Sen. Mattie Hunter

Filed: 1/5/2021

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 3840

2    AMENDMENT NO. ______. Amend House Bill 3840 by replacing
3everything after the enacting clause with the following:
 
4
"Title I. General Provisions

 
5
Article 1.

 
6    Section 1-1. This Act may be referred to as the Illinois
7Health Care and Human Service Reform Act.
 
8    Section 1-5. Findings.
9    "We, the People of the State of Illinois - grateful to
10Almighty God for the civil, political and religious liberty
11which He has permitted us to enjoy and seeking His blessing
12upon our endeavors - in order to provide for the health, safety
13and welfare of the people; maintain a representative and
14orderly government; eliminate poverty and inequality; assure

 

 

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1legal, social and economic justice; provide opportunity for the
2fullest development of the individual; insure domestic
3tranquility; provide for the common defense; and secure the
4blessings of freedom and liberty to ourselves and our posterity -
5 do ordain and establish this Constitution for the State of
6Illinois."
7    The Illinois Legislative Black Caucus finds that, in order
8to improve the health outcomes of Black residents in the State
9of Illinois, it is essential to dramatically reform the State's
10health and human service system. For over 3 decades. multiple
11health studies have found that health inequities at their very
12core are due to racism. As early as 1998 research demonstrated
13that Black Americans received less health care than white
14Americans because doctors treated patients differently on the
15basis of race. Yet, Illinois' health and human service system
16disappointingly continues to perpetuate health disparities
17among Black Illinoisans of all ages, genders, and socioeconomic
18status.
19    In July 2020, Trinity Health announced its plans to close
20Mercy Hospital, an essential resource serving the Chicago South
21Side's predominantly Black residents. Trinity Health argued
22that this closure would have no impact on health access but
23failed to understand the community's needs. Closure of Mercy
24Hospital would only serve to create a health access desert and
25exacerbate existing health disparities. On December 15, 2020,
26after hearing from community members and advocates, the Health

 

 

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1Facilities and Services Review Board unanimously voted to deny
2closure efforts, yet Trinity still seeks to cease Mercy's
3operations.
4    Prior to COVID-19, much of the social and political
5attention surrounding the nationwide opioid epidemic focused
6on the increase in overdose deaths among white, middle-class,
7suburban and rural users; the impact of the epidemic in Black
8communities was largely unrecognized. Research has shown rates
9of opioid use at the national scale are higher for whites than
10they are for Blacks, yet rates of opioid deaths are higher
11among Blacks (43%) than whites (22%). The COVID-19 pandemic
12will likely exacerbate this situation due to job loss,
13stay-at-home orders, and ongoing mitigation efforts creating a
14lack of physical access to addiction support and harm reduction
15groups.
16    In 2018, the Illinois Department of Public Health reported
17that Black women were about 6 times as likely to die from a
18pregnancy-related cause as white women. Of those, 72% of
19pregnancy-related deaths and 93% of violent
20pregnancy-associated deaths were deemed preventable. Between
212016 and 2017, Black women had the highest rate of severe
22maternal morbidity with a rate of 101.5 per 10,000 deliveries,
23which is almost 3 times as high as the rate for white women.
24    In the City of Chicago, African American and Latinx
25populations are suffering from higher rates of AIDS/HIV
26compared to the general population. Recent data places HIV as

 

 

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1one of the top 5 leading causes of death in African American
2women between the ages of 35 to 44 and the seventh ranking
3cause in African American women between the ages of 20 to 34.
4Among the Latinx population, nearly 20% with HIV exclusively
5depend on indigenous-led and staffed organizations for
6services.
7    Cardiovascular disease (CVD) accounts for more deaths in
8Illinois than any other cause of death, according to the
9Illinois Department of Public Health; CVD is the leading cause
10of death among Black residents. According to the Kaiser Family
11Foundation (KFF), for every 100,000 people, 224 Black
12Illinoisans die of CVD compared to 158 white Illinoisans.
13Cancer, the second leading cause of death in Illinois, too is
14pervasive among African Americans. In 2019, an estimated
15606,880 Americans, or 1,660 people a day, died of cancer; the
16American Cancer Society estimated 24,410 deaths occurred in
17Illinois. KFF estimates that, out of every 100,000 people, 191
18Black Illinoisans die of cancer compared to 152 white
19Illinoisans.
20    Black Americans suffer at much higher rates from chronic
21diseases, including diabetes, hypertension, heart disease,
22asthma, and many cancers. Utilizing community health workers in
23patient education and chronic disease management is needed to
24close these health disparities. Studies have shown that
25diabetes patients in the care of a community health worker
26demonstrate improved knowledge and lifestyle and

 

 

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1self-management behaviors, as well as decreases in the use of
2the emergency department. A study of asthma control among black
3adolescents concluded that asthma control was reduced by 35%
4among adolescents working with community health workers,
5resulting in a savings of $5.58 per dollar spent on the
6intervention. A study of the return on investment for community
7health workers employed in Colorado showed that, after a
89-month period, patients working with community health workers
9had an increased number of primary care visits and a decrease
10in urgent and inpatient care. Utilization of community health
11workers led to a $2.38 return on investment for every dollar
12invested in community health workers.
13    Adverse childhood experiences (ACEs) are traumatic
14experiences occurring during childhood that have been found to
15have a profound effect on a child's developing brain structure
16and body which may result in poor health during a person's
17adulthood. ACEs studies have found a strong correlation between
18the number of ACEs and a person's risk for disease and negative
19health behaviors, including suicide, depression, cancer,
20stroke, ischemic heart disease, diabetes, autoimmune disease,
21smoking, substance abuse, interpersonal violence, obesity,
22unplanned pregnancies, lower educational achievement,
23workplace absenteeism, and lower wages. Data also shows that
24approximately 20% of African American and Hispanic adults in
25Illinois reported 4 or more ACEs, compared to 13% of
26non-Hispanic whites. Long-standing ACE interventions include

 

 

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1tools such as trauma-informed care. Trauma-informed care has
2been promoted and established in communities across the country
3on a bipartisan basis, including in the states of California,
4Florida, Massachusetts, Missouri, Oregon, Pennsylvania,
5Washington, and Wisconsin. Several federal agencies have
6integrated trauma-informed approaches in their programs and
7grants which should be leveraged by the State.
8    According to a 2019 Rush University report, a Black
9person's life expectancy on average is less when compared to a
10white person's life expectancy. For instance, when comparing
11life expectancy in Chicago's Austin neighborhood to the Chicago
12Loop, there is a difference of 11 years between Black life
13expectancy (71 years) and white life expectancy (82 years).
14    In a 2015 literature review of implicit racial and ethnic
15bias among medical professionals, it was concluded that there
16is a moderate level of implicit bias in most medical
17professionals. Further, the literature review showed that
18implicit bias has negative consequences for patients,
19including strained patient relationships and negative health
20outcomes. It is critical for medical professionals to be aware
21of implicit racial and ethnic bias and work to eliminate bias
22through training.
23    In the field of medicine, a historically racist profession,
24Black medical professionals have commonly been ostracized. In
251934, Dr. Roland B. Scott was the first African American to
26pass the pediatric board exam, yet when he applied for

 

 

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1membership with the American Academy of Pediatrics he was
2rejected multiple times. Few medical organizations have
3confronted the roles they played in blocking opportunities for
4Black advancement in the medical profession until the formal
5apologies of the American Medical Association in 2008. For
6decades, organizations like the AMA predicated their
7membership on joining a local state medical society, several of
8which excluded Black physicians.
9    In 2010, the General Assembly, in partnership with
10Treatment Alternatives for Safe Communities, published the
11Disproportionate Justice Impact Study. The study examined the
12impact of Illinois drug laws on racial and ethnic groups and
13the resulting over-representation of racial and ethic minority
14groups in the Illinois criminal justice system. Unsurprisingly
15and disappointingly, the study confirmed decades long
16injustices, such as nonwhites being arrested at a higher rate
17than whites relative to their representation in the general
18population throughout Illinois.
19    All together, the above mentioned only begins to capture a
20part of a larger system of racial injustices and inequities.
21The General Assembly and the people of Illinois are urged to
22recognize while racism is a core fault of the current health
23and human service system, that it is a pervasive disease
24affecting a multiplitude of institutions which truly drive
25systematic health inequities: education, child care, criminal
26justice, affordable housing, environmental justice, and job

 

 

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1security and so forth. For persons to live up to their full
2human potential, their rights to quality of life, health care,
3a quality job, a fair wage, housing, and education must not be
4inhibited.
5    Therefore, the Illinois Legislative Black Caucus, as
6informed by the Senate's Health and Human Service Pillar
7subject matter hearings, seeks to remedy a fraction of a much
8larger broken system by addressing access to health care,
9hospital closures, managed care organization reform, community
10health worker certification, maternal and infant mortality,
11mental and substance abuse treatment, hospital reform, and
12medical implicit bias in the Illinois Health Care and Human
13Service Reform Act. This Act shall achieve needed change
14through the use of, but not limited to, the Medicaid Managed
15Care Oversight Commission, the Health and Human Services Task
16Force, and a hospital closure moratorium, in order to address
17Illinois' long-standing health inequities.
 
18
Title II. Community Health Workers

 
19
Article 5.

 
20    Section 5-1. Short title. This Article may be cited as the
21Community Health Worker Certification and Reimbursement Act.
22References in this Article to "this Act" mean this Article.
 

 

 

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1    Section 5-5. Definition. In this Act, "community health
2worker" means a frontline public health worker who is a trusted
3member or has an unusually close understanding of the community
4served. This trusting relationship enables the community
5health worker to serve as a liaison, link, and intermediary
6between health and social services and the community to
7facilitate access to services and improve the quality and
8cultural competence of service delivery. A community health
9worker also builds individual and community capacity by
10increasing health knowledge and self-sufficiency through a
11range of activities, including outreach, community education,
12informal counseling, social support, and advocacy. A community
13health worker shall have the following core competencies:
14        (1) communication;
15        (2) interpersonal skills and relationship building;
16        (3) service coordination and navigation skills;
17        (4) capacity-building;
18        (5) advocacy;
19        (6) presentation and facilitation skills;
20        (7) organizational skills; cultural competency;
21        (8) public health knowledge;
22        (9) understanding of health systems and basic
23    diseases;
24        (10) behavioral health issues; and
25        (11) field experience.
26    Nothing in this definition shall be construed to authorize

 

 

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1a community health worker to provide direct care or treatment
2to any person or to perform any act or service for which a
3license issued by a professional licensing board is required.
 
4    Section 5-10. Community health worker training.
5    (a) Community health workers shall be provided with
6multi-tiered academic and community-based training
7opportunities that lead to the mastery of community health
8worker core competencies.
9    (b) For academic-based training programs, the Department
10of Public Health shall collaborate with the Illinois State
11Board of Education, the Illinois Community College Board, and
12the Illinois Board of Higher Education to adopt a process to
13certify academic-based training programs that students can
14attend to obtain individual community health worker
15certification. Certified training programs shall reflect the
16approved core competencies and roles for community health
17workers.
18    (c) For community-based training programs, the Department
19of Public Health shall collaborate with a statewide association
20representing community health workers to adopt a process to
21certify community-based programs that students can attend to
22obtain individual community health worker certification.
23    (d) Community health workers may need to undergo additional
24training, including, but not limited to, asthma, diabetes,
25maternal child health, behavioral health, and social

 

 

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1determinants of health training. Multi-tiered training
2approaches shall provide opportunities that build on each other
3and prepare community health workers for career pathways both
4within the community health worker profession and within allied
5professions.
 
6    Section 5-15. Illinois Community Health Worker
7Certification Board.
8    (a) There is created within the Department of Public
9Health, in shared leadership with a statewide association
10representing community health workers, the Illinois Community
11Health Worker Certification Board. The Board shall serve as the
12regulatory body that develops and has oversight of initial
13community health workers certification and certification
14renewals for both individuals and academic and community-based
15training programs
16    (b) A representative from the Department of Public Health,
17the Department of Financial and Professional Regulation and the
18Department of Healthcare and Family Services shall serve on the
19Board. At least one full-time professional shall be assigned to
20staff the Board with additional administrative support
21available as needed. The Board shall have balanced
22representation from the community health worker workforce,
23community health worker employers, community health worker
24training and educational organizations, and other engaged
25stakeholders.

 

 

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1    (c) The Board shall propose a certification process for and
2be authorized to approve training from community-based
3organizations, in conjunction with a statewide organization
4representing community health workers, and academic
5institutions, in consultation with the Illinois State Board of
6Education, the Illinois Community College Board and the
7Illinois Board of Higher Education. The Board shall base
8training approval on core competencies, best practices, and
9affordability. In addition, the Board shall maintain a registry
10of certification records for individually certified community
11health workers.
12    (d) All training programs that are deemed certifiable by
13the Board shall go through a renewal process, which will be
14determined by the Board once established. The Board shall
15establish criteria to grandfather in any community health
16workers who were practicing prior to the establishment of a
17certification program.
 
18    Section 5-20. Reimbursement. Community health worker
19services shall be covered under the medical assistance program
20for persons who are otherwise eligible for medical assistance.
21The Department of Healthcare and Family Services shall develop
22services, including but not limited to, care coordination and
23diagnostic-related patient education services, for which
24community health workers will be eligible for reimbursement and
25shall submit a State Plan Amendment (SPA) to the Centers for

 

 

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1Medicare and Medicaid Services (CMS) to amend the agreement
2between Illinois and the Federal government to include
3community health workers as practitioners under Medicaid.
4Certification shall not be required for reimbursement. In
5addition, the Department of Healthcare and Family Services
6shall amend its contracts with managed care entities to allow
7managed care entities to employ community health workers or
8subcontract with community-based organizations that employ
9community health workers.
 
10
Title III. Hospital Reform

 
11
Article 10.

 
12    Section 10-5. The University of Illinois Hospital Act is
13amended by adding Section 12 as follows:
 
14    (110 ILCS 330/12 new)
15    Sec. 12. Credentials and certificates. The University of
16Illinois Hospital shall require an intern, resident, or
17physician who provides medical services at the University of
18Illinois Hospital to have proper credentials and any required
19certificates for ongoing training at the time the intern,
20resident, or physician renews his or her license.
 
21    Section 10-10. The Hospital Licensing Act is amended by

 

 

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1adding Section 10.12 as follows:
 
2    (210 ILCS 85/10.12 new)
3    Sec. 10.12. Credentials and certificates. A hospital
4licensed under this Act shall require an intern, resident, or
5physician who provides medical services at the hospital to have
6proper credentials and any required certificates for ongoing
7training at the time the intern, resident, or physician renews
8his or her license.
 
9    Section 10-15. The Hospital Report Card Act is amended by
10changing Section 25 as follows:
 
11    (210 ILCS 86/25)
12    Sec. 25. Hospital reports.
13    (a) Individual hospitals shall prepare a quarterly report
14including all of the following:
15        (1) Nursing hours per patient day, average daily
16    census, and average daily hours worked for each clinical
17    service area.
18        (2) Infection-related measures for the facility for
19    the specific clinical procedures and devices determined by
20    the Department by rule under 2 or more of the following
21    categories:
22            (A) Surgical procedure outcome measures.
23            (B) Surgical procedure infection control process

 

 

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1        measures.
2            (C) Outcome or process measures related to
3        ventilator-associated pneumonia.
4            (D) Central vascular catheter-related bloodstream
5        infection rates in designated critical care units.
6        (3) Information required under paragraph (4) of
7    Section 2310-312 of the Department of Public Health Powers
8    and Duties Law of the Civil Administrative Code of
9    Illinois.
10        (4) Additional infection measures mandated by the
11    Centers for Medicare and Medicaid Services that are
12    reported by hospitals to the Centers for Disease Control
13    and Prevention's National Healthcare Safety Network
14    surveillance system, or its successor, and deemed relevant
15    to patient safety by the Department.
16        (5) Each instance of preterm birth and infant mortality
17    within the reporting period, including the racial and
18    ethnic information of the mothers of those infants.
19        (6) Each instance of maternal mortality within the
20    reporting period, including the racial and ethnic
21    information of those mothers.
22        (7) The number of female patients who have died within
23    the reporting period.
24        (8) The number of female patients who have died of a
25    preventable cause within the reporting period and the
26    number of those preventable deaths that the hospital has

 

 

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1    otherwise reported within the reporting period.
2        (9) The number of physicians, as that term is defined
3    in the Medical Practice Act of 1987, required by the
4    hospital to undergo any amount or type of retraining during
5    the reporting period.
6    The infection-related measures developed by the Department
7shall be based upon measures and methods developed by the
8Centers for Disease Control and Prevention, the Centers for
9Medicare and Medicaid Services, the Agency for Healthcare
10Research and Quality, the Joint Commission on Accreditation of
11Healthcare Organizations, or the National Quality Forum. The
12Department may align the infection-related measures with the
13measures and methods developed by the Centers for Disease
14Control and Prevention, the Centers for Medicare and Medicaid
15Services, the Agency for Healthcare Research and Quality, the
16Joint Commission on Accreditation of Healthcare Organizations,
17and the National Quality Forum by adding reporting measures
18based on national health care strategies and measures deemed
19scientifically reliable and valid for public reporting. The
20Department shall receive approval from the State Board of
21Health to retire measures deemed no longer scientifically valid
22or valuable for informing quality improvement or infection
23prevention efforts. The Department shall notify the Chairs and
24Minority Spokespersons of the House Human Services Committee
25and the Senate Public Health Committee of its intent to have
26the State Board of Health take action to retire measures no

 

 

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1later than 7 business days before the meeting of the State
2Board of Health.
3    The Department shall include interpretive guidelines for
4infection-related indicators and, when available, shall
5include relevant benchmark information published by national
6organizations.
7    The Department shall collect the information reported
8under paragraphs (5) and (6) and shall use it to illustrate the
9disparity of those occurrences across different racial and
10ethnic groups.
11    (b) Individual hospitals shall prepare annual reports
12including vacancy and turnover rates for licensed nurses per
13clinical service area.
14    (c) None of the information the Department discloses to the
15public may be made available in any form or fashion unless the
16information has been reviewed, adjusted, and validated
17according to the following process:
18        (1) The Department shall organize an advisory
19    committee, including representatives from the Department,
20    public and private hospitals, direct care nursing staff,
21    physicians, academic researchers, consumers, health
22    insurance companies, organized labor, and organizations
23    representing hospitals and physicians. The advisory
24    committee must be meaningfully involved in the development
25    of all aspects of the Department's methodology for
26    collecting, analyzing, and disclosing the information

 

 

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1    collected under this Act, including collection methods,
2    formatting, and methods and means for release and
3    dissemination.
4        (2) The entire methodology for collecting and
5    analyzing the data shall be disclosed to all relevant
6    organizations and to all hospitals that are the subject of
7    any information to be made available to the public before
8    any public disclosure of such information.
9        (3) Data collection and analytical methodologies shall
10    be used that meet accepted standards of validity and
11    reliability before any information is made available to the
12    public.
13        (4) The limitations of the data sources and analytic
14    methodologies used to develop comparative hospital
15    information shall be clearly identified and acknowledged,
16    including but not limited to the appropriate and
17    inappropriate uses of the data.
18        (5) To the greatest extent possible, comparative
19    hospital information initiatives shall use standard-based
20    norms derived from widely accepted provider-developed
21    practice guidelines.
22        (6) Comparative hospital information and other
23    information that the Department has compiled regarding
24    hospitals shall be shared with the hospitals under review
25    prior to public dissemination of such information and these
26    hospitals have 30 days to make corrections and to add

 

 

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1    helpful explanatory comments about the information before
2    the publication.
3        (7) Comparisons among hospitals shall adjust for
4    patient case mix and other relevant risk factors and
5    control for provider peer groups, when appropriate.
6        (8) Effective safeguards to protect against the
7    unauthorized use or disclosure of hospital information
8    shall be developed and implemented.
9        (9) Effective safeguards to protect against the
10    dissemination of inconsistent, incomplete, invalid,
11    inaccurate, or subjective hospital data shall be developed
12    and implemented.
13        (10) The quality and accuracy of hospital information
14    reported under this Act and its data collection, analysis,
15    and dissemination methodologies shall be evaluated
16    regularly.
17        (11) Only the most basic identifying information from
18    mandatory reports shall be used, and information
19    identifying a patient, employee, or licensed professional
20    shall not be released. None of the information the
21    Department discloses to the public under this Act may be
22    used to establish a standard of care in a private civil
23    action.
24    (d) Quarterly reports shall be submitted, in a format set
25forth in rules adopted by the Department, to the Department by
26April 30, July 31, October 31, and January 31 each year for the

 

 

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1previous quarter. Data in quarterly reports must cover a period
2ending not earlier than one month prior to submission of the
3report. Annual reports shall be submitted by December 31 in a
4format set forth in rules adopted by the Department to the
5Department. All reports shall be made available to the public
6on-site and through the Department.
7    (e) If the hospital is a division or subsidiary of another
8entity that owns or operates other hospitals or related
9organizations, the annual public disclosure report shall be for
10the specific division or subsidiary and not for the other
11entity.
12    (f) The Department shall disclose information under this
13Section in accordance with provisions for inspection and
14copying of public records required by the Freedom of
15Information Act provided that such information satisfies the
16provisions of subsection (c) of this Section.
17    (g) Notwithstanding any other provision of law, under no
18circumstances shall the Department disclose information
19obtained from a hospital that is confidential under Part 21 of
20Article VIII of the Code of Civil Procedure.
21    (h) No hospital report or Department disclosure may contain
22information identifying a patient, employee, or licensed
23professional.
24(Source: P.A. 101-446, eff. 8-23-19.)
 
25
Article 15.

 

 

 

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1    Section 15-5. The Hospital Licensing Act is amended by
2adding Section 6.30 as follows:
 
3    (210 ILCS 85/6.30 new)
4    Sec. 6.30. Posting charity care policy, financial
5counselor. A hospital that receives a property tax exemption
6under Section 15-86 of the Property Tax Code must post the
7hospital's charity care policy and the contact information of a
8financial counselor in a reasonably viewable area in the
9hospital's emergency room.
 
10
Article 20.

 
11    Section 20-5. The University of Illinois Hospital Act is
12amended by adding Section 8d as follows:
 
13    (110 ILCS 330/8d new)
14    Sec. 8d. N95 masks. The University of Illinois Hospital
15shall provide N95 masks to all physicians licensed under the
16Medical Practice Act of 1987 and registered nurses and advanced
17practice registered nurses licensed under the Nurse Licensing
18Act if the physician, registered nurse, or advanced practice
19registered nurse is employed by or providing services for
20another employer at the University of Illinois Hospital.
 

 

 

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1    Section 20-10. The Hospital Licensing Act is amended by
2adding Section 6.28 as follows:
 
3    (210 ILCS 85/6.28 new)
4    Sec. 6.28. N95 masks. A hospital licensed under this Act
5shall provide N95 masks to all physicians licensed under the
6Medical Practice Act of 1987 and registered nurses and advanced
7practice registered nurses licensed under the Nurse Licensing
8Act if the physician, registered nurse, or advanced practice
9registered nurse is employed by or providing services for
10another employer at the hospital.
 
11
Article 25.

 
12    Section 25-5. The University of Illinois Hospital Act is
13amended by adding Section 11 as follows:
 
14    (110 ILCS 330/11 new)
15    Sec. 11. Demographic data; release of individuals with
16symptoms of COVID-19. The University of Illinois Hospital shall
17report to the Department of Public Health the demographic data
18of individuals who have symptoms of COVID-19 and are released
19from, not admitted to, the University of Illinois Hospital.
 
20    Section 25-10. The Hospital Licensing Act is amended by
21adding Section 6.31 as follows:
 

 

 

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1    (210 ILCS 85/6.31 new)
2    Sec. 6.31. Demographic data; release of individuals with
3symptoms of COVID-19. A hospital licensed under this Act shall
4report to the Department the demographic data of individuals
5who have symptoms of COVID-19 and are released from, not
6admitted to, the hospital.
 
7
Article 35.

 
8    Section 35-5. The Illinois Public Aid Code is amended by
9adding Section 5-1.6 and changing Section 5-5.05 as follows:
 
10    (305 ILCS 5/5-1.6 new)
11    Sec. 5-1.6. Community safety-net hospitals. Due to the
12inequitable distribution of hospital assessment payments and
13the continued lack of investment by the State of Illinois in
14under-resourced, minority communities, the Department of
15Healthcare and Family Services shall create a new
16classification of hospitals known as community safety-net
17hospitals. Community safety-net hospitals shall receive
18priority hospital assessment distribution funding and other
19funding considerations from the Department and the General
20Assembly. In order to be defined as a community safety-net
21hospital, a hospital must meet at least one of the following
22criteria:

 

 

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1    (1) a stand-alone safety-net hospital;
2    (2) a safety-net hospital inside a system of safety-net
3hospitals; or
4    (3) a safety-net hospital inside a system that contains
5safety-net hospitals and other hospitals, so long as the
6majority of hospitals in the system are safety-net hospitals.
 
7    (305 ILCS 5/5-5.05)
8    Sec. 5-5.05. Hospitals; psychiatric services.
9    (a) On and after July 1, 2008, the inpatient, per diem rate
10to be paid to a hospital for inpatient psychiatric services
11shall be $363.77.
12    (b) For purposes of this Section, "hospital" means the
13following:
14        (1) Advocate Christ Hospital, Oak Lawn, Illinois.
15        (2) Barnes-Jewish Hospital, St. Louis, Missouri.
16        (3) BroMenn Healthcare, Bloomington, Illinois.
17        (4) Jackson Park Hospital, Chicago, Illinois.
18        (5) Katherine Shaw Bethea Hospital, Dixon, Illinois.
19        (6) Lawrence County Memorial Hospital, Lawrenceville,
20    Illinois.
21        (7) Advocate Lutheran General Hospital, Park Ridge,
22    Illinois.
23        (8) Mercy Hospital and Medical Center, Chicago,
24    Illinois.
25        (9) Methodist Medical Center of Illinois, Peoria,

 

 

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1    Illinois.
2        (10) Provena United Samaritans Medical Center,
3    Danville, Illinois.
4        (11) Rockford Memorial Hospital, Rockford, Illinois.
5        (12) Sarah Bush Lincoln Health Center, Mattoon,
6    Illinois.
7        (13) Provena Covenant Medical Center, Urbana,
8    Illinois.
9        (14) Rush-Presbyterian-St. Luke's Medical Center,
10    Chicago, Illinois.
11        (15) Mt. Sinai Hospital, Chicago, Illinois.
12        (16) Gateway Regional Medical Center, Granite City,
13    Illinois.
14        (17) St. Mary of Nazareth Hospital, Chicago, Illinois.
15        (18) Provena St. Mary's Hospital, Kankakee, Illinois.
16        (19) St. Mary's Hospital, Decatur, Illinois.
17        (20) Memorial Hospital, Belleville, Illinois.
18        (21) Swedish Covenant Hospital, Chicago, Illinois.
19        (22) Trinity Medical Center, Rock Island, Illinois.
20        (23) St. Elizabeth Hospital, Chicago, Illinois.
21        (24) Richland Memorial Hospital, Olney, Illinois.
22        (25) St. Elizabeth's Hospital, Belleville, Illinois.
23        (26) Samaritan Health System, Clinton, Iowa.
24        (27) St. John's Hospital, Springfield, Illinois.
25        (28) St. Mary's Hospital, Centralia, Illinois.
26        (29) Loretto Hospital, Chicago, Illinois.

 

 

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1        (30) Kenneth Hall Regional Hospital, East St. Louis,
2    Illinois.
3        (31) Hinsdale Hospital, Hinsdale, Illinois.
4        (32) Pekin Hospital, Pekin, Illinois.
5        (33) University of Chicago Medical Center, Chicago,
6    Illinois.
7        (34) St. Anthony's Health Center, Alton, Illinois.
8        (35) OSF St. Francis Medical Center, Peoria, Illinois.
9        (36) Memorial Medical Center, Springfield, Illinois.
10        (37) A hospital with a distinct part unit for
11    psychiatric services that begins operating on or after July
12    1, 2008.
13    For purposes of this Section, "inpatient psychiatric
14services" means those services provided to patients who are in
15need of short-term acute inpatient hospitalization for active
16treatment of an emotional or mental disorder.
17    (b-5) Notwithstanding any other provision of this Section,
18the inpatient, per diem rate to be paid to all community
19safety-net hospitals for inpatient psychiatric services on and
20after January 1, 2021 shall be at least $630.
21    (c) No rules shall be promulgated to implement this
22Section. For purposes of this Section, "rules" is given the
23meaning contained in Section 1-70 of the Illinois
24Administrative Procedure Act.
25    (d) This Section shall not be in effect during any period
26of time that the State has in place a fully operational

 

 

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1hospital assessment plan that has been approved by the Centers
2for Medicare and Medicaid Services of the U.S. Department of
3Health and Human Services.
4    (e) On and after July 1, 2012, the Department shall reduce
5any rate of reimbursement for services or other payments or
6alter any methodologies authorized by this Code to reduce any
7rate of reimbursement for services or other payments in
8accordance with Section 5-5e.
9(Source: P.A. 97-689, eff. 6-14-12.)
 
