SB2043eng 96TH GENERAL ASSEMBLY

SB2043 Engrossed LRB096 11169 DRJ 21882 b

AN ACT concerning public aid.

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

Section 5. The Illinois Public Aid Code is amended by changing Sections 5-24 and 12-4.201 as follows:

(305 ILCS 5/5-24)

(Section scheduled to be repealed on January 1, 2014)

Sec. 5-24. Disease management programs and services for chronic conditions; pilot project.

(a) In this Section, "disease management programs and 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:

(1) A population identification process.

(2) Evidence-based or consensus-based clinical practice guidelines, risk identification, and matching of interventions with clinical need.

(3) Patient self-management and disease education.

(4) Process and outcomes measurement, evaluation, management, and reporting.

(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.

(c) The disease management programs and services pilot project shall examine whether chronic disease management programs and services for patients with specific chronic conditions do any or all of the following:

(1) Improve the patient's overall health in a more expeditious manner.

(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.

(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, surgeons, registered pharmacists, and registered nurses.

(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.

(f) The Department of Healthcare and Family Services may adopt rules to implement this Section.

(g) This Section is repealed 10 years after the effective date of this amendatory Act of the 93rd General Assembly.

(Source: P.A. 95-331, eff. 8-21-07.)

(305 ILCS 5/12-4.201)

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 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 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.

(c) The Department of Healthcare and Family Services shall integrate into its data warehouse data collected and housed at the Illinois Department of Public Health and the Illinois Department of Human Services that pertains to maternal and child health, including, but not limited to, the following data sets:

(1) United States Census.

(2) Vital Records as they relate to births and birth outcomes.

(3) Pregnancy Risk Assessment Monitoring System (PRAMS).

(4) Adverse Pregnancy Outcomes Reporting System (APORS).

(5) Behavioral Risk Factor Surveillance System (BRFSS).

(6) Fetal Infant Mortality Review (FIMR).

(7) Perinatal Mortality Review Database.

(8) Maternal Mortality Review Database.

(9) Genetics/Newborn Screenings/SIDS.

(10) Hospital Discharge Records.

(11) Cornerstone (WIC, FCM, Teen Parents, Immunization).

(12) Medicaid Claims Data.

(13) Illinois Project for Local Assessments of Needs (IPLAN).

(14) I-CARE.

(15) Children with Special Healthcare Needs Data.

(16) Sexually Transmitted Infection (excluding HIV/AIDS Surveillance).

The Departments shall cross-train personnel in the operation of the data warehouse so that all 3 agencies collaborate in utilizing this data warehouse to improve maternal and child health outcomes, and in particular improve birth outcomes, and to reduce racial health disparities in this area.

(Source: P.A. 94-267, eff. 7-19-05; 95-331, eff. 8-21-07.)

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