Rep. Camille Y. Lilly

Filed: 1/10/2021

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 558

2    AMENDMENT NO. ______. Amend Senate Bill 558, AS AMENDED, by
3replacing everything after the enacting clause with the
4following:
 
5
"Title I. General Provisions

 
6
Article 1.

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

 

 

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

 

 

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1after hearing from community members and advocates, the Health
2Facilities and Services Review Board unanimously voted to deny
3closure efforts, yet Trinity still seeks to cease Mercy's
4operations.
5    Prior to COVID-19, much of the social and political
6attention surrounding the nationwide opioid epidemic focused
7on the increase in overdose deaths among white, middle-class,
8suburban and rural users; the impact of the epidemic in Black
9communities was largely unrecognized. Research has shown rates
10of opioid use at the national scale are higher for whites than
11they are for Blacks, yet rates of opioid deaths are higher
12among Blacks (43%) than whites (22%). The COVID-19 pandemic
13will likely exacerbate this situation due to job loss,
14stay-at-home orders, and ongoing mitigation efforts creating a
15lack of physical access to addiction support and harm reduction
16groups.
17    In 2018, the Illinois Department of Public Health reported
18that Black women were about 6 times as likely to die from a
19pregnancy-related cause as white women. Of those, 72% of
20pregnancy-related deaths and 93% of violent
21pregnancy-associated deaths were deemed preventable. Between
222016 and 2017, Black women had the highest rate of severe
23maternal morbidity with a rate of 101.5 per 10,000 deliveries,
24which is almost 3 times as high as the rate for white women.
25    In the City of Chicago, African American and Latinx
26populations are suffering from higher rates of AIDS/HIV

 

 

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1compared to the general population. Recent data places HIV as
2one of the top 5 leading causes of death in African American
3women between the ages of 35 to 44 and the seventh ranking
4cause in African American women between the ages of 20 to 34.
5Among the Latinx population, nearly 20% with HIV exclusively
6depend on indigenous-led and staffed organizations for
7services.
8    Cardiovascular disease (CVD) accounts for more deaths in
9Illinois than any other cause of death, according to the
10Illinois Department of Public Health; CVD is the leading cause
11of death among Black residents. According to the Kaiser Family
12Foundation (KFF), for every 100,000 people, 224 Black
13Illinoisans die of CVD compared to 158 white Illinoisans.
14Cancer, the second leading cause of death in Illinois, too is
15pervasive among African Americans. In 2019, an estimated
16606,880 Americans, or 1,660 people a day, died of cancer; the
17American Cancer Society estimated 24,410 deaths occurred in
18Illinois. KFF estimates that, out of every 100,000 people, 191
19Black Illinoisans die of cancer compared to 152 white
20Illinoisans.
21    Black Americans suffer at much higher rates from chronic
22diseases, including diabetes, hypertension, heart disease,
23asthma, and many cancers. Utilizing community health workers in
24patient education and chronic disease management is needed to
25close these health disparities. Studies have shown that
26diabetes patients in the care of a community health worker

 

 

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1demonstrate improved knowledge and lifestyle and
2self-management behaviors, as well as decreases in the use of
3the emergency department. A study of asthma control among black
4adolescents concluded that asthma control was reduced by 35%
5among adolescents working with community health workers,
6resulting in a savings of $5.58 per dollar spent on the
7intervention. A study of the return on investment for community
8health workers employed in Colorado showed that, after a
99-month period, patients working with community health workers
10had an increased number of primary care visits and a decrease
11in urgent and inpatient care. Utilization of community health
12workers led to a $2.38 return on investment for every dollar
13invested in community health workers.
14    Adverse childhood experiences (ACEs) are traumatic
15experiences occurring during childhood that have been found to
16have a profound effect on a child's developing brain structure
17and body which may result in poor health during a person's
18adulthood. ACEs studies have found a strong correlation between
19the number of ACEs and a person's risk for disease and negative
20health behaviors, including suicide, depression, cancer,
21stroke, ischemic heart disease, diabetes, autoimmune disease,
22smoking, substance abuse, interpersonal violence, obesity,
23unplanned pregnancies, lower educational achievement,
24workplace absenteeism, and lower wages. Data also shows that
25approximately 20% of African American and Hispanic adults in
26Illinois reported 4 or more ACEs, compared to 13% of

 

 

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1non-Hispanic whites. Long-standing ACE interventions include
2tools such as trauma-informed care. Trauma-informed care has
3been promoted and established in communities across the country
4on a bipartisan basis, including in the states of California,
5Florida, Massachusetts, Missouri, Oregon, Pennsylvania,
6Washington, and Wisconsin. Several federal agencies have
7integrated trauma-informed approaches in their programs and
8grants which should be leveraged by the State.
9    According to a 2019 Rush University report, a Black
10person's life expectancy on average is less when compared to a
11white person's life expectancy. For instance, when comparing
12life expectancy in Chicago's Austin neighborhood to the Chicago
13Loop, there is a difference of 11 years between Black life
14expectancy (71 years) and white life expectancy (82 years).
15    In a 2015 literature review of implicit racial and ethnic
16bias among medical professionals, it was concluded that there
17is a moderate level of implicit bias in most medical
18professionals. Further, the literature review showed that
19implicit bias has negative consequences for patients,
20including strained patient relationships and negative health
21outcomes. It is critical for medical professionals to be aware
22of implicit racial and ethnic bias and work to eliminate bias
23through training.
24    In the field of medicine, a historically racist profession,
25Black medical professionals have commonly been ostracized. In
261934, Dr. Roland B. Scott was the first African American to

 

 

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

 

 

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1justice, affordable housing, environmental justice, and job
2security and so forth. For persons to live up to their full
3human potential, their rights to quality of life, health care,
4a quality job, a fair wage, housing, and education must not be
5inhibited.
6    Therefore, the Illinois Legislative Black Caucus, as
7informed by the Senate's Health and Human Service Pillar
8subject matter hearings, seeks to remedy a fraction of a much
9larger broken system by addressing access to health care,
10hospital closures, managed care organization reform, community
11health worker certification, maternal and infant mortality,
12mental and substance abuse treatment, hospital reform, and
13medical implicit bias in the Illinois Health Care and Human
14Service Reform Act. This Act shall achieve needed change
15through the use of, but not limited to, the Medicaid Managed
16Care Oversight Commission, the Health and Human Services Task
17Force, and a hospital closure moratorium, in order to address
18Illinois' long-standing health inequities.
 
19
Title II. Community Health Workers

 
20
Article 5.

 
21    Section 5-1. Short title. This Article may be cited as the
22Community Health Worker Certification and Reimbursement Act.
23References 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.

 

 

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1    Nothing in this definition shall be construed to authorize
2a community health worker to provide direct care or treatment
3to any person or to perform any act or service for which a
4license issued by a professional licensing board is required.
 
5    Section 5-10. Community health worker training.
6    (a) Community health workers shall be provided with
7multi-tiered academic and community-based training
8opportunities that lead to the mastery of community health
9worker core competencies.
10    (b) For academic-based training programs, the Department
11of Public Health shall collaborate with the Illinois State
12Board of Education, the Illinois Community College Board, and
13the Illinois Board of Higher Education to adopt a process to
14certify academic-based training programs that students can
15attend to obtain individual community health worker
16certification. Certified training programs shall reflect the
17approved core competencies and roles for community health
18workers.
19    (c) For community-based training programs, the Department
20of Public Health shall collaborate with a statewide association
21representing community health workers to adopt a process to
22certify community-based programs that students can attend to
23obtain individual community health worker certification.
24    (d) Community health workers may need to undergo additional
25training, including, but not limited to, asthma, diabetes,

 

 

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

 

 

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

 

 

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1shall submit a State Plan Amendment (SPA) to the Centers for
2Medicare and Medicaid Services (CMS) to amend the agreement
3between Illinois and the Federal government to include
4community health workers as practitioners under Medicaid.
5Certification shall not be required for reimbursement. In
6addition, the Department of Healthcare and Family Services
7shall amend its contracts with managed care entities to allow
8managed care entities to employ community health workers or
9subcontract with community-based organizations that employ
10community health workers.
 
11
Title III. Hospital Reform

 
12
Article 10.

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

 

 

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

 

 

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

 

 

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

 

 

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1the State Board of Health take action to retire measures no
2later than 7 business days before the meeting of the State
3Board of Health.
4    The Department shall include interpretive guidelines for
5infection-related indicators and, when available, shall
6include relevant benchmark information published by national
7organizations.
8    The Department shall collect the information reported
9under paragraphs (5) and (6) and shall use it to illustrate the
10disparity of those occurrences across different racial and
11ethnic groups.
12    (b) Individual hospitals shall prepare annual reports
13including vacancy and turnover rates for licensed nurses per
14clinical service area.
15    (c) None of the information the Department discloses to the
16public may be made available in any form or fashion unless the
17information has been reviewed, adjusted, and validated
18according to the following process:
19        (1) The Department shall organize an advisory
20    committee, including representatives from the Department,
21    public and private hospitals, direct care nursing staff,
22    physicians, academic researchers, consumers, health
23    insurance companies, organized labor, and organizations
24    representing hospitals and physicians. The advisory
25    committee must be meaningfully involved in the development
26    of all aspects of the Department's methodology for

 

 

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

 

 

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

 

 

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1April 30, July 31, October 31, and January 31 each year for the
2previous quarter. Data in quarterly reports must cover a period
3ending not earlier than one month prior to submission of the
4report. Annual reports shall be submitted by December 31 in a
5format set forth in rules adopted by the Department to the
6Department. All reports shall be made available to the public
7on-site and through the Department.
8    (e) If the hospital is a division or subsidiary of another
9entity that owns or operates other hospitals or related
10organizations, the annual public disclosure report shall be for
11the specific division or subsidiary and not for the other
12entity.
13    (f) The Department shall disclose information under this
14Section in accordance with provisions for inspection and
15copying of public records required by the Freedom of
16Information Act provided that such information satisfies the
17provisions of subsection (c) of this Section.
18    (g) Notwithstanding any other provision of law, under no
19circumstances shall the Department disclose information
20obtained from a hospital that is confidential under Part 21 of
21Article VIII of the Code of Civil Procedure.
22    (h) No hospital report or Department disclosure may contain
23information identifying a patient, employee, or licensed
24professional.
25(Source: P.A. 101-446, eff. 8-23-19.)
 

 

 

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1
Article 15.

 
2    Section 15-5. The Hospital Licensing Act is amended by
3adding Section 6.30 as follows:
 
4    (210 ILCS 85/6.30 new)
5    Sec. 6.30. Posting charity care policy, financial
6counselor. A hospital that receives a property tax exemption
7under Section 15-86 of the Property Tax Code must post the
8hospital's charity care policy and the contact information of a
9financial counselor in a reasonably viewable area in the
10hospital's emergency room.
 
11
Article 20.

 
12    Section 20-5. The University of Illinois Hospital Act is
13amended by adding Section 8d as follows:
 
14    (110 ILCS 330/8d new)
15    Sec. 8d. N95 masks. The University of Illinois Hospital
16shall provide N95 masks to all physicians licensed under the
17Medical Practice Act of 1987 and registered nurses and advanced
18practice registered nurses licensed under the Nurse Licensing
19Act if the physician, registered nurse, or advanced practice
20registered nurse is employed by or providing services for
21another 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

 

 

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1adding Section 6.31 as follows:
 
2    (210 ILCS 85/6.31 new)
3    Sec. 6.31. Demographic data; release of individuals with
4symptoms of COVID-19. A hospital licensed under this Act shall
5report to the Department the demographic data of individuals
6who have symptoms of COVID-19 and are released from, not
7admitted to, the hospital.
 