10
Article 40.

 
11    Section 40-5. The Illinois Public Aid Code is amended by
12changing Section 5A-12.7 as follows:
 
13    (305 ILCS 5/5A-12.7)
14    (Section scheduled to be repealed on December 31, 2022)
15    Sec. 5A-12.7. Continuation of hospital access payments on
16and after July 1, 2020.
17    (a) To preserve and improve access to hospital services,
18for hospital services rendered on and after July 1, 2020, the
19Department shall, except for hospitals described in subsection
20(b) of Section 5A-3, make payments to hospitals or require
21capitated managed care organizations to make payments as set
22forth in this Section. Payments under this Section are not due
23and payable, however, until: (i) the methodologies described in

 

 

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1this Section are approved by the federal government in an
2appropriate State Plan amendment or directed payment preprint;
3and (ii) the assessment imposed under this Article is
4determined to be a permissible tax under Title XIX of the
5Social Security Act. In determining the hospital access
6payments authorized under subsection (g) of this Section, if a
7hospital ceases to qualify for payments from the pool, the
8payments for all hospitals continuing to qualify for payments
9from such pool shall be uniformly adjusted to fully expend the
10aggregate net amount of the pool, with such adjustment being
11effective on the first day of the second month following the
12date the hospital ceases to receive payments from such pool.
13    (b) Amounts moved into claims-based rates and distributed
14in accordance with Section 14-12 shall remain in those
15claims-based rates.
16    (c) Graduate medical education.
17        (1) The calculation of graduate medical education
18    payments shall be based on the hospital's Medicare cost
19    report ending in Calendar Year 2018, as reported in the
20    Healthcare Cost Report Information System file, release
21    date September 30, 2019. An Illinois hospital reporting
22    intern and resident cost on its Medicare cost report shall
23    be eligible for graduate medical education payments.
24        (2) Each hospital's annualized Medicaid Intern
25    Resident Cost is calculated using annualized intern and
26    resident total costs obtained from Worksheet B Part I,

 

 

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1    Columns 21 and 22 the sum of Lines 30-43, 50-76, 90-93,
2    96-98, and 105-112 multiplied by the percentage that the
3    hospital's Medicaid days (Worksheet S3 Part I, Column 7,
4    Lines 2, 3, 4, 14, 16-18, and 32) comprise of the
5    hospital's total days (Worksheet S3 Part I, Column 8, Lines
6    14, 16-18, and 32).
7        (3) An annualized Medicaid indirect medical education
8    (IME) payment is calculated for each hospital using its IME
9    payments (Worksheet E Part A, Line 29, Column 1) multiplied
10    by the percentage that its Medicaid days (Worksheet S3 Part
11    I, Column 7, Lines 2, 3, 4, 14, 16-18, and 32) comprise of
12    its Medicare days (Worksheet S3 Part I, Column 6, Lines 2,
13    3, 4, 14, and 16-18).
14        (4) For each hospital, its annualized Medicaid Intern
15    Resident Cost and its annualized Medicaid IME payment are
16    summed, and, except as capped at 120% of the average cost
17    per intern and resident for all qualifying hospitals as
18    calculated under this paragraph, is multiplied by 22.6% to
19    determine the hospital's final graduate medical education
20    payment. Each hospital's average cost per intern and
21    resident shall be calculated by summing its total
22    annualized Medicaid Intern Resident Cost plus its
23    annualized Medicaid IME payment and dividing that amount by
24    the hospital's total Full Time Equivalent Residents and
25    Interns. If the hospital's average per intern and resident
26    cost is greater than 120% of the same calculation for all

 

 

10100HB3840sam001- 30 -LRB101 12454 CPF 74517 a

1    qualifying hospitals, the hospital's per intern and
2    resident cost shall be capped at 120% of the average cost
3    for all qualifying hospitals.
4    (d) Fee-for-service supplemental payments. Each Illinois
5hospital shall receive an annual payment equal to the amounts
6below, to be paid in 12 equal installments on or before the
7seventh State business day of each month, except that no
8payment shall be due within 30 days after the later of the date
9of notification of federal approval of the payment
10methodologies required under this Section or any waiver
11required under 42 CFR 433.68, at which time the sum of amounts
12required under this Section prior to the date of notification
13is due and payable.
14        (1) For critical access hospitals, $385 per covered
15    inpatient day contained in paid fee-for-service claims and
16    $530 per paid fee-for-service outpatient claim for dates of
17    service in Calendar Year 2019 in the Department's
18    Enterprise Data Warehouse as of May 11, 2020.
19        (2) For safety-net hospitals, $960 per covered
20    inpatient day contained in paid fee-for-service claims and
21    $625 per paid fee-for-service outpatient claim for dates of
22    service in Calendar Year 2019 in the Department's
23    Enterprise Data Warehouse as of May 11, 2020.
24        (3) For long term acute care hospitals, $295 per
25    covered inpatient day contained in paid fee-for-service
26    claims for dates of service in Calendar Year 2019 in the

 

 

10100HB3840sam001- 31 -LRB101 12454 CPF 74517 a

1    Department's Enterprise Data Warehouse as of May 11, 2020.
2        (4) For freestanding psychiatric hospitals, $125 per
3    covered inpatient day contained in paid fee-for-service
4    claims and $130 per paid fee-for-service outpatient claim
5    for dates of service in Calendar Year 2019 in the
6    Department's Enterprise Data Warehouse as of May 11, 2020.
7        (5) For freestanding rehabilitation hospitals, $355
8    per covered inpatient day contained in paid
9    fee-for-service claims for dates of service in Calendar
10    Year 2019 in the Department's Enterprise Data Warehouse as
11    of May 11, 2020.
12        (6) For all general acute care hospitals and high
13    Medicaid hospitals as defined in subsection (f), $350 per
14    covered inpatient day for dates of service in Calendar Year
15    2019 contained in paid fee-for-service claims and $620 per
16    paid fee-for-service outpatient claim in the Department's
17    Enterprise Data Warehouse as of May 11, 2020.
18        (7) Alzheimer's treatment access payment. Each
19    Illinois academic medical center or teaching hospital, as
20    defined in Section 5-5e.2 of this Code, that is identified
21    as the primary hospital affiliate of one of the Regional
22    Alzheimer's Disease Assistance Centers, as designated by
23    the Alzheimer's Disease Assistance Act and identified in
24    the Department of Public Health's Alzheimer's Disease
25    State Plan dated December 2016, shall be paid an
26    Alzheimer's treatment access payment equal to the product

 

 

10100HB3840sam001- 32 -LRB101 12454 CPF 74517 a

1    of the qualifying hospital's State Fiscal Year 2018 total
2    inpatient fee-for-service days multiplied by the
3    applicable Alzheimer's treatment rate of $226.30 for
4    hospitals located in Cook County and $116.21 for hospitals
5    located outside Cook County.
6    (e) The Department shall require managed care
7organizations (MCOs) to make directed payments and
8pass-through payments according to this Section. Each calendar
9year, the Department shall require MCOs to pay the maximum
10amount out of these funds as allowed as pass-through payments
11under federal regulations. The Department shall require MCOs to
12make such pass-through payments as specified in this Section.
13The Department shall require the MCOs to pay the remaining
14amounts as directed Payments as specified in this Section. The
15Department shall issue payments to the Comptroller by the
16seventh business day of each month for all MCOs that are
17sufficient for MCOs to make the directed payments and
18pass-through payments according to this Section. The
19Department shall require the MCOs to make pass-through payments
20and directed payments using electronic funds transfers (EFT),
21if the hospital provides the information necessary to process
22such EFTs, in accordance with directions provided monthly by
23the Department, within 7 business days of the date the funds
24are paid to the MCOs, as indicated by the "Paid Date" on the
25website of the Office of the Comptroller if the funds are paid
26by EFT and the MCOs have received directed payment

 

 

10100HB3840sam001- 33 -LRB101 12454 CPF 74517 a

1instructions. If funds are not paid through the Comptroller by
2EFT, payment must be made within 7 business days of the date
3actually received by the MCO. The MCO will be considered to
4have paid the pass-through payments when the payment remittance
5number is generated or the date the MCO sends the check to the
6hospital, if EFT information is not supplied. If an MCO is late
7in paying a pass-through payment or directed payment as
8required under this Section (including any extensions granted
9by the Department), it shall pay a penalty, unless waived by
10the Department for reasonable cause, to the Department equal to
115% of the amount of the pass-through payment or directed
12payment not paid on or before the due date plus 5% of the
13portion thereof remaining unpaid on the last day of each 30-day
14period thereafter. Payments to MCOs that would be paid
15consistent with actuarial certification and enrollment in the
16absence of the increased capitation payments under this Section
17shall not be reduced as a consequence of payments made under
18this subsection. The Department shall publish and maintain on
19its website for a period of no less than 8 calendar quarters,
20the quarterly calculation of directed payments and
21pass-through payments owed to each hospital from each MCO. All
22calculations and reports shall be posted no later than the
23first day of the quarter for which the payments are to be
24issued.
25    (f)(1) For purposes of allocating the funds included in
26capitation payments to MCOs, Illinois hospitals shall be

 

 

10100HB3840sam001- 34 -LRB101 12454 CPF 74517 a

1divided into the following classes as defined in administrative
2rules:
3        (A) Critical access hospitals.
4        (B) Safety-net hospitals, except that stand-alone
5    children's hospitals that are not specialty children's
6    hospitals will not be included.
7        (C) Long term acute care hospitals.
8        (D) Freestanding psychiatric hospitals.
9        (E) Freestanding rehabilitation hospitals.
10        (F) High Medicaid hospitals. As used in this Section,
11    "high Medicaid hospital" means a general acute care
12    hospital that is not a safety-net hospital or critical
13    access hospital and that has a Medicaid Inpatient
14    Utilization Rate above 30% or a hospital that had over
15    35,000 inpatient Medicaid days during the applicable
16    period. For the period July 1, 2020 through December 31,
17    2020, the applicable period for the Medicaid Inpatient
18    Utilization Rate (MIUR) is the rate year 2020 MIUR and for
19    the number of inpatient days it is State fiscal year 2018.
20    Beginning in calendar year 2021, the Department shall use
21    the most recently determined MIUR, as defined in subsection
22    (h) of Section 5-5.02, and for the inpatient day threshold,
23    the State fiscal year ending 18 months prior to the
24    beginning of the calendar year. For purposes of calculating
25    MIUR under this Section, children's hospitals and
26    affiliated general acute care hospitals shall be

 

 

10100HB3840sam001- 35 -LRB101 12454 CPF 74517 a

1    considered a single hospital.
2        (G) General acute care hospitals. As used under this
3    Section, "general acute care hospitals" means all other
4    Illinois hospitals not identified in subparagraphs (A)
5    through (F).
6    (2) Hospitals' qualification for each class shall be
7assessed prior to the beginning of each calendar year and the
8new class designation shall be effective January 1 of the next
9year. The Department shall publish by rule the process for
10establishing class determination.
11    (g) Fixed pool directed payments. Beginning July 1, 2020,
12the Department shall issue payments to MCOs which shall be used
13to issue directed payments to qualified Illinois safety-net
14hospitals and critical access hospitals on a monthly basis in
15accordance with this subsection. Prior to the beginning of each
16Payout Quarter beginning July 1, 2020, the Department shall use
17encounter claims data from the Determination Quarter, accepted
18by the Department's Medicaid Management Information System for
19inpatient and outpatient services rendered by safety-net
20hospitals and critical access hospitals to determine a
21quarterly uniform per unit add-on for each hospital class.
22        (1) Inpatient per unit add-on. A quarterly uniform per
23    diem add-on shall be derived by dividing the quarterly
24    Inpatient Directed Payments Pool amount allocated to the
25    applicable hospital class by the total inpatient days
26    contained on all encounter claims received during the

 

 

10100HB3840sam001- 36 -LRB101 12454 CPF 74517 a

1    Determination Quarter, for all hospitals in the class.
2            (A) Each hospital in the class shall have a
3        quarterly inpatient directed payment calculated that
4        is equal to the product of the number of inpatient days
5        attributable to the hospital used in the calculation of
6        the quarterly uniform class per diem add-on,
7        multiplied by the calculated applicable quarterly
8        uniform class per diem add-on of the hospital class.
9            (B) Each hospital shall be paid 1/3 of its
10        quarterly inpatient directed payment in each of the 3
11        months of the Payout Quarter, in accordance with
12        directions provided to each MCO by the Department.
13        (2) Outpatient per unit add-on. A quarterly uniform per
14    claim add-on shall be derived by dividing the quarterly
15    Outpatient Directed Payments Pool amount allocated to the
16    applicable hospital class by the total outpatient
17    encounter claims received during the Determination
18    Quarter, for all hospitals in the class.
19            (A) Each hospital in the class shall have a
20        quarterly outpatient directed payment calculated that
21        is equal to the product of the number of outpatient
22        encounter claims attributable to the hospital used in
23        the calculation of the quarterly uniform class per
24        claim add-on, multiplied by the calculated applicable
25        quarterly uniform class per claim add-on of the
26        hospital class.

 

 

10100HB3840sam001- 37 -LRB101 12454 CPF 74517 a

1            (B) Each hospital shall be paid 1/3 of its
2        quarterly outpatient directed payment in each of the 3
3        months of the Payout Quarter, in accordance with
4        directions provided to each MCO by the Department.
5        (3) Each MCO shall pay each hospital the Monthly
6    Directed Payment as identified by the Department on its
7    quarterly determination report.
8        (4) Definitions. As used in this subsection:
9            (A) "Payout Quarter" means each 3 month calendar
10        quarter, beginning July 1, 2020.
11            (B) "Determination Quarter" means each 3 month
12        calendar quarter, which ends 3 months prior to the
13        first day of each Payout Quarter.
14        (5) For the period July 1, 2020 through December 2020,
15    the following amounts shall be allocated to the following
16    hospital class directed payment pools for the quarterly
17    development of a uniform per unit add-on:
18            (A) $2,894,500 for hospital inpatient services for
19        critical access hospitals.
20            (B) $4,294,374 for hospital outpatient services
21        for critical access hospitals.
22            (C) $29,109,330 for hospital inpatient services
23        for safety-net hospitals.
24            (D) $35,041,218 for hospital outpatient services
25        for safety-net hospitals.
26    (h) Fixed rate directed payments. Effective July 1, 2020,

 

 

10100HB3840sam001- 38 -LRB101 12454 CPF 74517 a

1the Department shall issue payments to MCOs which shall be used
2to issue directed payments to Illinois hospitals not identified
3in paragraph (g) on a monthly basis. Prior to the beginning of
4each Payout Quarter beginning July 1, 2020, the Department
5shall use encounter claims data from the Determination Quarter,
6accepted by the Department's Medicaid Management Information
7System for inpatient and outpatient services rendered by
8hospitals in each hospital class identified in paragraph (f)
9and not identified in paragraph (g). For the period July 1,
102020 through December 2020, the Department shall direct MCOs to
11make payments as follows:
12        (1) For general acute care hospitals an amount equal to
13    $1,750 multiplied by the hospital's category of service 20
14    case mix index for the determination quarter multiplied by
15    the hospital's total number of inpatient admissions for
16    category of service 20 for the determination quarter.
17        (2) For general acute care hospitals an amount equal to
18    $160 multiplied by the hospital's category of service 21
19    case mix index for the determination quarter multiplied by
20    the hospital's total number of inpatient admissions for
21    category of service 21 for the determination quarter.
22        (3) For general acute care hospitals an amount equal to
23    $80 multiplied by the hospital's category of service 22
24    case mix index for the determination quarter multiplied by
25    the hospital's total number of inpatient admissions for
26    category of service 22 for the determination quarter.

 

 

10100HB3840sam001- 39 -LRB101 12454 CPF 74517 a

1        (4) For general acute care hospitals an amount equal to
2    $375 multiplied by the hospital's category of service 24
3    case mix index for the determination quarter multiplied by
4    the hospital's total number of category of service 24 paid
5    EAPG (EAPGs) for the determination quarter.
6        (5) For general acute care hospitals an amount equal to
7    $240 multiplied by the hospital's category of service 27
8    and 28 case mix index for the determination quarter
9    multiplied by the hospital's total number of category of
10    service 27 and 28 paid EAPGs for the determination quarter.
11        (6) For general acute care hospitals an amount equal to
12    $290 multiplied by the hospital's category of service 29
13    case mix index for the determination quarter multiplied by
14    the hospital's total number of category of service 29 paid
15    EAPGs for the determination quarter.
16        (7) For high Medicaid hospitals an amount equal to
17    $1,800 multiplied by the hospital's category of service 20
18    case mix index for the determination quarter multiplied by
19    the hospital's total number of inpatient admissions for
20    category of service 20 for the determination quarter.
21        (8) For high Medicaid hospitals an amount equal to $160
22    multiplied by the hospital's category of service 21 case
23    mix index for the determination quarter multiplied by the
24    hospital's total number of inpatient admissions for
25    category of service 21 for the determination quarter.
26        (9) For high Medicaid hospitals an amount equal to $80

 

 

10100HB3840sam001- 40 -LRB101 12454 CPF 74517 a

1    multiplied by the hospital's category of service 22 case
2    mix index for the determination quarter multiplied by the
3    hospital's total number of inpatient admissions for
4    category of service 22 for the determination quarter.
5        (10) For high Medicaid hospitals an amount equal to
6    $400 multiplied by the hospital's category of service 24
7    case mix index for the determination quarter multiplied by
8    the hospital's total number of category of service 24 paid
9    EAPG outpatient claims for the determination quarter.
10        (11) For high Medicaid hospitals an amount equal to
11    $240 multiplied by the hospital's category of service 27
12    and 28 case mix index for the determination quarter
13    multiplied by the hospital's total number of category of
14    service 27 and 28 paid EAPGs for the determination quarter.
15        (12) For high Medicaid hospitals an amount equal to
16    $290 multiplied by the hospital's category of service 29
17    case mix index for the determination quarter multiplied by
18    the hospital's total number of category of service 29 paid
19    EAPGs for the determination quarter.
20        (13) For long term acute care hospitals the amount of
21    $495 multiplied by the hospital's total number of inpatient
22    days for the determination quarter.
23        (14) For psychiatric hospitals the amount of $210
24    multiplied by the hospital's total number of inpatient days
25    for category of service 21 for the determination quarter.
26        (15) For psychiatric hospitals the amount of $250

 

 

10100HB3840sam001- 41 -LRB101 12454 CPF 74517 a

1    multiplied by the hospital's total number of outpatient
2    claims for category of service 27 and 28 for the
3    determination quarter.
4        (16) For rehabilitation hospitals the amount of $410
5    multiplied by the hospital's total number of inpatient days
6    for category of service 22 for the determination quarter.
7        (17) For rehabilitation hospitals the amount of $100
8    multiplied by the hospital's total number of outpatient
9    claims for category of service 29 for the determination
10    quarter.
11        (18) Each hospital shall be paid 1/3 of their quarterly
12    inpatient and outpatient directed payment in each of the 3
13    months of the Payout Quarter, in accordance with directions
14    provided to each MCO by the Department.
15        (19) Each MCO shall pay each hospital the Monthly
16    Directed Payment amount as identified by the Department on
17    its quarterly determination report.
18    Notwithstanding any other provision of this subsection, if
19the Department determines that the actual total hospital
20utilization data that is used to calculate the fixed rate
21directed payments is substantially different than anticipated
22when the rates in this subsection were initially determined
23(for unforeseeable circumstances such as the COVID-19
24pandemic), the Department may adjust the rates specified in
25this subsection so that the total directed payments approximate
26the total spending amount anticipated when the rates were

 

 

10100HB3840sam001- 42 -LRB101 12454 CPF 74517 a

1initially established.
2    Definitions. As used in this subsection:
3            (A) "Payout Quarter" means each calendar quarter,
4        beginning July 1, 2020.
5            (B) "Determination Quarter" means each calendar
6        quarter which ends 3 months prior to the first day of
7        each Payout Quarter.
8            (C) "Case mix index" means a hospital specific
9        calculation. For inpatient claims the case mix index is
10        calculated each quarter by summing the relative weight
11        of all inpatient Diagnosis-Related Group (DRG) claims
12        for a category of service in the applicable
13        Determination Quarter and dividing the sum by the
14        number of sum total of all inpatient DRG admissions for
15        the category of service for the associated claims. The
16        case mix index for outpatient claims is calculated each
17        quarter by summing the relative weight of all paid
18        EAPGs in the applicable Determination Quarter and
19        dividing the sum by the sum total of paid EAPGs for the
20        associated claims.
21    (i) Beginning January 1, 2021, the rates for directed
22payments shall be recalculated in order to spend the additional
23funds for directed payments that result from reduction in the
24amount of pass-through payments allowed under federal
25regulations. The additional funds for directed payments shall
26be allocated proportionally to each class of hospitals based on

 

 

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1that class' proportion of services.
2    (j) Pass-through payments.
3        (1) For the period July 1, 2020 through December 31,
4    2020, the Department shall assign quarterly pass-through
5    payments to each class of hospitals equal to one-fourth of
6    the following annual allocations:
7            (A) $390,487,095 to safety-net hospitals.
8            (B) $62,553,886 to critical access hospitals.
9            (C) $345,021,438 to high Medicaid hospitals.
10            (D) $551,429,071 to general acute care hospitals.
11            (E) $27,283,870 to long term acute care hospitals.
12            (F) $40,825,444 to freestanding psychiatric
13        hospitals.
14            (G) $9,652,108 to freestanding rehabilitation
15        hospitals.
16        (2) The pass-through payments shall at a minimum ensure
17    hospitals receive a total amount of monthly payments under
18    this Section as received in calendar year 2019 in
19    accordance with this Article and paragraph (1) of
20    subsection (d-5) of Section 14-12, exclusive of amounts
21    received through payments referenced in subsection (b).
22        (3) For the calendar year beginning January 1, 2021,
23    and each calendar year thereafter, each hospital's
24    pass-through payment amount shall be reduced
25    proportionally to the reduction of all pass-through
26    payments required by federal regulations; however, the

 

 

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1    Department shall take all steps necessary to minimize the
2    impact of any reduction in pass-through payments on
3    community safety-net hospitals and each individual
4    community safety-net hospital shall be held harmless if the
5    recalculation of directed payments results in a loss of
6    revenue during the calendar year.
7    (k) At least 30 days prior to each calendar year, the
8Department shall notify each hospital of changes to the payment
9methodologies in this Section, including, but not limited to,
10changes in the fixed rate directed payment rates, the aggregate
11pass-through payment amount for all hospitals, and the
12hospital's pass-through payment amount for the upcoming
13calendar year.
14    (l) Notwithstanding any other provisions of this Section,
15the Department may adopt rules to change the methodology for
16directed and pass-through payments as set forth in this
17Section, but only to the extent necessary to obtain federal
18approval of a necessary State Plan amendment or Directed
19Payment Preprint or to otherwise conform to federal law or
20federal regulation.
21    (m) As used in this subsection, "managed care organization"
22or "MCO" means an entity which contracts with the Department to
23provide services where payment for medical services is made on
24a capitated basis, excluding contracted entities for dual
25eligible or Department of Children and Family Services youth
26populations.

 

 

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1(Source: P.A. 101-650, eff. 7-7-20.)
 
2
Title IV. Medical Implicit Bias

 
3
Article 45.

 
4    Section 45-1. Findings. The General Assembly finds and
5declares all of the following:
6    (a) Implicit bias, meaning the attitudes or internalized
7stereotypes that affect our perceptions, actions, and
8decisions in an unconscious manner, exists and often
9contributes to unequal treatment of people based on race,
10ethnicity, gender identity, sexual orientation, age,
11disability, and other characteristics.
12    (b) Implicit bias contributes to health disparities by
13affecting the behavior of physicians and surgeons, nurses,
14physician assistants, and other healing arts licensees.
15    (c) African American women are 3 to 4 times more likely
16than white women to die from pregnancy-related causes
17nationwide. African American patients often are prescribed
18less pain medication than white patients who present the same
19complaints. African American patients with signs of heart
20problems are not referred for advanced cardiovascular
21procedures as often as white patients with the same symptoms.
22    (d) Implicit gender bias also impacts treatment decisions
23and outcomes. Women are less likely to survive a heart attack

 

 

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1when they are treated by a male physician and surgeon. LGBTQ
2and gender-nonconforming patients are less likely to seek
3timely medical care because they experience disrespect and
4discrimination from health care staff, with one out of 5
5transgender patients nationwide reporting that they were
6outright denied medical care due to bias.
7    (e) The General Assembly intends to reduce disparate
8outcomes and ensure that all patients receive fair treatment
9and quality health care.
 
10    Section 45-5. The Medical Practice Act of 1987 is amended
11by changing Section 20 as follows:
 
12    (225 ILCS 60/20)  (from Ch. 111, par. 4400-20)
13    (Section scheduled to be repealed on January 1, 2022)
14    Sec. 20. Continuing education.
15    (a) The Department shall promulgate rules of continuing
16education for persons licensed under this Act that require an
17average of 50 hours of continuing education per license year.
18These rules shall be consistent with requirements of relevant
19professional associations, specialty societies, or boards. The
20rules shall also address variances in part or in whole for good
21cause, including, but not limited to, temporary illness or
22hardship. In establishing these rules, the Department shall
23consider educational requirements for medical staffs,
24requirements for specialty society board certification or for

 

 

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1continuing education requirements as a condition of membership
2in societies representing the 2 categories of licensee under
3this Act. These rules shall assure that licensees are given the
4opportunity to participate in those programs sponsored by or
5through their professional associations or hospitals which are
6relevant to their practice.
7    (b) Except as otherwise provided in this subsection, the
8rules adopted under this Section shall require that, on and
9after January 1, 2022, all continuing education courses for
10persons licensed under this Act contain curriculum that
11includes the understanding of implicit bias. Beginning January
121, 2023, continuing education providers shall ensure
13compliance with this Section. Beginning January 1, 2023, the
14Department shall audit continuing education providers at least
15once every 5 years to ensure adherence to regulatory
16requirements and shall withhold or rescind approval from any
17provider that is in violation of the requirements of this
18subsection.
19    A continuing education course dedicated solely to research
20or other issues that does not include a direct patient care
21component is not required to contain curriculum that includes
22implicit bias in the practice of medicine.
23    To satisfy the requirements of this subsection, continuing
24education courses shall address at least one of the following:
25        (1) examples of how implicit bias affects perceptions
26    and treatment decisions, leading to disparities in health

 

 

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1    outcomes; or
2        (2) strategies to address how unintended biases in
3    decision making may contribute to health care disparities
4    by shaping behavior and producing differences in medical
5    treatment along lines of race, ethnicity, gender identity,
6    sexual orientation, age, socioeconomic status, or other
7    characteristics.
8    (c) Each licensee is responsible for maintaining records of
9completion of continuing education and shall be prepared to
10produce the records when requested by the Department.
11(Source: P.A. 97-622, eff. 11-23-11.)
 
12    Section 45-10. The Nurse Practice Act is amended by
13changing Sections 55-35, 60-40, and 65-60 as follows:
 
14    (225 ILCS 65/55-35)
15    (Section scheduled to be repealed on January 1, 2028)
16    Sec. 55-35. Continuing education for LPN licensees.
17    (a) The Department may adopt rules of continuing education
18for licensed practical nurses that require 20 hours of
19continuing education per 2-year license renewal cycle. The
20rules shall address variances in part or in whole for good
21cause, including without limitation illness or hardship. The
22continuing education rules must ensure that licensees are given
23the opportunity to participate in programs sponsored by or
24through their State or national professional associations,

 

 

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1hospitals, or other providers of continuing education.
2    (b) For license renewals occurring on or after January 1,
32022, all licensed practical nurses must complete at least one
4hour of implicit bias training per 2-year license renewal
5cycle. The Department may adopt rules for the implementation of
6this subsection.
7    (c) Each licensee is responsible for maintaining records of
8completion of continuing education and shall be prepared to
9produce the records when requested by the Department.
10(Source: P.A. 95-639, eff. 10-5-07.)
 
11    (225 ILCS 65/60-40)
12    (Section scheduled to be repealed on January 1, 2028)
13    Sec. 60-40. Continuing education for RN licensees.
14    (a) The Department may adopt rules of continuing education
15for registered professional nurses licensed under this Act that
16require 20 hours of continuing education per 2-year license
17renewal cycle. The rules shall address variances in part or in
18whole for good cause, including without limitation illness or
19hardship. The continuing education rules must ensure that
20licensees are given the opportunity to participate in programs
21sponsored by or through their State or national professional
22associations, hospitals, or other providers of continuing
23education.
24    (b) For license renewals occurring on or after January 1,
252022, all registered professional nurses must complete at least

 

 

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1one hour of implicit bias training per 2-year license renewal
2cycle. The Department may adopt rules for the implementation of
3this subsection.
4    (c) Each licensee is responsible for maintaining records of
5completion of continuing education and shall be prepared to
6produce the records when requested by the Department.
7(Source: P.A. 95-639, eff. 10-5-07.)
 
8    (225 ILCS 65/65-60)   (was 225 ILCS 65/15-45)
9    (Section scheduled to be repealed on January 1, 2028)
10    Sec. 65-60. Continuing education.
11    (a) The Department shall adopt rules of continuing
12education for persons licensed under this Article as advanced
13practice registered nurses that require 80 hours of continuing
14education per 2-year license renewal cycle. Completion of the
1580 hours of continuing education shall be deemed to satisfy the
16continuing education requirements for renewal of a registered
17professional nurse license as required by this Act.
18    The 80 hours of continuing education required under this
19Section shall be completed as follows:
20        (1) A minimum of 50 hours of the continuing education
21    shall be obtained in continuing education programs as
22    determined by rule that shall include no less than 20 hours
23    of pharmacotherapeutics, including 10 hours of opioid
24    prescribing or substance abuse education. Continuing
25    education programs may be conducted or endorsed by

 

 

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1    educational institutions, hospitals, specialist
2    associations, facilities, or other organizations approved
3    to offer continuing education under this Act or rules and
4    shall be in the advanced practice registered nurse's
5    specialty.
6        (2) A maximum of 30 hours of credit may be obtained by
7    presentations in the advanced practice registered nurse's
8    clinical specialty, evidence-based practice, or quality
9    improvement projects, publications, research projects, or
10    preceptor hours as determined by rule.
11    The rules adopted regarding continuing education shall be
12consistent to the extent possible with requirements of relevant
13national certifying bodies or State or national professional
14associations.
15    (b) The rules shall not be inconsistent with requirements
16of relevant national certifying bodies or State or national
17professional associations. The rules shall also address
18variances in part or in whole for good cause, including but not
19limited to illness or hardship. The continuing education rules
20shall assure that licensees are given the opportunity to
21participate in programs sponsored by or through their State or
22national professional associations, hospitals, or other
23providers of continuing education.
24    (c) For license renewals occurring on or after January 1,
252022, all advanced practice registered nurses must complete at
26least one hour of implicit bias training per 2-year license

 

 

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1renewal cycle. The Department may adopt rules for the
2implementation of this subsection.
3    (d) Each licensee is responsible for maintaining records of
4completion of continuing education and shall be prepared to
5produce the records when requested by the Department.
6(Source: P.A. 100-513, eff. 1-1-18.)
 
7    Section 45-15. The Physician Assistant Practice Act of 1987
8is amended by changing Section 11.5 as follows:
 
9    (225 ILCS 95/11.5)
10    (Section scheduled to be repealed on January 1, 2028)
11    Sec. 11.5. Continuing education.
12    (a) The Department shall adopt rules for continuing
13education for persons licensed under this Act that require 50
14hours of continuing education per 2-year license renewal cycle.
15Completion of the 50 hours of continuing education shall be
16deemed to satisfy the continuing education requirements for
17renewal of a physician assistant license as required by this
18Act. The rules shall not be inconsistent with requirements of
19relevant national certifying bodies or State or national
20professional associations. The rules shall also address
21variances in part or in whole for good cause, including, but
22not limited to, illness or hardship. The continuing education
23rules shall ensure that licensees are given the opportunity to
24participate in programs sponsored by or through their State or

 

 

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1national professional associations, hospitals, or other
2providers of continuing education.
3    (b) Except as otherwise provided in this subsection, the
4rules adopted under this Section shall require that, on and
5after January 1, 2022, all continuing education courses for
6persons licensed under this Act contain curriculum that
7includes the understanding of implicit bias. Beginning January
81, 2023, continuing education providers shall ensure
9compliance with this Section. Beginning January 1, 2023, the
10Department shall audit continuing education providers at least
11once every 5 years to ensure adherence to regulatory
12requirements and shall withhold or rescind approval from any
13provider that is in violation of the regulatory requirements.
14    A continuing education course dedicated solely to research
15or other issues that does not include a direct patient care
16component is not required to contain curriculum that includes
17implicit bias in the practice of medicine.
18    To satisfy the requirements of subsection (a) of this
19Section, continuing education courses shall address at least
20one of the following:
21        (1) examples of how implicit bias affects perceptions
22    and treatment decisions, leading to disparities in health
23    outcomes; or
24        (2) strategies to address how unintended biases in
25    decision making may contribute to health care disparities
26    by shaping behavior and producing differences in medical

 

 

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1    treatment along lines of race, ethnicity, gender identity,
2    sexual orientation, age, socioeconomic status, or other
3    characteristics.
4    (c) Each licensee is responsible for maintaining records of
5completion of continuing education and shall be prepared to
6produce the records when requested by the Department.
7(Source: P.A. 100-453, eff. 8-25-17.)
 
