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Public Act 096-0799
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| SB2043 Enrolled |
LRB096 11169 DRJ 21882 b |
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by |
changing Sections 5-24 and 12-4.201 as follows:
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(305 ILCS 5/5-24)
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(Section scheduled to be repealed on January 1, 2014)
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Sec. 5-24. Disease management programs and services for
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chronic conditions; pilot project.
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(a) In this Section, "disease management programs and
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services" means services administered to patients in order to |
improve
their overall health and to prevent clinical |
exacerbations and
complications, using cost-effective, |
evidence-based practice
guidelines and patient self-management |
strategies. Disease
management programs and services include |
all of the following:
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(1) A population identification process.
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(2) Evidence-based or consensus-based clinical |
practice
guidelines, risk identification, and matching of |
interventions with
clinical need.
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(3) Patient self-management and disease education.
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(4) Process and outcomes measurement, evaluation, |
management, and
reporting.
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(b) Subject to appropriations, the Department of |
Healthcare and Family Services may
undertake a pilot project to |
study patient outcomes, for patients with chronic
diseases or |
patients at risk of low birth weight or premature birth, |
associated with the use of disease management programs and |
services
for chronic condition management. "Chronic diseases" |
include, but are not
limited to, diabetes, congestive heart |
failure, and chronic obstructive
pulmonary disease. Low birth |
weight and premature birth include all medical and other |
conditions that lead to poor birth outcomes or problematic |
pregnancies.
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(c) The disease management programs and services pilot
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project shall examine whether chronic disease management |
programs and
services for patients with specific chronic |
conditions do any or all
of the following:
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(1) Improve the patient's overall health in a more |
expeditious
manner.
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(2) Lower costs in other aspects of the medical |
assistance program, such
as hospital admissions, days in |
skilled nursing homes, emergency room
visits, or more |
frequent physician office visits.
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(d) In carrying out the pilot project, the Department of |
Healthcare and Family Services shall
examine all relevant |
scientific literature and shall consult with
health care |
practitioners including, but not limited to, physicians,
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surgeons, registered pharmacists, and registered nurses.
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(e) The Department of Healthcare and Family Services shall |
consult with medical experts,
disease advocacy groups, and |
academic institutions to develop criteria
to be used in |
selecting a vendor for the pilot project.
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(f) The Department of Healthcare and Family Services may |
adopt rules to implement this
Section.
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(g) This Section is repealed 10 years after the effective |
date of this
amendatory Act of the 93rd General Assembly.
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(Source: P.A. 95-331, eff. 8-21-07.)
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(305 ILCS 5/12-4.201)
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Sec. 12-4.201. (a) Data warehouse concerning medical and |
related
services. The Department of Healthcare and Family |
Services may purchase services and
materials associated with |
the costs of developing and implementing a data
warehouse |
comprised of management and decision making information in
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regard to the liability associated with, and utilization of, |
medical and
related services, out of moneys available for that |
purpose. |
(b) The Department of Healthcare and Family Services shall |
perform all necessary administrative functions to expand its |
linearly-scalable data warehouse to encompass other healthcare |
data sources at both the Department of Human Services and the |
Department of Public Health. The Department of Healthcare and |
Family Services shall leverage the inherent capabilities of the |
data warehouse to accomplish this expansion with marginal |
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additional technical administration. The purpose of
this |
expansion is to allow for programmatic review and analysis |
including the interrelatedness among the various healthcare |
programs in order to ascertain effectiveness toward, and |
ultimate impact on, clients. Beginning
July 1, 2005, the |
Department of Healthcare and Family Services (formerly |
Department of Public Aid) shall supply quarterly reports to the |
Commission on Government Forecasting and Accountability |
detailing progress toward this mandate.
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(c) The Department of Healthcare and Family Services (HFS), |
the Illinois Department of Public Health, the Illinois |
Department of Human Services, and the Division of Specialized |
Care for Children, University of Illinois at Chicago, with |
necessary support from the Department of Central Management |
Services, shall integrate into the medical data warehouse |
individual record level data owned by one of these agencies |
that pertains to maternal and child health, including the |
following data sets:
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(1) Vital Records as they relate to births, birth |
outcomes, and deaths. |
(2) Adverse Pregnancy Outcomes Reporting System |
(APORS). |
(3) Genetics/Newborn Screenings/SIDS. |
(4) Cornerstone (WIC, FCM, Teen Parents, |
Immunization). |
(5) HFS medical claims data. |
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(6) I-CARE. |
(7) Children with Special Healthcare Needs Data. |
By September 1, 2009, the departments of Healthcare and |
Family Services, Public Health, and Human Services and the |
Division of Specialized Care for Children shall jointly prepare |
a work plan for fully integrating these data sets into the |
medical data warehouse. The work plan shall provide an overall |
project design, including defining a mutually acceptable |
transfer format for each discrete data set, the data update |
frequency, and a single method of data transfer for each data |
set. By October 1, 2009, the Department of Public Health shall |
grant to the Department of Healthcare and Family Services |
complete access to all vital records data. The Department of |
Public Health shall prepare a report detailing that this task |
has been accomplished and submit this report to the Commission |
on Government Forecasting and Accountability by October 15, |
2009. By March 1, 2010, the data sets shall be completely |
loaded into the medical data warehouse. By July 1, 2010, data |
from the various sources shall be processed so as to be |
compatible with other data in the medical data warehouse and |
available for analysis in an integrated manner. |
With the cooperation of the other agencies, HFS shall |
submit status reports on the progress of these efforts to the |
Governor and the General Assembly no later than October 1, 2009 |
and April 1, 2010, with a final report due no later than |
November 1, 2010. |
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On an ongoing basis, the 4 agencies shall review the |
feasibility of adding data from additional sources to the |
warehouse. Such review may take into account the cost |
effectiveness of adding the data, the utility of adding data |
that is not available as identifiable individual record level |
data, the requirements related to adding data owned by another |
entity or not available in electronic form, whether sharing of |
the data is otherwise prohibited by law and the resources |
required and available for effecting the addition. |
The departments shall use analysis of the data in the |
medical data warehouse to improve maternal and child health |
outcomes, and in particular improve birth outcomes, and to |
reduce racial health disparities in this area. |
All access and use of the data shall be in compliance with |
all applicable federal and State laws, regulations, and |
mandates. |
Notwithstanding anything in this Section, data |
incorporated into the data warehouse shall remain subject to |
the same provisions of law regarding confidentiality and use |
restrictions as they are subject to in the control of the |
contributing agency. The Department of Healthcare and Family |
Services shall develop measures to ensure that the interplay of |
the several data sets contributed to the data warehouse does |
not lead to the use or release of data from the data warehouse |
that would not otherwise be subject to use or release under |
State or federal law. |