8
Article 35.

 
9    Section 35-5. The Illinois Public Aid Code is amended by
10changing Section 5-5.05 as follows:
 
11    (305 ILCS 5/5-5.05)
12    Sec. 5-5.05. Hospitals; psychiatric services.
13    (a) On and after July 1, 2008, the inpatient, per diem rate
14to be paid to a hospital for inpatient psychiatric services
15shall be $363.77.
16    (b) For purposes of this Section, "hospital" means the
17following:
18        (1) Advocate Christ Hospital, Oak Lawn, Illinois.
19        (2) Barnes-Jewish Hospital, St. Louis, Missouri.
20        (3) BroMenn Healthcare, Bloomington, Illinois.
21        (4) Jackson Park Hospital, Chicago, Illinois.
22        (5) Katherine Shaw Bethea Hospital, Dixon, Illinois.

 

 

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1        (6) Lawrence County Memorial Hospital, Lawrenceville,
2    Illinois.
3        (7) Advocate Lutheran General Hospital, Park Ridge,
4    Illinois.
5        (8) Mercy Hospital and Medical Center, Chicago,
6    Illinois.
7        (9) Methodist Medical Center of Illinois, Peoria,
8    Illinois.
9        (10) Provena United Samaritans Medical Center,
10    Danville, Illinois.
11        (11) Rockford Memorial Hospital, Rockford, Illinois.
12        (12) Sarah Bush Lincoln Health Center, Mattoon,
13    Illinois.
14        (13) Provena Covenant Medical Center, Urbana,
15    Illinois.
16        (14) Rush-Presbyterian-St. Luke's Medical Center,
17    Chicago, Illinois.
18        (15) Mt. Sinai Hospital, Chicago, Illinois.
19        (16) Gateway Regional Medical Center, Granite City,
20    Illinois.
21        (17) St. Mary of Nazareth Hospital, Chicago, Illinois.
22        (18) Provena St. Mary's Hospital, Kankakee, Illinois.
23        (19) St. Mary's Hospital, Decatur, Illinois.
24        (20) Memorial Hospital, Belleville, Illinois.
25        (21) Swedish Covenant Hospital, Chicago, Illinois.
26        (22) Trinity Medical Center, Rock Island, Illinois.

 

 

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1        (23) St. Elizabeth Hospital, Chicago, Illinois.
2        (24) Richland Memorial Hospital, Olney, Illinois.
3        (25) St. Elizabeth's Hospital, Belleville, Illinois.
4        (26) Samaritan Health System, Clinton, Iowa.
5        (27) St. John's Hospital, Springfield, Illinois.
6        (28) St. Mary's Hospital, Centralia, Illinois.
7        (29) Loretto Hospital, Chicago, Illinois.
8        (30) Kenneth Hall Regional Hospital, East St. Louis,
9    Illinois.
10        (31) Hinsdale Hospital, Hinsdale, Illinois.
11        (32) Pekin Hospital, Pekin, Illinois.
12        (33) University of Chicago Medical Center, Chicago,
13    Illinois.
14        (34) St. Anthony's Health Center, Alton, Illinois.
15        (35) OSF St. Francis Medical Center, Peoria, Illinois.
16        (36) Memorial Medical Center, Springfield, Illinois.
17        (37) A hospital with a distinct part unit for
18    psychiatric services that begins operating on or after July
19    1, 2008.
20    For purposes of this Section, "inpatient psychiatric
21services" means those services provided to patients who are in
22need of short-term acute inpatient hospitalization for active
23treatment of an emotional or mental disorder.
24    (b-5) Notwithstanding any other provision of this Section,
25the inpatient, per diem rate to be paid to all community
26safety-net hospitals for inpatient psychiatric services on and

 

 

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1after January 1, 2021 shall be at least $630.
2    (c) No rules shall be promulgated to implement this
3Section. For purposes of this Section, "rules" is given the
4meaning contained in Section 1-70 of the Illinois
5Administrative Procedure Act.
6    (d) This Section shall not be in effect during any period
7of time that the State has in place a fully operational
8hospital assessment plan that has been approved by the Centers
9for Medicare and Medicaid Services of the U.S. Department of
10Health and Human Services.
11    (e) On and after July 1, 2012, the Department shall reduce
12any rate of reimbursement for services or other payments or
13alter any methodologies authorized by this Code to reduce any
14rate of reimbursement for services or other payments in
15accordance with Section 5-5e.
16(Source: P.A. 97-689, eff. 6-14-12.)
 
17
Title IV. Medical Implicit Bias

 
18
Article 45.

 
19    Section 45-1. Findings. The General Assembly finds and
20declares all of the following:
21    (a) Implicit bias, meaning the attitudes or internalized
22stereotypes that affect our perceptions, actions, and
23decisions in an unconscious manner, exists and often

 

 

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1contributes to unequal treatment of people based on race,
2ethnicity, gender identity, sexual orientation, age,
3disability, and other characteristics.
4    (b) Implicit bias contributes to health disparities by
5affecting the behavior of physicians and surgeons, nurses,
6physician assistants, and other healing arts licensees.
7    (c) African American women are 3 to 4 times more likely
8than white women to die from pregnancy-related causes
9nationwide. African American patients often are prescribed
10less pain medication than white patients who present the same
11complaints. African American patients with signs of heart
12problems are not referred for advanced cardiovascular
13procedures as often as white patients with the same symptoms.
14    (d) Implicit gender bias also impacts treatment decisions
15and outcomes. Women are less likely to survive a heart attack
16when they are treated by a male physician and surgeon. LGBTQ
17and gender-nonconforming patients are less likely to seek
18timely medical care because they experience disrespect and
19discrimination from health care staff, with one out of 5
20transgender patients nationwide reporting that they were
21outright denied medical care due to bias.
22    (e) The General Assembly intends to reduce disparate
23outcomes and ensure that all patients receive fair treatment
24and quality health care.
 
25    Section 45-5. The Medical Practice Act of 1987 is amended

 

 

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1by changing Section 20 as follows:
 
2    (225 ILCS 60/20)  (from Ch. 111, par. 4400-20)
3    (Section scheduled to be repealed on January 1, 2022)
4    Sec. 20. Continuing education.
5    (a) The Department shall promulgate rules of continuing
6education for persons licensed under this Act that require an
7average of 50 hours of continuing education per license year.
8These rules shall be consistent with requirements of relevant
9professional associations, specialty societies, or boards. The
10rules shall also address variances in part or in whole for good
11cause, including, but not limited to, temporary illness or
12hardship. In establishing these rules, the Department shall
13consider educational requirements for medical staffs,
14requirements for specialty society board certification or for
15continuing education requirements as a condition of membership
16in societies representing the 2 categories of licensee under
17this Act. These rules shall assure that licensees are given the
18opportunity to participate in those programs sponsored by or
19through their professional associations or hospitals which are
20relevant to their practice.
21    (b) Except as otherwise provided in this subsection, the
22rules adopted under this Section shall require that, on and
23after January 1, 2022, all continuing education courses for
24persons licensed under this Act contain curriculum that
25includes the understanding of implicit bias. Beginning January

 

 

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11, 2023, continuing education providers shall ensure
2compliance with this Section. Beginning January 1, 2023, the
3Department shall audit continuing education providers at least
4once every 5 years to ensure adherence to regulatory
5requirements and shall withhold or rescind approval from any
6provider that is in violation of the requirements of this
7subsection.
8    A continuing education course dedicated solely to research
9or other issues that does not include a direct patient care
10component is not required to contain curriculum that includes
11implicit bias in the practice of medicine.
12    To satisfy the requirements of this subsection, continuing
13education courses shall address at least one of the following:
14        (1) examples of how implicit bias affects perceptions
15    and treatment decisions, leading to disparities in health
16    outcomes; or
17        (2) strategies to address how unintended biases in
18    decision making may contribute to health care disparities
19    by shaping behavior and producing differences in medical
20    treatment along lines of race, ethnicity, gender identity,
21    sexual orientation, age, socioeconomic status, or other
22    characteristics.
23    (c) Each licensee is responsible for maintaining records of
24completion of continuing education and shall be prepared to
25produce the records when requested by the Department.
26(Source: P.A. 97-622, eff. 11-23-11.)
 

 

 

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1    Section 45-10. The Nurse Practice Act is amended by
2changing Sections 55-35, 60-40, and 65-60 as follows:
 
3    (225 ILCS 65/55-35)
4    (Section scheduled to be repealed on January 1, 2028)
5    Sec. 55-35. Continuing education for LPN licensees.
6    (a) The Department may adopt rules of continuing education
7for licensed practical nurses that require 20 hours of
8continuing education per 2-year license renewal cycle. The
9rules shall address variances in part or in whole for good
10cause, including without limitation illness or hardship. The
11continuing education rules must ensure that licensees are given
12the opportunity to participate in programs sponsored by or
13through their State or national professional associations,
14hospitals, or other providers of continuing education.
15    (b) For license renewals occurring on or after January 1,
162022, all licensed practical nurses must complete at least one
17hour of implicit bias training per 2-year license renewal
18cycle. The Department may adopt rules for the implementation of
19this subsection.
20    (c) Each licensee is responsible for maintaining records of
21completion of continuing education and shall be prepared to
22produce the records when requested by the Department.
23(Source: P.A. 95-639, eff. 10-5-07.)
 

 

 

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1    (225 ILCS 65/60-40)
2    (Section scheduled to be repealed on January 1, 2028)
3    Sec. 60-40. Continuing education for RN licensees.
4    (a) The Department may adopt rules of continuing education
5for registered professional nurses licensed under this Act that
6require 20 hours of continuing education per 2-year license
7renewal cycle. The rules shall address variances in part or in
8whole for good cause, including without limitation illness or
9hardship. The continuing education rules must ensure that
10licensees are given the opportunity to participate in programs
11sponsored by or through their State or national professional
12associations, hospitals, or other providers of continuing
13education.
14    (b) For license renewals occurring on or after January 1,
152022, all registered professional nurses must complete at least
16one hour of implicit bias training per 2-year license renewal
17cycle. The Department may adopt rules for the implementation of
18this subsection.
19    (c) Each licensee is responsible for maintaining records of
20completion of continuing education and shall be prepared to
21produce the records when requested by the Department.
22(Source: P.A. 95-639, eff. 10-5-07.)
 
23    (225 ILCS 65/65-60)   (was 225 ILCS 65/15-45)
24    (Section scheduled to be repealed on January 1, 2028)
25    Sec. 65-60. Continuing education.