8
Title V. Substance Abuse and Mental Health Treatment

 
9
Article 50.

 
10    Section 50-5. The Illinois Controlled Substances Act is
11amended by changing Section 414 as follows:
 
12    (720 ILCS 570/414)
13    Sec. 414. Overdose; limited immunity from prosecution.
14    (a) For the purposes of this Section, "overdose" means a
15controlled substance-induced physiological event that results
16in a life-threatening emergency to the individual who ingested,
17inhaled, injected or otherwise bodily absorbed a controlled,
18counterfeit, or look-alike substance or a controlled substance
19analog.
20    (b) A person who, in good faith, seeks or obtains emergency
21medical assistance for someone experiencing an overdose shall
22not be arrested, charged, or prosecuted for a violation of

 

 

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1Section 401 or 402 of the Illinois Controlled Substances Act,
2Section 3.5 of the Drug Paraphernalia Control Act, Section 55
3or 60 of the Methamphetamine Control and Community Protection
4Act, Section 9-3.3 of the Criminal Code of 2012, or paragraph
5(1) of subsection (g) of Section 12-3.05 of the Criminal Code
6of 2012 Class 4 felony possession of a controlled, counterfeit,
7or look-alike substance or a controlled substance analog if
8evidence for the violation Class 4 felony possession charge was
9acquired as a result of the person seeking or obtaining
10emergency medical assistance and providing the amount of
11substance recovered is within the amount identified in
12subsection (d) of this Section. The violations listed in this
13subsection (b) must not serve as the sole basis of a violation
14of parole, mandatory supervised release, probation, or
15conditional discharge, a Department of Children and Family
16Services investigation, or any seizure of property under any
17State law authorizing civil forfeiture so long as the evidence
18for the violation was acquired as a result of the person
19seeking or obtaining emergency medical assistance in the event
20of an overdose.
21    (c) A person who is experiencing an overdose shall not be
22arrested, charged, or prosecuted for a violation of Section 401
23or 402 of the Illinois Controlled Substances Act, Section 3.5
24of the Drug Paraphernalia Control Act, Section 9-3.3 of the
25Criminal Code of 2012, or paragraph (1) of subsection (g) of
26Section 12-3.05 of the Criminal Code of 2012 Class 4 felony

 

 

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1possession of a controlled, counterfeit, or look-alike
2substance or a controlled substance analog if evidence for the
3violation Class 4 felony possession charge was acquired as a
4result of the person seeking or obtaining emergency medical
5assistance and providing the amount of substance recovered is
6within the amount identified in subsection (d) of this Section.
7The violations listed in this subsection (c) must not serve as
8the sole basis of a violation of parole, mandatory supervised
9release, probation, or conditional discharge, a Department of
10Children and Family Services investigation, or any seizure of
11property under any State law authorizing civil forfeiture so
12long as the evidence for the violation was acquired as a result
13of the person seeking or obtaining emergency medical assistance
14in the event of an overdose.
15    (d) For the purposes of subsections (b) and (c), the
16limited immunity shall only apply to a person possessing the
17following amount:
18        (1) less than 3 grams of a substance containing heroin;
19        (2) less than 3 grams of a substance containing
20    cocaine;
21        (3) less than 3 grams of a substance containing
22    morphine;
23        (4) less than 40 grams of a substance containing
24    peyote;
25        (5) less than 40 grams of a substance containing a
26    derivative of barbituric acid or any of the salts of a

 

 

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1    derivative of barbituric acid;
2        (6) less than 40 grams of a substance containing
3    amphetamine or any salt of an optical isomer of
4    amphetamine;
5        (7) less than 3 grams of a substance containing
6    lysergic acid diethylamide (LSD), or an analog thereof;
7        (8) less than 6 grams of a substance containing
8    pentazocine or any of the salts, isomers and salts of
9    isomers of pentazocine, or an analog thereof;
10        (9) less than 6 grams of a substance containing
11    methaqualone or any of the salts, isomers and salts of
12    isomers of methaqualone;
13        (10) less than 6 grams of a substance containing
14    phencyclidine or any of the salts, isomers and salts of
15    isomers of phencyclidine (PCP);
16        (11) less than 6 grams of a substance containing
17    ketamine or any of the salts, isomers and salts of isomers
18    of ketamine;
19        (12) less than 40 grams of a substance containing a
20    substance classified as a narcotic drug in Schedules I or
21    II, or an analog thereof, which is not otherwise included
22    in this subsection.
23    (e) The limited immunity described in subsections (b) and
24(c) of this Section shall not be extended if law enforcement
25has reasonable suspicion or probable cause to detain, arrest,
26or search the person described in subsection (b) or (c) of this

 

 

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1Section for criminal activity and the reasonable suspicion or
2probable cause is based on information obtained prior to or
3independent of the individual described in subsection (b) or
4(c) taking action to seek or obtain emergency medical
5assistance and not obtained as a direct result of the action of
6seeking or obtaining emergency medical assistance. Nothing in
7this Section is intended to interfere with or prevent the
8investigation, arrest, or prosecution of any person for the
9delivery or distribution of cannabis, methamphetamine or other
10controlled substances, drug-induced homicide, or any other
11crime if the evidence of the violation is not acquired as a
12result of the person seeking or obtaining emergency medical
13assistance in the event of an overdose.
14(Source: P.A. 97-678, eff. 6-1-12.)
 
15    Section 50-10. The Methamphetamine Control and Community
16Protection Act is amended by changing Section 115 as follows:
 
17    (720 ILCS 646/115)
18    Sec. 115. Overdose; limited immunity from prosecution.
19    (a) For the purposes of this Section, "overdose" means a
20methamphetamine-induced physiological event that results in a
21life-threatening emergency to the individual who ingested,
22inhaled, injected, or otherwise bodily absorbed
23methamphetamine.
24    (b) A person who, in good faith, seeks emergency medical

 

 

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1assistance for someone experiencing an overdose shall not be
2arrested, charged or prosecuted for a violation of Section 55
3or 60 of this Act or Section 3.5 of the Drug Paraphernalia
4Control Act, Section 9-3.3 of the Criminal Code of 2012, or
5paragraph (1) of subsection (g) of Section 12-3.05 of the
6Criminal Code of 2012 Class 3 felony possession of
7methamphetamine if evidence for the violation Class 3 felony
8possession charge was acquired as a result of the person
9seeking or obtaining emergency medical assistance and
10providing the amount of substance recovered is less than 3
11grams one gram of methamphetamine or a substance containing
12methamphetamine. The violations listed in this subsection (b)
13must not serve as the sole basis of a violation of parole,
14mandatory supervised release, probation, or conditional
15discharge, a Department of Children and Family Services
16investigation, or any seizure of property under any State law
17authorizing civil forfeiture so long as the evidence for the
18violation was acquired as a result of the person seeking or
19obtaining emergency medical assistance in the event of an
20overdose.
21    (c) A person who is experiencing an overdose shall not be
22arrested, charged, or prosecuted for a violation of Section 55
23or 60 of this Act or Section 3.5 of the Drug Paraphernalia
24Control Act, Section 9-3.3 of the Criminal Code of 2012, or
25paragraph (1) of subsection (g) of Section 12-3.05 of the
26Criminal Code of 2012 Class 3 felony possession of

 

 

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1methamphetamine if evidence for the Class 3 felony possession
2charge was acquired as a result of the person seeking or
3obtaining emergency medical assistance and providing the
4amount of substance recovered is less than one gram of
5methamphetamine or a substance containing methamphetamine. The
6violations listed in this subsection (c) must not serve as the
7sole basis of a violation of parole, mandatory supervised
8release, probation, or conditional discharge, a Department of
9Children and Family Services investigation, or any seizure of
10property under any State law authorizing civil forfeiture so
11long as the evidence for the violation was acquired as a result
12of the person seeking or obtaining emergency medical assistance
13in the event of an overdose.
14    (d) The limited immunity described in subsections (b) and
15(c) of this Section shall not be extended if law enforcement
16has reasonable suspicion or probable cause to detain, arrest,
17or search the person described in subsection (b) or (c) of this
18Section for criminal activity and the reasonable suspicion or
19probable cause is based on information obtained prior to or
20independent of the individual described in subsection (b) or
21(c) taking action to seek or obtain emergency medical
22assistance and not obtained as a direct result of the action of
23seeking or obtaining emergency medical assistance. Nothing in
24this Section is intended to interfere with or prevent the
25investigation, arrest, or prosecution of any person for the
26delivery or distribution of cannabis, methamphetamine or other

 

 

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1controlled substances, drug-induced homicide, or any other
2crime if the evidence of the violation is not acquired as a
3result of the person seeking or obtaining emergency medical
4assistance in the event of an overdose.
5(Source: P.A. 97-678, eff. 6-1-12.)
 
6
Article 55.

 
7    Section 55-5. The Illinois Controlled Substances Act is
8amended by changing Section 316 as follows:
 
9    (720 ILCS 570/316)
10    Sec. 316. Prescription Monitoring Program.
11    (a) The Department must provide for a Prescription
12Monitoring Program for Schedule II, III, IV, and V controlled
13substances that includes the following components and
14requirements:
15        (1) The dispenser must transmit to the central
16    repository, in a form and manner specified by the
17    Department, the following information:
18            (A) The recipient's name and address.
19            (B) The recipient's date of birth and gender.
20            (C) The national drug code number of the controlled
21        substance dispensed.
22            (D) The date the controlled substance is
23        dispensed.

 

 

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1            (E) The quantity of the controlled substance
2        dispensed and days supply.
3            (F) The dispenser's United States Drug Enforcement
4        Administration registration number.
5            (G) The prescriber's United States Drug
6        Enforcement Administration registration number.
7            (H) The dates the controlled substance
8        prescription is filled.
9            (I) The payment type used to purchase the
10        controlled substance (i.e. Medicaid, cash, third party
11        insurance).
12            (J) The patient location code (i.e. home, nursing
13        home, outpatient, etc.) for the controlled substances
14        other than those filled at a retail pharmacy.
15            (K) Any additional information that may be
16        required by the department by administrative rule,
17        including but not limited to information required for
18        compliance with the criteria for electronic reporting
19        of the American Society for Automation and Pharmacy or
20        its successor.
21        (2) The information required to be transmitted under
22    this Section must be transmitted not later than the end of
23    the next business day after the date on which a controlled
24    substance is dispensed, or at such other time as may be
25    required by the Department by administrative rule.
26        (3) A dispenser must transmit the information required

 

 

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1    under this Section by:
2            (A) an electronic device compatible with the
3        receiving device of the central repository;
4            (B) a computer diskette;
5            (C) a magnetic tape; or
6            (D) a pharmacy universal claim form or Pharmacy
7        Inventory Control form.
8        (3.5) The requirements of paragraphs (1), (2), and (3)
9    of this subsection (a) also apply to opioid treatment
10    programs that prescribe Schedule II, III, IV, or V
11    controlled substances for the treatment of opioid use
12    disorder.
13        (4) The Department may impose a civil fine of up to
14    $100 per day for willful failure to report controlled
15    substance dispensing to the Prescription Monitoring
16    Program. The fine shall be calculated on no more than the
17    number of days from the time the report was required to be
18    made until the time the problem was resolved, and shall be
19    payable to the Prescription Monitoring Program.
20    (a-5) Notwithstanding subsection (a), a licensed
21veterinarian is exempt from the reporting requirements of this
22Section. If a person who is presenting an animal for treatment
23is suspected of fraudulently obtaining any controlled
24substance or prescription for a controlled substance, the
25licensed veterinarian shall report that information to the
26local law enforcement agency.

 

 

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1    (b) The Department, by rule, may include in the
2Prescription Monitoring Program certain other select drugs
3that are not included in Schedule II, III, IV, or V. The
4Prescription Monitoring Program does not apply to controlled
5substance prescriptions as exempted under Section 313.
6    (c) The collection of data on select drugs and scheduled
7substances by the Prescription Monitoring Program may be used
8as a tool for addressing oversight requirements of long-term
9care institutions as set forth by Public Act 96-1372. Long-term
10care pharmacies shall transmit patient medication profiles to
11the Prescription Monitoring Program monthly or more frequently
12as established by administrative rule.
13    (d) The Department of Human Services shall appoint a
14full-time Clinical Director of the Prescription Monitoring
15Program.
16    (e) (Blank).
17    (f) Within one year of January 1, 2018 (the effective date
18of Public Act 100-564), the Department shall adopt rules
19requiring all Electronic Health Records Systems to interface
20with the Prescription Monitoring Program application program
21on or before January 1, 2021 to ensure that all providers have
22access to specific patient records during the treatment of
23their patients. These rules shall also address the electronic
24integration of pharmacy records with the Prescription
25Monitoring Program to allow for faster transmission of the
26information required under this Section. The Department shall

 

 

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1establish actions to be taken if a prescriber's Electronic
2Health Records System does not effectively interface with the
3Prescription Monitoring Program within the required timeline.
4    (g) The Department, in consultation with the Advisory
5Committee, shall adopt rules allowing licensed prescribers or
6pharmacists who have registered to access the Prescription
7Monitoring Program to authorize a licensed or non-licensed
8designee employed in that licensed prescriber's office or a
9licensed designee in a licensed pharmacist's pharmacy who has
10received training in the federal Health Insurance Portability
11and Accountability Act to consult the Prescription Monitoring
12Program on their behalf. The rules shall include reasonable
13parameters concerning a practitioner's authority to authorize
14a designee, and the eligibility of a person to be selected as a
15designee. In this subsection (g), "pharmacist" shall include a
16clinical pharmacist employed by and designated by a Medicaid
17Managed Care Organization providing services under Article V of
18the Illinois Public Aid Code under a contract with the
19Department of Healthcare and Family Services for the sole
20purpose of clinical review of services provided to persons
21covered by the entity under the contract to determine
22compliance with subsections (a) and (b) of Section 314.5 of
23this Act. A managed care entity pharmacist shall notify
24prescribers of review activities.
25(Source: P.A. 100-564, eff. 1-1-18; 100-861, eff. 8-14-18;
26100-1005, eff. 8-21-18; 100-1093, eff. 8-26-18; 101-81, eff.

 

 

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17-12-19; 101-414, eff. 8-16-19.)
 
2
Article 60.

 
3    Section 60-5. The Adult Protective Services Act is amended
4by adding Section 3.1 as follows:
 
5    (320 ILCS 20/3.1 new)
6    Sec. 3.1. Adult protective services dementia training.
7    (a) This Section shall apply to any person who is employed
8by the Department in the Adult Protective Services division who
9works on the development and implementation of social services
10to respond to and prevent adult abuse, neglect, or
11exploitation.
12    (b) The Department shall develop and implement a dementia
13training program that must include instruction on the
14identification of people with dementia, risks such as
15wandering, communication impairments, elder abuse, and the
16best practices for interacting with people with dementia.
17    (c) Initial training of 4 hours shall be completed at the
18start of employment with the Adult Protective Services division
19and shall cover the following:
20        (1) Dementia, psychiatric, and behavioral symptoms.
21        (2) Communication issues, including how to communicate
22    respectfully and effectively.
23        (3) Techniques for understanding and approaching

 

 

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1    behavioral symptoms.
2        (4) Information on how to address specific aspects of
3    safety, for example tips to prevent wandering.
4        (5) When it is necessary to alert law enforcement
5    agencies of potential criminal behavior involving a family
6    member, caretaker, or institutional abuse; neglect or
7    exploitation of a person with dementia; and what types of
8    abuse that are most common to people with dementia.
9        (6) Identifying incidents of self-neglect for people
10    with dementia who live alone as well as neglect by a
11    caregiver.
12        (7) Protocols for connecting people living with
13    dementia to local care resources and professionals who are
14    skilled in dementia care to encourage cross-referral and
15    reporting regarding incidents of abuse.
16    (d) Annual continuing education shall include 2 hours of
17dementia training covering the subjects described in
18subsection (c).
19    (e) This Section is designed to address gaps in current
20dementia training requirements for Adult Protective Services
21officials and improve the quality of training. If currently
22existing law or rules contain more rigorous training
23requirements for Adult Protective Service officials, those
24laws or rules shall apply. Where there is overlap between this
25Section and other laws and rules, the Department shall
26interpret this Section to avoid duplication of requirements

 

 

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1while ensuring that the minimum requirements set in this
2Section are met.
3    (f) The Department may adopt rules for the administration
4of this Section.
 
5
Article 65.

 
6    Section 65-1. Short title. This Article may be cited as the
7Behavioral Health Workforce Education Center of Illinois Act.
8References in this Article to "this Act" mean this Article.
 
9    Section 65-5. Findings. The General Assembly finds as
10follows:
11        (1) There are insufficient behavioral health
12    professionals in this State's behavioral health workforce
13    and further that there are insufficient behavioral health
14    professionals trained in evidence-based practices.
15        (2) The Illinois behavioral health workforce situation
16    is at a crisis state and the lack of a behavioral health
17    strategy is exacerbating the problem.
18        (3) In 2019, the Journal of Community Health found that
19    suicide rates are disproportionately higher among African
20    American adolescents. From 2001 to 2017, the rate for
21    African American teen boys rose 60%, according to the
22    study. Among African American teen girls, rates nearly
23    tripled, rising by an astounding 182%. Illinois was among

 

 

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1    the 10 states with the greatest number of African American
2    adolescent suicides (2015-2017).
3        (4) Workforce shortages are evident in all behavioral
4    health professions, including, but not limited to,
5    psychiatry, psychiatric nursing, psychiatric physician
6    assistant, social work (licensed social work, licensed
7    clinical social work), counseling (licensed professional
8    counseling, licensed clinical professional counseling),
9    marriage and family therapy, licensed clinical psychology,
10    occupational therapy, prevention, substance use disorder
11    counseling, and peer support.
12        (5) The shortage of behavioral health practitioners
13    affects every Illinois county, every group of people with
14    behavioral health needs, including children and
15    adolescents, justice-involved populations, working adults,
16    people experiencing homelessness, veterans, and older
17    adults, and every health care and social service setting,
18    from residential facilities and hospitals to
19    community-based organizations and primary care clinics.
20        (6) Estimates of unmet needs consistently highlight
21    the dire situation in Illinois. Mental Health America ranks
22    Illinois 29th in the country in mental health workforce
23    availability based on its 480-to-1 ratio of population to
24    mental health professionals, and the Kaiser Family
25    Foundation estimates that only 23.3% of Illinoisans'
26    mental health needs can be met with its current workforce.

 

 

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1        (7) Shortages are especially acute in rural areas and
2    among low-income and under-insured individuals and
3    families. 30.3% of Illinois' rural hospitals are in
4    designated primary care shortage areas and 93.7% are in
5    designated mental health shortage areas. Nationally, 40%
6    of psychiatrists work in cash-only practices, limiting
7    access for those who cannot afford high out-of-pocket
8    costs, especially Medicaid eligible individuals and
9    families.
10        (8) Spanish-speaking therapists in suburban Cook
11    County, as well as in immigrant new growth communities
12    throughout the State, for example, and master's-prepared
13    social workers in rural communities are especially
14    difficult to recruit and retain.
15        (9) Illinois' shortage of psychiatrists specializing
16    in serving children and adolescents is also severe.
17    Eighty-one out of 102 Illinois counties have no child and
18    adolescent psychiatrists, and the remaining 21 counties
19    have only 310 child and adolescent psychiatrists for a
20    population of 2,450,000 children.
21        (10) Only 38.9% of the 121,000 Illinois youth aged 12
22    through 17 who experienced a major depressive episode
23    received care.
24        (11) An annual average of 799,000 people in Illinois
25    aged 12 and older need but do not receive substance use
26    disorder treatment at specialty facilities.

 

 

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1        (12) According to the Statewide Semiannual Opioid
2    Report, Illinois Department of Public Health, September
3    2020, the number of opioid deaths in Illinois has increased
4    3% from 2,167 deaths in 2018 to 2,233 deaths in 2019.
5        (13) Behavioral health workforce shortages have led to
6    well-documented problems of long wait times for
7    appointments with psychiatrists (4 to 6 months in some
8    cases), high turnover, and unfilled vacancies for social
9    workers and other behavioral health professionals that
10    have eroded the gains in insurance coverage for mental
11    illness and substance use disorder under the federal
12    Affordable Care Act and parity laws.
13        (14) As a result, individuals with mental illness or
14    substance use disorders end up in hospital emergency rooms,
15    which are the most expensive level of care, or are
16    incarcerated and do not receive adequate care, if any.
17        (15) There are many organizations and institutions
18    that are affected by behavioral health workforce
19    shortages, but no one entity is responsible for monitoring
20    the workforce supply and intervening to ensure it can
21    effectively meet behavioral health needs throughout the
22    State.
23        (16) Workforce shortages are more complex than simple
24    numerical shortfalls. Identifying the optimal number,
25    type, and location of behavioral health professionals to
26    meet the differing needs of Illinois' diverse regions and

 

 

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1    populations across the lifespan is a difficult logistical
2    problem at the system and practice level that requires
3    coordinated efforts in research, education, service
4    delivery, and policy.
5        (17) This State has a compelling and substantial
6    interest in building a pipeline for behavioral health
7    professionals and to anchor research and education for
8    behavioral health workforce development. Beginning with
9    the proposed Behavioral Health Workforce Education Center
10    of Illinois, Illinois has the chance to develop a blueprint
11    to be a national leader in behavioral health workforce
12    development.
13        (18) The State must act now to improve the ability of
14    its residents to achieve their human potential and to live
15    healthy, productive lives by reducing the misery and
16    suffering with unmet behavioral health needs.
 
17    Section 65-10. Behavioral Health Workforce Education
18Center of Illinois.
19    (a) The Behavioral Health Workforce Education Center of
20Illinois is created and shall be administered by a teaching,
21research, or both teaching and research public institution of
22higher education in this State. Subject to appropriation, the
23Center shall be operational on or before July 1, 2022.
24    (b) The Behavioral Health Workforce Education Center of
25Illinois shall leverage workforce and behavioral health

 

 

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1resources, including, but not limited to, State, federal, and
2foundation grant funding, federal Workforce Investment Act of
31998 programs, the National Health Service Corps and other
4nongraduate medical education physician workforce training
5programs, and existing behavioral health partnerships, and
6align with reforms in Illinois.
 
7    Section 65-15. Structure.
8    (a) The Behavioral Health Workforce Education Center of
9Illinois shall be structured as a multisite model, and the
10administering public institution of higher education shall
11serve as the hub institution, complemented by secondary
12regional hubs, namely academic institutions, that serve rural
13and small urban areas and at least one academic institution
14serving a densely urban municipality with more than 1,000,000
15inhabitants.
16    (b) The Behavioral Health Workforce Education Center of
17Illinois shall be located within one academic institution and
18shall be tasked with a convening and coordinating role for
19workforce research and planning, including monitoring progress
20toward Center goals.
21    (c) The Behavioral Health Workforce Education Center of
22Illinois shall also coordinate with key State agencies involved
23in behavioral health, workforce development, and higher
24education in order to leverage disparate resources from health
25care, workforce, and economic development programs in Illinois

 

 

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1government.
 
2    Section 65-20. Duties. The Behavioral Health Workforce
3Education Center of Illinois shall perform the following
4duties:
5        (1) Organize a consortium of universities in
6    partnerships with providers, school districts, law
7    enforcement, consumers and their families, State agencies,
8    and other stakeholders to implement workforce development
9    concepts and strategies in every region of this State.
10        (2) Be responsible for developing and implementing a
11    strategic plan for the recruitment, education, and
12    retention of a qualified, diverse, and evolving behavioral
13    health workforce in this State. Its planning and activities
14    shall include:
15            (A) convening and organizing vested stakeholders
16        spanning government agencies, clinics, behavioral
17        health facilities, prevention programs, hospitals,
18        schools, jails, prisons and juvenile justice, police
19        and emergency medical services, consumers and their
20        families, and other stakeholders;
21            (B) collecting and analyzing data on the
22        behavioral health workforce in Illinois, with detailed
23        information on specialties, credentials, additional
24        qualifications (such as training or experience in
25        particular models of care), location of practice, and

 

 

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1        demographic characteristics, including age, gender,
2        race and ethnicity, and languages spoken;
3            (C) building partnerships with school districts,
4        public institutions of higher education, and workforce
5        investment agencies to create pipelines to behavioral
6        health careers from high schools and colleges,
7        pathways to behavioral health specialization among
8        health professional students, and expanded behavioral
9        health residency and internship opportunities for
10        graduates;
11            (D) evaluating and disseminating information about
12        evidence-based practices emerging from research
13        regarding promising modalities of treatment, care
14        coordination models, and medications;
15            (E) developing systems for tracking the
16        utilization of evidence-based practices that most
17        effectively meet behavioral health needs; and
18            (F) providing technical assistance to support
19        professional training and continuing education
20        programs that provide effective training in
21        evidence-based behavioral health practices.
22        (3) Coordinate data collection and analysis, including
23    systematic tracking of the behavioral health workforce and
24    datasets that support workforce planning for an
25    accessible, high-quality behavioral health system. In the
26    medium to long-term, the Center shall develop Illinois

 

 

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1    behavioral workforce data capacity by:
2            (A) filling gaps in workforce data by collecting
3        information on specialty, training, and qualifications
4        for specific models of care, demographic
5        characteristics, including gender, race, ethnicity,
6        and languages spoken, and participation in public and
7        private insurance networks;
8            (B) identifying the highest priority geographies,
9        populations, and occupations for recruitment and
10        training;
11            (C) monitoring the incidence of behavioral health
12        conditions to improve estimates of unmet need; and
13            (D) compiling up-to-date, evidence-based
14        practices, monitoring utilization, and aligning
15        training resources to improve the uptake of the most
16        effective practices.
17        (4) Work to grow and advance peer and parent-peer
18    workforce development by:
19            (A) assessing the credentialing and reimbursement
20        processes and recommending reforms;
21            (B) evaluating available peer-parent training
22        models, choosing a model that meets Illinois' needs,
23        and working with partners to implement it universally
24        in child-serving programs throughout this State; and
25            (C) including peer recovery specialists and
26        parent-peer support professionals in interdisciplinary

 

 

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1        training programs.
2        (5) Focus on the training of behavioral health
3    professionals in telehealth techniques, including taking
4    advantage of a telehealth network that exists, and other
5    innovative means of care delivery in order to increase
6    access to behavioral health services for all persons within
7    this State.
8        (6) No later than December 1 of every odd-numbered
9    year, prepare a report of its activities under this Act.
10    The report shall be filed electronically with the General
11    Assembly, as provided under Section 3.1 of the General
12    Assembly Organization Act, and shall be provided
13    electronically to any member of the General Assembly upon
14    request.
 
15    Section 65-25. Selection process.
16    (a) No later than 90 days after the effective date of this
17Act, the Board of Higher Education shall select a public
18institution of higher education, with input and assistance from
19the Division of Mental Health of the Department of Human
20Services, to administer the Behavioral Health Workforce
21Education Center of Illinois.
22    (b) The selection process shall articulate the principles
23of the Behavioral Health Workforce Education Center of
24Illinois, not inconsistent with this Act.
25    (c) The Board of Higher Education, with input and

 

 

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1assistance from the Division of Mental Health of the Department
2of Human Services, shall make its selection of a public
3institution of higher education based on its ability and
4willingness to execute the following tasks:
5        (1) Convening academic institutions providing
6    behavioral health education to:
7            (A) develop curricula to train future behavioral
8        health professionals in evidence-based practices that
9        meet the most urgent needs of Illinois' residents;
10            (B) build capacity to provide clinical training
11        and supervision; and
12            (C) facilitate telehealth services to every region
13        of the State.
14        (2) Functioning as a clearinghouse for research,
15    education, and training efforts to identify and
16    disseminate evidence-based practices across the State.
17        (3) Leveraging financial support from grants and
18    social impact loan funds.
19        (4) Providing infrastructure to organize regional
20    behavioral health education and outreach. As budgets
21    allow, this shall include conference and training space,
22    research and faculty staff time, telehealth, and distance
23    learning equipment.
24        (5) Working with regional hubs that assess and serve
25    the workforce needs of specific, well-defined regions and
26    specialize in specific research and training areas, such as

 

 

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1    telehealth or mental health-criminal justice partnerships,
2    for which the regional hub can serve as a statewide leader.
3    (d) The Board of Higher Education may adopt such rules as
4may be necessary to implement and administer this Section.
 
