with existing services during transition.

Affected parties

  • Illinois residents who require long-term care services and meet eligibility criteria.
  • Current long-term care program participants and Medicaid-eligible individuals, due to coordination provisions.
  • Employers and employees if payroll-based funding is used.
  • Healthcare and social service providers delivering long-term care services.
  • State agencies responsible for health, aging, and finance, as well as the governing board or commission established for the fund.

Procedural and timeline aspects

  • Enactment and effective date: The bill outlines when the Long-Term Care Trust Act becomes law and when program provisions take effect.
  • Transition and implementation phases: Steps for establishing the fund, hiring staff, and rolling out benefits, possibly through pilot or phased deployment.
  • Annual reporting: Requirements for actuarial reviews, fiscal audits, and program performance reports to the legislature.

Potential impact

  • Increased access to funded long-term care services, with a more predictable financing mechanism for beneficiaries.
  • Potential reduction in catastrophic out-of-pocket costs and improved care coordination.
  • Administrative changes across state agencies to manage the new fund and oversee benefits.
  • Long-term fiscal implications depend on funding structure, actuarial assumptions, and population needs, necessitating ongoing oversight and adjustments.

Note: This summary reflects the bill’s stated structure and common elements of long-term care trust legislation. For precise language, specific funding amounts, eligibility thresholds, and phased implementation details, consult the official bill text and fiscal notes.

Compiled from official sources — confirm details with the bill’s official record.

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