 

 

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1    (a) The Department shall adopt rules of continuing
2education for persons licensed under this Article as advanced
3practice registered nurses that require 80 hours of continuing
4education per 2-year license renewal cycle. Completion of the
580 hours of continuing education shall be deemed to satisfy the
6continuing education requirements for renewal of a registered
7professional nurse license as required by this Act.
8    The 80 hours of continuing education required under this
9Section shall be completed as follows:
10        (1) A minimum of 50 hours of the continuing education
11    shall be obtained in continuing education programs as
12    determined by rule that shall include no less than 20 hours
13    of pharmacotherapeutics, including 10 hours of opioid
14    prescribing or substance abuse education. Continuing
15    education programs may be conducted or endorsed by
16    educational institutions, hospitals, specialist
17    associations, facilities, or other organizations approved
18    to offer continuing education under this Act or rules and
19    shall be in the advanced practice registered nurse's
20    specialty.
21        (2) A maximum of 30 hours of credit may be obtained by
22    presentations in the advanced practice registered nurse's
23    clinical specialty, evidence-based practice, or quality
24    improvement projects, publications, research projects, or
25    preceptor hours as determined by rule.
26    The rules adopted regarding continuing education shall be

 

 

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1consistent to the extent possible with requirements of relevant
2national certifying bodies or State or national professional
3associations.
4    (b) The rules shall not be inconsistent with requirements
5of relevant national certifying bodies or State or national
6professional associations. The rules shall also address
7variances in part or in whole for good cause, including but not
8limited to illness or hardship. The continuing education rules
9shall assure that licensees are given the opportunity to
10participate in programs sponsored by or through their State or
11national professional associations, hospitals, or other
12providers of continuing education.
13    (c) For license renewals occurring on or after January 1,
142022, all advanced practice registered nurses must complete at
15least one hour of implicit bias training per 2-year license
16renewal cycle. The Department may adopt rules for the
17implementation of this subsection.
18    (d) Each licensee is responsible for maintaining records of
19completion of continuing education and shall be prepared to
20produce the records when requested by the Department.
21(Source: P.A. 100-513, eff. 1-1-18.)
 
22    Section 45-15. The Physician Assistant Practice Act of 1987
23is amended by changing Section 11.5 as follows:
 
24    (225 ILCS 95/11.5)

 

 

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1    (Section scheduled to be repealed on January 1, 2028)
2    Sec. 11.5. Continuing education.
3    (a) The Department shall adopt rules for continuing
4education for persons licensed under this Act that require 50
5hours of continuing education per 2-year license renewal cycle.
6Completion of the 50 hours of continuing education shall be
7deemed to satisfy the continuing education requirements for
8renewal of a physician assistant license as required by this
9Act. The rules shall not be inconsistent with requirements of
10relevant national certifying bodies or State or national
11professional associations. The rules shall also address
12variances in part or in whole for good cause, including, but
13not limited to, illness or hardship. The continuing education
14rules shall ensure that licensees are given the opportunity to
15participate in programs sponsored by or through their State or
16national professional associations, hospitals, or other
17providers of continuing education.
18    (b) Except as otherwise provided in this subsection, the
19rules adopted under this Section shall require that, on and
20after January 1, 2022, all continuing education courses for
21persons licensed under this Act contain curriculum that
22includes the understanding of implicit bias. Beginning January
231, 2023, continuing education providers shall ensure
24compliance with this Section. Beginning January 1, 2023, the
25Department shall audit continuing education providers at least
26once every 5 years to ensure adherence to regulatory

 

 

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1requirements and shall withhold or rescind approval from any
2provider that is in violation of the regulatory requirements.
3    A continuing education course dedicated solely to research
4or other issues that does not include a direct patient care
5component is not required to contain curriculum that includes
6implicit bias in the practice of medicine.
7    To satisfy the requirements of subsection (a) of this
8Section, continuing education courses shall address at least
9one of the following:
10        (1) examples of how implicit bias affects perceptions
11    and treatment decisions, leading to disparities in health
12    outcomes; or
13        (2) strategies to address how unintended biases in
14    decision making may contribute to health care disparities
15    by shaping behavior and producing differences in medical
16    treatment along lines of race, ethnicity, gender identity,
17    sexual orientation, age, socioeconomic status, or other
18    characteristics.
19    (c) Each licensee is responsible for maintaining records of
20completion of continuing education and shall be prepared to
21produce the records when requested by the Department.
22(Source: P.A. 100-453, eff. 8-25-17.)
 
23
Title V. Substance Abuse and Mental Health Treatment

 
24
Article 50.

 

 

 

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1    Section 50-5. The Illinois Controlled Substances Act is
2amended by changing Section 414 as follows:
 
3    (720 ILCS 570/414)
4    Sec. 414. Overdose; limited immunity from prosecution.
5    (a) For the purposes of this Section, "overdose" means a
6controlled substance-induced physiological event that results
7in a life-threatening emergency to the individual who ingested,
8inhaled, injected or otherwise bodily absorbed a controlled,
9counterfeit, or look-alike substance or a controlled substance
10analog.
11    (b) A person who, in good faith, seeks or obtains emergency
12medical assistance for someone experiencing an overdose shall
13not be arrested, charged, or prosecuted for a violation of
14Section 401 or 402 of the Illinois Controlled Substances Act,
15Section 3.5 of the Drug Paraphernalia Control Act, Section 55
16or 60 of the Methamphetamine Control and Community Protection
17Act, Section 9-3.3 of the Criminal Code of 2012, or paragraph
18(1) of subsection (g) of Section 12-3.05 of the Criminal Code
19of 2012 Class 4 felony possession of a controlled, counterfeit,
20or look-alike substance or a controlled substance analog if
21evidence for the violation Class 4 felony possession charge was
22acquired as a result of the person seeking or obtaining
23emergency medical assistance and providing the amount of
24substance recovered is within the amount identified in

 

 

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

 

 

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1long as the evidence for the violation was acquired as a result
2of the person seeking or obtaining emergency medical assistance
3in the event of an overdose.
4    (d) For the purposes of subsections (b) and (c), the
5limited immunity shall only apply to a person possessing the
6following amount:
7        (1) less than 3 grams of a substance containing heroin;
8        (2) less than 3 grams of a substance containing
9    cocaine;
10        (3) less than 3 grams of a substance containing
11    morphine;
12        (4) less than 40 grams of a substance containing
13    peyote;
14        (5) less than 40 grams of a substance containing a
15    derivative of barbituric acid or any of the salts of a
16    derivative of barbituric acid;
17        (6) less than 40 grams of a substance containing
18    amphetamine or any salt of an optical isomer of
19    amphetamine;
20        (7) less than 3 grams of a substance containing
21    lysergic acid diethylamide (LSD), or an analog thereof;
22        (8) less than 6 grams of a substance containing
23    pentazocine or any of the salts, isomers and salts of
24    isomers of pentazocine, or an analog thereof;
25        (9) less than 6 grams of a substance containing
26    methaqualone or any of the salts, isomers and salts of

 

 

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1    isomers of methaqualone;
2        (10) less than 6 grams of a substance containing
3    phencyclidine or any of the salts, isomers and salts of
4    isomers of phencyclidine (PCP);
5        (11) less than 6 grams of a substance containing
6    ketamine or any of the salts, isomers and salts of isomers
7    of ketamine;
8        (12) less than 40 grams of a substance containing a
9    substance classified as a narcotic drug in Schedules I or
10    II, or an analog thereof, which is not otherwise included
11    in this subsection.
12    (e) The limited immunity described in subsections (b) and
13(c) of this Section shall not be extended if law enforcement
14has reasonable suspicion or probable cause to detain, arrest,
15or search the person described in subsection (b) or (c) of this
16Section for criminal activity and the reasonable suspicion or
17probable cause is based on information obtained prior to or
18independent of the individual described in subsection (b) or
19(c) taking action to seek or obtain emergency medical
20assistance and not obtained as a direct result of the action of
21seeking or obtaining emergency medical assistance. Nothing in
22this Section is intended to interfere with or prevent the
23investigation, arrest, or prosecution of any person for the
24delivery or distribution of cannabis, methamphetamine or other
25controlled substances, drug-induced homicide, or any other
26crime if the evidence of the violation is not acquired as a

 

 

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1result of the person seeking or obtaining emergency medical
2assistance in the event of an overdose.
3(Source: P.A. 97-678, eff. 6-1-12.)
 
4    Section 50-10. The Methamphetamine Control and Community
5Protection Act is amended by changing Section 115 as follows:
 
6    (720 ILCS 646/115)
7    Sec. 115. Overdose; limited immunity from prosecution.
8    (a) For the purposes of this Section, "overdose" means a
9methamphetamine-induced physiological event that results in a
10life-threatening emergency to the individual who ingested,
11inhaled, injected, or otherwise bodily absorbed
12methamphetamine.
13    (b) A person who, in good faith, seeks emergency medical
14assistance for someone experiencing an overdose shall not be
15arrested, charged or prosecuted for a violation of Section 55
16or 60 of this Act or Section 3.5 of the Drug Paraphernalia
17Control Act, Section 9-3.3 of the Criminal Code of 2012, or
18paragraph (1) of subsection (g) of Section 12-3.05 of the
19Criminal Code of 2012 Class 3 felony possession of
20methamphetamine if evidence for the violation Class 3 felony
21possession charge was acquired as a result of the person
22seeking or obtaining emergency medical assistance and
23providing the amount of substance recovered is less than 3
24grams one gram of methamphetamine or a substance containing

 

 

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

 

 

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1of the person seeking or obtaining emergency medical assistance
2in the event of an overdose.
3    (d) The limited immunity described in subsections (b) and
4(c) of this Section shall not be extended if law enforcement
5has reasonable suspicion or probable cause to detain, arrest,
6or search the person described in subsection (b) or (c) of this
7Section for criminal activity and the reasonable suspicion or
8probable cause is based on information obtained prior to or
9independent of the individual described in subsection (b) or
10(c) taking action to seek or obtain emergency medical
11assistance and not obtained as a direct result of the action of
12seeking or obtaining emergency medical assistance. Nothing in
13this Section is intended to interfere with or prevent the
14investigation, arrest, or prosecution of any person for the
15delivery or distribution of cannabis, methamphetamine or other
16controlled substances, drug-induced homicide, or any other
17crime if the evidence of the violation is not acquired as a
18result of the person seeking or obtaining emergency medical
19assistance in the event of an overdose.
20(Source: P.A. 97-678, eff. 6-1-12.)
 
21
Article 55.

 
22    Section 55-5. The Illinois Controlled Substances Act is
23amended by changing Section 316 as follows:
 

 

 

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1    (720 ILCS 570/316)
2    Sec. 316. Prescription Monitoring Program.
3    (a) The Department must provide for a Prescription
4Monitoring Program for Schedule II, III, IV, and V controlled
5substances that includes the following components and
6requirements:
7        (1) The dispenser must transmit to the central
8    repository, in a form and manner specified by the
9    Department, the following information:
10            (A) The recipient's name and address.
11            (B) The recipient's date of birth and gender.
12            (C) The national drug code number of the controlled
13        substance dispensed.
14            (D) The date the controlled substance is
15        dispensed.
16            (E) The quantity of the controlled substance
17        dispensed and days supply.
18            (F) The dispenser's United States Drug Enforcement
19        Administration registration number.
20            (G) The prescriber's United States Drug
21        Enforcement Administration registration number.
22            (H) The dates the controlled substance
23        prescription is filled.
24            (I) The payment type used to purchase the
25        controlled substance (i.e. Medicaid, cash, third party
26        insurance).