5
Title VI. Access to Health Care

 
6
Article 70.

 
7    Section 70-5. The Use Tax Act is amended by changing
8Section 3-10 as follows:
 
9    (35 ILCS 105/3-10)
10    Sec. 3-10. Rate of tax. Unless otherwise provided in this
11Section, the tax imposed by this Act is at the rate of 6.25% of
12either the selling price or the fair market value, if any, of
13the tangible personal property. In all cases where property
14functionally used or consumed is the same as the property that
15was purchased at retail, then the tax is imposed on the selling
16price of the property. In all cases where property functionally
17used or consumed is a by-product or waste product that has been
18refined, manufactured, or produced from property purchased at
19retail, then the tax is imposed on the lower of the fair market
20value, if any, of the specific property so used in this State
21or on the selling price of the property purchased at retail.
22For purposes of this Section "fair market value" means the

 

 

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1price at which property would change hands between a willing
2buyer and a willing seller, neither being under any compulsion
3to buy or sell and both having reasonable knowledge of the
4relevant facts. The fair market value shall be established by
5Illinois sales by the taxpayer of the same property as that
6functionally used or consumed, or if there are no such sales by
7the taxpayer, then comparable sales or purchases of property of
8like kind and character in Illinois.
9    Beginning on July 1, 2000 and through December 31, 2000,
10with respect to motor fuel, as defined in Section 1.1 of the
11Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
12the Use Tax Act, the tax is imposed at the rate of 1.25%.
13    Beginning on August 6, 2010 through August 15, 2010, with
14respect to sales tax holiday items as defined in Section 3-6 of
15this Act, the tax is imposed at the rate of 1.25%.
16    With respect to gasohol, the tax imposed by this Act
17applies to (i) 70% of the proceeds of sales made on or after
18January 1, 1990, and before July 1, 2003, (ii) 80% of the
19proceeds of sales made on or after July 1, 2003 and on or
20before July 1, 2017, and (iii) 100% of the proceeds of sales
21made thereafter. If, at any time, however, the tax under this
22Act on sales of gasohol is imposed at the rate of 1.25%, then
23the tax imposed by this Act applies to 100% of the proceeds of
24sales of gasohol made during that time.
25    With respect to majority blended ethanol fuel, the tax
26imposed by this Act does not apply to the proceeds of sales

 

 

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1made on or after July 1, 2003 and on or before December 31,
22023 but applies to 100% of the proceeds of sales made
3thereafter.
4    With respect to biodiesel blends with no less than 1% and
5no more than 10% biodiesel, the tax imposed by this Act applies
6to (i) 80% of the proceeds of sales made on or after July 1,
72003 and on or before December 31, 2018 and (ii) 100% of the
8proceeds of sales made thereafter. If, at any time, however,
9the tax under this Act on sales of biodiesel blends with no
10less than 1% and no more than 10% biodiesel is imposed at the
11rate of 1.25%, then the tax imposed by this Act applies to 100%
12of the proceeds of sales of biodiesel blends with no less than
131% and no more than 10% biodiesel made during that time.
14    With respect to 100% biodiesel and biodiesel blends with
15more than 10% but no more than 99% biodiesel, the tax imposed
16by this Act does not apply to the proceeds of sales made on or
17after July 1, 2003 and on or before December 31, 2023 but
18applies to 100% of the proceeds of sales made thereafter.
19    With respect to food for human consumption that is to be
20consumed off the premises where it is sold (other than
21alcoholic beverages, food consisting of or infused with adult
22use cannabis, soft drinks, and food that has been prepared for
23immediate consumption) and prescription and nonprescription
24medicines, drugs, medical appliances, products classified as
25Class III medical devices by the United States Food and Drug
26Administration that are used for cancer treatment pursuant to a

 

 

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1prescription, as well as any accessories and components related
2to those devices, modifications to a motor vehicle for the
3purpose of rendering it usable by a person with a disability,
4and insulin, blood sugar urine testing materials, syringes, and
5needles used by human diabetics, for human use, the tax is
6imposed at the rate of 1%. For the purposes of this Section,
7until September 1, 2009: the term "soft drinks" means any
8complete, finished, ready-to-use, non-alcoholic drink, whether
9carbonated or not, including but not limited to soda water,
10cola, fruit juice, vegetable juice, carbonated water, and all
11other preparations commonly known as soft drinks of whatever
12kind or description that are contained in any closed or sealed
13bottle, can, carton, or container, regardless of size; but
14"soft drinks" does not include coffee, tea, non-carbonated
15water, infant formula, milk or milk products as defined in the
16Grade A Pasteurized Milk and Milk Products Act, or drinks
17containing 50% or more natural fruit or vegetable juice.
18    Notwithstanding any other provisions of this Act,
19beginning September 1, 2009, "soft drinks" means non-alcoholic
20beverages that contain natural or artificial sweeteners. "Soft
21drinks" do not include beverages that contain milk or milk
22products, soy, rice or similar milk substitutes, or greater
23than 50% of vegetable or fruit juice by volume.
24    Until August 1, 2009, and notwithstanding any other
25provisions of this Act, "food for human consumption that is to
26be consumed off the premises where it is sold" includes all

 

 

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1food sold through a vending machine, except soft drinks and
2food products that are dispensed hot from a vending machine,
3regardless of the location of the vending machine. Beginning
4August 1, 2009, and notwithstanding any other provisions of
5this Act, "food for human consumption that is to be consumed
6off the premises where it is sold" includes all food sold
7through a vending machine, except soft drinks, candy, and food
8products that are dispensed hot from a vending machine,
9regardless of the location of the vending machine.
10    Notwithstanding any other provisions of this Act,
11beginning September 1, 2009, "food for human consumption that
12is to be consumed off the premises where it is sold" does not
13include candy. For purposes of this Section, "candy" means a
14preparation of sugar, honey, or other natural or artificial
15sweeteners in combination with chocolate, fruits, nuts or other
16ingredients or flavorings in the form of bars, drops, or
17pieces. "Candy" does not include any preparation that contains
18flour or requires refrigeration.
19    Notwithstanding any other provisions of this Act,
20beginning September 1, 2009, "nonprescription medicines and
21drugs" does not include grooming and hygiene products. For
22purposes of this Section, "grooming and hygiene products"
23includes, but is not limited to, soaps and cleaning solutions,
24shampoo, toothpaste, mouthwash, antiperspirants, and sun tan
25lotions and screens, unless those products are available by
26prescription only, regardless of whether the products meet the

 

 

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1definition of "over-the-counter-drugs". For the purposes of
2this paragraph, "over-the-counter-drug" means a drug for human
3use that contains a label that identifies the product as a drug
4as required by 21 C.F.R. 201.66. The "over-the-counter-drug"
5label includes:
6        (A) A "Drug Facts" panel; or
7        (B) A statement of the "active ingredient(s)" with a
8    list of those ingredients contained in the compound,
9    substance or preparation.
10    Beginning on the effective date of this amendatory Act of
11the 98th General Assembly, "prescription and nonprescription
12medicines and drugs" includes medical cannabis purchased from a
13registered dispensing organization under the Compassionate Use
14of Medical Cannabis Program Act.
15    As used in this Section, "adult use cannabis" means
16cannabis subject to tax under the Cannabis Cultivation
17Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
18does not include cannabis subject to tax under the
19Compassionate Use of Medical Cannabis Program Act.
20    If the property that is purchased at retail from a retailer
21is acquired outside Illinois and used outside Illinois before
22being brought to Illinois for use here and is taxable under
23this Act, the "selling price" on which the tax is computed
24shall be reduced by an amount that represents a reasonable
25allowance for depreciation for the period of prior out-of-state
26use.

 

 

10100HB3840sam001- 85 -LRB101 12454 CPF 74517 a

1(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
2101-593, eff. 12-4-19.)
 
3    Section 70-10. The Service Use Tax Act is amended by
4changing Section 3-10 as follows:
 
5    (35 ILCS 110/3-10)  (from Ch. 120, par. 439.33-10)
6    Sec. 3-10. Rate of tax. Unless otherwise provided in this
7Section, the tax imposed by this Act is at the rate of 6.25% of
8the selling price of tangible personal property transferred as
9an incident to the sale of service, but, for the purpose of
10computing this tax, in no event shall the selling price be less
11than the cost price of the property to the serviceman.
12    Beginning on July 1, 2000 and through December 31, 2000,
13with respect to motor fuel, as defined in Section 1.1 of the
14Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
15the Use Tax Act, the tax is imposed at the rate of 1.25%.
16    With respect to gasohol, as defined in the Use Tax Act, the
17tax imposed by this Act applies to (i) 70% of the selling price
18of property transferred as an incident to the sale of service
19on or after January 1, 1990, and before July 1, 2003, (ii) 80%
20of the selling price of property transferred as an incident to
21the sale of service on or after July 1, 2003 and on or before
22July 1, 2017, and (iii) 100% of the selling price thereafter.
23If, at any time, however, the tax under this Act on sales of
24gasohol, as defined in the Use Tax Act, is imposed at the rate

 

 

10100HB3840sam001- 86 -LRB101 12454 CPF 74517 a

1of 1.25%, then the tax imposed by this Act applies to 100% of
2the proceeds of sales of gasohol made during that time.
3    With respect to majority blended ethanol fuel, as defined
4in the Use Tax Act, the tax imposed by this Act does not apply
5to the selling price of property transferred as an incident to
6the sale of service on or after July 1, 2003 and on or before
7December 31, 2023 but applies to 100% of the selling price
8thereafter.
9    With respect to biodiesel blends, as defined in the Use Tax
10Act, with no less than 1% and no more than 10% biodiesel, the
11tax imposed by this Act applies to (i) 80% of the selling price
12of property transferred as an incident to the sale of service
13on or after July 1, 2003 and on or before December 31, 2018 and
14(ii) 100% of the proceeds of the selling price thereafter. If,
15at any time, however, the tax under this Act on sales of
16biodiesel blends, as defined in the Use Tax Act, with no less
17than 1% and no more than 10% biodiesel is imposed at the rate
18of 1.25%, then the tax imposed by this Act applies to 100% of
19the proceeds of sales of biodiesel blends with no less than 1%
20and no more than 10% biodiesel made during that time.
21    With respect to 100% biodiesel, as defined in the Use Tax
22Act, and biodiesel blends, as defined in the Use Tax Act, with
23more than 10% but no more than 99% biodiesel, the tax imposed
24by this Act does not apply to the proceeds of the selling price
25of property transferred as an incident to the sale of service
26on or after July 1, 2003 and on or before December 31, 2023 but

 

 

10100HB3840sam001- 87 -LRB101 12454 CPF 74517 a

1applies to 100% of the selling price thereafter.
2    At the election of any registered serviceman made for each
3fiscal year, sales of service in which the aggregate annual
4cost price of tangible personal property transferred as an
5incident to the sales of service is less than 35%, or 75% in
6the case of servicemen transferring prescription drugs or
7servicemen engaged in graphic arts production, of the aggregate
8annual total gross receipts from all sales of service, the tax
9imposed by this Act shall be based on the serviceman's cost
10price of the tangible personal property transferred as an
11incident to the sale of those services.
12    The tax shall be imposed at the rate of 1% on food prepared
13for immediate consumption and transferred incident to a sale of
14service subject to this Act or the Service Occupation Tax Act
15by an entity licensed under the Hospital Licensing Act, the
16Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD
17Act, the Specialized Mental Health Rehabilitation Act of 2013,
18or the Child Care Act of 1969. The tax shall also be imposed at
19the rate of 1% on food for human consumption that is to be
20consumed off the premises where it is sold (other than
21alcoholic beverages, food consisting of or infused with adult
22use cannabis, soft drinks, and food that has been prepared for
23immediate consumption and is not otherwise included in this
24paragraph) and prescription and nonprescription medicines,
25drugs, medical appliances, products classified as Class III
26medical devices by the United States Food and Drug

 

 

10100HB3840sam001- 88 -LRB101 12454 CPF 74517 a

1Administration that are used for cancer treatment pursuant to a
2prescription, as well as any accessories and components related
3to those devices, modifications to a motor vehicle for the
4purpose of rendering it usable by a person with a disability,
5and insulin, blood sugar urine testing materials, syringes, and
6needles used by human diabetics, for human use. For the
7purposes of this Section, until September 1, 2009: the term
8"soft drinks" means any complete, finished, ready-to-use,
9non-alcoholic drink, whether carbonated or not, including but
10not limited to soda water, cola, fruit juice, vegetable juice,
11carbonated water, and all other preparations commonly known as
12soft drinks of whatever kind or description that are contained
13in any closed or sealed bottle, can, carton, or container,
14regardless of size; but "soft drinks" does not include coffee,
15tea, non-carbonated water, infant formula, milk or milk
16products as defined in the Grade A Pasteurized Milk and Milk
17Products Act, or drinks containing 50% or more natural fruit or
18vegetable juice.
19    Notwithstanding any other provisions of this Act,
20beginning September 1, 2009, "soft drinks" means non-alcoholic
21beverages that contain natural or artificial sweeteners. "Soft
22drinks" do not include beverages that contain milk or milk
23products, soy, rice or similar milk substitutes, or greater
24than 50% of vegetable or fruit juice by volume.
25    Until August 1, 2009, and notwithstanding any other
26provisions of this Act, "food for human consumption that is to

 

 

10100HB3840sam001- 89 -LRB101 12454 CPF 74517 a

1be consumed off the premises where it is sold" includes all
2food sold through a vending machine, except soft drinks and
3food products that are dispensed hot from a vending machine,
4regardless of the location of the vending machine. Beginning
5August 1, 2009, and notwithstanding any other provisions of
6this Act, "food for human consumption that is to be consumed
7off the premises where it is sold" includes all food sold
8through a vending machine, except soft drinks, candy, and food
9products that are dispensed hot from a vending machine,
10regardless of the location of the vending machine.
11    Notwithstanding any other provisions of this Act,
12beginning September 1, 2009, "food for human consumption that
13is to be consumed off the premises where it is sold" does not
14include candy. For purposes of this Section, "candy" means a
15preparation of sugar, honey, or other natural or artificial
16sweeteners in combination with chocolate, fruits, nuts or other
17ingredients or flavorings in the form of bars, drops, or
18pieces. "Candy" does not include any preparation that contains
19flour or requires refrigeration.
20    Notwithstanding any other provisions of this Act,
21beginning September 1, 2009, "nonprescription medicines and
22drugs" does not include grooming and hygiene products. For
23purposes of this Section, "grooming and hygiene products"
24includes, but is not limited to, soaps and cleaning solutions,
25shampoo, toothpaste, mouthwash, antiperspirants, and sun tan
26lotions and screens, unless those products are available by

 

 

10100HB3840sam001- 90 -LRB101 12454 CPF 74517 a

1prescription only, regardless of whether the products meet the
2definition of "over-the-counter-drugs". For the purposes of
3this paragraph, "over-the-counter-drug" means a drug for human
4use that contains a label that identifies the product as a drug
5as required by 21 C.F.R. 201.66. The "over-the-counter-drug"
6label includes:
7        (A) A "Drug Facts" panel; or
8        (B) A statement of the "active ingredient(s)" with a
9    list of those ingredients contained in the compound,
10    substance or preparation.
11    Beginning on January 1, 2014 (the effective date of Public
12Act 98-122), "prescription and nonprescription medicines and
13drugs" includes medical cannabis purchased from a registered
14dispensing organization under the Compassionate Use of Medical
15Cannabis Program Act.
16    As used in this Section, "adult use cannabis" means
17cannabis subject to tax under the Cannabis Cultivation
18Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
19does not include cannabis subject to tax under the
20Compassionate Use of Medical Cannabis Program Act.
21    If the property that is acquired from a serviceman is
22acquired outside Illinois and used outside Illinois before
23being brought to Illinois for use here and is taxable under
24this Act, the "selling price" on which the tax is computed
25shall be reduced by an amount that represents a reasonable
26allowance for depreciation for the period of prior out-of-state

 

 

10100HB3840sam001- 91 -LRB101 12454 CPF 74517 a

1use.
2(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
3101-593, eff. 12-4-19.)
 
4    Section 70-15. The Service Occupation Tax Act is amended by
5changing Section 3-10 as follows:
 
6    (35 ILCS 115/3-10)  (from Ch. 120, par. 439.103-10)
7    Sec. 3-10. Rate of tax. Unless otherwise provided in this
8Section, the tax imposed by this Act is at the rate of 6.25% of
9the "selling price", as defined in Section 2 of the Service Use
10Tax Act, of the tangible personal property. For the purpose of
11computing this tax, in no event shall the "selling price" be
12less than the cost price to the serviceman of the tangible
13personal property transferred. The selling price of each item
14of tangible personal property transferred as an incident of a
15sale of service may be shown as a distinct and separate item on
16the serviceman's billing to the service customer. If the
17selling price is not so shown, the selling price of the
18tangible personal property is deemed to be 50% of the
19serviceman's entire billing to the service customer. When,
20however, a serviceman contracts to design, develop, and produce
21special order machinery or equipment, the tax imposed by this
22Act shall be based on the serviceman's cost price of the
23tangible personal property transferred incident to the
24completion of the contract.

 

 

10100HB3840sam001- 92 -LRB101 12454 CPF 74517 a

1    Beginning on July 1, 2000 and through December 31, 2000,
2with respect to motor fuel, as defined in Section 1.1 of the
3Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
4the Use Tax Act, the tax is imposed at the rate of 1.25%.
5    With respect to gasohol, as defined in the Use Tax Act, the
6tax imposed by this Act shall apply to (i) 70% of the cost
7price of property transferred as an incident to the sale of
8service on or after January 1, 1990, and before July 1, 2003,
9(ii) 80% of the selling price of property transferred as an
10incident to the sale of service on or after July 1, 2003 and on
11or before July 1, 2017, and (iii) 100% of the cost price
12thereafter. If, at any time, however, the tax under this Act on
13sales of gasohol, as defined in the Use Tax Act, is imposed at
14the rate of 1.25%, then the tax imposed by this Act applies to
15100% of the proceeds of sales of gasohol made during that time.
16    With respect to majority blended ethanol fuel, as defined
17in the Use Tax Act, the tax imposed by this Act does not apply
18to the selling price of property transferred as an incident to
19the sale of service on or after July 1, 2003 and on or before
20December 31, 2023 but applies to 100% of the selling price
21thereafter.
22    With respect to biodiesel blends, as defined in the Use Tax
23Act, with no less than 1% and no more than 10% biodiesel, the
24tax imposed by this Act applies to (i) 80% of the selling price
25of property transferred as an incident to the sale of service
26on or after July 1, 2003 and on or before December 31, 2018 and

 

 

10100HB3840sam001- 93 -LRB101 12454 CPF 74517 a

1(ii) 100% of the proceeds of the selling price thereafter. If,
2at any time, however, the tax under this Act on sales of
3biodiesel blends, as defined in the Use Tax Act, with no less
4than 1% and no more than 10% biodiesel is imposed at the rate
5of 1.25%, then the tax imposed by this Act applies to 100% of
6the proceeds of sales of biodiesel blends with no less than 1%
7and no more than 10% biodiesel made during that time.
8    With respect to 100% biodiesel, as defined in the Use Tax
9Act, and biodiesel blends, as defined in the Use Tax Act, with
10more than 10% but no more than 99% biodiesel material, the tax
11imposed by this Act does not apply to the proceeds of the
12selling price of property transferred as an incident to the
13sale of service on or after July 1, 2003 and on or before
14December 31, 2023 but applies to 100% of the selling price
15thereafter.
16    At the election of any registered serviceman made for each
17fiscal year, sales of service in which the aggregate annual
18cost price of tangible personal property transferred as an
19incident to the sales of service is less than 35%, or 75% in
20the case of servicemen transferring prescription drugs or
21servicemen engaged in graphic arts production, of the aggregate
22annual total gross receipts from all sales of service, the tax
23imposed by this Act shall be based on the serviceman's cost
24price of the tangible personal property transferred incident to
25the sale of those services.
26    The tax shall be imposed at the rate of 1% on food prepared

 

 

10100HB3840sam001- 94 -LRB101 12454 CPF 74517 a

1for immediate consumption and transferred incident to a sale of
2service subject to this Act or the Service Occupation Tax Act
3by an entity licensed under the Hospital Licensing Act, the
4Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD
5Act, the Specialized Mental Health Rehabilitation Act of 2013,
6or the Child Care Act of 1969. The tax shall also be imposed at
7the rate of 1% on food for human consumption that is to be
8consumed off the premises where it is sold (other than
9alcoholic beverages, food consisting of or infused with adult
10use cannabis, soft drinks, and food that has been prepared for
11immediate consumption and is not otherwise included in this
12paragraph) and prescription and nonprescription medicines,
13drugs, medical appliances, products classified as Class III
14medical devices by the United States Food and Drug
15Administration that are used for cancer treatment pursuant to a
16prescription, as well as any accessories and components related
17to those devices, modifications to a motor vehicle for the
18purpose of rendering it usable by a person with a disability,
19and insulin, blood sugar urine testing materials, syringes, and
20needles used by human diabetics, for human use. For the
21purposes of this Section, until September 1, 2009: the term
22"soft drinks" means any complete, finished, ready-to-use,
23non-alcoholic drink, whether carbonated or not, including but
24not limited to soda water, cola, fruit juice, vegetable juice,
25carbonated water, and all other preparations commonly known as
26soft drinks of whatever kind or description that are contained

 

 

10100HB3840sam001- 95 -LRB101 12454 CPF 74517 a

1in any closed or sealed can, carton, or container, regardless
2of size; but "soft drinks" does not include coffee, tea,
3non-carbonated water, infant formula, milk or milk products as
4defined in the Grade A Pasteurized Milk and Milk Products Act,
5or drinks containing 50% or more natural fruit or vegetable
6juice.
7    Notwithstanding any other provisions of this Act,
8beginning September 1, 2009, "soft drinks" means non-alcoholic
9beverages that contain natural or artificial sweeteners. "Soft
10drinks" do not include beverages that contain milk or milk
11products, soy, rice or similar milk substitutes, or greater
12than 50% of vegetable or fruit juice by volume.
13    Until August 1, 2009, and notwithstanding any other
14provisions of this Act, "food for human consumption that is to
15be consumed off the premises where it is sold" includes all
16food sold through a vending machine, except soft drinks and
17food products that are dispensed hot from a vending machine,
18regardless of the location of the vending machine. Beginning
19August 1, 2009, and notwithstanding any other provisions of
20this Act, "food for human consumption that is to be consumed
21off the premises where it is sold" includes all food sold
22through a vending machine, except soft drinks, candy, and food
23products that are dispensed hot from a vending machine,
24regardless of the location of the vending machine.
25    Notwithstanding any other provisions of this Act,
26beginning September 1, 2009, "food for human consumption that

 

 

10100HB3840sam001- 96 -LRB101 12454 CPF 74517 a

1is to be consumed off the premises where it is sold" does not
2include candy. For purposes of this Section, "candy" means a
3preparation of sugar, honey, or other natural or artificial
4sweeteners in combination with chocolate, fruits, nuts or other
5ingredients or flavorings in the form of bars, drops, or
6pieces. "Candy" does not include any preparation that contains
7flour or requires refrigeration.
8    Notwithstanding any other provisions of this Act,
9beginning September 1, 2009, "nonprescription medicines and
10drugs" does not include grooming and hygiene products. For
11purposes of this Section, "grooming and hygiene products"
12includes, but is not limited to, soaps and cleaning solutions,
13shampoo, toothpaste, mouthwash, antiperspirants, and sun tan
14lotions and screens, unless those products are available by
15prescription only, regardless of whether the products meet the
16definition of "over-the-counter-drugs". For the purposes of
17this paragraph, "over-the-counter-drug" means a drug for human
18use that contains a label that identifies the product as a drug
19as required by 21 C.F.R. 201.66. The "over-the-counter-drug"
20label includes:
21        (A) A "Drug Facts" panel; or
22        (B) A statement of the "active ingredient(s)" with a
23    list of those ingredients contained in the compound,
24    substance or preparation.
25    Beginning on January 1, 2014 (the effective date of Public
26Act 98-122), "prescription and nonprescription medicines and

 

 

10100HB3840sam001- 97 -LRB101 12454 CPF 74517 a

1drugs" includes medical cannabis purchased from a registered
2dispensing organization under the Compassionate Use of Medical
3Cannabis Program Act.
4    As used in this Section, "adult use cannabis" means
5cannabis subject to tax under the Cannabis Cultivation
6Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
7does not include cannabis subject to tax under the
8Compassionate Use of Medical Cannabis Program Act.
9(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
10101-593, eff. 12-4-19.)
 
11    Section 70-20. The Retailers' Occupation Tax Act is amended
12by changing Section 2-10 as follows:
 
13    (35 ILCS 120/2-10)
14    Sec. 2-10. Rate of tax. Unless otherwise provided in this
15Section, the tax imposed by this Act is at the rate of 6.25% of
16gross receipts from sales of tangible personal property made in
17the course of business.
18    Beginning on July 1, 2000 and through December 31, 2000,
19with respect to motor fuel, as defined in Section 1.1 of the
20Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
21the Use Tax Act, the tax is imposed at the rate of 1.25%.
22    Beginning on August 6, 2010 through August 15, 2010, with
23respect to sales tax holiday items as defined in Section 2-8 of
24this Act, the tax is imposed at the rate of 1.25%.

 

 

10100HB3840sam001- 98 -LRB101 12454 CPF 74517 a

1    Within 14 days after the effective date of this amendatory
2Act of the 91st General Assembly, each retailer of motor fuel
3and gasohol shall cause the following notice to be posted in a
4prominently visible place on each retail dispensing device that
5is used to dispense motor fuel or gasohol in the State of
6Illinois: "As of July 1, 2000, the State of Illinois has
7eliminated the State's share of sales tax on motor fuel and
8gasohol through December 31, 2000. The price on this pump
9should reflect the elimination of the tax." The notice shall be
10printed in bold print on a sign that is no smaller than 4
11inches by 8 inches. The sign shall be clearly visible to
12customers. Any retailer who fails to post or maintain a
13required sign through December 31, 2000 is guilty of a petty
14offense for which the fine shall be $500 per day per each
15retail premises where a violation occurs.
16    With respect to gasohol, as defined in the Use Tax Act, the
17tax imposed by this Act applies to (i) 70% of the proceeds of
18sales made on or after January 1, 1990, and before July 1,
192003, (ii) 80% of the proceeds of sales made on or after July
201, 2003 and on or before July 1, 2017, and (iii) 100% of the
21proceeds of sales made thereafter. If, at any time, however,
22the tax under this Act on sales of gasohol, as defined in the
23Use Tax Act, is imposed at the rate of 1.25%, then the tax
24imposed by this Act applies to 100% of the proceeds of sales of
25gasohol made during that time.
26    With respect to majority blended ethanol fuel, as defined

 

 

10100HB3840sam001- 99 -LRB101 12454 CPF 74517 a

1in the Use Tax Act, the tax imposed by this Act does not apply
2to the proceeds of sales made on or after July 1, 2003 and on or
3before December 31, 2023 but applies to 100% of the proceeds of
4sales made thereafter.
5    With respect to biodiesel blends, as defined in the Use Tax
6Act, with no less than 1% and no more than 10% biodiesel, the
7tax imposed by this Act applies to (i) 80% of the proceeds of
8sales made on or after July 1, 2003 and on or before December
931, 2018 and (ii) 100% of the proceeds of sales made
10thereafter. If, at any time, however, the tax under this Act on
11sales of biodiesel blends, as defined in the Use Tax Act, with
12no less than 1% and no more than 10% biodiesel is imposed at
13the rate of 1.25%, then the tax imposed by this Act applies to
14100% of the proceeds of sales of biodiesel blends with no less
15than 1% and no more than 10% biodiesel made during that time.
16    With respect to 100% biodiesel, as defined in the Use Tax
17Act, and biodiesel blends, as defined in the Use Tax Act, with
18more than 10% but no more than 99% biodiesel, the tax imposed
19by this Act does not apply to the proceeds of sales made on or
20after July 1, 2003 and on or before December 31, 2023 but
21applies to 100% of the proceeds of sales made thereafter.
22    With respect to food for human consumption that is to be
23consumed off the premises where it is sold (other than
24alcoholic beverages, food consisting of or infused with adult
25use cannabis, soft drinks, and food that has been prepared for
26immediate consumption) and prescription and nonprescription

 

 

10100HB3840sam001- 100 -LRB101 12454 CPF 74517 a

1medicines, drugs, medical appliances, products classified as
2Class III medical devices by the United States Food and Drug
3Administration that are used for cancer treatment pursuant to a
4prescription, as well as any accessories and components related
5to those devices, modifications to a motor vehicle for the
6purpose of rendering it usable by a person with a disability,
7and insulin, blood sugar urine testing materials, syringes, and
8needles used by human diabetics, for human use, the tax is
9imposed at the rate of 1%. For the purposes of this Section,
10until September 1, 2009: the term "soft drinks" means any
11complete, finished, ready-to-use, non-alcoholic drink, whether
12carbonated or not, including but not limited to soda water,
13cola, fruit juice, vegetable juice, carbonated water, and all
14other preparations commonly known as soft drinks of whatever
15kind or description that are contained in any closed or sealed
16bottle, can, carton, or container, regardless of size; but
17"soft drinks" does not include coffee, tea, non-carbonated
18water, infant formula, milk or milk products as defined in the
19Grade A Pasteurized Milk and Milk Products Act, or drinks
20containing 50% or more natural fruit or vegetable juice.
21    Notwithstanding any other provisions of this Act,
22beginning September 1, 2009, "soft drinks" means non-alcoholic
23beverages that contain natural or artificial sweeteners. "Soft
24drinks" do not include beverages that contain milk or milk
25products, soy, rice or similar milk substitutes, or greater
26than 50% of vegetable or fruit juice by volume.

 

 

10100HB3840sam001- 101 -LRB101 12454 CPF 74517 a

1    Until August 1, 2009, and notwithstanding any other
2provisions of this Act, "food for human consumption that is to
3be consumed off the premises where it is sold" includes all
4food sold through a vending machine, except soft drinks and
5food products that are dispensed hot from a vending machine,
6regardless of the location of the vending machine. Beginning
7August 1, 2009, and notwithstanding any other provisions of
8this Act, "food for human consumption that is to be consumed
9off the premises where it is sold" includes all food sold
10through a vending machine, except soft drinks, candy, and food
11products that are dispensed hot from a vending machine,
12regardless of the location of the vending machine.
13    Notwithstanding any other provisions of this Act,
14beginning September 1, 2009, "food for human consumption that
15is to be consumed off the premises where it is sold" does not
16include candy. For purposes of this Section, "candy" means a
17preparation of sugar, honey, or other natural or artificial
18sweeteners in combination with chocolate, fruits, nuts or other
19ingredients or flavorings in the form of bars, drops, or
20pieces. "Candy" does not include any preparation that contains
21flour or requires refrigeration.
22    Notwithstanding any other provisions of this Act,
23beginning September 1, 2009, "nonprescription medicines and
24drugs" does not include grooming and hygiene products. For
25purposes of this Section, "grooming and hygiene products"
26includes, but is not limited to, soaps and cleaning solutions,

 

 

10100HB3840sam001- 102 -LRB101 12454 CPF 74517 a

1shampoo, toothpaste, mouthwash, antiperspirants, and sun tan
2lotions and screens, unless those products are available by
3prescription only, regardless of whether the products meet the
4definition of "over-the-counter-drugs". For the purposes of
5this paragraph, "over-the-counter-drug" means a drug for human
6use that contains a label that identifies the product as a drug
7as required by 21 C.F.R. 201.66. The "over-the-counter-drug"
8label includes:
9        (A) A "Drug Facts" panel; or
10        (B) A statement of the "active ingredient(s)" with a
11    list of those ingredients contained in the compound,
12    substance or preparation.
13    Beginning on the effective date of this amendatory Act of
14the 98th General Assembly, "prescription and nonprescription
15medicines and drugs" includes medical cannabis purchased from a
16registered dispensing organization under the Compassionate Use
17of Medical Cannabis Program Act.
18    As used in this Section, "adult use cannabis" means
19cannabis subject to tax under the Cannabis Cultivation
20Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
21does not include cannabis subject to tax under the
22Compassionate Use of Medical Cannabis Program Act.
23(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
24101-593, eff. 12-4-19.)
 
