Illinois § 5

§ 5.

Legislative declaration. The General Assembly finds and declares that it is the intent of this Act to replicate the On Lok program in San Francisco, California, that has proven to be cost-effective at both the state and federal levels. The PACE program is part of a national replication project authorized in Section 9412(b)(2) of the federal Omnibus Reconciliation Act of 1986, which instructs the Secretary of the federal Department of Health and Human Services to grant Medicare and Medicaid waivers to permit not more than 10 public or nonprofit private community-based organizations in the country to provide comprehensive health care services on a capitated basis to frail elderly who are at risk of institutionalization. The General Assembly finds that by coordinating an extensive array of medical and nonmedical services, the needs of the participants will be met primarily in an outpatient environment in an adult day health center, in their homes, or in an institutional setting. The General Assembly finds that such a service delivery system will enhance the quality of life for the participant and offers the potential to reduce and cap costs to Illinois of the medical needs of the participants, including hospital and nursing home admissions. The General Assembly declares that the purpose of this Act is to provide services that would foster the following goals: To maintain eligible persons at home as an alternative to long-term institutionalization; To provide optimum accessibility to various important social and health resources that are available to assist eligible persons in maintaining independent living; To provide that eligible persons who are frail elderly but who have the capacity to remain in an independent living situation have access to the appropriate social and health services without which independent living would not be possible; To coordinate, integrate, and link these social and health services by removing obstacles that impede or limit improvements in delivery of these services; To provide the most efficient and effective use of capitated funds for the delivery of these social and health services; To assure that capitation payments amount to no more than 95% of the amount paid under the Medicaid fee-for-service structure of an actuarially similar population. (Source: P.A. 95-331, eff. 8-21-07.)