 

 

10100SB0558ham003- 44 -LRB101 04319 CPF 74762 a

1            (J) The patient location code (i.e. home, nursing
2        home, outpatient, etc.) for the controlled substances
3        other than those filled at a retail pharmacy.
4            (K) Any additional information that may be
5        required by the department by administrative rule,
6        including but not limited to information required for
7        compliance with the criteria for electronic reporting
8        of the American Society for Automation and Pharmacy or
9        its successor.
10        (2) The information required to be transmitted under
11    this Section must be transmitted not later than the end of
12    the next business day after the date on which a controlled
13    substance is dispensed, or at such other time as may be
14    required by the Department by administrative rule.
15        (3) A dispenser must transmit the information required
16    under this Section by:
17            (A) an electronic device compatible with the
18        receiving device of the central repository;
19            (B) a computer diskette;
20            (C) a magnetic tape; or
21            (D) a pharmacy universal claim form or Pharmacy
22        Inventory Control form.
23        (3.5) The requirements of paragraphs (1), (2), and (3)
24    of this subsection (a) also apply to opioid treatment
25    programs that prescribe Schedule II, III, IV, or V
26    controlled substances for the treatment of opioid use

 

 

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1    disorder.
2        (4) The Department may impose a civil fine of up to
3    $100 per day for willful failure to report controlled
4    substance dispensing to the Prescription Monitoring
5    Program. The fine shall be calculated on no more than the
6    number of days from the time the report was required to be
7    made until the time the problem was resolved, and shall be
8    payable to the Prescription Monitoring Program.
9    (a-5) Notwithstanding subsection (a), a licensed
10veterinarian is exempt from the reporting requirements of this
11Section. If a person who is presenting an animal for treatment
12is suspected of fraudulently obtaining any controlled
13substance or prescription for a controlled substance, the
14licensed veterinarian shall report that information to the
15local law enforcement agency.
16    (b) The Department, by rule, may include in the
17Prescription Monitoring Program certain other select drugs
18that are not included in Schedule II, III, IV, or V. The
19Prescription Monitoring Program does not apply to controlled
20substance prescriptions as exempted under Section 313.
21    (c) The collection of data on select drugs and scheduled
22substances by the Prescription Monitoring Program may be used
23as a tool for addressing oversight requirements of long-term
24care institutions as set forth by Public Act 96-1372. Long-term
25care pharmacies shall transmit patient medication profiles to
26the Prescription Monitoring Program monthly or more frequently

 

 

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1as established by administrative rule.
2    (d) The Department of Human Services shall appoint a
3full-time Clinical Director of the Prescription Monitoring
4Program.
5    (e) (Blank).
6    (f) Within one year of January 1, 2018 (the effective date
7of Public Act 100-564), the Department shall adopt rules
8requiring all Electronic Health Records Systems to interface
9with the Prescription Monitoring Program application program
10on or before January 1, 2021 to ensure that all providers have
11access to specific patient records during the treatment of
12their patients. These rules shall also address the electronic
13integration of pharmacy records with the Prescription
14Monitoring Program to allow for faster transmission of the
15information required under this Section. The Department shall
16establish actions to be taken if a prescriber's Electronic
17Health Records System does not effectively interface with the
18Prescription Monitoring Program within the required timeline.
19    (g) The Department, in consultation with the Advisory
20Committee, shall adopt rules allowing licensed prescribers or
21pharmacists who have registered to access the Prescription
22Monitoring Program to authorize a licensed or non-licensed
23designee employed in that licensed prescriber's office or a
24licensed designee in a licensed pharmacist's pharmacy who has
25received training in the federal Health Insurance Portability
26and Accountability Act to consult the Prescription Monitoring

 

 

10100SB0558ham003- 47 -LRB101 04319 CPF 74762 a

1Program on their behalf. The rules shall include reasonable
2parameters concerning a practitioner's authority to authorize
3a designee, and the eligibility of a person to be selected as a
4designee. In this subsection (g), "pharmacist" shall include a
5clinical pharmacist employed by and designated by a Medicaid
6Managed Care Organization providing services under Article V of
7the Illinois Public Aid Code under a contract with the
8Department of Healthcare and Family Services for the sole
9purpose of clinical review of services provided to persons
10covered by the entity under the contract to determine
11compliance with subsections (a) and (b) of Section 314.5 of
12this Act. A managed care entity pharmacist shall notify
13prescribers of review activities.
14(Source: P.A. 100-564, eff. 1-1-18; 100-861, eff. 8-14-18;
15100-1005, eff. 8-21-18; 100-1093, eff. 8-26-18; 101-81, eff.
167-12-19; 101-414, eff. 8-16-19.)
 
17
Article 60.

 
18    Section 60-5. The Adult Protective Services Act is amended
19by adding Section 3.1 as follows:
 
20    (320 ILCS 20/3.1 new)
21    Sec. 3.1. Adult protective services dementia training.
22    (a) This Section shall apply to any person who is employed
23by the Department in the Adult Protective Services division who

 

 

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1works on the development and implementation of social services
2to respond to and prevent adult abuse, neglect, or
3exploitation.
4    (b) The Department shall develop and implement a dementia
5training program that must include instruction on the
6identification of people with dementia, risks such as
7wandering, communication impairments, elder abuse, and the
8best practices for interacting with people with dementia.
9    (c) Initial training of 4 hours shall be completed at the
10start of employment with the Adult Protective Services division
11and shall cover the following:
12        (1) Dementia, psychiatric, and behavioral symptoms.
13        (2) Communication issues, including how to communicate
14    respectfully and effectively.
15        (3) Techniques for understanding and approaching
16    behavioral symptoms.
17        (4) Information on how to address specific aspects of
18    safety, for example tips to prevent wandering.
19        (5) When it is necessary to alert law enforcement
20    agencies of potential criminal behavior involving a family
21    member, caretaker, or institutional abuse; neglect or
22    exploitation of a person with dementia; and what types of
23    abuse that are most common to people with dementia.
24        (6) Identifying incidents of self-neglect for people
25    with dementia who live alone as well as neglect by a
26    caregiver.

 

 

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1        (7) Protocols for connecting people living with
2    dementia to local care resources and professionals who are
3    skilled in dementia care to encourage cross-referral and
4    reporting regarding incidents of abuse.
5    (d) Annual continuing education shall include 2 hours of
6dementia training covering the subjects described in
7subsection (c).
8    (e) This Section is designed to address gaps in current
9dementia training requirements for Adult Protective Services
10officials and improve the quality of training. If currently
11existing law or rules contain more rigorous training
12requirements for Adult Protective Service officials, those
13laws or rules shall apply. Where there is overlap between this
14Section and other laws and rules, the Department shall
15interpret this Section to avoid duplication of requirements
16while ensuring that the minimum requirements set in this
17Section are met.
18    (f) The Department may adopt rules for the administration
19of this Section.
 
20
Title VI. Access to Health Care

 
21
Article 70.

 
22    Section 70-5. The Use Tax Act is amended by changing
23Section 3-10 as follows:
 

 

 

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1    (35 ILCS 105/3-10)
2    Sec. 3-10. Rate of tax. Unless otherwise provided in this
3Section, the tax imposed by this Act is at the rate of 6.25% of
4either the selling price or the fair market value, if any, of
5the tangible personal property. In all cases where property
6functionally used or consumed is the same as the property that
7was purchased at retail, then the tax is imposed on the selling
8price of the property. In all cases where property functionally
9used or consumed is a by-product or waste product that has been
10refined, manufactured, or produced from property purchased at
11retail, then the tax is imposed on the lower of the fair market
12value, if any, of the specific property so used in this State
13or on the selling price of the property purchased at retail.
14For purposes of this Section "fair market value" means the
15price at which property would change hands between a willing
16buyer and a willing seller, neither being under any compulsion
17to buy or sell and both having reasonable knowledge of the
18relevant facts. The fair market value shall be established by
19Illinois sales by the taxpayer of the same property as that
20functionally used or consumed, or if there are no such sales by
21the taxpayer, then comparable sales or purchases of property of
22like kind and character in Illinois.
23    Beginning on July 1, 2000 and through December 31, 2000,
24with respect to motor fuel, as defined in Section 1.1 of the
25Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of

 

 

10100SB0558ham003- 51 -LRB101 04319 CPF 74762 a

1the Use Tax Act, the tax is imposed at the rate of 1.25%.
2    Beginning on August 6, 2010 through August 15, 2010, with
3respect to sales tax holiday items as defined in Section 3-6 of
4this Act, the tax is imposed at the rate of 1.25%.
5    With respect to gasohol, the tax imposed by this Act
6applies to (i) 70% of the proceeds of sales made on or after
7January 1, 1990, and before July 1, 2003, (ii) 80% of the
8proceeds of sales made on or after July 1, 2003 and on or
9before July 1, 2017, and (iii) 100% of the proceeds of sales
10made thereafter. If, at any time, however, the tax under this
11Act on sales of gasohol is imposed at the rate of 1.25%, then
12the tax imposed by this Act applies to 100% of the proceeds of
13sales of gasohol made during that time.
14    With respect to majority blended ethanol fuel, the tax
15imposed by this Act does not apply to the proceeds of sales
16made on or after July 1, 2003 and on or before December 31,
172023 but applies to 100% of the proceeds of sales made
18thereafter.
19    With respect to biodiesel blends with no less than 1% and
20no more than 10% biodiesel, the tax imposed by this Act applies
21to (i) 80% of the proceeds of sales made on or after July 1,
222003 and on or before December 31, 2018 and (ii) 100% of the
23proceeds of sales made thereafter. If, at any time, however,
24the tax under this Act on sales of biodiesel blends with no
25less than 1% and no more than 10% biodiesel is imposed at the
26rate of 1.25%, then the tax imposed by this Act applies to 100%

 

 

10100SB0558ham003- 52 -LRB101 04319 CPF 74762 a

1of the proceeds of sales of biodiesel blends with no less than
21% and no more than 10% biodiesel made during that time.
3    With respect to 100% biodiesel and biodiesel blends with
4more than 10% but no more than 99% biodiesel, the tax imposed
5by this Act does not apply to the proceeds of sales made on or
6after July 1, 2003 and on or before December 31, 2023 but
7applies to 100% of the proceeds of sales made thereafter.
8    With respect to food for human consumption that is to be
9consumed off the premises where it is sold (other than
10alcoholic beverages, food consisting of or infused with adult
11use cannabis, soft drinks, and food that has been prepared for
12immediate consumption) and prescription and nonprescription
13medicines, drugs, medical appliances, products classified as
14Class III medical 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, the tax is
21imposed at the rate of 1%. For the purposes of this Section,
22until September 1, 2009: the term "soft drinks" means any
23complete, finished, ready-to-use, non-alcoholic drink, whether
24carbonated or not, including but not limited to soda water,
25cola, fruit juice, vegetable juice, carbonated water, and all
26other preparations commonly known as soft drinks of whatever

 

 

10100SB0558ham003- 53 -LRB101 04319 CPF 74762 a

1kind or description that are contained in any closed or sealed
2bottle, can, carton, or container, regardless of size; but
3"soft drinks" does not include coffee, tea, non-carbonated
4water, infant formula, milk or milk products as defined in the
5Grade A Pasteurized Milk and Milk Products Act, or drinks
6containing 50% or more natural fruit or vegetable juice.
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

 

 

10100SB0558ham003- 54 -LRB101 04319 CPF 74762 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 the effective date of this amendatory Act of
26the 98th General Assembly, "prescription and nonprescription

 

 

10100SB0558ham003- 55 -LRB101 04319 CPF 74762 a

1medicines and drugs" includes medical cannabis purchased from a
2registered dispensing organization under the Compassionate Use
3of Medical Cannabis 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    If the property that is purchased at retail from a retailer
10is acquired outside Illinois and used outside Illinois before
11being brought to Illinois for use here and is taxable under
12this Act, the "selling price" on which the tax is computed
13shall be reduced by an amount that represents a reasonable
14allowance for depreciation for the period of prior out-of-state
15use.
16(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
17101-593, eff. 12-4-19.)
 