25
Article 75.

 

 

 

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1    Section 75-5. The Illinois Public Aid Code is amended by
2changing Section 9A-11 as follows:
 
3    (305 ILCS 5/9A-11)  (from Ch. 23, par. 9A-11)
4    Sec. 9A-11. Child care.
5    (a) The General Assembly recognizes that families with
6children need child care in order to work. Child care is
7expensive and families with low incomes, including those who
8are transitioning from welfare to work, often struggle to pay
9the costs of day care. The General Assembly understands the
10importance of helping low-income working families become and
11remain self-sufficient. The General Assembly also believes
12that it is the responsibility of families to share in the costs
13of child care. It is also the preference of the General
14Assembly that all working poor families should be treated
15equally, regardless of their welfare status.
16    (b) To the extent resources permit, the Illinois Department
17shall provide child care services to parents or other relatives
18as defined by rule who are working or participating in
19employment or Department approved education or training
20programs. At a minimum, the Illinois Department shall cover the
21following categories of families:
22        (1) recipients of TANF under Article IV participating
23    in work and training activities as specified in the
24    personal plan for employment and self-sufficiency;

 

 

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1        (2) families transitioning from TANF to work;
2        (3) families at risk of becoming recipients of TANF;
3        (4) families with special needs as defined by rule;
4        (5) working families with very low incomes as defined
5    by rule;
6        (6) families that are not recipients of TANF and that
7    need child care assistance to participate in education and
8    training activities; and
9        (7) families with children under the age of 5 who have
10    an open intact family services case with the Department of
11    Children and Family Services. Any family that receives
12    child care assistance in accordance with this paragraph
13    shall remain eligible for child care assistance 6 months
14    after the child's intact family services case is closed,
15    regardless of whether the child's parents or other
16    relatives as defined by rule are working or participating
17    in Department approved employment or education or training
18    programs. The Department of Human Services, in
19    consultation with the Department of Children and Family
20    Services, shall adopt rules to protect the privacy of
21    families who are the subject of an open intact family
22    services case when such families enroll in child care
23    services. Additional rules shall be adopted to offer
24    children who have an open intact family services case the
25    opportunity to receive an Early Intervention screening and
26    other services that their families may be eligible for as

 

 

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1    provided by the Department of Human Services.
2    The Department shall specify by rule the conditions of
3eligibility, the application process, and the types, amounts,
4and duration of services. Eligibility for child care benefits
5and the amount of child care provided may vary based on family
6size, income, and other factors as specified by rule.
7    The Department shall update the Child Care Assistance
8Program Eligibility Calculator posted on its website to include
9a question on whether a family is applying for child care
10assistance for the first time or is applying for a
11redetermination of eligibility.
12    A family's eligibility for child care services shall be
13redetermined no sooner than 12 months following the initial
14determination or most recent redetermination. During the
1512-month periods, the family shall remain eligible for child
16care services regardless of (i) a change in family income,
17unless family income exceeds 85% of State median income, or
18(ii) a temporary change in the ongoing status of the parents or
19other relatives, as defined by rule, as working or attending a
20job training or educational program.
21    In determining income eligibility for child care benefits,
22the Department annually, at the beginning of each fiscal year,
23shall establish, by rule, one income threshold for each family
24size, in relation to percentage of State median income for a
25family of that size, that makes families with incomes below the
26specified threshold eligible for assistance and families with

 

 

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1incomes above the specified threshold ineligible for
2assistance. Through and including fiscal year 2007, the
3specified threshold must be no less than 50% of the
4then-current State median income for each family size.
5Beginning in fiscal year 2008, the specified threshold must be
6no less than 185% of the then-current federal poverty level for
7each family size. Notwithstanding any other provision of law or
8administrative rule to the contrary, beginning in fiscal year
92019, the specified threshold for working families with very
10low incomes as defined by rule must be no less than 185% of the
11then-current federal poverty level for each family size.
12    In determining eligibility for assistance, the Department
13shall not give preference to any category of recipients or give
14preference to individuals based on their receipt of benefits
15under this Code.
16    Nothing in this Section shall be construed as conferring
17entitlement status to eligible families.
18    The Illinois Department is authorized to lower income
19eligibility ceilings, raise parent co-payments, create waiting
20lists, or take such other actions during a fiscal year as are
21necessary to ensure that child care benefits paid under this
22Article do not exceed the amounts appropriated for those child
23care benefits. These changes may be accomplished by emergency
24rule under Section 5-45 of the Illinois Administrative
25Procedure Act, except that the limitation on the number of
26emergency rules that may be adopted in a 24-month period shall

 

 

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1not apply.
2    The Illinois Department may contract with other State
3agencies or child care organizations for the administration of
4child care services.
5    (c) Payment shall be made for child care that otherwise
6meets the requirements of this Section and applicable standards
7of State and local law and regulation, including any
8requirements the Illinois Department promulgates by rule in
9addition to the licensure requirements promulgated by the
10Department of Children and Family Services and Fire Prevention
11and Safety requirements promulgated by the Office of the State
12Fire Marshal, and is provided in any of the following:
13        (1) a child care center which is licensed or exempt
14    from licensure pursuant to Section 2.09 of the Child Care
15    Act of 1969;
16        (2) a licensed child care home or home exempt from
17    licensing;
18        (3) a licensed group child care home;
19        (4) other types of child care, including child care
20    provided by relatives or persons living in the same home as
21    the child, as determined by the Illinois Department by
22    rule.
23    (c-5) Solely for the purposes of coverage under the
24Illinois Public Labor Relations Act, child and day care home
25providers, including licensed and license exempt,
26participating in the Department's child care assistance

 

 

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1program shall be considered to be public employees and the
2State of Illinois shall be considered to be their employer as
3of January 1, 2006 (the effective date of Public Act 94-320),
4but not before. The State shall engage in collective bargaining
5with an exclusive representative of child and day care home
6providers participating in the child care assistance program
7concerning their terms and conditions of employment that are
8within the State's control. Nothing in this subsection shall be
9understood to limit the right of families receiving services
10defined in this Section to select child and day care home
11providers or supervise them within the limits of this Section.
12The State shall not be considered to be the employer of child
13and day care home providers for any purposes not specifically
14provided in Public Act 94-320, including, but not limited to,
15purposes of vicarious liability in tort and purposes of
16statutory retirement or health insurance benefits. Child and
17day care home providers shall not be covered by the State
18Employees Group Insurance Act of 1971.
19    In according child and day care home providers and their
20selected representative rights under the Illinois Public Labor
21Relations Act, the State intends that the State action
22exemption to application of federal and State antitrust laws be
23fully available to the extent that their activities are
24authorized by Public Act 94-320.
25    (d) The Illinois Department shall establish, by rule, a
26co-payment scale that provides for cost sharing by families

 

 

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1that receive child care services, including parents whose only
2income is from assistance under this Code. The co-payment shall
3be based on family income and family size and may be based on
4other factors as appropriate. Co-payments may be waived for
5families whose incomes are at or below the federal poverty
6level.
7    (d-5) The Illinois Department, in consultation with its
8Child Care and Development Advisory Council, shall develop a
9plan to revise the child care assistance program's co-payment
10scale. The plan shall be completed no later than February 1,
112008, and shall include:
12        (1) findings as to the percentage of income that the
13    average American family spends on child care and the
14    relative amounts that low-income families and the average
15    American family spend on other necessities of life;
16        (2) recommendations for revising the child care
17    co-payment scale to assure that families receiving child
18    care services from the Department are paying no more than
19    they can reasonably afford;
20        (3) recommendations for revising the child care
21    co-payment scale to provide at-risk children with complete
22    access to Preschool for All and Head Start; and
23        (4) recommendations for changes in child care program
24    policies that affect the affordability of child care.
25    (e) (Blank).
26    (f) The Illinois Department shall, by rule, set rates to be

 

 

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1paid for the various types of child care. Child care may be
2provided through one of the following methods:
3        (1) arranging the child care through eligible
4    providers by use of purchase of service contracts or
5    vouchers;
6        (2) arranging with other agencies and community
7    volunteer groups for non-reimbursed child care;
8        (3) (blank); or
9        (4) adopting such other arrangements as the Department
10    determines appropriate.
11    (f-1) Within 30 days after June 4, 2018 (the effective date
12of Public Act 100-587), the Department of Human Services shall
13establish rates for child care providers that are no less than
14the rates in effect on January 1, 2018 increased by 4.26%.
15    (f-5) (Blank).
16    (g) Families eligible for assistance under this Section
17shall be given the following options:
18        (1) receiving a child care certificate issued by the
19    Department or a subcontractor of the Department that may be
20    used by the parents as payment for child care and
21    development services only; or
22        (2) if space is available, enrolling the child with a
23    child care provider that has a purchase of service contract
24    with the Department or a subcontractor of the Department
25    for the provision of child care and development services.
26    The Department may identify particular priority

 

 

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1    populations for whom they may request special
2    consideration by a provider with purchase of service
3    contracts, provided that the providers shall be permitted
4    to maintain a balance of clients in terms of household
5    incomes and families and children with special needs, as
6    defined by rule.
7(Source: P.A. 100-387, eff. 8-25-17; 100-587, eff. 6-4-18;
8100-860, eff. 2-14-19; 100-909, eff. 10-1-18; 100-916, eff.
98-17-18; 101-81, eff. 7-12-19.)
 
10
Article 80.

 
11    Section 80-5. The Employee Sick Leave Act is amended by
12changing Sections 5 and 10 as follows:
 
13    (820 ILCS 191/5)
14    Sec. 5. Definitions. In this Act:
15    "Department" means the Department of Labor.
16    "Personal sick leave benefits" means any paid or unpaid
17time available to an employee as provided through an employment
18benefit plan or paid time off policy to be used as a result of
19absence from work due to personal illness, injury, or medical
20appointment or for the personal care of a parent,
21mother-in-law, father-in-law, grandparent, or stepparent. An
22employment benefit plan or paid time off policy does not
23include long term disability, short term disability, an

 

 

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1insurance policy, or other comparable benefit plan or policy.
2(Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)
 
3    (820 ILCS 191/10)
4    Sec. 10. Use of leave; limitations.
5    (a) An employee may use personal sick leave benefits
6provided by the employer for absences due to an illness,
7injury, or medical appointment of the employee's child,
8stepchild, spouse, domestic partner, sibling, parent,
9mother-in-law, father-in-law, grandchild, grandparent, or
10stepparent, or for the personal care of a parent,
11mother-in-law, father-in-law, grandparent, or stepparent on
12the same terms upon which the employee is able to use personal
13sick leave benefits for the employee's own illness or injury.
14An employer may request written verification of the employee's
15absence from a health care professional if such verification is
16required under the employer's employment benefit plan or paid
17time off policy.
18    (b) An employer may limit the use of personal sick leave
19benefits provided by the employer for absences due to an
20illness, injury, or medical appointment of the employee's
21child, stepchild, spouse, domestic partner, sibling, parent,
22mother-in-law, father-in-law, grandchild, grandparent, or
23stepparent to an amount not less than the personal sick leave
24that would be earned or accrued during 6 months at the
25employee's then current rate of entitlement. For employers who

 

 

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1base personal sick leave benefits on an employee's years of
2service instead of annual or monthly accrual, such employer may
3limit the amount of sick leave to be used under this Act to
4half of the employee's maximum annual grant.
5    (c) An employer who provides personal sick leave benefits
6or a paid time off policy that would otherwise provide benefits
7as required under subsections (a) and (b) shall not be required
8to modify such benefits.
9(Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)
 
10
Article 85.

 
11    Section 85-5. The State Finance Act is amended by changing
12Section 5.666 as follows:
 
13    (30 ILCS 105/5.666)
14    (Section scheduled to be repealed on July 1, 2026)
15    Sec. 5.666. The African-American and Latinx HIV/AIDS
16Response Fund. This Section is repealed on July 1, 2026.
17(Source: P.A. 99-54, eff. 1-1-16.)
 
18    Section 85-10. The African-American HIV/AIDS Response Act
19is amended by changing Sections 1, 5, 10, 15, 25, 27, and 30 as
20follows:
 
21    (410 ILCS 303/1)

 

 

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1    Sec. 1. Short title. This Act may be cited as the
2African-American and Latinx HIV/AIDS Response Act.
3(Source: P.A. 94-629, eff. 1-1-06.)
 
4    (410 ILCS 303/5)
5    Sec. 5. Legislative finding. The General Assembly finds
6that HIV/AIDS in the African-American and Latinx communities
7community is a crisis separate and apart from the overall issue
8of HIV/AIDS in other communities.
9(Source: P.A. 94-629, eff. 1-1-06.)
 
10    (410 ILCS 303/10)
11    Sec. 10. African-American and Latinx HIV/AIDS Response
12Officer. An African-American and Latinx HIV/AIDS Response
13Officer, responsible for coordinating efforts to address the
14African-American and Latinx AIDS crisis within his or her
15respective Office or Department and serving as a liaison to
16governmental and non-governmental entities beyond his or her
17respective Office or Department regarding the same, shall be
18designated in each of the following:
19        (1) The Office of the Governor.
20        (2) The Department of Human Services.
21        (3) The Department of Public Health.
22        (4) The Department of Corrections.
23(Source: P.A. 94-629, eff. 1-1-06.)
 

 

 

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1    (410 ILCS 303/15)
2    Sec. 15. State agencies; HIV testing.
3    (a) In this Section:
4    "High-risk community" means a community designated as
5high-risk by the Department of Public Health in rules.
6    "High-traffic facility" means a high-traffic facility as
7defined by the State agency operating the facility.
8    "State agency" means (i) any department of State government
9created under Section 5-15 of the Departments of State
10Government Law of the Civil Administrative Code of Illinois or
11(ii) the Office of the Secretary of State.
12    (b) The Department of Public Health shall coordinate the
13response to HIV/AIDS in the African-American and Latinx
14communities community.
15    (c) A State agency that operates a facility that (i) is
16accessible to the public, (ii) is a high-traffic facility, and
17(iii) serves a high-risk community must provide the following
18in each such facility where space and security reasonably
19permit: space for free HIV counseling and antibody testing to a
20community-based organization licensed to do testing, in
21accordance with the AIDS Confidentiality Act and rules adopted
22by the Department of Public Health. The State agency or its
23employees shall not conduct any counseling or testing required
24to be provided under this subsection, but the agency shall make
25appropriate arrangements with one or more certified
26community-based organizations to conduct the counseling or

 

 

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1testing. The testing required to be provided under this
2subsection is the rapid testing authorized under Section 5.5 of
3the AIDS Confidentiality Act.
4    (d) Neither the State of Illinois nor any State agency
5supplying space for services authorized by this Section shall
6be liable for damages based on the provision of such space or
7claimed to result from any services performed in such space,
8except that this immunity does not apply in the case of willful
9and wanton misconduct.
10(Source: P.A. 94-629, eff. 1-1-06.)
 
11    (410 ILCS 303/25)
12    Sec. 25. HIV/AIDS Response Review Panel.
13    (a) The HIV/AIDS Response Review Panel is established
14within the Office of the Governor. The Panel shall consist of
15the following members:
16        (1) One member appointed by the Governor. This member
17    shall serve as the Chair of the Panel.
18        (2) One representative of each of the following,
19    appointed by the head of the department: the Department of
20    Corrections; the Department of Human Services; and the
21    Department of Public Health.
22        (3) Two ex-offenders who are familiar with the issue of
23    HIV/AIDS as it relates to incarceration, appointed by the
24    Governor. One of these members must be from Cook County,
25    and the other must be from a county other than Cook. Both

 

 

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1    of these members must have received a final discharge from
2    the Department of Corrections.
3        (4) Three representatives of HIV/AIDS organizations
4    that have been in business for at least 2 years, appointed
5    by the Governor. In the case of such an organization that
6    represents a constituency the majority of whom are
7    African-American or Latinx, the organization's
8    representative who is a member of the Panel must be
9    African-American or Latinx.
10    (b) The Panel shall review the implementation of this Act
11within the Department of Corrections and shall file a report
12with the General Assembly and with the Governor every January 1
13stating the results of its review.
14(Source: P.A. 94-629, eff. 1-1-06.)
 
15    (410 ILCS 303/27)
16    (Section scheduled to be repealed on July 1, 2026)
17    Sec. 27. African-American and Latinx HIV/AIDS Response
18Fund.
19    (a) The African-American and Latinx HIV/AIDS Response Fund
20is created as a special fund in the State treasury. Moneys
21deposited into the Fund shall, subject to appropriation, be
22used for grants for programs to prevent the transmission of HIV
23and other programs and activities consistent with the purposes
24of this Act, including, but not limited to, preventing and
25treating HIV/AIDS, the creation of an HIV/AIDS service delivery

 

 

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1system, and the administration of the Act. Moneys for the Fund
2shall come from appropriations by the General Assembly, federal
3funds, and other public resources.
4    (b) The Fund shall provide resources for communities in
5Illinois to create an HIV/AIDS service delivery system that
6reduces the disparity of HIV infection and AIDS cases between
7African-Americans and Latinxs and other population groups in
8Illinois that may be impacted by the disease by, including but,
9not limited to:
10        (1) developing, implementing, and maintaining a
11    comprehensive, culturally sensitive HIV Prevention Plan
12    targeting communities that are identified as high-risk in
13    terms of the impact of the disease on African-Americans and
14    Latinxs;
15        (2) developing, implementing, and maintaining a stable
16    HIV/AIDS service delivery infrastructure in Illinois
17    communities that will meet the needs of African-Americans
18    and Latinxs;
19        (3) developing, implementing, and maintaining a
20    statewide HIV/AIDS testing program;
21        (4) providing funding for HIV/AIDS social and
22    scientific research to improve prevention and treatment;
23        (5) providing comprehensive technical and other
24    assistance to African-American and Latinx community
25    service organizations that are involved in HIV/AIDS
26    prevention and treatment;

 

 

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1        (6) developing, implementing, and maintaining an
2    infrastructure for African-American and Latinx community
3    service organizations to make them less dependent on
4    government resources; and
5        (7) creating and maintaining at least 17 one-stop
6    shopping HIV/AIDS facilities across the State.
7    (c) When providing grants pursuant to this Fund, the
8Department of Public Health shall give priority to the
9development of comprehensive medical and social services to
10African-Americans and Latinxs at risk of infection from or
11infected with HIV/AIDS in areas of the State determined to have
12the greatest geographic prevalence of HIV/AIDS in the
13African-American and Latinx population.
14    (d) The Section is repealed on July 1, 2026.
15(Source: P.A. 99-54, eff. 1-1-16.)
 
16    (410 ILCS 303/30)
17    Sec. 30. Rules.
18    (a) No later than March 15, 2006, the Department of Public
19Health shall issue proposed rules for designating high-risk
20communities and for implementing subsection (c) of Section 15.
21The rules must include, but may not be limited to, a standard
22testing protocol, training for staff, community-based
23organization experience, and the removal and proper disposal of
24hazardous waste.
25    (b) The Department of Human Services, the Department of

 

 

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1Public Health, and the Department of Corrections shall adopt
2rules as necessary to ensure that this Act is implemented
3within 6 months after the effective date of this Act.
4    (c) The Department of Public Health shall adopt rules
5necessary to implement and administer the African-American and
6Latinx HIV/AIDS Response Fund.
7(Source: P.A. 94-629, eff. 1-1-06; 94-797, eff. 1-1-07.)
 
8
Article 90.

 
9    Section 90-5. The Nursing Home Care Act is amended by
10adding Section 3-206.06 as follows:
 
11    (210 ILCS 45/3-206.06 new)
12    Sec. 3-206.06. Testing for Legionnaires' disease. A
13facility licensed under this Act must prove upon inspection by
14the Department that it has provided testing for Legionnaires'
15disease. The facility must also provide the results of that
16testing to the Department.
 
17    Section 90-10. The Hospital Licensing Act is amended by
18adding Section 6.29 as follows:
 
19    (210 ILCS 85/6.29 new)
20    Sec. 6.29. Testing for Legionnaires' disease. A hospital
21licensed under this Act must prove upon inspection by the

 

 

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1Department that it has provided testing for Legionnaires'
2disease. The hospital must also provide the results of that
3testing to the Department.
 
4
Article 95.

 
5    Section 95-1. Short title. This Article may be cited as the
6Child Trauma Counseling Act. References in this Article to
7"this Act" mean this Article.
 
8    Section 95-5. Definitions. As used in this Act:
9    "Day care center" has the meaning given to that term in
10Section 2.09 of the Child Care Act of 1969.
11    "School" means a public or nonpublic elementary school.
12    "Trauma counselor" means a licensed professional
13counselor, as that term is defined in Section 10 of the
14Professional Counselor and Clinical Professional Counselor
15Licensing and Practice Act, who has experience in treating
16childhood trauma or who has a certification relating to
17treating childhood trauma.
 
18    Section 95-10. Trauma counseling through fifth grade.
19    (a) Notwithstanding any other provision of law:
20        (1) a day care center shall provide the services of a
21    trauma counselor to a child, from birth through the fifth
22    grade, enrolled and attending the day care center who has

 

 

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1    been identified as needing trauma counseling; and
2        (2) a school shall provide the services of a trauma
3    counselor to a child who is enrolled and attending
4    kindergarten through the fifth grade at that school and has
5    been identified as needing trauma counseling.
6    There shall be no cost for such trauma counseling to the
7parents or guardians of the child.
8    (b) A child is identified as needing trauma counseling
9under subsection (a) if the child reports trauma to a day care
10center or a school or a parent or guardian of the child or
11employee of a day care center or a school reports that the
12child has experienced trauma.
 
13    Section 95-15. Rules.
14    (a) The Department of Children and Family Services shall
15adopt rules to implement this Act. The Department shall seek
16recommendations and advice from the State Board of Education as
17to adoption of the Department's rules as they relate to
18schools.
19    (b) The Department of Financial and Professional
20Regulation may adopt rules regarding the qualifications of
21trauma counselors working with children under this Act.
 
22    Section 95-90. The State Mandates Act is amended by adding
23Section 8.45 as follows:
 

 

 

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1    (30 ILCS 805/8.45 new)
2    Sec. 8.45. Exempt mandate. Notwithstanding Sections 6 and 8
3of this Act, no reimbursement by the State is required for the
4implementation of any mandate created by the Child Trauma
5Counseling Act.
 
6
Article 100.

 
7    Section 100-1. Short title. This Article may be cited as
8the Special Commission on Gynecologic Cancers Act.
 
9    Section 100-5. Creation; members; duties; report.    
10    (a) The Special Commission on Gynecologic Cancers is
11created. Membership of the Commission shall be as follows:
12        (1) A representative of the Illinois Comprehensive
13    Cancer Control Program, appointed by the Director of Public
14    Health;
15        (2) The Director of Insurance, or his or her designee;
16    and
17        (3) 20 members who shall be appointed as follows:
18                (A) three members appointed by the Speaker of
19        the House of Representatives, one of whom shall be a
20        survivor of ovarian cancer, one of whom shall be a
21        survivor of cervical, vaginal, vulvar, or uterine
22        cancer, and one of whom shall be a medical specialist
23        in gynecologic cancers;

 

 

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1                (B) three members appointed by the Senate
2        President, one of whom shall be a survivor of ovarian
3        cancer, one of whom shall be a survivor of cervical,
4        vaginal, vulvar, or uterine cancer, and one of whom
5        shall be a medical specialist in gynecologic cancers;
6                (C) three members appointed by the House
7        Minority Leader, one of whom shall be a survivor of
8        ovarian cancer, one of whom shall be a survivor of
9        cervical, vaginal, vulvar, or uterine cancer, and one
10        of whom shall be a medical specialist in gynecologic
11        cancers;
12                (D) three members appointed by the Senate
13        Minority Leader, one of whom shall be a survivor of
14        ovarian cancer, one of whom shall be a survivor of
15        cervical, vaginal, vulvar, or uterine cancer, and one
16        of whom shall be a medical specialist in gynecologic
17        cancers; and
18                (E) eight members appointed by the Governor,
19        one of whom shall be a caregiver of a woman diagnosed
20        with a gynecologic cancer, one of whom shall be a
21        medical specialist in gynecologic cancers, one of whom
22        shall be an individual with expertise in community
23        based health care and issues affecting underserved and
24        vulnerable populations, 2 of whom shall be individuals
25        representing gynecologic cancer awareness and support
26        groups in the State, one of whom shall be a researcher

 

 

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1        specializing in gynecologic cancers, and 2 of whom
2        shall be members of the public with demonstrated
3        expertise in issues relating to the work of the
4        Commission.
5    (b) Members of the Commission shall serve without
6compensation or reimbursement from the Commission. Members
7shall select a Chair from among themselves and the Chair shall
8set the meeting schedule.
9    (c) The Illinois Department of Public Health shall provide
10administrative support to the Commission.
11    (d) The Commission is charged with the study of the
12following:
13        (1) establishing a mechanism to ascertain the
14    prevalence of gynecologic cancers in the State and, to the
15    extent possible, to collect statistics relative to the
16    timing of diagnosis and risk factors associated with
17    gynecologic cancers;
18        (2) determining how to best effectuate early diagnosis
19    and treatment for gynecologic cancer patients;
20        (3) determining best practices for closing disparities
21    in outcomes for gynecologic cancer patients and innovative
22    approaches to reaching underserved and vulnerable
23    populations;
24        (4) determining any unmet needs of persons with
25    gynecologic cancers and those of their families; and
26        (5) providing recommendations for additional

 

 

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1    legislation, support programs, and resources to meet the
2    unmet needs of persons with gynecologic cancers and their
3    families.
4    (e) The Commission shall file its final report with the
5General Assembly no later than December 31, 2021 and, upon the
6filing of its report, is dissolved.
 
7    Section 100-90. Repeal. This Article is repealed on January
81, 2023.
 
9
Article 105.

 
10    Section 5. The Illinois Public Aid Code is amended by
11changing Section 5A-12.7 as follows:
 
12    (305 ILCS 5/5A-12.7)
13    (Section scheduled to be repealed on December 31, 2022)
14    Sec. 5A-12.7. Continuation of hospital access payments on
15and after July 1, 2020.
16    (a) To preserve and improve access to hospital services,
17for hospital services rendered on and after July 1, 2020, the
18Department shall, except for hospitals described in subsection
19(b) of Section 5A-3, make payments to hospitals or require
20capitated managed care organizations to make payments as set
21forth in this Section. Payments under this Section are not due
22and payable, however, until: (i) the methodologies described in

 

 

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1this Section are approved by the federal government in an
2appropriate State Plan amendment or directed payment preprint;
3and (ii) the assessment imposed under this Article is
4determined to be a permissible tax under Title XIX of the
5Social Security Act. In determining the hospital access
6payments authorized under subsection (g) of this Section, if a
7hospital ceases to qualify for payments from the pool, the
8payments for all hospitals continuing to qualify for payments
9from such pool shall be uniformly adjusted to fully expend the
10aggregate net amount of the pool, with such adjustment being
11effective on the first day of the second month following the
12date the hospital ceases to receive payments from such pool.
13    (b) Amounts moved into claims-based rates and distributed
14in accordance with Section 14-12 shall remain in those
15claims-based rates.
16    (c) Graduate medical education.
17        (1) The calculation of graduate medical education
18    payments shall be based on the hospital's Medicare cost
19    report ending in Calendar Year 2018, as reported in the
20    Healthcare Cost Report Information System file, release
21    date September 30, 2019. An Illinois hospital reporting
22    intern and resident cost on its Medicare cost report shall
23    be eligible for graduate medical education payments.
24        (2) Each hospital's annualized Medicaid Intern
25    Resident Cost is calculated using annualized intern and
26    resident total costs obtained from Worksheet B Part I,

 

 

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1    Columns 21 and 22 the sum of Lines 30-43, 50-76, 90-93,
2    96-98, and 105-112 multiplied by the percentage that the
3    hospital's Medicaid days (Worksheet S3 Part I, Column 7,
4    Lines 2, 3, 4, 14, 16-18, and 32) comprise of the
5    hospital's total days (Worksheet S3 Part I, Column 8, Lines
6    14, 16-18, and 32).
7        (3) An annualized Medicaid indirect medical education
8    (IME) payment is calculated for each hospital using its IME
9    payments (Worksheet E Part A, Line 29, Column 1) multiplied
10    by the percentage that its Medicaid days (Worksheet S3 Part
11    I, Column 7, Lines 2, 3, 4, 14, 16-18, and 32) comprise of
12    its Medicare days (Worksheet S3 Part I, Column 6, Lines 2,
13    3, 4, 14, and 16-18).
14        (4) For each hospital, its annualized Medicaid Intern
15    Resident Cost and its annualized Medicaid IME payment are
16    summed, and, except as capped at 120% of the average cost
17    per intern and resident for all qualifying hospitals as
18    calculated under this paragraph, is multiplied by 22.6% to
19    determine the hospital's final graduate medical education
20    payment. Each hospital's average cost per intern and
21    resident shall be calculated by summing its total
22    annualized Medicaid Intern Resident Cost plus its
23    annualized Medicaid IME payment and dividing that amount by
24    the hospital's total Full Time Equivalent Residents and
25    Interns. If the hospital's average per intern and resident
26    cost is greater than 120% of the same calculation for all

 

 

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1    qualifying hospitals, the hospital's per intern and
2    resident cost shall be capped at 120% of the average cost
3    for all qualifying hospitals.
4    (d) Fee-for-service supplemental payments. Each Illinois
5hospital shall receive an annual payment equal to the amounts
6below, to be paid in 12 equal installments on or before the
7seventh State business day of each month, except that no
8payment shall be due within 30 days after the later of the date
9of notification of federal approval of the payment
10methodologies required under this Section or any waiver
11required under 42 CFR 433.68, at which time the sum of amounts
12required under this Section prior to the date of notification
13is due and payable.
14        (1) For critical access hospitals, $385 per covered
15    inpatient day contained in paid fee-for-service claims and
16    $530 per paid fee-for-service outpatient claim for dates of
17    service in Calendar Year 2019 in the Department's
18    Enterprise Data Warehouse as of May 11, 2020.
19        (2) For safety-net hospitals, $960 per covered
20    inpatient day contained in paid fee-for-service claims and
21    $625 per paid fee-for-service outpatient claim for dates of
22    service in Calendar Year 2019 in the Department's
23    Enterprise Data Warehouse as of May 11, 2020.
24        (3) For long term acute care hospitals, $295 per
25    covered inpatient day contained in paid fee-for-service
26    claims for dates of service in Calendar Year 2019 in the

 

 

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1    Department's Enterprise Data Warehouse as of May 11, 2020.
2        (4) For freestanding psychiatric hospitals, $125 per
3    covered inpatient day contained in paid fee-for-service
4    claims and $130 per paid fee-for-service outpatient claim
5    for dates of service in Calendar Year 2019 in the
6    Department's Enterprise Data Warehouse as of May 11, 2020.
7        (5) For freestanding rehabilitation hospitals, $355
8    per covered inpatient day contained in paid
9    fee-for-service claims for dates of service in Calendar
10    Year 2019 in the Department's Enterprise Data Warehouse as
11    of May 11, 2020.
12        (6) For all general acute care hospitals and high
13    Medicaid hospitals as defined in subsection (f), $350 per
14    covered inpatient day for dates of service in Calendar Year
15    2019 contained in paid fee-for-service claims and $620 per
16    paid fee-for-service outpatient claim in the Department's
17    Enterprise Data Warehouse as of May 11, 2020.
18        (7) Alzheimer's treatment access payment. Each
19    Illinois academic medical center or teaching hospital, as
20    defined in Section 5-5e.2 of this Code, that is identified
21    as the primary hospital affiliate of one of the Regional
22    Alzheimer's Disease Assistance Centers, as designated by
23    the Alzheimer's Disease Assistance Act and identified in
24    the Department of Public Health's Alzheimer's Disease
25    State Plan dated December 2016, shall be paid an
26    Alzheimer's treatment access payment equal to the product

 

 

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1    of the qualifying hospital's State Fiscal Year 2018 total
2    inpatient fee-for-service days multiplied by the
3    applicable Alzheimer's treatment rate of $226.30 for
4    hospitals located in Cook County and $116.21 for hospitals
5    located outside Cook County.
6    (e) The Department shall require managed care
7organizations (MCOs) to make directed payments and
8pass-through payments according to this Section. Each calendar
9year, the Department shall require MCOs to pay the maximum
10amount out of these funds as allowed as pass-through payments
11under federal regulations. The Department shall require MCOs to
12make such pass-through payments as specified in this Section.
13The Department shall require the MCOs to pay the remaining
14amounts as directed Payments as specified in this Section. The
15Department shall issue payments to the Comptroller by the
16seventh business day of each month for all MCOs that are
17sufficient for MCOs to make the directed payments and
18pass-through payments according to this Section. The
19Department shall require the MCOs to make pass-through payments
20and directed payments using electronic funds transfers (EFT),
21if the hospital provides the information necessary to process
22such EFTs, in accordance with directions provided monthly by
23the Department, within 7 business days of the date the funds
24are paid to the MCOs, as indicated by the "Paid Date" on the
25website of the Office of the Comptroller if the funds are paid
26by EFT and the MCOs have received directed payment

 

 

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1instructions. If funds are not paid through the Comptroller by
2EFT, payment must be made within 7 business days of the date
3actually received by the MCO. The MCO will be considered to
4have paid the pass-through payments when the payment remittance
5number is generated or the date the MCO sends the check to the
6hospital, if EFT information is not supplied. If an MCO is late
7in paying a pass-through payment or directed payment as
8required under this Section (including any extensions granted
9by the Department), it shall pay a penalty, unless waived by
10the Department for reasonable cause, to the Department equal to
115% of the amount of the pass-through payment or directed
12payment not paid on or before the due date plus 5% of the
13portion thereof remaining unpaid on the last day of each 30-day
14period thereafter. Payments to MCOs that would be paid
15consistent with actuarial certification and enrollment in the
16absence of the increased capitation payments under this Section
17shall not be reduced as a consequence of payments made under
18this subsection. The Department shall publish and maintain on
19its website for a period of no less than 8 calendar quarters,
20the quarterly calculation of directed payments and
21pass-through payments owed to each hospital from each MCO. All
22calculations and reports shall be posted no later than the
23first day of the quarter for which the payments are to be
24issued.
25    (f)(1) For purposes of allocating the funds included in
26capitation payments to MCOs, Illinois hospitals shall be

 

 

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1divided into the following classes as defined in administrative
2rules:
3        (A) Critical access hospitals.
4        (B) Safety-net hospitals, except that stand-alone
5    children's hospitals that are not specialty children's
6    hospitals will not be included.
7        (C) Long term acute care hospitals.
8        (D) Freestanding psychiatric hospitals.
9        (E) Freestanding rehabilitation hospitals.
10        (F) High Medicaid hospitals. As used in this Section,
11    "high Medicaid hospital" means a general acute care
12    hospital that is not a safety-net hospital or critical
13    access hospital and that has a Medicaid Inpatient
14    Utilization Rate above 30% or a hospital that had over
15    35,000 inpatient Medicaid days during the applicable
16    period. For the period July 1, 2020 through December 31,
17    2020, the applicable period for the Medicaid Inpatient
18    Utilization Rate (MIUR) is the rate year 2020 MIUR and for
19    the number of inpatient days it is State fiscal year 2018.
20    Beginning in calendar year 2021, the Department shall use
21    the most recently determined MIUR, as defined in subsection
22    (h) of Section 5-5.02, and for the inpatient day threshold,
23    the State fiscal year ending 18 months prior to the
24    beginning of the calendar year. For purposes of calculating
25    MIUR under this Section, children's hospitals and
26    affiliated general acute care hospitals shall be

 

 

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1    considered a single hospital.
2        (G) General acute care hospitals. As used under this
3    Section, "general acute care hospitals" means all other
4    Illinois hospitals not identified in subparagraphs (A)
5    through (F).
6    (2) Hospitals' qualification for each class shall be
7assessed prior to the beginning of each calendar year and the
8new class designation shall be effective January 1 of the next
9year. The Department shall publish by rule the process for
10establishing class determination.
11    (g) Fixed pool directed payments. Beginning July 1, 2020,
12the Department shall issue payments to MCOs which shall be used
13to issue directed payments to qualified Illinois safety-net
14hospitals and critical access hospitals on a monthly basis in
15accordance with this subsection. Prior to the beginning of each
16Payout Quarter beginning July 1, 2020, the Department shall use
17encounter claims data from the Determination Quarter, accepted
18by the Department's Medicaid Management Information System for
19inpatient and outpatient services rendered by safety-net
20hospitals and critical access hospitals to determine a
21quarterly uniform per unit add-on for each hospital class.
22        (1) Inpatient per unit add-on. A quarterly uniform per
23    diem add-on shall be derived by dividing the quarterly
24    Inpatient Directed Payments Pool amount allocated to the
25    applicable hospital class by the total inpatient days
26    contained on all encounter claims received during the

 

 

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1    Determination Quarter, for all hospitals in the class.
2            (A) Each hospital in the class shall have a
3        quarterly inpatient directed payment calculated that
4        is equal to the product of the number of inpatient days
5        attributable to the hospital used in the calculation of
6        the quarterly uniform class per diem add-on,
7        multiplied by the calculated applicable quarterly
8        uniform class per diem add-on of the hospital class.
9            (B) Each hospital shall be paid 1/3 of its
10        quarterly inpatient directed payment in each of the 3
11        months of the Payout Quarter, in accordance with
12        directions provided to each MCO by the Department.
13        (2) Outpatient per unit add-on. A quarterly uniform per
14    claim add-on shall be derived by dividing the quarterly
15    Outpatient Directed Payments Pool amount allocated to the
16    applicable hospital class by the total outpatient
17    encounter claims received during the Determination
18    Quarter, for all hospitals in the class.
19            (A) Each hospital in the class shall have a
20        quarterly outpatient directed payment calculated that
21        is equal to the product of the number of outpatient
22        encounter claims attributable to the hospital used in
23        the calculation of the quarterly uniform class per
24        claim add-on, multiplied by the calculated applicable
25        quarterly uniform class per claim add-on of the
26        hospital class.