18    Section 70-10. The Service Use Tax Act is amended by
19changing Section 3-10 as follows:
 
20    (35 ILCS 110/3-10)  (from Ch. 120, par. 439.33-10)
21    Sec. 3-10. Rate of tax. Unless otherwise provided in this
22Section, the tax imposed by this Act is at the rate of 6.25% of
23the selling price of tangible personal property transferred as
24an incident to the sale of service, but, for the purpose of

 

 

10100SB0558ham003- 56 -LRB101 04319 CPF 74762 a

1computing this tax, in no event shall the selling price be less
2than the cost price of the property to the serviceman.
3    Beginning on July 1, 2000 and through December 31, 2000,
4with respect to motor fuel, as defined in Section 1.1 of the
5Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
6the Use Tax Act, the tax is imposed at the rate of 1.25%.
7    With respect to gasohol, as defined in the Use Tax Act, the
8tax imposed by this Act applies to (i) 70% of the selling price
9of property transferred as an incident to the sale of service
10on or after January 1, 1990, and before July 1, 2003, (ii) 80%
11of the selling price of property transferred as an incident to
12the sale of service on or after July 1, 2003 and on or before
13July 1, 2017, and (iii) 100% of the selling price thereafter.
14If, at any time, however, the tax under this Act on sales of
15gasohol, as defined in the Use Tax Act, is imposed at the rate
16of 1.25%, then the tax imposed by this Act applies to 100% of
17the proceeds of sales of gasohol made during that time.
18    With respect to majority blended ethanol fuel, as defined
19in the Use Tax Act, the tax imposed by this Act does not apply
20to the selling price of property transferred as an incident to
21the sale of service on or after July 1, 2003 and on or before
22December 31, 2023 but applies to 100% of the selling price
23thereafter.
24    With respect to biodiesel blends, as defined in the Use Tax
25Act, with no less than 1% and no more than 10% biodiesel, the
26tax imposed by this Act applies to (i) 80% of the selling price

 

 

10100SB0558ham003- 57 -LRB101 04319 CPF 74762 a

1of property transferred as an incident to the sale of service
2on or after July 1, 2003 and on or before December 31, 2018 and
3(ii) 100% of the proceeds of the selling price thereafter. If,
4at any time, however, the tax under this Act on sales of
5biodiesel blends, as defined in the Use Tax Act, with no less
6than 1% and no more than 10% biodiesel is imposed at the rate
7of 1.25%, then the tax imposed by this Act applies to 100% of
8the proceeds of sales of biodiesel blends with no less than 1%
9and no more than 10% biodiesel made during that time.
10    With respect to 100% biodiesel, as defined in the Use Tax
11Act, and biodiesel blends, as defined in the Use Tax Act, with
12more than 10% but no more than 99% biodiesel, the tax imposed
13by this Act does not apply to the proceeds of the selling price
14of property transferred as an incident to the sale of service
15on or after July 1, 2003 and on or before December 31, 2023 but
16applies to 100% of the selling price thereafter.
17    At the election of any registered serviceman made for each
18fiscal year, sales of service in which the aggregate annual
19cost price of tangible personal property transferred as an
20incident to the sales of service is less than 35%, or 75% in
21the case of servicemen transferring prescription drugs or
22servicemen engaged in graphic arts production, of the aggregate
23annual total gross receipts from all sales of service, the tax
24imposed by this Act shall be based on the serviceman's cost
25price of the tangible personal property transferred as an
26incident to the sale of those services.

 

 

10100SB0558ham003- 58 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 59 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 60 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 61 -LRB101 04319 CPF 74762 a

1Act 98-122), "prescription and nonprescription medicines and
2drugs" includes medical cannabis purchased from a registered
3dispensing organization under the Compassionate Use of Medical
4Cannabis Program Act.
5    As used in this Section, "adult use cannabis" means
6cannabis subject to tax under the Cannabis Cultivation
7Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
8does not include cannabis subject to tax under the
9Compassionate Use of Medical Cannabis Program Act.
10    If the property that is acquired from a serviceman is
11acquired outside Illinois and used outside Illinois before
12being brought to Illinois for use here and is taxable under
13this Act, the "selling price" on which the tax is computed
14shall be reduced by an amount that represents a reasonable
15allowance for depreciation for the period of prior out-of-state
16use.
17(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
18101-593, eff. 12-4-19.)
 
19    Section 70-15. The Service Occupation Tax Act is amended by
20changing Section 3-10 as follows:
 
21    (35 ILCS 115/3-10)  (from Ch. 120, par. 439.103-10)
22    Sec. 3-10. Rate of tax. Unless otherwise provided in this
23Section, the tax imposed by this Act is at the rate of 6.25% of
24the "selling price", as defined in Section 2 of the Service Use

 

 

10100SB0558ham003- 62 -LRB101 04319 CPF 74762 a

1Tax Act, of the tangible personal property. For the purpose of
2computing this tax, in no event shall the "selling price" be
3less than the cost price to the serviceman of the tangible
4personal property transferred. The selling price of each item
5of tangible personal property transferred as an incident of a
6sale of service may be shown as a distinct and separate item on
7the serviceman's billing to the service customer. If the
8selling price is not so shown, the selling price of the
9tangible personal property is deemed to be 50% of the
10serviceman's entire billing to the service customer. When,
11however, a serviceman contracts to design, develop, and produce
12special order machinery or equipment, the tax imposed by this
13Act shall be based on the serviceman's cost price of the
14tangible personal property transferred incident to the
15completion of the contract.
16    Beginning on July 1, 2000 and through December 31, 2000,
17with respect to motor fuel, as defined in Section 1.1 of the
18Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
19the Use Tax Act, the tax is imposed at the rate of 1.25%.
20    With respect to gasohol, as defined in the Use Tax Act, the
21tax imposed by this Act shall apply to (i) 70% of the cost
22price of property transferred as an incident to the sale of
23service on or after January 1, 1990, and before July 1, 2003,
24(ii) 80% of the selling price of property transferred as an
25incident to the sale of service on or after July 1, 2003 and on
26or before July 1, 2017, and (iii) 100% of the cost price

 

 

10100SB0558ham003- 63 -LRB101 04319 CPF 74762 a

1thereafter. If, at any time, however, the tax under this Act on
2sales of gasohol, as defined in the Use Tax Act, is imposed at
3the rate of 1.25%, then the tax imposed by this Act applies to
4100% of the proceeds of sales of gasohol made during that time.
5    With respect to majority blended ethanol fuel, as defined
6in the Use Tax Act, the tax imposed by this Act does not apply
7to the selling price of property transferred as an incident to
8the sale of service on or after July 1, 2003 and on or before
9December 31, 2023 but applies to 100% of the selling price
10thereafter.
11    With respect to biodiesel blends, as defined in the Use Tax
12Act, with no less than 1% and no more than 10% biodiesel, the
13tax imposed by this Act applies to (i) 80% of the selling price
14of property transferred as an incident to the sale of service
15on or after July 1, 2003 and on or before December 31, 2018 and
16(ii) 100% of the proceeds of the selling price thereafter. If,
17at any time, however, the tax under this Act on sales of
18biodiesel blends, as defined in the Use Tax Act, with no less
19than 1% and no more than 10% biodiesel is imposed at the rate
20of 1.25%, then the tax imposed by this Act applies to 100% of
21the proceeds of sales of biodiesel blends with no less than 1%
22and no more than 10% biodiesel made during that time.
23    With respect to 100% biodiesel, as defined in the Use Tax
24Act, and biodiesel blends, as defined in the Use Tax Act, with
25more than 10% but no more than 99% biodiesel material, the tax
26imposed by this Act does not apply to the proceeds of the

 

 

10100SB0558ham003- 64 -LRB101 04319 CPF 74762 a

1selling price of property transferred as an incident to the
2sale of service on or after July 1, 2003 and on or before
3December 31, 2023 but applies to 100% of the selling price
4thereafter.
5    At the election of any registered serviceman made for each
6fiscal year, sales of service in which the aggregate annual
7cost price of tangible personal property transferred as an
8incident to the sales of service is less than 35%, or 75% in
9the case of servicemen transferring prescription drugs or
10servicemen engaged in graphic arts production, of the aggregate
11annual total gross receipts from all sales of service, the tax
12imposed by this Act shall be based on the serviceman's cost
13price of the tangible personal property transferred incident to
14the sale of those services.
15    The tax shall be imposed at the rate of 1% on food prepared
16for immediate consumption and transferred incident to a sale of
17service subject to this Act or the Service Occupation Tax Act
18by an entity licensed under the Hospital Licensing Act, the
19Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD
20Act, the Specialized Mental Health Rehabilitation Act of 2013,
21or the Child Care Act of 1969. The tax shall also be imposed at
22the rate of 1% on 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 is not otherwise included in this

 

 

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

 

 

10100SB0558ham003- 66 -LRB101 04319 CPF 74762 a

1than 50% of vegetable or fruit juice by volume.
2    Until August 1, 2009, and notwithstanding any other
3provisions of this Act, "food for human consumption that is to
4be consumed off the premises where it is sold" includes all
5food sold through a vending machine, except soft drinks and
6food products that are dispensed hot from a vending machine,
7regardless of the location of the vending machine. Beginning
8August 1, 2009, and notwithstanding any other provisions of
9this Act, "food for human consumption that is to be consumed
10off the premises where it is sold" includes all food sold
11through a vending machine, except soft drinks, candy, and food
12products that are dispensed hot from a vending machine,
13regardless of the location of the vending machine.
14    Notwithstanding any other provisions of this Act,
15beginning September 1, 2009, "food for human consumption that
16is to be consumed off the premises where it is sold" does not
17include candy. For purposes of this Section, "candy" means a
18preparation of sugar, honey, or other natural or artificial
19sweeteners in combination with chocolate, fruits, nuts or other
20ingredients or flavorings in the form of bars, drops, or
21pieces. "Candy" does not include any preparation that contains
22flour or requires refrigeration.
23    Notwithstanding any other provisions of this Act,
24beginning September 1, 2009, "nonprescription medicines and
25drugs" does not include grooming and hygiene products. For
26purposes of this Section, "grooming and hygiene products"

 

 

10100SB0558ham003- 67 -LRB101 04319 CPF 74762 a

1includes, but is not limited to, soaps and cleaning solutions,
2shampoo, toothpaste, mouthwash, antiperspirants, and sun tan
3lotions and screens, unless those products are available by
4prescription only, regardless of whether the products meet the
5definition of "over-the-counter-drugs". For the purposes of
6this paragraph, "over-the-counter-drug" means a drug for human
7use that contains a label that identifies the product as a drug
8as required by 21 C.F.R. 201.66. The "over-the-counter-drug"
9label includes:
10        (A) A "Drug Facts" panel; or
11        (B) A statement of the "active ingredient(s)" with a
12    list of those ingredients contained in the compound,
13    substance or preparation.
14    Beginning on January 1, 2014 (the effective date of Public
15Act 98-122), "prescription and nonprescription medicines and
16drugs" includes medical cannabis purchased from a registered
17dispensing organization under the Compassionate Use of Medical
18Cannabis Program Act.
19    As used in this Section, "adult use cannabis" means
20cannabis subject to tax under the Cannabis Cultivation
21Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
22does not include cannabis subject to tax under the
23Compassionate Use of Medical Cannabis Program Act.
24(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
25101-593, eff. 12-4-19.)
 

 

 

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1    Section 70-20. The Retailers' Occupation Tax Act is amended
2by changing Section 2-10 as follows:
 
3    (35 ILCS 120/2-10)
4    Sec. 2-10. Rate of tax. Unless otherwise provided in this
5Section, the tax imposed by this Act is at the rate of 6.25% of
6gross receipts from sales of tangible personal property made in
7the course of business.
8    Beginning on July 1, 2000 and through December 31, 2000,
9with respect to motor fuel, as defined in Section 1.1 of the
10Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of
11the Use Tax Act, the tax is imposed at the rate of 1.25%.
12    Beginning on August 6, 2010 through August 15, 2010, with
13respect to sales tax holiday items as defined in Section 2-8 of
14this Act, the tax is imposed at the rate of 1.25%.
15    Within 14 days after the effective date of this amendatory
16Act of the 91st General Assembly, each retailer of motor fuel
17and gasohol shall cause the following notice to be posted in a
18prominently visible place on each retail dispensing device that
19is used to dispense motor fuel or gasohol in the State of
20Illinois: "As of July 1, 2000, the State of Illinois has
21eliminated the State's share of sales tax on motor fuel and
22gasohol through December 31, 2000. The price on this pump
23should reflect the elimination of the tax." The notice shall be
24printed in bold print on a sign that is no smaller than 4
25inches by 8 inches. The sign shall be clearly visible to

 

 

10100SB0558ham003- 69 -LRB101 04319 CPF 74762 a

1customers. Any retailer who fails to post or maintain a
2required sign through December 31, 2000 is guilty of a petty
3offense for which the fine shall be $500 per day per each
4retail premises where a violation occurs.
5    With respect to gasohol, as defined in the Use Tax Act, the
6tax imposed by this Act applies to (i) 70% of the proceeds of
7sales made on or after January 1, 1990, and before July 1,
82003, (ii) 80% of the proceeds of sales made on or after July
91, 2003 and on or before July 1, 2017, and (iii) 100% of the
10proceeds of sales made thereafter. If, at any time, however,
11the tax under this Act on sales of gasohol, as defined in the
12Use Tax Act, is imposed at the rate of 1.25%, then the tax
13imposed by this Act applies to 100% of the proceeds of sales of
14gasohol made during that time.
15    With respect to majority blended ethanol fuel, as defined
16in the Use Tax Act, the tax imposed by this Act does not apply
17to the proceeds of sales made on or after July 1, 2003 and on or
18before December 31, 2023 but applies to 100% of the proceeds of
19sales made thereafter.
20    With respect to biodiesel blends, as defined in the Use Tax
21Act, with no less than 1% and no more than 10% biodiesel, the
22tax imposed by this Act applies to (i) 80% of the proceeds of
23sales made on or after July 1, 2003 and on or before December
2431, 2018 and (ii) 100% of the proceeds of sales made
25thereafter. If, at any time, however, the tax under this Act on
26sales of biodiesel blends, as defined in the Use Tax Act, with

 

 

10100SB0558ham003- 70 -LRB101 04319 CPF 74762 a

1no less than 1% and no more than 10% biodiesel is imposed at
2the rate of 1.25%, then the tax imposed by this Act applies to
3100% of the proceeds of sales of biodiesel blends with no less
4than 1% and no more than 10% biodiesel made during that time.
5    With respect to 100% biodiesel, as defined in the Use Tax
6Act, and biodiesel blends, as defined in the Use Tax Act, with
7more than 10% but no more than 99% biodiesel, the tax imposed
8by this Act does not apply to the proceeds of sales made on or
9after July 1, 2003 and on or before December 31, 2023 but
10applies to 100% of the proceeds of sales made thereafter.
11    With respect to food for human consumption that is to be
12consumed off the premises where it is sold (other than
13alcoholic beverages, food consisting of or infused with adult
14use cannabis, soft drinks, and food that has been prepared for
15immediate consumption) and prescription and nonprescription
16medicines, drugs, medical appliances, products classified as
17Class III medical devices by the United States Food and Drug
18Administration that are used for cancer treatment pursuant to a
19prescription, as well as any accessories and components related
20to those devices, modifications to a motor vehicle for the
21purpose of rendering it usable by a person with a disability,
22and insulin, blood sugar urine testing materials, syringes, and
23needles used by human diabetics, for human use, the tax is
24imposed at the rate of 1%. For the purposes of this Section,
25until September 1, 2009: the term "soft drinks" means any
26complete, finished, ready-to-use, non-alcoholic drink, whether

 

 

10100SB0558ham003- 71 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 72 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 73 -LRB101 04319 CPF 74762 a

1    substance or preparation.
2    Beginning on the effective date of this amendatory Act of
3the 98th General Assembly, "prescription and nonprescription
4medicines and drugs" includes medical cannabis purchased from a
5registered dispensing organization under the Compassionate Use
6of Medical Cannabis Program Act.
7    As used in this Section, "adult use cannabis" means
8cannabis subject to tax under the Cannabis Cultivation
9Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and
10does not include cannabis subject to tax under the
11Compassionate Use of Medical Cannabis Program Act.
12(Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;
13101-593, eff. 12-4-19.)
 
14
Article 75.

 
15    Section 75-5. The Illinois Public Aid Code is amended by
16changing Section 9A-11 as follows:
 
17    (305 ILCS 5/9A-11)  (from Ch. 23, par. 9A-11)
18    Sec. 9A-11. Child care.
19    (a) The General Assembly recognizes that families with
20children need child care in order to work. Child care is
21expensive and families with low incomes, including those who
22are transitioning from welfare to work, often struggle to pay
23the costs of day care. The General Assembly understands the

 

 

10100SB0558ham003- 74 -LRB101 04319 CPF 74762 a

1importance of helping low-income working families become and
2remain self-sufficient. The General Assembly also believes
3that it is the responsibility of families to share in the costs
4of child care. It is also the preference of the General
5Assembly that all working poor families should be treated
6equally, regardless of their welfare status.
7    (b) To the extent resources permit, the Illinois Department
8shall provide child care services to parents or other relatives
9as defined by rule who are working or participating in
10employment or Department approved education or training
11programs. At a minimum, the Illinois Department shall cover the
12following categories of families:
13        (1) recipients of TANF under Article IV participating
14    in work and training activities as specified in the
15    personal plan for employment and self-sufficiency;
16        (2) families transitioning from TANF to work;
17        (3) families at risk of becoming recipients of TANF;
18        (4) families with special needs as defined by rule;
19        (5) working families with very low incomes as defined
20    by rule;
21        (6) families that are not recipients of TANF and that
22    need child care assistance to participate in education and
23    training activities; and
24        (7) families with children under the age of 5 who have
25    an open intact family services case with the Department of
26    Children and Family Services. Any family that receives

 

 

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1    child care assistance in accordance with this paragraph
2    shall remain eligible for child care assistance 6 months
3    after the child's intact family services case is closed,
4    regardless of whether the child's parents or other
5    relatives as defined by rule are working or participating
6    in Department approved employment or education or training
7    programs. The Department of Human Services, in
8    consultation with the Department of Children and Family
9    Services, shall adopt rules to protect the privacy of
10    families who are the subject of an open intact family
11    services case when such families enroll in child care
12    services. Additional rules shall be adopted to offer
13    children who have an open intact family services case the
14    opportunity to receive an Early Intervention screening and
15    other services that their families may be eligible for as
16    provided by the Department of Human Services.
17    The Department shall specify by rule the conditions of
18eligibility, the application process, and the types, amounts,
19and duration of services. Eligibility for child care benefits
20and the amount of child care provided may vary based on family
21size, income, and other factors as specified by rule.
22    The Department shall update the Child Care Assistance
23Program Eligibility Calculator posted on its website to include
24a question on whether a family is applying for child care
25assistance for the first time or is applying for a
26redetermination of eligibility.

 

 

10100SB0558ham003- 76 -LRB101 04319 CPF 74762 a

1    A family's eligibility for child care services shall be
2redetermined no sooner than 12 months following the initial
3determination or most recent redetermination. During the
412-month periods, the family shall remain eligible for child
5care services regardless of (i) a change in family income,
6unless family income exceeds 85% of State median income, or
7(ii) a temporary change in the ongoing status of the parents or
8other relatives, as defined by rule, as working or attending a
9job training or educational program.
10    In determining income eligibility for child care benefits,
11the Department annually, at the beginning of each fiscal year,
12shall establish, by rule, one income threshold for each family
13size, in relation to percentage of State median income for a
14family of that size, that makes families with incomes below the
15specified threshold eligible for assistance and families with
16incomes above the specified threshold ineligible for
17assistance. Through and including fiscal year 2007, the
18specified threshold must be no less than 50% of the
19then-current State median income for each family size.
20Beginning in fiscal year 2008, the specified threshold must be
21no less than 185% of the then-current federal poverty level for
22each family size. Notwithstanding any other provision of law or
23administrative rule to the contrary, beginning in fiscal year
242019, the specified threshold for working families with very
25low incomes as defined by rule must be no less than 185% of the
26then-current federal poverty level for each family size.

 

 

10100SB0558ham003- 77 -LRB101 04319 CPF 74762 a

1    In determining eligibility for assistance, the Department
2shall not give preference to any category of recipients or give
3preference to individuals based on their receipt of benefits
4under this Code.
5    Nothing in this Section shall be construed as conferring
6entitlement status to eligible families.
7    The Illinois Department is authorized to lower income
8eligibility ceilings, raise parent co-payments, create waiting
9lists, or take such other actions during a fiscal year as are
10necessary to ensure that child care benefits paid under this
11Article do not exceed the amounts appropriated for those child
12care benefits. These changes may be accomplished by emergency
13rule under Section 5-45 of the Illinois Administrative
14Procedure Act, except that the limitation on the number of
15emergency rules that may be adopted in a 24-month period shall
16not apply.
17    The Illinois Department may contract with other State
18agencies or child care organizations for the administration of
19child care services.
20    (c) Payment shall be made for child care that otherwise
21meets the requirements of this Section and applicable standards
22of State and local law and regulation, including any
23requirements the Illinois Department promulgates by rule in
24addition to the licensure requirements promulgated by the
25Department of Children and Family Services and Fire Prevention
26and Safety requirements promulgated by the Office of the State

 

 

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1Fire Marshal, and is provided in any of the following:
2        (1) a child care center which is licensed or exempt
3    from licensure pursuant to Section 2.09 of the Child Care
4    Act of 1969;
5        (2) a licensed child care home or home exempt from
6    licensing;
7        (3) a licensed group child care home;
8        (4) other types of child care, including child care
9    provided by relatives or persons living in the same home as
10    the child, as determined by the Illinois Department by
11    rule.
12    (c-5) Solely for the purposes of coverage under the
13Illinois Public Labor Relations Act, child and day care home
14providers, including licensed and license exempt,
15participating in the Department's child care assistance
16program shall be considered to be public employees and the
17State of Illinois shall be considered to be their employer as
18of January 1, 2006 (the effective date of Public Act 94-320),
19but not before. The State shall engage in collective bargaining
20with an exclusive representative of child and day care home
21providers participating in the child care assistance program
22concerning their terms and conditions of employment that are
23within the State's control. Nothing in this subsection shall be
24understood to limit the right of families receiving services
25defined in this Section to select child and day care home
26providers or supervise them within the limits of this Section.