 

 

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1            (B) Each hospital shall be paid 1/3 of its
2        quarterly outpatient directed payment in each of the 3
3        months of the Payout Quarter, in accordance with
4        directions provided to each MCO by the Department.
5        (3) Each MCO shall pay each hospital the Monthly
6    Directed Payment as identified by the Department on its
7    quarterly determination report.
8        (4) Definitions. As used in this subsection:
9            (A) "Payout Quarter" means each 3 month calendar
10        quarter, beginning July 1, 2020.
11            (B) "Determination Quarter" means each 3 month
12        calendar quarter, which ends 3 months prior to the
13        first day of each Payout Quarter.
14        (5) For the period July 1, 2020 through December 2020,
15    the following amounts shall be allocated to the following
16    hospital class directed payment pools for the quarterly
17    development of a uniform per unit add-on:
18            (A) $2,894,500 for hospital inpatient services for
19        critical access hospitals.
20            (B) $4,294,374 for hospital outpatient services
21        for critical access hospitals.
22            (C) $29,109,330 for hospital inpatient services
23        for safety-net hospitals.
24            (D) $35,041,218 for hospital outpatient services
25        for safety-net hospitals.
26    (h) Fixed rate directed payments. Effective July 1, 2020,

 

 

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1the Department shall issue payments to MCOs which shall be used
2to issue directed payments to Illinois hospitals not identified
3in paragraph (g) on a monthly basis. Prior to the beginning of
4each Payout Quarter beginning July 1, 2020, the Department
5shall use encounter claims data from the Determination Quarter,
6accepted by the Department's Medicaid Management Information
7System for inpatient and outpatient services rendered by
8hospitals in each hospital class identified in paragraph (f)
9and not identified in paragraph (g). For the period July 1,
102020 through December 2020, the Department shall direct MCOs to
11make payments as follows:
12        (1) For general acute care hospitals an amount equal to
13    $1,750 multiplied by the hospital's category of service 20
14    case mix index for the determination quarter multiplied by
15    the hospital's total number of inpatient admissions for
16    category of service 20 for the determination quarter.
17        (2) For general acute care hospitals an amount equal to
18    $160 multiplied by the hospital's category of service 21
19    case mix index for the determination quarter multiplied by
20    the hospital's total number of inpatient admissions for
21    category of service 21 for the determination quarter.
22        (3) For general acute care hospitals an amount equal to
23    $80 multiplied by the hospital's category of service 22
24    case mix index for the determination quarter multiplied by
25    the hospital's total number of inpatient admissions for
26    category of service 22 for the determination quarter.

 

 

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1        (4) For general acute care hospitals an amount equal to
2    $375 multiplied by the hospital's category of service 24
3    case mix index for the determination quarter multiplied by
4    the hospital's total number of category of service 24 paid
5    EAPG (EAPGs) for the determination quarter.
6        (5) For general acute care hospitals an amount equal to
7    $240 multiplied by the hospital's category of service 27
8    and 28 case mix index for the determination quarter
9    multiplied by the hospital's total number of category of
10    service 27 and 28 paid EAPGs for the determination quarter.
11        (6) For general acute care hospitals an amount equal to
12    $290 multiplied by the hospital's category of service 29
13    case mix index for the determination quarter multiplied by
14    the hospital's total number of category of service 29 paid
15    EAPGs for the determination quarter.
16        (7) For high Medicaid hospitals an amount equal to
17    $1,800 multiplied by the hospital's category of service 20
18    case mix index for the determination quarter multiplied by
19    the hospital's total number of inpatient admissions for
20    category of service 20 for the determination quarter.
21        (8) For high Medicaid hospitals an amount equal to $160
22    multiplied by the hospital's category of service 21 case
23    mix index for the determination quarter multiplied by the
24    hospital's total number of inpatient admissions for
25    category of service 21 for the determination quarter.
26        (9) For high Medicaid hospitals an amount equal to $80

 

 

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1    multiplied by the hospital's category of service 22 case
2    mix index for the determination quarter multiplied by the
3    hospital's total number of inpatient admissions for
4    category of service 22 for the determination quarter.
5        (10) For high Medicaid hospitals an amount equal to
6    $400 multiplied by the hospital's category of service 24
7    case mix index for the determination quarter multiplied by
8    the hospital's total number of category of service 24 paid
9    EAPG outpatient claims for the determination quarter.
10        (11) For high Medicaid hospitals an amount equal to
11    $240 multiplied by the hospital's category of service 27
12    and 28 case mix index for the determination quarter
13    multiplied by the hospital's total number of category of
14    service 27 and 28 paid EAPGs for the determination quarter.
15        (12) For high Medicaid hospitals an amount equal to
16    $290 multiplied by the hospital's category of service 29
17    case mix index for the determination quarter multiplied by
18    the hospital's total number of category of service 29 paid
19    EAPGs for the determination quarter.
20        (13) For long term acute care hospitals the amount of
21    $495 multiplied by the hospital's total number of inpatient
22    days for the determination quarter.
23        (14) For psychiatric hospitals the amount of $210
24    multiplied by the hospital's total number of inpatient days
25    for category of service 21 for the determination quarter.
26        (15) For psychiatric hospitals the amount of $250

 

 

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1    multiplied by the hospital's total number of outpatient
2    claims for category of service 27 and 28 for the
3    determination quarter.
4        (16) For rehabilitation hospitals the amount of $410
5    multiplied by the hospital's total number of inpatient days
6    for category of service 22 for the determination quarter.
7        (17) For rehabilitation hospitals the amount of $100
8    multiplied by the hospital's total number of outpatient
9    claims for category of service 29 for the determination
10    quarter.
11        (18) Each hospital shall be paid 1/3 of their quarterly
12    inpatient and outpatient directed payment in each of the 3
13    months of the Payout Quarter, in accordance with directions
14    provided to each MCO by the Department.
15        (19) Each MCO shall pay each hospital the Monthly
16    Directed Payment amount as identified by the Department on
17    its quarterly determination report.
18    Notwithstanding any other provision of this subsection, if
19the Department determines that the actual total hospital
20utilization data that is used to calculate the fixed rate
21directed payments is substantially different than anticipated
22when the rates in this subsection were initially determined
23(for unforeseeable circumstances such as the COVID-19
24pandemic), the Department may adjust the rates specified in
25this subsection so that the total directed payments approximate
26the total spending amount anticipated when the rates were

 

 

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1initially established.
2    Definitions. As used in this subsection:
3            (A) "Payout Quarter" means each calendar quarter,
4        beginning July 1, 2020.
5            (B) "Determination Quarter" means each calendar
6        quarter which ends 3 months prior to the first day of
7        each Payout Quarter.
8            (C) "Case mix index" means a hospital specific
9        calculation. For inpatient claims the case mix index is
10        calculated each quarter by summing the relative weight
11        of all inpatient Diagnosis-Related Group (DRG) claims
12        for a category of service in the applicable
13        Determination Quarter and dividing the sum by the
14        number of sum total of all inpatient DRG admissions for
15        the category of service for the associated claims. The
16        case mix index for outpatient claims is calculated each
17        quarter by summing the relative weight of all paid
18        EAPGs in the applicable Determination Quarter and
19        dividing the sum by the sum total of paid EAPGs for the
20        associated claims.
21    (i) Beginning January 1, 2021, the rates for directed
22payments shall be recalculated in order to spend the additional
23funds for directed payments that result from reduction in the
24amount of pass-through payments allowed under federal
25regulations. The additional funds for directed payments shall
26be allocated proportionally to each class of hospitals based on

 

 

10100HB3840sam001- 142 -LRB101 12454 CPF 74517 a

1that class' proportion of services.
2    (j) Pass-through payments.
3        (1) For the period July 1, 2020 through December 31,
4    2020, the Department shall assign quarterly pass-through
5    payments to each class of hospitals equal to one-fourth of
6    the following annual allocations:
7            (A) $390,487,095 to safety-net hospitals.
8            (B) $62,553,886 to critical access hospitals.
9            (C) $345,021,438 to high Medicaid hospitals.
10            (D) $551,429,071 to general acute care hospitals.
11            (E) $27,283,870 to long term acute care hospitals.
12            (F) $40,825,444 to freestanding psychiatric
13        hospitals.
14            (G) $9,652,108 to freestanding rehabilitation
15        hospitals.
16        (2) The pass-through payments shall at a minimum ensure
17    hospitals receive a total amount of monthly payments under
18    this Section as received in calendar year 2019 in
19    accordance with this Article and paragraph (1) of
20    subsection (d-5) of Section 14-12, exclusive of amounts
21    received through payments referenced in subsection (b).
22        (3) For the calendar year beginning January 1, 2021,
23    and each calendar year thereafter, each hospital's
24    pass-through payment amount shall be reduced
25    proportionally to the reduction of all pass-through
26    payments required by federal regulations.

 

 

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1    (k) At least 30 days prior to each calendar year, the
2Department shall notify each hospital of changes to the payment
3methodologies in this Section, including, but not limited to,
4changes in the fixed rate directed payment rates, the aggregate
5pass-through payment amount for all hospitals, and the
6hospital's pass-through payment amount for the upcoming
7calendar year.
8    (l) Notwithstanding any other provisions of this Section,
9the Department may adopt rules to change the methodology for
10directed and pass-through payments as set forth in this
11Section, but only to the extent necessary to obtain federal
12approval of a necessary State Plan amendment or Directed
13Payment Preprint or to otherwise conform to federal law or
14federal regulation.
15    (m) As used in this subsection, "managed care organization"
16or "MCO" means an entity which contracts with the Department to
17provide services where payment for medical services is made on
18a capitated basis, excluding contracted entities for dual
19eligible or Department of Children and Family Services youth
20populations.
21    (n) In order to address the escalating infant mortality
22rates among minority communities in Illinois, the State shall
23create a pool of funding of at least $50,000,000 annually to be
24dispersed among community safety-net hospitals that maintain
25perinatal designation from the Department of Public Health.
26(Source: P.A. 101-650, eff. 7-7-20.)
 

 

 

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1
Article 110.

 
2    Section 110-1. Short title. This Article may be cited as
3the Racial Impact Note Act.
 
4    Section 110-5. Racial impact note.
5    (a) Every bill which has or could have a disparate impact
6on racial and ethnic minorities, upon the request of any
7member, shall have prepared for it, before second reading in
8the house of introduction, a brief explanatory statement or
9note that shall include a reliable estimate of the anticipated
10impact on those racial and ethnic minorities likely to be
11impacted by the bill. Each racial impact note must include, for
12racial and ethnic minorities for which data are available: (i)
13an estimate of how the proposed legislation would impact racial
14and ethnic minorities; (ii) a statement of the methodologies
15and assumptions used in preparing the estimate; (iii) an
16estimate of the racial and ethnic composition of the population
17who may be impacted by the proposed legislation, including
18those persons who may be negatively impacted and those persons
19who may benefit from the proposed legislation; and (iv) any
20other matter that a responding agency considers appropriate in
21relation to the racial and ethnic minorities likely to be
22affected by the bill.
 

 

 

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1    Section 110-10. Preparation.
2    (a) The sponsor of each bill for which a request under
3Section 110-5 has been made shall present a copy of the bill
4with the request for a racial impact note to the appropriate
5responding agency or agencies under subsection (b). The
6responding agency or agencies shall prepare and submit the note
7to the sponsor of the bill within 5 calendar days, except that
8whenever, because of the complexity of the measure, additional
9time is required for the preparation of the racial impact note,
10the responding agency or agencies may inform the sponsor of the
11bill, and the sponsor may approve an extension of the time
12within which the note is to be submitted, not to extend,
13however, beyond June 15, following the date of the request. If,
14in the opinion of the responding agency or agencies, there is
15insufficient information to prepare a reliable estimate of the
16anticipated impact, a statement to that effect can be filed and
17shall meet the requirements of this Act.
18    (b) If a bill concerns arrests, convictions, or law
19enforcement, a statement shall be prepared by the Illinois
20Criminal Justice Information Authority specifying the impact
21on racial and ethnic minorities. If a bill concerns
22corrections, sentencing, or the placement of individuals
23within the Department of Corrections, a statement shall be
24prepared by the Department of Corrections specifying the impact
25on racial and ethnic minorities. If a bill concerns local
26government, a statement shall be prepared by the Department of

 

 

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1Commerce and Economic Opportunity specifying the impact on
2racial and ethnic minorities. If a bill concerns education, one
3of the following agencies shall prepare a statement specifying
4the impact on racial and ethnic minorities: (i) the Illinois
5Community College Board, if the bill affects community
6colleges; (ii) the Illinois State Board of Education, if the
7bill affects primary and secondary education; or (iii) the
8Illinois Board of Higher Education, if the bill affects State
9universities. Any other State agency impacted or responsible
10for implementing all or part of this bill shall prepare a
11statement of the racial and ethnic impact of the bill as it
12relates to that agency.
 
13    Section 110-15. Requisites and contents. The note shall be
14factual in nature, as brief and concise as may be, and, in
15addition, it shall include both the immediate effect and, if
16determinable or reasonably foreseeable, the long range effect
17of the measure on racial and ethnic minorities. If, after
18careful investigation, it is determined that such an effect is
19not ascertainable, the note shall contain a statement to that
20effect, setting forth the reasons why no ascertainable effect
21can be given.
 
22    Section 110-20. Comment or opinion; technical or
23mechanical defects. No comment or opinion shall be included in
24the racial impact note with regard to the merits of the measure

 

 

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1for which the racial impact note is prepared; however,
2technical or mechanical defects may be noted.
 
3    Section 110-25. Appearance of State officials and
4employees in support or opposition of measure. The fact that a
5racial impact note is prepared for any bill shall not preclude
6or restrict the appearance before any committee of the General
7Assembly of any official or authorized employee of the
8responding agency or agencies, or any other impacted State
9agency, who desires to be heard in support of or in opposition
10to the measure.
 
11
Article 115.

 
12    Section 115-5. The Department of Healthcare and Family
13Services Law of the Civil Administrative Code of Illinois is
14amended by adding Section 2205-35 as follows:
 
15    (20 ILCS 2205/2205-35 new)
16    Sec. 2205-35. Increasing access to primary care in
17hospitals. The Department of Healthcare and Family Services
18shall develop a program to increase the presence of Federally
19Qualified Health Centers (FQHCs) in hospitals, including, but
20not limited to, safety-net hospitals, with the goal of
21increasing care coordination, managing chronic diseases, and
22addressing the social determinants of health on or before

 

 

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1December 31, 2021. In addition, the Department shall develop a
2payment methodology to allow FQHCs to provide care coordination
3services, including, but not limited to, chronic disease
4management and behavioral health services. The Department of
5Healthcare and Family Services shall develop a payment
6methodology to allow for care coordination services in FQHCs by
7no later than December 31, 2021.
 
8
Article 120.

 
9    Section 120-5. The Civil Administrative Code of Illinois is
10amended by changing Section 5-565 as follows:
 
11    (20 ILCS 5/5-565)  (was 20 ILCS 5/6.06)
12    Sec. 5-565. In the Department of Public Health.
13    (a) The General Assembly declares it to be the public
14policy of this State that all residents citizens of Illinois
15are entitled to lead healthy lives. Governmental public health
16has a specific responsibility to ensure that a public health
17system is in place to allow the public health mission to be
18achieved. The public health system is the collection of public,
19private, and voluntary entities as well as individuals and
20informal associations that contribute to the public's health
21within the State. To develop a public health system requires
22certain core functions to be performed by government. The State
23Board of Health is to assume the leadership role in advising

 

 

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1the Director in meeting the following functions:
2        (1) Needs assessment.
3        (2) Statewide health objectives.
4        (3) Policy development.
5        (4) Assurance of access to necessary services.
6    There shall be a State Board of Health composed of 20
7persons, all of whom shall be appointed by the Governor, with
8the advice and consent of the Senate for those appointed by the
9Governor on and after June 30, 1998, and one of whom shall be a
10senior citizen age 60 or over. Five members shall be physicians
11licensed to practice medicine in all its branches, one
12representing a medical school faculty, one who is board
13certified in preventive medicine, and one who is engaged in
14private practice. One member shall be a chiropractic physician.
15One member shall be a dentist; one an environmental health
16practitioner; one a local public health administrator; one a
17local board of health member; one a registered nurse; one a
18physical therapist; one an optometrist; one a veterinarian; one
19a public health academician; one a health care industry
20representative; one a representative of the business
21community; one a representative of the non-profit public
22interest community; and 2 shall be citizens at large.
23    The terms of Board of Health members shall be 3 years,
24except that members shall continue to serve on the Board of
25Health until a replacement is appointed. Upon the effective
26date of Public Act 93-975 (January 1, 2005) this amendatory Act

 

 

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1of the 93rd General Assembly, in the appointment of the Board
2of Health members appointed to vacancies or positions with
3terms expiring on or before December 31, 2004, the Governor
4shall appoint up to 6 members to serve for terms of 3 years; up
5to 6 members to serve for terms of 2 years; and up to 5 members
6to serve for a term of one year, so that the term of no more
7than 6 members expire in the same year. All members shall be
8legal residents of the State of Illinois. The duties of the
9Board shall include, but not be limited to, the following:
10        (1) To advise the Department of ways to encourage
11    public understanding and support of the Department's
12    programs.
13        (2) To evaluate all boards, councils, committees,
14    authorities, and bodies advisory to, or an adjunct of, the
15    Department of Public Health or its Director for the purpose
16    of recommending to the Director one or more of the
17    following:
18            (i) The elimination of bodies whose activities are
19        not consistent with goals and objectives of the
20        Department.
21            (ii) The consolidation of bodies whose activities
22        encompass compatible programmatic subjects.
23            (iii) The restructuring of the relationship
24        between the various bodies and their integration
25        within the organizational structure of the Department.
26            (iv) The establishment of new bodies deemed

 

 

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1        essential to the functioning of the Department.
2        (3) To serve as an advisory group to the Director for
3    public health emergencies and control of health hazards.
4        (4) To advise the Director regarding public health
5    policy, and to make health policy recommendations
6    regarding priorities to the Governor through the Director.
7        (5) To present public health issues to the Director and
8    to make recommendations for the resolution of those issues.
9        (6) To recommend studies to delineate public health
10    problems.
11        (7) To make recommendations to the Governor through the
12    Director regarding the coordination of State public health
13    activities with other State and local public health
14    agencies and organizations.
15        (8) To report on or before February 1 of each year on
16    the health of the residents of Illinois to the Governor,
17    the General Assembly, and the public.
18        (9) To review the final draft of all proposed
19    administrative rules, other than emergency or peremptory
20    preemptory rules and those rules that another advisory body
21    must approve or review within a statutorily defined time
22    period, of the Department after September 19, 1991 (the
23    effective date of Public Act 87-633). The Board shall
24    review the proposed rules within 90 days of submission by
25    the Department. The Department shall take into
26    consideration any comments and recommendations of the

 

 

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1    Board regarding the proposed rules prior to submission to
2    the Secretary of State for initial publication. If the
3    Department disagrees with the recommendations of the
4    Board, it shall submit a written response outlining the
5    reasons for not accepting the recommendations.
6        In the case of proposed administrative rules or
7    amendments to administrative rules regarding immunization
8    of children against preventable communicable diseases
9    designated by the Director under the Communicable Disease
10    Prevention Act, after the Immunization Advisory Committee
11    has made its recommendations, the Board shall conduct 3
12    public hearings, geographically distributed throughout the
13    State. At the conclusion of the hearings, the State Board
14    of Health shall issue a report, including its
15    recommendations, to the Director. The Director shall take
16    into consideration any comments or recommendations made by
17    the Board based on these hearings.
18        (10) To deliver to the Governor for presentation to the
19    General Assembly a State Health Assessment (SHA) and a
20    State Health Improvement Plan (SHIP). The first 5 3 such
21    plans shall be delivered to the Governor on January 1,
22    2006, January 1, 2009, and January 1, 2016, January 1,
23    2021, and June 30, 2022, and then every 5 years thereafter.
24        The State Health Assessment and State Health
25    Improvement Plan Plan shall assess and recommend
26    priorities and strategies to improve the public health

 

 

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1    system, and the health status of Illinois residents, reduce
2    health disparities and inequities, and promote health
3    equity. The State Health Assessment and State Health
4    Improvement Plan development and implementation shall
5    conform to national Public Health Accreditation Board
6    Standards. The State Health Assessment and State Health
7    Improvement Plan development and implementation process
8    shall be carried out with the administrative and
9    operational support of the Department of Public Health
10    taking into consideration national health objectives and
11    system standards as frameworks for assessment.
12        The State Health Assessment shall include
13    comprehensive, broad-based data and information from a
14    variety of sources on health status and the public health
15    system including:
16            (i) quantitative data on the demographics and
17        health status of the population, including data over
18        time on health by gender, sex, race, ethnicity, age,
19        socio-economic factors, geographic region, and other
20        indicators of disparity;
21            (ii) quantitative data on social and structural
22        issues affecting health (social and structural
23        determinants of health), including, but not limited
24        to, housing, transportation, educational attainment,
25        employment, and income inequality;
26            (iii) priorities and strategies developed at the

 

 

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1        community level through the Illinois Project for Local
2        Assessment of Needs (IPLAN) and other local and
3        regional community health needs assessments;
4            (iv) qualitative data representing the
5        population's input on health concerns and well-being,
6        including the perceptions of people experiencing
7        disparities and health inequities;
8            (v) information on health disparities and health
9        inequities; and
10            (vi) information on public health system strengths
11        and areas for improvement.
12        The Plan shall also take into consideration priorities
13    and strategies developed at the community level through the
14    Illinois Project for Local Assessment of Needs (IPLAN) and
15    any regional health improvement plans that may be
16    developed.
17        The State Health Improvement Plan Plan shall focus on
18    prevention, social determinants of health, and promoting
19    health equity as key strategies as a key strategy for
20    long-term health improvement in Illinois.
21        The State Health Improvement Plan Plan shall identify
22    priority State health issues and social issues affecting
23    health, and shall examine and make recommendations on the
24    contributions and strategies of the public and private
25    sectors for improving health status and the public health
26    system in the State. In addition to recommendations on

 

 

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1    health status improvement priorities and strategies for
2    the population of the State as a whole, the State Health
3    Improvement Plan Plan shall make recommendations regarding
4    priorities and strategies for reducing and eliminating
5    health disparities and health inequities in Illinois;
6    including racial, ethnic, gender, sex, age,
7    socio-economic, and geographic disparities. The State
8    Health Improvement Plan shall make recommendations
9    regarding social determinants of health, such as housing,
10    transportation, educational attainment, employment, and
11    income inequality.
12        The development and implementation of the State Health
13    Assessment and State Health Improvement Plan shall be a
14    collaborative public-private cross-agency effort overseen
15    by the SHA and SHIP Partnership. The Director of Public
16    Health shall consult with the Governor to ensure
17    participation by the head of State agencies with public
18    health responsibilities (or their designees) in the SHA and
19    SHIP Partnership, including, but not limited to, the
20    Department of Public Health, the Department of Human
21    Services, the Department of Healthcare and Family
22    Services, the Department of Children and Family Services,
23    the Environmental Protection Agency, the Illinois State
24    Board of Education, the Department on Aging, the Illinois
25    Housing Development Authority, the Illinois Criminal
26    Justice Information Authority, the Department of

 

 

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1    Agriculture, the Department of Transportation, the
2    Department of Corrections, the Department of Commerce and
3    Economic Opportunity, and the Chair of the State Board of
4    Health to also serve on the Partnership. A member of the
5    Governors' staff shall participate in the Partnership and
6    serve as a liaison to the Governors' office.
7        The Director of the Illinois Department of Public
8    Health shall appoint a minimum of 20 other members of the
9    SHA and SHIP Partnership representing a Planning Team that
10    includes a range of public, private, and voluntary sector
11    stakeholders and participants in the public health system.
12    For the first SHA and SHIP Partnership after the effective
13    date of this amendatory Act of the 102nd General Assembly,
14    one-half of the members shall be appointed for a 3-year
15    term, and one-half of the members shall be appointed for a
16    5-year term. Subsequently, members shall be appointed to
17    5-year terms. Should any member not be able to fulfill his
18    or her term, the Director may appoint a replacement to
19    complete that term. The Director, in consultation with the
20    SHA and SHIP Partnership, may engage additional
21    individuals and organizations to serve on subcommittees
22    and ad hoc efforts to conduct the State Health Assessment
23    and develop and implement the State Health Improvement
24    Plan. Members of the SHA and SHIP Partnership shall receive
25    no compensation for serving as members, but may be
26    reimbursed for their necessary expenses.