 

 

10100SB0558ham003- 79 -LRB101 04319 CPF 74762 a

1The State shall not be considered to be the employer of child
2and day care home providers for any purposes not specifically
3provided in Public Act 94-320, including, but not limited to,
4purposes of vicarious liability in tort and purposes of
5statutory retirement or health insurance benefits. Child and
6day care home providers shall not be covered by the State
7Employees Group Insurance Act of 1971.
8    In according child and day care home providers and their
9selected representative rights under the Illinois Public Labor
10Relations Act, the State intends that the State action
11exemption to application of federal and State antitrust laws be
12fully available to the extent that their activities are
13authorized by Public Act 94-320.
14    (d) The Illinois Department shall establish, by rule, a
15co-payment scale that provides for cost sharing by families
16that receive child care services, including parents whose only
17income is from assistance under this Code. The co-payment shall
18be based on family income and family size and may be based on
19other factors as appropriate. Co-payments may be waived for
20families whose incomes are at or below the federal poverty
21level.
22    (d-5) The Illinois Department, in consultation with its
23Child Care and Development Advisory Council, shall develop a
24plan to revise the child care assistance program's co-payment
25scale. The plan shall be completed no later than February 1,
262008, and shall include:

 

 

10100SB0558ham003- 80 -LRB101 04319 CPF 74762 a

1        (1) findings as to the percentage of income that the
2    average American family spends on child care and the
3    relative amounts that low-income families and the average
4    American family spend on other necessities of life;
5        (2) recommendations for revising the child care
6    co-payment scale to assure that families receiving child
7    care services from the Department are paying no more than
8    they can reasonably afford;
9        (3) recommendations for revising the child care
10    co-payment scale to provide at-risk children with complete
11    access to Preschool for All and Head Start; and
12        (4) recommendations for changes in child care program
13    policies that affect the affordability of child care.
14    (e) (Blank).
15    (f) The Illinois Department shall, by rule, set rates to be
16paid for the various types of child care. Child care may be
17provided through one of the following methods:
18        (1) arranging the child care through eligible
19    providers by use of purchase of service contracts or
20    vouchers;
21        (2) arranging with other agencies and community
22    volunteer groups for non-reimbursed child care;
23        (3) (blank); or
24        (4) adopting such other arrangements as the Department
25    determines appropriate.
26    (f-1) Within 30 days after June 4, 2018 (the effective date

 

 

10100SB0558ham003- 81 -LRB101 04319 CPF 74762 a

1of Public Act 100-587), the Department of Human Services shall
2establish rates for child care providers that are no less than
3the rates in effect on January 1, 2018 increased by 4.26%.
4    (f-5) (Blank).
5    (g) Families eligible for assistance under this Section
6shall be given the following options:
7        (1) receiving a child care certificate issued by the
8    Department or a subcontractor of the Department that may be
9    used by the parents as payment for child care and
10    development services only; or
11        (2) if space is available, enrolling the child with a
12    child care provider that has a purchase of service contract
13    with the Department or a subcontractor of the Department
14    for the provision of child care and development services.
15    The Department may identify particular priority
16    populations for whom they may request special
17    consideration by a provider with purchase of service
18    contracts, provided that the providers shall be permitted
19    to maintain a balance of clients in terms of household
20    incomes and families and children with special needs, as
21    defined by rule.
22(Source: P.A. 100-387, eff. 8-25-17; 100-587, eff. 6-4-18;
23100-860, eff. 2-14-19; 100-909, eff. 10-1-18; 100-916, eff.
248-17-18; 101-81, eff. 7-12-19.)
 
25
Article 80.

 

 

 

10100SB0558ham003- 82 -LRB101 04319 CPF 74762 a

1    Section 80-5. The Employee Sick Leave Act is amended by
2changing Sections 5 and 10 as follows:
 
3    (820 ILCS 191/5)
4    Sec. 5. Definitions. In this Act:
5    "Department" means the Department of Labor.
6    "Personal sick leave benefits" means any paid or unpaid
7time available to an employee as provided through an employment
8benefit plan or paid time off policy to be used as a result of
9absence from work due to personal illness, injury, or medical
10appointment or for the personal care of a parent,
11mother-in-law, father-in-law, grandparent, or stepparent. An
12employment benefit plan or paid time off policy does not
13include long term disability, short term disability, an
14insurance policy, or other comparable benefit plan or policy.
15(Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)
 
16    (820 ILCS 191/10)
17    Sec. 10. Use of leave; limitations.
18    (a) An employee may use personal sick leave benefits
19provided by the employer for absences due to an illness,
20injury, or medical appointment of the employee's child,
21stepchild, spouse, domestic partner, sibling, parent,
22mother-in-law, father-in-law, grandchild, grandparent, or
23stepparent, or for the personal care of a parent,

 

 

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1mother-in-law, father-in-law, grandparent, or stepparent on
2the same terms upon which the employee is able to use personal
3sick leave benefits for the employee's own illness or injury.
4An employer may request written verification of the employee's
5absence from a health care professional if such verification is
6required under the employer's employment benefit plan or paid
7time off policy.
8    (b) An employer may limit the use of personal sick leave
9benefits provided by the employer for absences due to an
10illness, injury, or medical appointment of the employee's
11child, stepchild, spouse, domestic partner, sibling, parent,
12mother-in-law, father-in-law, grandchild, grandparent, or
13stepparent to an amount not less than the personal sick leave
14that would be earned or accrued during 6 months at the
15employee's then current rate of entitlement. For employers who
16base personal sick leave benefits on an employee's years of
17service instead of annual or monthly accrual, such employer may
18limit the amount of sick leave to be used under this Act to
19half of the employee's maximum annual grant.
20    (c) An employer who provides personal sick leave benefits
21or a paid time off policy that would otherwise provide benefits
22as required under subsections (a) and (b) shall not be required
23to modify such benefits.
24(Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)
 
25
Article 90.

 

 

 

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1    Section 90-5. The Nursing Home Care Act is amended by
2adding Section 3-206.06 as follows:
 
3    (210 ILCS 45/3-206.06 new)
4    Sec. 3-206.06. Testing for Legionnaires' disease. A
5facility licensed under this Act must prove upon inspection by
6the Department that it has provided testing for Legionnaires'
7disease. The facility must also provide the results of that
8testing to the Department.
 
9    Section 90-10. The Hospital Licensing Act is amended by
10adding Section 6.29 as follows:
 
11    (210 ILCS 85/6.29 new)
12    Sec. 6.29. Testing for Legionnaires' disease. A hospital
13licensed under this Act must prove upon inspection by the
14Department that it has provided testing for Legionnaires'
15disease. The hospital must also provide the results of that
16testing to the Department.
 
17
Article 95.

 
18    Section 95-1. Short title. This Article may be cited as the
19Child Trauma Counseling Act. References in this Article to
20"this Act" mean this Article.
 

 

 

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1    Section 95-5. Definitions. As used in this Act:
2    "Day care center" has the meaning given to that term in
3Section 2.09 of the Child Care Act of 1969.
4    "School" means a public or nonpublic elementary school.
5    "Trauma counselor" means a licensed professional
6counselor, as that term is defined in Section 10 of the
7Professional Counselor and Clinical Professional Counselor
8Licensing and Practice Act, who has experience in treating
9childhood trauma or who has a certification relating to
10treating childhood trauma.
 
11    Section 95-10. Trauma counseling through fifth grade.
12    (a) Notwithstanding any other provision of law:
13        (1) a day care center shall provide the services of a
14    trauma counselor to a child, from birth through the fifth
15    grade, enrolled and attending the day care center who has
16    been identified as needing trauma counseling; and
17        (2) a school shall provide the services of a trauma
18    counselor to a child who is enrolled and attending
19    kindergarten through the fifth grade at that school and has
20    been identified as needing trauma counseling.
21    There shall be no cost for such trauma counseling to the
22parents or guardians of the child.
23    (b) A child is identified as needing trauma counseling
24under subsection (a) if the child reports trauma to a day care

 

 

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1center or a school or a parent or guardian of the child or
2employee of a day care center or a school reports that the
3child has experienced trauma.
 
4    Section 95-15. Rules.
5    (a) The Department of Children and Family Services shall
6adopt rules to implement this Act. The Department shall seek
7recommendations and advice from the State Board of Education as
8to adoption of the Department's rules as they relate to
9schools.
10    (b) The Department of Financial and Professional
11Regulation may adopt rules regarding the qualifications of
12trauma counselors working with children under this Act.
 
13    Section 95-90. The State Mandates Act is amended by adding
14Section 8.45 as follows:
 
15    (30 ILCS 805/8.45 new)
16    Sec. 8.45. Exempt mandate. Notwithstanding Sections 6 and 8
17of this Act, no reimbursement by the State is required for the
18implementation of any mandate created by the Child Trauma
19Counseling Act.
 
20
Article 100.

 
21    Section 100-1. Short title. This Article may be cited as

 

 

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1the Special Commission on Gynecologic Cancers Act.
 
2    Section 100-5. Creation; members; duties; report.    
3    (a) The Special Commission on Gynecologic Cancers is
4created. Membership of the Commission shall be as follows:
5        (1) A representative of the Illinois Comprehensive
6    Cancer Control Program, appointed by the Director of Public
7    Health;
8        (2) The Director of Insurance, or his or her designee;
9    and
10        (3) 20 members who shall be appointed as follows:
11                (A) three members appointed by the Speaker of
12        the House of Representatives, one of whom shall be a
13        survivor of ovarian cancer, one of whom shall be a
14        survivor of cervical, vaginal, vulvar, or uterine
15        cancer, and one of whom shall be a medical specialist
16        in gynecologic cancers;
17                (B) three members appointed by the Senate
18        President, one of whom shall be a survivor of ovarian
19        cancer, one of whom shall be a survivor of cervical,
20        vaginal, vulvar, or uterine cancer, and one of whom
21        shall be a medical specialist in gynecologic cancers;
22                (C) three members appointed by the House
23        Minority Leader, one of whom shall be a survivor of
24        ovarian cancer, one of whom shall be a survivor of
25        cervical, vaginal, vulvar, or uterine cancer, and one

 

 

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1        of whom shall be a medical specialist in gynecologic
2        cancers;
3                (D) three members appointed by the Senate
4        Minority Leader, one of whom shall be a survivor of
5        ovarian cancer, one of whom shall be a survivor of
6        cervical, vaginal, vulvar, or uterine cancer, and one
7        of whom shall be a medical specialist in gynecologic
8        cancers; and
9                (E) eight members appointed by the Governor,
10        one of whom shall be a caregiver of a woman diagnosed
11        with a gynecologic cancer, one of whom shall be a
12        medical specialist in gynecologic cancers, one of whom
13        shall be an individual with expertise in community
14        based health care and issues affecting underserved and
15        vulnerable populations, 2 of whom shall be individuals
16        representing gynecologic cancer awareness and support
17        groups in the State, one of whom shall be a researcher
18        specializing in gynecologic cancers, and 2 of whom
19        shall be members of the public with demonstrated
20        expertise in issues relating to the work of the
21        Commission.
22    (b) Members of the Commission shall serve without
23compensation or reimbursement from the Commission. Members
24shall select a Chair from among themselves and the Chair shall
25set the meeting schedule.
26    (c) The Illinois Department of Public Health shall provide

 

 

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1administrative support to the Commission.
2    (d) The Commission is charged with the study of the
3following:
4        (1) establishing a mechanism to ascertain the
5    prevalence of gynecologic cancers in the State and, to the
6    extent possible, to collect statistics relative to the
7    timing of diagnosis and risk factors associated with
8    gynecologic cancers;
9        (2) determining how to best effectuate early diagnosis
10    and treatment for gynecologic cancer patients;
11        (3) determining best practices for closing disparities
12    in outcomes for gynecologic cancer patients and innovative
13    approaches to reaching underserved and vulnerable
14    populations;
15        (4) determining any unmet needs of persons with
16    gynecologic cancers and those of their families; and
17        (5) providing recommendations for additional
18    legislation, support programs, and resources to meet the
19    unmet needs of persons with gynecologic cancers and their
20    families.
21    (e) The Commission shall file its final report with the
22General Assembly no later than December 31, 2021 and, upon the
23filing of its report, is dissolved.
 