 

 

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1        The SHA and SHIP Partnership This Team shall include:
2    the directors of State agencies with public health
3    responsibilities (or their designees), including but not
4    limited to the Illinois Departments of Public Health and
5    Department of Human Services, representatives of local
6    health departments, representatives of local community
7    health partnerships, and individuals with expertise who
8    represent an array of organizations and constituencies
9    engaged in public health improvement and prevention, such
10    as non-profit public interest groups, groups serving
11    populations that experience health disparities and health
12    inequities, groups addressing social determinants of
13    health, health issue groups, faith community groups,
14    health care providers, businesses and employers, academic
15    institutions, and community-based organizations.
16        The Director shall endeavor to make the membership of
17    the Partnership diverse and inclusive of the racial,
18    ethnic, gender, socio-economic, and geographic diversity
19    of the State. The SHA and SHIP Partnership shall be chaired
20    by the Director of Public Health or his or her designee.
21        The SHA and SHIP Partnership shall develop and
22    implement a community engagement process that facilitates
23    input into the development of the State Health Assessment
24    and State Health Improvement Plan. This engagement process
25    shall ensure that individuals with lived experience in the
26    issues addressed in the State Health Assessment and State

 

 

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1    Health Improvement Plan are meaningfully engaged in the
2    development and implementation of the State Health
3    Assessment and State Health Improvement Plan.
4        The State Board of Health shall hold at least 3 public
5    hearings addressing a draft of the State Health Improvement
6    Plan drafts of the Plan in representative geographic areas
7    of the State. Members of the Planning Team shall receive no
8    compensation for their services, but may be reimbursed for
9    their necessary expenses.
10        Upon the delivery of each State Health Improvement
11    Plan, the Governor shall appoint a SHIP Implementation
12    Coordination Council that includes a range of public,
13    private, and voluntary sector stakeholders and
14    participants in the public health system. The Council shall
15    include the directors of State agencies and entities with
16    public health system responsibilities (or their
17    designees), including but not limited to the Department of
18    Public Health, Department of Human Services, Department of
19    Healthcare and Family Services, Environmental Protection
20    Agency, Illinois State Board of Education, Department on
21    Aging, Illinois Violence Prevention Authority, Department
22    of Agriculture, Department of Insurance, Department of
23    Financial and Professional Regulation, Department of
24    Transportation, and Department of Commerce and Economic
25    Opportunity and the Chair of the State Board of Health. The
26    Council shall include representatives of local health

 

 

10100HB3840sam001- 159 -LRB101 12454 CPF 74517 a

1    departments and individuals with expertise who represent
2    an array of organizations and constituencies engaged in
3    public health improvement and prevention, including
4    non-profit public interest groups, health issue groups,
5    faith community groups, health care providers, businesses
6    and employers, academic institutions, and community-based
7    organizations. The Governor shall endeavor to make the
8    membership of the Council representative of the racial,
9    ethnic, gender, socio-economic, and geographic diversity
10    of the State. The Governor shall designate one State agency
11    representative and one other non-governmental member as
12    co-chairs of the Council. The Governor shall designate a
13    member of the Governor's office to serve as liaison to the
14    Council and one or more State agencies to provide or
15    arrange for support to the Council. The members of the SHIP
16    Implementation Coordination Council for each State Health
17    Improvement Plan shall serve until the delivery of the
18    subsequent State Health Improvement Plan, whereupon a new
19    Council shall be appointed. Members of the SHIP Planning
20    Team may serve on the SHIP Implementation Coordination
21    Council if so appointed by the Governor.
22        Upon the delivery of each State Health Assessment and
23    State Health Improvement Plan, the SHA and SHIP Partnership
24    The SHIP Implementation Coordination Council shall
25    coordinate the efforts and engagement of the public,
26    private, and voluntary sector stakeholders and

 

 

10100HB3840sam001- 160 -LRB101 12454 CPF 74517 a

1    participants in the public health system to implement each
2    SHIP. The Partnership Council shall serve as a forum for
3    collaborative action; coordinate existing and new
4    initiatives; develop detailed implementation steps, with
5    mechanisms for action; implement specific projects;
6    identify public and private funding sources at the local,
7    State and federal level; promote public awareness of the
8    SHIP; and advocate for the implementation of the SHIP. The
9    SHA and SHIP Partnership shall implement strategies to
10    ensure that individuals and communities affected by health
11    disparities and health inequities are engaged in the
12    process throughout the 5-year cycle. The SHA and SHIP
13    Partnership shall not have the authority to direct any
14    public or private entity to take specific action to
15    implement the SHIP. ; and develop an annual report to the
16    Governor, General Assembly, and public regarding the
17    status of implementation of the SHIP. The Council shall
18    not, however, have the authority to direct any public or
19    private entity to take specific action to implement the
20    SHIP.
21        The SHA and SHIP Partnership shall regularly evaluate
22    and update the State Health Assessment and track
23    implementation of the State Health Improvement Plan with
24    revisions as necessary. The State Board of Health shall
25    submit a report by January 31 of each year on the status of
26    State Health Improvement Plan implementation and community

 

 

10100HB3840sam001- 161 -LRB101 12454 CPF 74517 a

1    engagement activities to the Governor, General Assembly,
2    and public. In the fifth year, the report may be
3    consolidated into the new State Health Assessment and State
4    Health Improvement Plan.
5        (11) Upon the request of the Governor, to recommend to
6    the Governor candidates for Director of Public Health when
7    vacancies occur in the position.
8        (12) To adopt bylaws for the conduct of its own
9    business, including the authority to establish ad hoc
10    committees to address specific public health programs
11    requiring resolution.
12        (13) (Blank).
13    Upon appointment, the Board shall elect a chairperson from
14among its members.
15    Members of the Board shall receive compensation for their
16services at the rate of $150 per day, not to exceed $10,000 per
17year, as designated by the Director for each day required for
18transacting the business of the Board and shall be reimbursed
19for necessary expenses incurred in the performance of their
20duties. The Board shall meet from time to time at the call of
21the Department, at the call of the chairperson, or upon the
22request of 3 of its members, but shall not meet less than 4
23times per year.
24    (b) (Blank).
25    (c) An Advisory Board on Necropsy Service to Coroners,
26which shall counsel and advise with the Director on the

 

 

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1administration of the Autopsy Act. The Advisory Board shall
2consist of 11 members, including a senior citizen age 60 or
3over, appointed by the Governor, one of whom shall be
4designated as chairman by a majority of the members of the
5Board. In the appointment of the first Board the Governor shall
6appoint 3 members to serve for terms of 1 year, 3 for terms of 2
7years, and 3 for terms of 3 years. The members first appointed
8under Public Act 83-1538 shall serve for a term of 3 years. All
9members appointed thereafter shall be appointed for terms of 3
10years, except that when an appointment is made to fill a
11vacancy, the appointment shall be for the remaining term of the
12position vacant. The members of the Board shall be citizens of
13the State of Illinois. In the appointment of members of the
14Advisory Board the Governor shall appoint 3 members who shall
15be persons licensed to practice medicine and surgery in the
16State of Illinois, at least 2 of whom shall have received
17post-graduate training in the field of pathology; 3 members who
18are duly elected coroners in this State; and 5 members who
19shall have interest and abilities in the field of forensic
20medicine but who shall be neither persons licensed to practice
21any branch of medicine in this State nor coroners. In the
22appointment of medical and coroner members of the Board, the
23Governor shall invite nominations from recognized medical and
24coroners organizations in this State respectively. Board
25members, while serving on business of the Board, shall receive
26actual necessary travel and subsistence expenses while so

 

 

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1serving away from their places of residence.
2(Source: P.A. 98-463, eff. 8-16-13; 99-527, eff. 1-1-17;
3revised 7-17-19.)
 
4
Article 125.

 
5    Section 125-1. Short title. This Article may be cited as
6the Health and Human Services Task Force and Study Act.
7References in this Article to "this Act" mean this Article.
 
8    Section 125-5. Findings. The General Assembly finds that:
9        (1) The State is committed to improving the health and
10    well-being of Illinois residents and families.
11        (2) According to data collected by the Kaiser
12    Foundation, Illinois had over 905,000 uninsured residents
13    in 2019, with a total uninsured rate of 7.3%.
14        (3) Many Illinois residents and families who have
15    health insurance cannot afford to use it due to high
16    deductibles and cost sharing.
17        (4) Lack of access to affordable health care services
18    disproportionately affects minority communities throughout
19    the State, leading to poorer health outcomes among those
20    populations.
21        (5) Illinois Medicaid beneficiaries are not receiving
22    the coordinated and effective care they need to support
23    their overall health and well-being.

 

 

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1        (6) Illinois has an opportunity to improve the health
2    and well-being of a historically underserved and
3    vulnerable population by providing more coordinated and
4    higher quality care to its Medicaid beneficiaries.
5        (7) The State of Illinois has a responsibility to help
6    crime victims access justice, assistance, and the support
7    they need to heal.
8        (8) Research has shown that people who are repeatedly
9    victimized are more likely to face mental health problems
10    such as depression, anxiety, and symptoms related to
11    post-traumatic stress disorder and chronic trauma.
12        (9) Trauma-informed care has been promoted and
13    established in communities across the country on a
14    bipartisan basis, and numerous federal agencies have
15    integrated trauma-informed approaches into their programs
16    and grants, which should be leveraged by the State of
17    Illinois.
18        (10) Infants, children, and youth and their families
19    who have experienced or are at risk of experiencing trauma,
20    including those who are low-income, homeless, involved
21    with the child welfare system, involved in the juvenile or
22    adult justice system, unemployed, or not enrolled in or at
23    risk of dropping out of an educational institution and live
24    in a community that has faced acute or long-term exposure
25    to substantial discrimination, historical oppression,
26    intergenerational poverty, a high rate of violence or drug

 

 

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1    overdose deaths, should have an opportunity for improved
2    outcomes; this means increasing access to greater
3    opportunities to meet educational, employment, health,
4    developmental, community reentry, permanency from foster
5    care, or other key goals.
 
6    Section 125-10. Health and Human Services Task Force. The
7Health and Human Services Task Force is created within the
8Department of Human Services to undertake a systematic review
9of health and human service departments and programs with the
10goal of improving health and human service outcomes for
11Illinois residents.
 
12    Section 125-15. Study.
13    (1) The Task Force shall review all health and human
14service departments and programs and make recommendations for
15achieving a system that will improve interagency
16interoperability with respect to improving access to
17healthcare, healthcare disparities, workforce competency and
18diversity, social determinants of health, and data sharing and
19collection. These recommendations shall include, but are not
20limited to, the following elements:
21        (i) impact on infant and maternal mortality;
22        (ii) impact of hospital closures, including safety-net
23    hospitals, on local communities; and
24        (iii) impact on Medicaid Managed Care Organizations.

 

 

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1    (2) The Task Force shall review and make recommendations on
2ways the Medicaid program can partner and cooperate with other
3agencies, including but not limited to the Department of
4Agriculture, the Department of Insurance, the Department of
5Human Services, the Department of Labor, the Environmental
6Protection Agency, and the Department of Public Health, to
7better address social determinants of public health,
8including, but not limited to, food deserts, affordable
9housing, environmental pollutions, employment, education, and
10public support services. This shall include a review and
11recommendations on ways Medicaid and the agencies can share
12costs related to better health outcomes.
13    (3) The Task Force shall review the current partnership,
14communication, and cooperation between Federally Qualified
15Health Centers (FQHCs) and safety-net hospitals in Illinois and
16make recommendations on public policies that will improve
17interoperability and cooperations between these entities in
18order to achieve improved coordinated care and better health
19outcomes for vulnerable populations in the State.
20    (4) The Task Force shall review and examine public policies
21affecting trauma and social determinants of health, including
22trauma-informed care, and make recommendations on ways to
23improve and integrate trauma-informed approaches into programs
24and agencies in the State, including, but not limited to,
25Medicaid and other health care programs administered by the
26State, and increase awareness of trauma and its effects on

 

 

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1communities across Illinois.
2    (5) The Task Force shall review and examine the connection
3between access to education and health outcomes particularly in
4African American and minority communities and make
5recommendations on public policies to address any gaps or
6deficiencies.
 
7    Section 125-20. Membership; appointments; meetings;
8support.
9    (1) The Task Force shall include representation from both
10public and private organizations, and its membership shall
11reflect regional, racial, and cultural diversity to ensure
12representation of the needs of all Illinois citizens. Task
13Force members shall include one member appointed by the
14President of the Senate, one member appointed by the Minority
15Leader of the Senate, one member appointed by the Speaker of
16the House of Representatives, one member appointed by the
17Minority Leader of the House of Representatives, and other
18members appointed by the Governor. The Governor's appointments
19shall include, without limitation, the following:
20        (A) One member of the Senate, appointed by the Senate
21    President, who shall serve as Co-Chair;
22        (B) One member of the House of Representatives,
23    appointed by the Speaker of the House, who shall serve as
24    Co-Chair;
25        (C) Eight members of the General Assembly representing

 

 

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1    each of the majority and minority caucuses of each chamber.
2        (D) The Directors or Secretaries of the following State
3    agencies or their designees:
4            (i) Department of Human Services.
5            (ii) Department of Children and Family Services.
6            (iii) Department of Healthcare and Family
7        Services.
8            (iv) State Board of Education.
9            (v) Department on Aging.
10            (vi) Department of Public Health.
11            (vii) Department of Veterans' Affairs.
12            (viii) Department of Insurance.
13        (E) Local government stakeholders and nongovernmental
14    stakeholders with an interest in human services, including
15    representation among the following private-sector fields
16    and constituencies:
17            (i) Early childhood education and development.
18            (ii) Child care.
19            (iii) Child welfare.
20            (iv) Youth services.
21            (v) Developmental disabilities.
22            (vi) Mental health.
23            (vii) Employment and training.
24            (viii) Sexual and domestic violence.
25            (ix) Alcohol and substance abuse.
26            (x) Local community collaborations among human

 

 

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1        services programs.
2            (xi) Immigrant services.
3            (xii) Affordable housing.
4            (xiii) Food and nutrition.
5            (xiv) Homelessness.
6            (xv) Older adults.
7            (xvi) Physical disabilities.
8            (xvii) Maternal and child health.
9            (xviii) Medicaid managed care organizations.
10            (xix) Healthcare delivery.
11            (xx) Health insurance.
12    (2) Members shall serve without compensation for the
13duration of the Task Force.
14    (3) In the event of a vacancy, the appointment to fill the
15vacancy shall be made in the same manner as the original
16appointment.
17    (4) The Task Force shall convene within 60 days after the
18effective date of this Act. The initial meeting of the Task
19Force shall be convened by the co-chair selected by the
20Governor. Subsequent meetings shall convene at the call of the
21co-chairs. The Task Force shall meet on a quarterly basis, or
22more often if necessary.
23    (5) The Department of Human Services shall provide
24administrative support to the Task Force.
 
25    Section 125-25. Report. The Task Force shall report to the

 

 

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1Governor and the General Assembly on the Task Force's progress
2toward its goals and objectives by June 30, 2021, and every
3June 30 thereafter.
 
4    Section 125-30. Transparency. In addition to whatever
5policies or procedures it may adopt, all operations of the Task
6Force shall be subject to the provisions of the Freedom of
7Information Act and the Open Meetings Act. This Section shall
8not be construed so as to preclude other State laws from
9applying to the Task Force and its activities.
 
10    Section 125-40. Repeal. This Article is repealed June 30,
112023.
 
12
Article 130.

 
13    Section 130-1. Short title. This Article may be cited as
14the Anti-Racism Commission Act. References in this Article to
15"this Act" mean this Article.
 
16    Section 130-5. Findings. The General Assembly finds and
17declares all of the following:
18        (1) Public health is the science and art of preventing
19    disease, of protecting and improving the health of people,
20    entire populations, and their communities; this work is
21    achieved by promoting healthy lifestyles and choices,

 

 

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1    researching disease, and preventing injury.
2        (2) Public health professionals try to prevent
3    problems from happening or recurring through implementing
4    educational programs, recommending policies, administering
5    services, and limiting health disparities through the
6    promotion of equitable and accessible healthcare.
7        (3) According to the Centers for Disease Control and
8    Prevention, racism and segregation in the State of Illinois
9    have exacerbated a health divide, resulting in Black
10    residents having lower life expectancies than white
11    citizens of this State and being far more likely than other
12    races to die prematurely (before the age of 75) and to die
13    of heart disease or stroke; Black residents of Illinois
14    have a higher level of infant mortality, lower birth weight
15    babies, and are more likely to be overweight or obese as
16    adults, have adult diabetes, and have long-term
17    complications from diabetes that exacerbate other
18    conditions, including the susceptibility to COVID-19.
19        (4) Black and Brown people are more likely to
20    experience poor health outcomes as a consequence of their
21    social determinants of health, health inequities stemming
22    from economic instability, education, physical
23    environment, food, and access to health care systems.
24        (5) Black residents in Illinois are more likely than
25    white residents to experience violence-related trauma as a
26    result of socioeconomic conditions resulting from systemic

 

 

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1    racism.
2        (6) Racism is a social system with multiple dimensions
3    in which individual racism is internalized or
4    interpersonal and systemic racism is institutional or
5    structural and is a system of structuring opportunity and
6    assigning value based on the social interpretation of how
7    one looks; this unfairly disadvantages specific
8    individuals and communities, while unfairly giving
9    advantages to other individuals and communities; it saps
10    the strength of the whole society through the waste of
11    human resources.
12        (7) Racism causes persistent racial discrimination
13    that influences many areas of life, including housing,
14    education, employment, and criminal justice; an emerging
15    body of research demonstrates that racism itself is a
16    social determinant of health.
17        (8) More than 100 studies have linked racism to worse
18    health outcomes.
19        (9) The American Public Health Association launched a
20    National Campaign against Racism.
21        (10) Public health's responsibilities to address
22    racism include reshaping our discourse and agenda so that
23    we all actively engage in racial justice work.
 
24    Section 130-10. Anti-Racism Commission.
25    (a) The Anti-Racism Commission is hereby created to

 

 

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1identify and propose statewide policies to eliminate systemic
2racism and advance equitable solutions for Black and Brown
3people in Illinois.
4    (b) The Anti-Racism Commission shall consist of the
5following members, who shall serve without compensation:
6        (1) one member of the House of Representatives,
7    appointed by the Speaker of the House of Representatives,
8    who shall serve as co-chair;
9        (2) one member of the Senate, appointed by the Senate
10    President, who shall serve as co-chair;
11        (3) one member of the House of Representatives,
12    appointed by the Minority Leader of the House of
13    Representatives;
14        (4) one member of the Senate, appointed by the Minority
15    Leader of the Senate;
16        (5) the Director of Public Health, or his or her
17    designee;
18        (6) the Chair of the House Black Caucus;
19        (7) the Chair of the Senate Black Caucus;
20        (8) the Chair of the Joint Legislative Black Caucus;
21        (9) the director of a statewide association
22    representing public health departments, appointed by the
23    Speaker of the House of Representatives;
24        (10) the Chair of the House Latino Caucus;
25        (11) the Chair of the Senate Latino Caucus;
26        (12) one community member appointed by the House Black

 

 

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1    Caucus Chair;
2        (13) one community member appointed by the Senate Black
3    Caucus Chair;
4        (14) one community member appointed by the House Latino
5    Caucus Chair; and
6        (15) one community member appointed by the Senate
7    Latino Caucus Chair.
8    (c) The Department of Public Health shall provide
9administrative support for the Commission.
10    (d) The Commission is charged with, but not limited to, the
11following tasks:
12        (1) Working to create an equity and justice-oriented
13    State government.
14        (2) Assessing the policy and procedures of all State
15    agencies to ensure racial equity is a core element of State
16    government.
17        (3) Developing and incorporating into the
18    organizational structure of State government a plan for
19    educational efforts to understand, address, and dismantle
20    systemic racism in government actions.
21        (4) Recommending and advocating for policies that
22    improve health in Black and Brown people and support local,
23    State, regional, and federal initiatives that advance
24    efforts to dismantle systemic racism.
25        (5) Working to build alliances and partnerships with
26    organizations that are confronting racism and encouraging

 

 

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1    other local, State, regional, and national entities to
2    recognize racism as a public health crisis.
3        (6) Promoting community engagement, actively engaging
4    citizens on issues of racism and assisting in providing
5    tools to engage actively and authentically with Black and
6    Brown people.
7        (7) Reviewing all portions of codified State laws
8    through the lens of racial equity.
9        (8) Working with the Department of Central Management
10    Services to update policies that encourage diversity in
11    human resources, including hiring, board appointments, and
12    vendor selection by agencies, and to review all grant
13    management activities with an eye toward equity and
14    workforce development.
15        (9) Recommending policies that promote racially
16    equitable economic and workforce development practices.
17        (10) Promoting and supporting all policies that
18    prioritize the health of all people, especially people of
19    color, by mitigating exposure to adverse childhood
20    experiences and trauma in childhood and ensuring
21    implementation of health and equity in all policies.
22        (11) Encouraging community partners and stakeholders
23    in the education, employment, housing, criminal justice,
24    and safety arenas to recognize racism as a public health
25    crisis and to implement policy recommendations.
26        (12) Identifying clear goals and objectives, including

 

 

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1    specific benchmarks, to assess progress.
2        (13) Holding public hearings across Illinois to
3    continue to explore and to recommend needed action by the
4    General Assembly.
5        (14) Working with the Governor and the General Assembly
6    to identify the necessary funds to support the Anti-Racism
7    Commission and its endeavors.
8        (15) Identifying resources to allocate to Black and
9    Brown communities on an annual basis.
10        (16) Encouraging corporate investment in anti-racism
11    policies in Black and Brown communities.
12    (e) The Commission shall submit its final report to the
13Governor and the General Assembly no later than December 31,
142021. The Commission is dissolved upon the filing of its
15report.
 
16    Section 130-15. Repeal. This Article is repealed on January
171, 2023.
 
18
Title VII. Hospital Closure

 
19
Article 135.

 
20    Section 135-5. The Illinois Health Facilities Planning Act
21is amended by changing Sections 4 and 8.7 and by adding Section
225.5 as follows:
 

 

 

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1    (20 ILCS 3960/4)  (from Ch. 111 1/2, par. 1154)
2    (Section scheduled to be repealed on December 31, 2029)
3    Sec. 4. Health Facilities and Services Review Board;
4membership; appointment; term; compensation; quorum.
5    (a) There is created the Health Facilities and Services
6Review Board, which shall perform the functions described in
7this Act. The Department shall provide operational support to
8the Board as necessary, including the provision of office
9space, supplies, and clerical, financial, and accounting
10services. The Board may contract for functions or operational
11support as needed. The Board may also contract with experts
12related to specific health services or facilities and create
13technical advisory panels to assist in the development of
14criteria, standards, and procedures used in the evaluation of
15applications for permit and exemption.
16    (b) The State Board shall consist of 11 9 voting members.
17All members shall be residents of Illinois and at least 4 shall
18reside outside the Chicago Metropolitan Statistical Area.
19Consideration shall be given to potential appointees who
20reflect the ethnic and cultural diversity of the State. Neither
21Board members nor Board staff shall be convicted felons or have
22pled guilty to a felony.
23    Each member shall have a reasonable knowledge of the
24practice, procedures and principles of the health care delivery
25system in Illinois, including at least 5 members who shall be

 

 

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1knowledgeable about health care delivery systems, health
2systems planning, finance, or the management of health care
3facilities currently regulated under the Act. One member shall
4be a representative of a non-profit health care consumer
5advocacy organization. Two members shall be representatives
6from the community with experience on the effects of
7discontinuing health care services or the closure of health
8care facilities on the surrounding community. A spouse, parent,
9sibling, or child of a Board member cannot be an employee,
10agent, or under contract with services or facilities subject to
11the Act. Prior to appointment and in the course of service on
12the Board, members of the Board shall disclose the employment
13or other financial interest of any other relative of the
14member, if known, in service or facilities subject to the Act.
15Members of the Board shall declare any conflict of interest
16that may exist with respect to the status of those relatives
17and recuse themselves from voting on any issue for which a
18conflict of interest is declared. No person shall be appointed
19or continue to serve as a member of the State Board who is, or
20whose spouse, parent, sibling, or child is, a member of the
21Board of Directors of, has a financial interest in, or has a
22business relationship with a health care facility.
23    Notwithstanding any provision of this Section to the
24contrary, the term of office of each member of the State Board
25serving on the day before the effective date of this amendatory
26Act of the 96th General Assembly is abolished on the date upon

 

 

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1which members of the 9-member Board, as established by this
2amendatory Act of the 96th General Assembly, have been
3appointed and can begin to take action as a Board.
4    (c) The State Board shall be appointed by the Governor,
5with the advice and consent of the Senate. Not more than 5 of
6the appointments shall be of the same political party at the
7time of the appointment.
8    The Secretary of Human Services, the Director of Healthcare
9and Family Services, and the Director of Public Health, or
10their designated representatives, shall serve as ex-officio,
11non-voting members of the State Board.
12    (d) Of those 9 members initially appointed by the Governor
13following the effective date of this amendatory Act of the 96th
14General Assembly, 3 shall serve for terms expiring July 1,
152011, 3 shall serve for terms expiring July 1, 2012, and 3
16shall serve for terms expiring July 1, 2013. Thereafter, each
17appointed member shall hold office for a term of 3 years,
18provided that any member appointed to fill a vacancy occurring
19prior to the expiration of the term for which his or her
20predecessor was appointed shall be appointed for the remainder
21of such term and the term of office of each successor shall
22commence on July 1 of the year in which his predecessor's term
23expires. Each member shall hold office until his or her
24successor is appointed and qualified. The Governor may
25reappoint a member for additional terms, but no member shall
26serve more than 3 terms, subject to review and re-approval

 

 

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1every 3 years.
2    (e) State Board members, while serving on business of the
3State Board, shall receive actual and necessary travel and
4subsistence expenses while so serving away from their places of
5residence. Until March 1, 2010, a member of the State Board who
6experiences a significant financial hardship due to the loss of
7income on days of attendance at meetings or while otherwise
8engaged in the business of the State Board may be paid a
9hardship allowance, as determined by and subject to the
10approval of the Governor's Travel Control Board.
11    (f) The Governor shall designate one of the members to
12serve as the Chairman of the Board, who shall be a person with
13expertise in health care delivery system planning, finance or
14management of health care facilities that are regulated under
15the Act. The Chairman shall annually review Board member
16performance and shall report the attendance record of each
17Board member to the General Assembly.
18    (g) The State Board, through the Chairman, shall prepare a
19separate and distinct budget approved by the General Assembly
20and shall hire and supervise its own professional staff
21responsible for carrying out the responsibilities of the Board.
22    (h) The State Board shall meet at least every 45 days, or
23as often as the Chairman of the State Board deems necessary, or
24upon the request of a majority of the members.
25    (i) Five members of the State Board shall constitute a
26quorum. The affirmative vote of 5 of the members of the State

 

 

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1Board shall be necessary for any action requiring a vote to be
2taken by the State Board. A vacancy in the membership of the
3State Board shall not impair the right of a quorum to exercise
4all the rights and perform all the duties of the State Board as
5provided by this Act.
6    (j) A State Board member shall disqualify himself or
7herself from the consideration of any application for a permit
8or exemption in which the State Board member or the State Board
9member's spouse, parent, sibling, or child: (i) has an economic
10interest in the matter; or (ii) is employed by, serves as a
11consultant for, or is a member of the governing board of the
12applicant or a party opposing the application.
13    (k) The Chairman, Board members, and Board staff must
14comply with the Illinois Governmental Ethics Act.
15(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
16    (20 ILCS 3960/5.5 new)
17    Sec. 5.5. Moratorium on hospital closures.    
18Notwithstanding any law or rule to the contrary, due to the
19COVID-19 pandemic, the State shall institute a moratorium on
20the closure of hospitals until December 31, 2023. As such, no
21hospital shall close or reduce capacity below the hospital's
22capacity as of January 1, 2020 before the end of such
23moratorium.
24    (b) This Section is repealed on January 1, 2024.
 

 

 

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1    (20 ILCS 3960/8.7)
2    (Section scheduled to be repealed on December 31, 2029)
3    Sec. 8.7. Application for permit for discontinuation of a
4health care facility or category of service; public notice and
5public hearing.
6    (a) Upon a finding that an application to close a health
7care facility or discontinue a category of service is complete,
8the State Board shall publish a legal notice on 3 consecutive
9days in a newspaper of general circulation in the area or
10community to be affected and afford the public an opportunity
11to request a hearing. If the application is for a facility
12located in a Metropolitan Statistical Area, an additional legal
13notice shall be published in a newspaper of limited
14circulation, if one exists, in the area in which the facility
15is located. If the newspaper of limited circulation is
16published on a daily basis, the additional legal notice shall
17be published on 3 consecutive days. The legal notice shall also
18be posted on the Health Facilities and Services Review Board's
19website and sent to the State Representative and State Senator
20of the district in which the health care facility is located.
21In addition, the health care facility shall provide notice of
22closure to the local media that the health care facility would
23routinely notify about facility events.
24    Upon the completion of an application to close a health
25care facility or discontinue a category of service, the State
26Board shall conduct a racial equity impact assessment to

 

 

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1determine the effect of the closure or discontinuation of
2service on racial and ethnic minorities. The results of the
3racial equity impact assessment shall be made available to the
4public.
5    An application to close a health care facility shall only
6be deemed complete if it includes evidence that the health care
7facility provided written notice at least 30 days prior to
8filing the application of its intent to do so to the
9municipality in which it is located, the State Representative
10and State Senator of the district in which the health care
11facility is located, the State Board, the Director of Public
12Health, and the Director of Healthcare and Family Services. The
13changes made to this subsection by this amendatory Act of the
14101st General Assembly shall apply to all applications
15submitted after the effective date of this amendatory Act of
16the 101st General Assembly.
17    (b) No later than 30 days after issuance of a permit to
18close a health care facility or discontinue a category of
19service, the permit holder shall give written notice of the
20closure or discontinuation to the State Senator and State
21Representative serving the legislative district in which the
22health care facility is located.
23    (c) If there is a pending lawsuit that challenges an
24application to discontinue a health care facility that either
25names the Board as a party or alleges fraud in the filing of
26the application, the Board may defer action on the application

 

 

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1for up to 6 months after the date of the initial deferral of
2the application.
3    (d) The changes made to this Section by this amendatory Act
4of the 101st General Assembly shall apply to all applications
5submitted after the effective date of this amendatory Act of
6the 101st General Assembly.
7(Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)
 
8
Title VIII. Managed Care Organization Reform

 
9
Article 145.

 
10    Section 145-5. The Illinois Public Aid Code is amended by
11changing Section 5-30.1 as follows:
 
12    (305 ILCS 5/5-30.1)
13    Sec. 5-30.1. Managed care protections.
14    (a) As used in this Section:
15    "Managed care organization" or "MCO" means any entity which
16contracts with the Department to provide services where payment
17for medical services is made on a capitated basis.
18    "Emergency services" include:
19        (1) emergency services, as defined by Section 10 of the
20    Managed Care Reform and Patient Rights Act;
21        (2) emergency medical screening examinations, as
22    defined by Section 10 of the Managed Care Reform and

 

 

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1    Patient Rights Act;
2        (3) post-stabilization medical services, as defined by
3    Section 10 of the Managed Care Reform and Patient Rights
4    Act; and
5        (4) emergency medical conditions, as defined by
6    Section 10 of the Managed Care Reform and Patient Rights
7    Act.
8    (b) As provided by Section 5-16.12, managed care
9organizations are subject to the provisions of the Managed Care
10Reform and Patient Rights Act.
11    (c) An MCO shall pay any provider of emergency services
12that does not have in effect a contract with the contracted
13Medicaid MCO. The default rate of reimbursement shall be the
14rate paid under Illinois Medicaid fee-for-service program
15methodology, including all policy adjusters, including but not
16limited to Medicaid High Volume Adjustments, Medicaid
17Percentage Adjustments, Outpatient High Volume Adjustments,
18and all outlier add-on adjustments to the extent such
19adjustments are incorporated in the development of the
20applicable MCO capitated rates.
21    (d) An MCO shall pay for all post-stabilization services as
22a covered service in any of the following situations:
23        (1) the MCO authorized such services;
24        (2) such services were administered to maintain the
25    enrollee's stabilized condition within one hour after a
26    request to the MCO for authorization of further

 

 

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1    post-stabilization services;
2        (3) the MCO did not respond to a request to authorize
3    such services within one hour;
4        (4) the MCO could not be contacted; or
5        (5) the MCO and the treating provider, if the treating
6    provider is a non-affiliated provider, could not reach an
7    agreement concerning the enrollee's care and an affiliated
8    provider was unavailable for a consultation, in which case
9    the MCO must pay for such services rendered by the treating
10    non-affiliated provider until an affiliated provider was
11    reached and either concurred with the treating
12    non-affiliated provider's plan of care or assumed
13    responsibility for the enrollee's care. Such payment shall
14    be made at the default rate of reimbursement paid under
15    Illinois Medicaid fee-for-service program methodology,
16    including all policy adjusters, including but not limited
17    to Medicaid High Volume Adjustments, Medicaid Percentage
18    Adjustments, Outpatient High Volume Adjustments and all
19    outlier add-on adjustments to the extent that such
20    adjustments are incorporated in the development of the
21    applicable MCO capitated rates.
22    (e) The following requirements apply to MCOs in determining
23payment for all emergency services:
24        (1) MCOs shall not impose any requirements for prior
25    approval of emergency services.
26        (2) The MCO shall cover emergency services provided to

 

 

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1    enrollees who are temporarily away from their residence and
2    outside the contracting area to the extent that the
3    enrollees would be entitled to the emergency services if
4    they still were within the contracting area.
5        (3) The MCO shall have no obligation to cover medical
6    services provided on an emergency basis that are not
7    covered services under the contract.
8        (4) The MCO shall not condition coverage for emergency
9    services on the treating provider notifying the MCO of the
10    enrollee's screening and treatment within 10 days after
11    presentation for emergency services.
12        (5) The determination of the attending emergency
13    physician, or the provider actually treating the enrollee,
14    of whether an enrollee is sufficiently stabilized for
15    discharge or transfer to another facility, shall be binding
16    on the MCO. The MCO shall cover emergency services for all
17    enrollees whether the emergency services are provided by an
18    affiliated or non-affiliated provider.
19        (6) The MCO's financial responsibility for
20    post-stabilization care services it has not pre-approved
21    ends when:
22            (A) a plan physician with privileges at the
23        treating hospital assumes responsibility for the
24        enrollee's care;
25            (B) a plan physician assumes responsibility for
26        the enrollee's care through transfer;

 

 

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1            (C) a contracting entity representative and the
2        treating physician reach an agreement concerning the
3        enrollee's care; or
4            (D) the enrollee is discharged.
5    (f) Network adequacy and transparency.
6        (1) The Department shall:
7            (A) ensure that an adequate provider network is in
8        place, taking into consideration health professional
9        shortage areas and medically underserved areas;
10            (B) publicly release an explanation of its process
11        for analyzing network adequacy;
12            (C) periodically ensure that an MCO continues to
13        have an adequate network in place; and
14            (D) require MCOs, including Medicaid Managed Care
15        Entities as defined in Section 5-30.2, to meet provider
16        directory requirements under Section 5-30.3.
17        (2) Each MCO shall confirm its receipt of information
18    submitted specific to physician or dentist additions or
19    physician or dentist deletions from the MCO's provider
20    network within 3 days after receiving all required
21    information from contracted physicians or dentists, and
22    electronic physician and dental directories must be
23    updated consistent with current rules as published by the
24    Centers for Medicare and Medicaid Services or its successor
25    agency.
26    (g) Timely payment of claims.

 

 

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1        (1) The MCO shall pay a claim within 30 days of
2    receiving a claim that contains all the essential
3    information needed to adjudicate the claim.
4        (2) The MCO shall notify the billing party of its
5    inability to adjudicate a claim within 30 days of receiving
6    that claim.
7        (3) The MCO shall pay a penalty that is at least equal
8    to the timely payment interest penalty imposed under
9    Section 368a of the Illinois Insurance Code for any claims
10    not timely paid.
11            (A) When an MCO is required to pay a timely payment
12        interest penalty to a provider, the MCO must calculate
13        and pay the timely payment interest penalty that is due
14        to the provider within 30 days after the payment of the
15        claim. In no event shall a provider be required to
16        request or apply for payment of any owed timely payment
17        interest penalties.
18            (B) Such payments shall be reported separately
19        from the claim payment for services rendered to the
20        MCO's enrollee and clearly identified as interest
21        payments.
22        (4)(A) The Department shall require MCOs to expedite
23    payments to providers identified on the Department's
24    expedited provider list, determined in accordance with 89
25    Ill. Adm. Code 140.71(b), on a schedule at least as
26    frequently as the providers are paid under the Department's

 

 

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1    fee-for-service expedited provider schedule.
2        (B) Compliance with the expedited provider requirement
3    may be satisfied by an MCO through the use of a Periodic
4    Interim Payment (PIP) program that has been mutually agreed
5    to and documented between the MCO and the provider, and the
6    PIP program ensures that any expedited provider receives
7    regular and periodic payments based on prior period payment
8    experience from that MCO. Total payments under the PIP
9    program may be reconciled against future PIP payments on a
10    schedule mutually agreed to between the MCO and the
11    provider.
12        (C) The Department shall share at least monthly its
13    expedited provider list and the frequency with which it
14    pays providers on the expedited list.
15    (g-5) Recognizing that the rapid transformation of the
16Illinois Medicaid program may have unintended operational
17challenges for both payers and providers:
18        (1) in no instance shall a medically necessary covered
19    service rendered in good faith, based upon eligibility
20    information documented by the provider, be denied coverage
21    or diminished in payment amount if the eligibility or
22    coverage information available at the time the service was
23    rendered is later found to be inaccurate in the assignment
24    of coverage responsibility between MCOs or the
25    fee-for-service system, except for instances when an
26    individual is deemed to have not been eligible for coverage

 

 

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1    under the Illinois Medicaid program; and
2        (2) the Department shall, by December 31, 2016, adopt
3    rules establishing policies that shall be included in the
4    Medicaid managed care policy and procedures manual
5    addressing payment resolutions in situations in which a
6    provider renders services based upon information obtained
7    after verifying a patient's eligibility and coverage plan
8    through either the Department's current enrollment system
9    or a system operated by the coverage plan identified by the
10    patient presenting for services:
11            (A) such medically necessary covered services
12        shall be considered rendered in good faith;
13            (B) such policies and procedures shall be
14        developed in consultation with industry
15        representatives of the Medicaid managed care health
16        plans and representatives of provider associations
17        representing the majority of providers within the
18        identified provider industry; and
19            (C) such rules shall be published for a review and
20        comment period of no less than 30 days on the
21        Department's website with final rules remaining
22        available on the Department's website.
23    The rules on payment resolutions shall include, but not be
24limited to:
25        (A) the extension of the timely filing period;
26        (B) retroactive prior authorizations; and

 

 

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1        (C) guaranteed minimum payment rate of no less than the
2    current, as of the date of service, fee-for-service rate,
3    plus all applicable add-ons, when the resulting service
4    relationship is out of network.
5    The rules shall be applicable for both MCO coverage and
6fee-for-service coverage.
7    If the fee-for-service system is ultimately determined to
8have been responsible for coverage on the date of service, the
9Department shall provide for an extended period for claims
10submission outside the standard timely filing requirements.
11    (g-6) MCO Performance Metrics Report.
12        (1) The Department shall publish, on at least a
13    quarterly basis, each MCO's operational performance,
14    including, but not limited to, the following categories of
15    metrics:
16            (A) claims payment, including timeliness and
17        accuracy;
18            (B) prior authorizations;
19            (C) grievance and appeals;
20            (D) utilization statistics;
21            (E) provider disputes;
22            (F) provider credentialing; and
23            (G) member and provider customer service.
24        (2) The Department shall ensure that the metrics report
25    is accessible to providers online by January 1, 2017.
26        (3) The metrics shall be developed in consultation with

 

 

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1    industry representatives of the Medicaid managed care
2    health plans and representatives of associations
3    representing the majority of providers within the
4    identified industry.
5        (4) Metrics shall be defined and incorporated into the
6    applicable Managed Care Policy Manual issued by the
7    Department.
8    (g-7) MCO claims processing and performance analysis. In
9order to monitor MCO payments to hospital providers, pursuant
10to this amendatory Act of the 100th General Assembly, the
11Department shall post an analysis of MCO claims processing and
12payment performance on its website every 6 months. Such
13analysis shall include a review and evaluation of a
14representative sample of hospital claims that are rejected and
15denied for clean and unclean claims and the top 5 reasons for
16such actions and timeliness of claims adjudication, which
17identifies the percentage of claims adjudicated within 30, 60,
1890, and over 90 days, and the dollar amounts associated with
19those claims. The Department shall post the contracted claims
20report required by HealthChoice Illinois on its website every 3
21months.
22    (g-8) Dispute resolution process. The Department shall
23maintain a provider complaint portal through which a provider
24can submit to the Department unresolved disputes with an MCO.
25An unresolved dispute means an MCO's decision that denies in
26whole or in part a claim for reimbursement to a provider for

 

 

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1health care services rendered by the provider to an enrollee of
2the MCO with which the provider disagrees. Disputes shall not
3be submitted to the portal until the provider has availed
4itself of the MCO's internal dispute resolution process.
5Disputes that are submitted to the MCO internal dispute
6resolution process may be submitted to the Department of
7Healthcare and Family Services' complaint portal no sooner than
830 days after submitting to the MCO's internal process and not
9later than 30 days after the unsatisfactory resolution of the
10internal MCO process or 60 days after submitting the dispute to
11the MCO internal process. Multiple claim disputes involving the
12same MCO may be submitted in one complaint, regardless of
13whether the claims are for different enrollees, when the
14specific reason for non-payment of the claims involves a common
15question of fact or policy. Within 10 business days of receipt
16of a complaint, the Department shall present such disputes to
17the appropriate MCO, which shall then have 30 days to issue its
18written proposal to resolve the dispute. The Department may
19grant one 30-day extension of this time frame to one of the
20parties to resolve the dispute. If the dispute remains
21unresolved at the end of this time frame or the provider is not
22satisfied with the MCO's written proposal to resolve the
23dispute, the provider may, within 30 days, request the
24Department to review the dispute and make a final
25determination. Within 30 days of the request for Department
26review of the dispute, both the provider and the MCO shall

 

 

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1present all relevant information to the Department for
2resolution and make individuals with knowledge of the issues
3available to the Department for further inquiry if needed.
4Within 30 days of receiving the relevant information on the
5dispute, or the lapse of the period for submitting such
6information, the Department shall issue a written decision on
7the dispute based on contractual terms between the provider and
8the MCO, contractual terms between the MCO and the Department
9of Healthcare and Family Services and applicable Medicaid
10policy. The decision of the Department shall be final. By
11January 1, 2020, the Department shall establish by rule further
12details of this dispute resolution process. Disputes between
13MCOs and providers presented to the Department for resolution
14are not contested cases, as defined in Section 1-30 of the
15Illinois Administrative Procedure Act, conferring any right to
16an administrative hearing.
17    (g-9)(1) The Department shall publish annually on its
18website a report on the calculation of each managed care
19organization's medical loss ratio showing the following:
20        (A) Premium revenue, with appropriate adjustments.
21        (B) Benefit expense, setting forth the aggregate
22    amount spent for the following:
23            (i) Direct paid claims.
24            (ii) Subcapitation payments.
25            (iii) Other claim payments.
26            (iv) Direct reserves.

 

 

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1            (v) Gross recoveries.
2            (vi) Expenses for activities that improve health
3        care quality as allowed by the Department.
4    (2) The medical loss ratio shall be calculated consistent
5with federal law and regulation following a claims runout
6period determined by the Department.
7    (g-10)(1) "Liability effective date" means the date on
8which an MCO becomes responsible for payment for medically
9necessary and covered services rendered by a provider to one of
10its enrollees in accordance with the contract terms between the
11MCO and the provider. The liability effective date shall be the
12later of:
13        (A) The execution date of a network participation
14    contract agreement.
15        (B) The date the provider or its representative submits
16    to the MCO the complete and accurate standardized roster
17    form for the provider in the format approved by the
18    Department.
19        (C) The provider effective date contained within the
20    Department's provider enrollment subsystem within the
21    Illinois Medicaid Program Advanced Cloud Technology
22    (IMPACT) System.
23    (2) The standardized roster form may be submitted to the
24MCO at the same time that the provider submits an enrollment
25application to the Department through IMPACT.
26    (3) By October 1, 2019, the Department shall require all

 

 

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1MCOs to update their provider directory with information for
2new practitioners of existing contracted providers within 30
3days of receipt of a complete and accurate standardized roster
4template in the format approved by the Department provided that
5the provider is effective in the Department's provider
6enrollment subsystem within the IMPACT system. Such provider
7directory shall be readily accessible for purposes of selecting
8an approved health care provider and comply with all other
9federal and State requirements.
10    (g-11) The Department shall work with relevant
11stakeholders on the development of operational guidelines to
12enhance and improve operational performance of Illinois'
13Medicaid managed care program, including, but not limited to,
14improving provider billing practices, reducing claim
15rejections and inappropriate payment denials, and
16standardizing processes, procedures, definitions, and response
17timelines, with the goal of reducing provider and MCO
18administrative burdens and conflict. The Department shall
19include a report on the progress of these program improvements
20and other topics in its Fiscal Year 2020 annual report to the
21General Assembly.
22    (h) The Department shall not expand mandatory MCO
23enrollment into new counties beyond those counties already
24designated by the Department as of June 1, 2014 for the
25individuals whose eligibility for medical assistance is not the
26seniors or people with disabilities population until the

 

 

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1Department provides an opportunity for accountable care
2entities and MCOs to participate in such newly designated
3counties.
4    (h-5) MCOs shall be required to publish, at least quarterly
5for the preceding quarter, on their websites:
6        (1) the total number of claims received by the MCO;
7        (2) the number and monetary amount of claims payments
8    made to a service provider as defined in Section 2-16 of
9    this Code;
10        (3) the dates of services rendered for the claims
11    payments made under paragraph (2);
12        (4) the dates the claims were received by the MCO for
13    the claims payments made under paragraph (2); and
14        (5) the dates on which claims payments under paragraph
15    (2) were released.
16    (i) The requirements of this Section apply to contracts
17with accountable care entities and MCOs entered into, amended,
18or renewed after June 16, 2014 (the effective date of Public
19Act 98-651).
20    (j) Health care information released to managed care
21organizations. A health care provider shall release to a
22Medicaid managed care organization, upon request, and subject
23to the Health Insurance Portability and Accountability Act of
241996 and any other law applicable to the release of health
25information, the health care information of the MCO's enrollee,
26if the enrollee has completed and signed a general release form

 

 

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1that grants to the health care provider permission to release
2the recipient's health care information to the recipient's
3insurance carrier.
4(Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18;
5100-587, eff. 6-4-18; 101-209, eff. 8-5-19.)
 
6
Article 150.

 
7    Section 150-5. The Illinois Public Aid Code is amended by
8changing Section 5-30.1 and by adding Section 5-30.15 as
9follows:
 
10    (305 ILCS 5/5-30.1)
11    Sec. 5-30.1. Managed care protections.
12    (a) As used in this Section:
13    "Managed care organization" or "MCO" means any entity which
14contracts with the Department to provide services where payment
15for medical services is made on a capitated basis.
16    "Emergency services" include:
17        (1) emergency services, as defined by Section 10 of the
18    Managed Care Reform and Patient Rights Act;
19        (2) emergency medical screening examinations, as
20    defined by Section 10 of the Managed Care Reform and
21    Patient Rights Act;
22        (3) post-stabilization medical services, as defined by
23    Section 10 of the Managed Care Reform and Patient Rights

 

 

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1    Act; and
2        (4) emergency medical conditions, as defined by
3    Section 10 of the Managed Care Reform and Patient Rights
4    Act.
5    (b) As provided by Section 5-16.12, managed care
6organizations are subject to the provisions of the Managed Care
7Reform and Patient Rights Act.
8    (c) An MCO shall pay any provider of emergency services
9that does not have in effect a contract with the contracted
10Medicaid MCO. The default rate of reimbursement shall be the
11rate paid under Illinois Medicaid fee-for-service program
12methodology, including all policy adjusters, including but not
13limited to Medicaid High Volume Adjustments, Medicaid
14Percentage Adjustments, Outpatient High Volume Adjustments,
15and all outlier add-on adjustments to the extent such
16adjustments are incorporated in the development of the
17applicable MCO capitated rates.
18    (d) An MCO shall pay for all post-stabilization services as
19a covered service in any of the following situations:
20        (1) the MCO authorized such services;
21        (2) such services were administered to maintain the
22    enrollee's stabilized condition within one hour after a
23    request to the MCO for authorization of further
24    post-stabilization services;
25        (3) the MCO did not respond to a request to authorize
26    such services within one hour;

 

 

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1        (4) the MCO could not be contacted; or
2        (5) the MCO and the treating provider, if the treating
3    provider is a non-affiliated provider, could not reach an
4    agreement concerning the enrollee's care and an affiliated
5    provider was unavailable for a consultation, in which case
6    the MCO must pay for such services rendered by the treating
7    non-affiliated provider until an affiliated provider was
8    reached and either concurred with the treating
9    non-affiliated provider's plan of care or assumed
10    responsibility for the enrollee's care. Such payment shall
11    be made at the default rate of reimbursement paid under
12    Illinois Medicaid fee-for-service program methodology,
13    including all policy adjusters, including but not limited
14    to Medicaid High Volume Adjustments, Medicaid Percentage
15    Adjustments, Outpatient High Volume Adjustments and all
16    outlier add-on adjustments to the extent that such
17    adjustments are incorporated in the development of the
18    applicable MCO capitated rates.
19    (e) The following requirements apply to MCOs in determining
20payment for all emergency services:
21        (1) MCOs shall not impose any requirements for prior
22    approval of emergency services.
23        (2) The MCO shall cover emergency services provided to
24    enrollees who are temporarily away from their residence and
25    outside the contracting area to the extent that the
26    enrollees would be entitled to the emergency services if

 

 

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1    they still were within the contracting area.
2        (3) The MCO shall have no obligation to cover medical
3    services provided on an emergency basis that are not
4    covered services under the contract.
5        (4) The MCO shall not condition coverage for emergency
6    services on the treating provider notifying the MCO of the
7    enrollee's screening and treatment within 10 days after
8    presentation for emergency services.
9        (5) The determination of the attending emergency
10    physician, or the provider actually treating the enrollee,
11    of whether an enrollee is sufficiently stabilized for
12    discharge or transfer to another facility, shall be binding
13    on the MCO. The MCO shall cover emergency services for all
14    enrollees whether the emergency services are provided by an
15    affiliated or non-affiliated provider.
16        (6) The MCO's financial responsibility for
17    post-stabilization care services it has not pre-approved
18    ends when:
19            (A) a plan physician with privileges at the
20        treating hospital assumes responsibility for the
21        enrollee's care;
22            (B) a plan physician assumes responsibility for
23        the enrollee's care through transfer;
24            (C) a contracting entity representative and the
25        treating physician reach an agreement concerning the
26        enrollee's care; or

 

 

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1            (D) the enrollee is discharged.
2    (f) Network adequacy and transparency.
3        (1) The Department shall:
4            (A) ensure that an adequate provider network is in
5        place, taking into consideration health professional
6        shortage areas and medically underserved areas;
7            (B) publicly release an explanation of its process
8        for analyzing network adequacy;
9            (C) periodically ensure that an MCO continues to
10        have an adequate network in place; and
11            (D) require MCOs, including Medicaid Managed Care
12        Entities as defined in Section 5-30.2, to meet provider
13        directory requirements under Section 5-30.3; and .
14            (E) require MCOs to: (i) ensure that any provider
15        under contract with an MCO on the date of service is
16        paid for any medically necessary service rendered to
17        any of the MCO's enrollees, regardless of inclusion on
18        the MCO's published and publicly available roster of
19        available providers; and (ii) ensure that all
20        contracted providers are listed on an updated roster
21        within 7 days of entering into a contract with the MCO
22        and that such roster is readily accessible to all
23        medical assistance enrollees for purposes of selecting
24        an approved healthcare provider.
25        (2) Each MCO shall confirm its receipt of information
26    submitted specific to physician or dentist additions or

 

 

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1    physician or dentist deletions from the MCO's provider
2    network within 3 days after receiving all required
3    information from contracted physicians or dentists, and
4    electronic physician and dental directories must be
5    updated consistent with current rules as published by the
6    Centers for Medicare and Medicaid Services or its successor
7    agency.
8    (g) Timely payment of claims.
9        (1) The MCO shall pay a claim within 30 days of
10    receiving a claim that contains all the essential
11    information needed to adjudicate the claim.
12        (2) The MCO shall notify the billing party of its
13    inability to adjudicate a claim within 30 days of receiving
14    that claim.
15        (3) The MCO shall pay a penalty that is at least equal
16    to the timely payment interest penalty imposed under
17    Section 368a of the Illinois Insurance Code for any claims
18    not timely paid.
19            (A) When an MCO is required to pay a timely payment
20        interest penalty to a provider, the MCO must calculate
21        and pay the timely payment interest penalty that is due
22        to the provider within 30 days after the payment of the
23        claim. In no event shall a provider be required to
24        request or apply for payment of any owed timely payment
25        interest penalties.
26            (B) Such payments shall be reported separately

 

 

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1        from the claim payment for services rendered to the
2        MCO's enrollee and clearly identified as interest
3        payments.
4        (4)(A) The Department shall require MCOs to expedite
5    payments to providers based on criteria that include, but
6    are not limited to:
7            (A) At a minimum, each MCO shall ensure that
8        providers identified on the Department's expedited
9        provider list, determined in accordance with 89 Ill.
10        Adm. Code 140.71(b), are paid by the MCO on a schedule
11        at least as frequently as the providers are paid under
12        the Department's fee-for-service expedited provider
13        schedule.
14            (B) Compliance with the expedited provider
15        requirement may be satisfied by an MCO through the use
16        of a Periodic Interim Payment (PIP) program that has
17        been mutually agreed to and documented between the MCO
18        and the provider, if and the PIP program ensures that
19        any expedited provider receives regular and periodic
20        payments based on prior period payment experience from
21        that MCO. Total payments under the PIP program may be
22        reconciled against future PIP payments on a schedule
23        mutually agreed to between the MCO and the provider.
24            (C) The Department shall share at least monthly its
25        expedited provider list and the frequency with which it
26        pays providers on the expedited list.

 

 

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1    (g-5) Recognizing that the rapid transformation of the
2Illinois Medicaid program may have unintended operational
3challenges for both payers and providers:
4        (1) in no instance shall a medically necessary covered
5    service rendered in good faith, based upon eligibility
6    information documented by the provider, be denied coverage
7    or diminished in payment amount if the eligibility or
8    coverage information available at the time the service was
9    rendered is later found to be inaccurate in the assignment
10    of coverage responsibility between MCOs or the
11    fee-for-service system, except for instances when an
12    individual is deemed to have not been eligible for coverage
13    under the Illinois Medicaid program; and
14        (2) the Department shall, by December 31, 2016, adopt
15    rules establishing policies that shall be included in the
16    Medicaid managed care policy and procedures manual
17    addressing payment resolutions in situations in which a
18    provider renders services based upon information obtained
19    after verifying a patient's eligibility and coverage plan
20    through either the Department's current enrollment system
21    or a system operated by the coverage plan identified by the
22    patient presenting for services:
23            (A) such medically necessary covered services
24        shall be considered rendered in good faith;
25            (B) such policies and procedures shall be
26        developed in consultation with industry

 

 

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1        representatives of the Medicaid managed care health
2        plans and representatives of provider associations
3        representing the majority of providers within the
4        identified provider industry; and
5            (C) such rules shall be published for a review and
6        comment period of no less than 30 days on the
7        Department's website with final rules remaining
8        available on the Department's website.
9    The rules on payment resolutions shall include, but not be
10limited to:
11        (A) the extension of the timely filing period;
12        (B) retroactive prior authorizations; and
13        (C) guaranteed minimum payment rate of no less than the
14    current, as of the date of service, fee-for-service rate,
15    plus all applicable add-ons, when the resulting service
16    relationship is out of network.
17    The rules shall be applicable for both MCO coverage and
18fee-for-service coverage.
19    If the fee-for-service system is ultimately determined to
20have been responsible for coverage on the date of service, the
21Department shall provide for an extended period for claims
22submission outside the standard timely filing requirements.
23    (g-6) MCO Performance Metrics Report.
24        (1) The Department shall publish, on at least a
25    quarterly basis, each MCO's operational performance,
26    including, but not limited to, the following categories of

 

 

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1    metrics:
2            (A) claims payment, including timeliness and
3        accuracy;
4            (B) prior authorizations;
5            (C) grievance and appeals;
6            (D) utilization statistics;
7            (E) provider disputes;
8            (F) provider credentialing; and
9            (G) member and provider customer service.
10        (2) The Department shall ensure that the metrics report
11    is accessible to providers online by January 1, 2017.
12        (3) The metrics shall be developed in consultation with
13    industry representatives of the Medicaid managed care
14    health plans and representatives of associations
15    representing the majority of providers within the
16    identified industry.
17        (4) Metrics shall be defined and incorporated into the
18    applicable Managed Care Policy Manual issued by the
19    Department.
20    (g-7) MCO claims processing and performance analysis. In
21order to monitor MCO payments to hospital providers, pursuant
22to this amendatory Act of the 100th General Assembly, the
23Department shall post an analysis of MCO claims processing and
24payment performance on its website every 6 months. Such
25analysis shall include a review and evaluation of a
26representative sample of hospital claims that are rejected and

 

 

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1denied for clean and unclean claims and the top 5 reasons for
2such actions and timeliness of claims adjudication, which
3identifies the percentage of claims adjudicated within 30, 60,
490, and over 90 days, and the dollar amounts associated with
5those claims. The Department shall post the contracted claims
6report required by HealthChoice Illinois on its website every 3
7months.
8    (g-8) Dispute resolution process. The Department shall
9maintain a provider complaint portal through which a provider
10can submit to the Department unresolved disputes with an MCO.
11An unresolved dispute means an MCO's decision that denies in
12whole or in part a claim for reimbursement to a provider for
13health care services rendered by the provider to an enrollee of
14the MCO with which the provider disagrees. Disputes shall not
15be submitted to the portal until the provider has availed
16itself of the MCO's internal dispute resolution process.
17Disputes that are submitted to the MCO internal dispute
18resolution process may be submitted to the Department of
19Healthcare and Family Services' complaint portal no sooner than
2030 days after submitting to the MCO's internal process and not
21later than 30 days after the unsatisfactory resolution of the
22internal MCO process or 60 days after submitting the dispute to
23the MCO internal process. Multiple claim disputes involving the
24same MCO may be submitted in one complaint, regardless of
25whether the claims are for different enrollees, when the
26specific reason for non-payment of the claims involves a common

 

 

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1question of fact or policy. Within 10 business days of receipt
2of a complaint, the Department shall present such disputes to
3the appropriate MCO, which shall then have 30 days to issue its
4written proposal to resolve the dispute. The Department may
5grant one 30-day extension of this time frame to one of the
6parties to resolve the dispute. If the dispute remains
7unresolved at the end of this time frame or the provider is not
8satisfied with the MCO's written proposal to resolve the
9dispute, the provider may, within 30 days, request the
10Department to review the dispute and make a final
11determination. Within 30 days of the request for Department
12review of the dispute, both the provider and the MCO shall
13present all relevant information to the Department for
14resolution and make individuals with knowledge of the issues
15available to the Department for further inquiry if needed.
16Within 30 days of receiving the relevant information on the
17dispute, or the lapse of the period for submitting such
18information, the Department shall issue a written decision on
19the dispute based on contractual terms between the provider and
20the MCO, contractual terms between the MCO and the Department
21of Healthcare and Family Services and applicable Medicaid
22policy. The decision of the Department shall be final. By
23January 1, 2020, the Department shall establish by rule further
24details of this dispute resolution process. Disputes between
25MCOs and providers presented to the Department for resolution
26are not contested cases, as defined in Section 1-30 of the

 

 

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1Illinois Administrative Procedure Act, conferring any right to
2an administrative hearing.
3    (g-9)(1) The Department shall publish annually on its
4website a report on the calculation of each managed care
5organization's medical loss ratio showing the following:
6        (A) Premium revenue, with appropriate adjustments.
7        (B) Benefit expense, setting forth the aggregate
8    amount spent for the following:
9            (i) Direct paid claims.
10            (ii) Subcapitation payments.
11            (iii) Other claim payments.
12            (iv) Direct reserves.
13            (v) Gross recoveries.
14            (vi) Expenses for activities that improve health
15        care quality as allowed by the Department.
16    (2) The medical loss ratio shall be calculated consistent
17with federal law and regulation following a claims runout
18period determined by the Department.
19    (g-10)(1) "Liability effective date" means the date on
20which an MCO becomes responsible for payment for medically
21necessary and covered services rendered by a provider to one of
22its enrollees in accordance with the contract terms between the
23MCO and the provider. The liability effective date shall be the
24later of:
25        (A) The execution date of a network participation
26    contract agreement.

 

 

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1        (B) The date the provider or its representative submits
2    to the MCO the complete and accurate standardized roster
3    form for the provider in the format approved by the
4    Department.
5        (C) The provider effective date contained within the
6    Department's provider enrollment subsystem within the
7    Illinois Medicaid Program Advanced Cloud Technology
8    (IMPACT) System.
9    (2) The standardized roster form may be submitted to the
10MCO at the same time that the provider submits an enrollment
11application to the Department through IMPACT.
12    (3) By October 1, 2019, the Department shall require all
13MCOs to update their provider directory with information for
14new practitioners of existing contracted providers within 30
15days of receipt of a complete and accurate standardized roster
16template in the format approved by the Department provided that
17the provider is effective in the Department's provider
18enrollment subsystem within the IMPACT system. Such provider
19directory shall be readily accessible for purposes of selecting
20an approved health care provider and comply with all other
21federal and State requirements.
22    (g-11) The Department shall work with relevant
23stakeholders on the development of operational guidelines to
24enhance and improve operational performance of Illinois'
25Medicaid managed care program, including, but not limited to,
26improving provider billing practices, reducing claim

 

 

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1rejections and inappropriate payment denials, and
2standardizing processes, procedures, definitions, and response
3timelines, with the goal of reducing provider and MCO
4administrative burdens and conflict. The Department shall
5include a report on the progress of these program improvements
6and other topics in its Fiscal Year 2020 annual report to the
7General Assembly.
8    (g-12) Notwithstanding any other provision of law, if the
9Department or an MCO requires submission of a claim for payment
10in a non-electronic format, a provider shall always be afforded
11a period of no less than 90 business days, as a correction
12period, following any notification of rejection by either the
13Department or the MCO to correct errors or omissions in the
14original submission.
15    Under no circumstances, either by an MCO or under the
16State's fee-for-service system, shall a provider be denied
17payment for failure to comply with any timely claims submission
18requirements under this Code or under any existing contract,
19unless the non-electronic format claim submission occurs after
20the initial 180 days following the latest date of service on
21the claim, or after the 90 business days correction period
22following notification to the provider of rejection or denial
23of payment.
24    (h) The Department shall not expand mandatory MCO
25enrollment into new counties beyond those counties already
26designated by the Department as of June 1, 2014 for the

 

 

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1individuals whose eligibility for medical assistance is not the
2seniors or people with disabilities population until the
3Department provides an opportunity for accountable care
4entities and MCOs to participate in such newly designated
5counties.
6    (h-5) MCOs shall be required to publish, at least quarterly
7for the preceding quarter, on their websites:
8        (1) the total number of claims received by the MCO;
9        (2) the number and monetary amount of claims payments
10    made to a service provider as defined in Section 2-16 of
11    this Code;
12        (3) the dates of services rendered for the claims
13    payments made under paragraph (2);
14        (4) the dates the claims were received by the MCO for
15    the claims payments made under paragraph (2); and
16        (5) the dates on which claims payments under paragraph
17    (2) were released.
18    (i) The requirements of this Section apply to contracts
19with accountable care entities and MCOs entered into, amended,
20or renewed after June 16, 2014 (the effective date of Public
21Act 98-651).
22    (j) Health care information released to managed care
23organizations. A health care provider shall release to a
24Medicaid managed care organization, upon request, and subject
25to the Health Insurance Portability and Accountability Act of
261996 and any other law applicable to the release of health

 

 

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1information, the health care information of the MCO's enrollee,
2if the enrollee has completed and signed a general release form
3that grants to the health care provider permission to release
4the recipient's health care information to the recipient's
5insurance carrier.
6    (k) The requirements of this Section added by this
7amendatory Act of the 101st General Assembly shall apply to
8services provided on or after the first day of the month that
9begins 60 days after the effective date of this amendatory Act
10of the 101st General Assembly.
11(Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18;
12100-587, eff. 6-4-18; 101-209, eff. 8-5-19.)
 
13    (305 ILCS 5/5-30.15 new)
14    Sec. 5-30.15. Discharge notification and facility
15placement of individuals; managed care. Whenever a hospital
16provides notice to a managed care organization (MCO) that an
17individual covered under the State's medical assistance
18