24    Section 100-90. Repeal. This Article is repealed on January
251, 2023.
 

 

 

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1
Article 105.

 
2    Section 5. The Illinois Public Aid Code is amended by
3changing Section 5A-12.7 as follows:
 
4    (305 ILCS 5/5A-12.7)
5    (Section scheduled to be repealed on December 31, 2022)
6    Sec. 5A-12.7. Continuation of hospital access payments on
7and after July 1, 2020.
8    (a) To preserve and improve access to hospital services,
9for hospital services rendered on and after July 1, 2020, the
10Department shall, except for hospitals described in subsection
11(b) of Section 5A-3, make payments to hospitals or require
12capitated managed care organizations to make payments as set
13forth in this Section. Payments under this Section are not due
14and payable, however, until: (i) the methodologies described in
15this Section are approved by the federal government in an
16appropriate State Plan amendment or directed payment preprint;
17and (ii) the assessment imposed under this Article is
18determined to be a permissible tax under Title XIX of the
19Social Security Act. In determining the hospital access
20payments authorized under subsection (g) of this Section, if a
21hospital ceases to qualify for payments from the pool, the
22payments for all hospitals continuing to qualify for payments
23from such pool shall be uniformly adjusted to fully expend the

 

 

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1aggregate net amount of the pool, with such adjustment being
2effective on the first day of the second month following the
3date the hospital ceases to receive payments from such pool.
4    (b) Amounts moved into claims-based rates and distributed
5in accordance with Section 14-12 shall remain in those
6claims-based rates.
7    (c) Graduate medical education.
8        (1) The calculation of graduate medical education
9    payments shall be based on the hospital's Medicare cost
10    report ending in Calendar Year 2018, as reported in the
11    Healthcare Cost Report Information System file, release
12    date September 30, 2019. An Illinois hospital reporting
13    intern and resident cost on its Medicare cost report shall
14    be eligible for graduate medical education payments.
15        (2) Each hospital's annualized Medicaid Intern
16    Resident Cost is calculated using annualized intern and
17    resident total costs obtained from Worksheet B Part I,
18    Columns 21 and 22 the sum of Lines 30-43, 50-76, 90-93,
19    96-98, and 105-112 multiplied by the percentage that the
20    hospital's Medicaid days (Worksheet S3 Part I, Column 7,
21    Lines 2, 3, 4, 14, 16-18, and 32) comprise of the
22    hospital's total days (Worksheet S3 Part I, Column 8, Lines
23    14, 16-18, and 32).
24        (3) An annualized Medicaid indirect medical education
25    (IME) payment is calculated for each hospital using its IME
26    payments (Worksheet E Part A, Line 29, Column 1) multiplied

 

 

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1    by the percentage that its Medicaid days (Worksheet S3 Part
2    I, Column 7, Lines 2, 3, 4, 14, 16-18, and 32) comprise of
3    its Medicare days (Worksheet S3 Part I, Column 6, Lines 2,
4    3, 4, 14, and 16-18).
5        (4) For each hospital, its annualized Medicaid Intern
6    Resident Cost and its annualized Medicaid IME payment are
7    summed, and, except as capped at 120% of the average cost
8    per intern and resident for all qualifying hospitals as
9    calculated under this paragraph, is multiplied by 22.6% to
10    determine the hospital's final graduate medical education
11    payment. Each hospital's average cost per intern and
12    resident shall be calculated by summing its total
13    annualized Medicaid Intern Resident Cost plus its
14    annualized Medicaid IME payment and dividing that amount by
15    the hospital's total Full Time Equivalent Residents and
16    Interns. If the hospital's average per intern and resident
17    cost is greater than 120% of the same calculation for all
18    qualifying hospitals, the hospital's per intern and
19    resident cost shall be capped at 120% of the average cost
20    for all qualifying hospitals.
21    (d) Fee-for-service supplemental payments. Each Illinois
22hospital shall receive an annual payment equal to the amounts
23below, to be paid in 12 equal installments on or before the
24seventh State business day of each month, except that no
25payment shall be due within 30 days after the later of the date
26of notification of federal approval of the payment

 

 

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1methodologies required under this Section or any waiver
2required under 42 CFR 433.68, at which time the sum of amounts
3required under this Section prior to the date of notification
4is due and payable.
5        (1) For critical access hospitals, $385 per covered
6    inpatient day contained in paid fee-for-service claims and
7    $530 per paid fee-for-service outpatient claim for dates of
8    service in Calendar Year 2019 in the Department's
9    Enterprise Data Warehouse as of May 11, 2020.
10        (2) For safety-net hospitals, $960 per covered
11    inpatient day contained in paid fee-for-service claims and
12    $625 per paid fee-for-service outpatient claim for dates of
13    service in Calendar Year 2019 in the Department's
14    Enterprise Data Warehouse as of May 11, 2020.
15        (3) For long term acute care hospitals, $295 per
16    covered inpatient day contained in paid fee-for-service
17    claims for dates of service in Calendar Year 2019 in the
18    Department's Enterprise Data Warehouse as of May 11, 2020.
19        (4) For freestanding psychiatric hospitals, $125 per
20    covered inpatient day contained in paid fee-for-service
21    claims and $130 per paid fee-for-service outpatient claim
22    for dates of service in Calendar Year 2019 in the
23    Department's Enterprise Data Warehouse as of May 11, 2020.
24        (5) For freestanding rehabilitation hospitals, $355
25    per covered inpatient day contained in paid
26    fee-for-service claims for dates of service in Calendar

 

 

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1    Year 2019 in the Department's Enterprise Data Warehouse as
2    of May 11, 2020.
3        (6) For all general acute care hospitals and high
4    Medicaid hospitals as defined in subsection (f), $350 per
5    covered inpatient day for dates of service in Calendar Year
6    2019 contained in paid fee-for-service claims and $620 per
7    paid fee-for-service outpatient claim in the Department's
8    Enterprise Data Warehouse as of May 11, 2020.
9        (7) Alzheimer's treatment access payment. Each
10    Illinois academic medical center or teaching hospital, as
11    defined in Section 5-5e.2 of this Code, that is identified
12    as the primary hospital affiliate of one of the Regional
13    Alzheimer's Disease Assistance Centers, as designated by
14    the Alzheimer's Disease Assistance Act and identified in
15    the Department of Public Health's Alzheimer's Disease
16    State Plan dated December 2016, shall be paid an
17    Alzheimer's treatment access payment equal to the product
18    of the qualifying hospital's State Fiscal Year 2018 total
19    inpatient fee-for-service days multiplied by the
20    applicable Alzheimer's treatment rate of $226.30 for
21    hospitals located in Cook County and $116.21 for hospitals
22    located outside Cook County.
23    (e) The Department shall require managed care
24organizations (MCOs) to make directed payments and
25pass-through payments according to this Section. Each calendar
26year, the Department shall require MCOs to pay the maximum

 

 

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1amount out of these funds as allowed as pass-through payments
2under federal regulations. The Department shall require MCOs to
3make such pass-through payments as specified in this Section.
4The Department shall require the MCOs to pay the remaining
5amounts as directed Payments as specified in this Section. The
6Department shall issue payments to the Comptroller by the
7seventh business day of each month for all MCOs that are
8sufficient for MCOs to make the directed payments and
9pass-through payments according to this Section. The
10Department shall require the MCOs to make pass-through payments
11and directed payments using electronic funds transfers (EFT),
12if the hospital provides the information necessary to process
13such EFTs, in accordance with directions provided monthly by
14the Department, within 7 business days of the date the funds
15are paid to the MCOs, as indicated by the "Paid Date" on the
16website of the Office of the Comptroller if the funds are paid
17by EFT and the MCOs have received directed payment
18instructions. If funds are not paid through the Comptroller by
19EFT, payment must be made within 7 business days of the date
20actually received by the MCO. The MCO will be considered to
21have paid the pass-through payments when the payment remittance
22number is generated or the date the MCO sends the check to the
23hospital, if EFT information is not supplied. If an MCO is late
24in paying a pass-through payment or directed payment as
25required under this Section (including any extensions granted
26by the Department), it shall pay a penalty, unless waived by

 

 

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1the Department for reasonable cause, to the Department equal to
25% of the amount of the pass-through payment or directed
3payment not paid on or before the due date plus 5% of the
4portion thereof remaining unpaid on the last day of each 30-day
5period thereafter. Payments to MCOs that would be paid
6consistent with actuarial certification and enrollment in the
7absence of the increased capitation payments under this Section
8shall not be reduced as a consequence of payments made under
9this subsection. The Department shall publish and maintain on
10its website for a period of no less than 8 calendar quarters,
11the quarterly calculation of directed payments and
12pass-through payments owed to each hospital from each MCO. All
13calculations and reports shall be posted no later than the
14first day of the quarter for which the payments are to be
15issued.
16    (f)(1) For purposes of allocating the funds included in
17capitation payments to MCOs, Illinois hospitals shall be
18divided into the following classes as defined in administrative
19rules:
20        (A) Critical access hospitals.
21        (B) Safety-net hospitals, except that stand-alone
22    children's hospitals that are not specialty children's
23    hospitals will not be included.
24        (C) Long term acute care hospitals.
25        (D) Freestanding psychiatric hospitals.
26        (E) Freestanding rehabilitation hospitals.

 

 

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1        (F) High Medicaid hospitals. As used in this Section,
2    "high Medicaid hospital" means a general acute care
3    hospital that is not a safety-net hospital or critical
4    access hospital and that has a Medicaid Inpatient
5    Utilization Rate above 30% or a hospital that had over
6    35,000 inpatient Medicaid days during the applicable
7    period. For the period July 1, 2020 through December 31,
8    2020, the applicable period for the Medicaid Inpatient
9    Utilization Rate (MIUR) is the rate year 2020 MIUR and for
10    the number of inpatient days it is State fiscal year 2018.
11    Beginning in calendar year 2021, the Department shall use
12    the most recently determined MIUR, as defined in subsection
13    (h) of Section 5-5.02, and for the inpatient day threshold,
14    the State fiscal year ending 18 months prior to the
15    beginning of the calendar year. For purposes of calculating
16    MIUR under this Section, children's hospitals and
17    affiliated general acute care hospitals shall be
18    considered a single hospital.
19        (G) General acute care hospitals. As used under this
20    Section, "general acute care hospitals" means all other
21    Illinois hospitals not identified in subparagraphs (A)
22    through (F).
23    (2) Hospitals' qualification for each class shall be
24assessed prior to the beginning of each calendar year and the
25new class designation shall be effective January 1 of the next
26year. The Department shall publish by rule the process for

 

 

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1establishing class determination.
2    (g) Fixed pool directed payments. Beginning July 1, 2020,
3the Department shall issue payments to MCOs which shall be used
4to issue directed payments to qualified Illinois safety-net
5hospitals and critical access hospitals on a monthly basis in
6accordance with this subsection. Prior to the beginning of each
7Payout Quarter beginning July 1, 2020, the Department shall use
8encounter claims data from the Determination Quarter, accepted
9by the Department's Medicaid Management Information System for
10inpatient and outpatient services rendered by safety-net
11hospitals and critical access hospitals to determine a
12quarterly uniform per unit add-on for each hospital class.
13        (1) Inpatient per unit add-on. A quarterly uniform per
14    diem add-on shall be derived by dividing the quarterly
15    Inpatient Directed Payments Pool amount allocated to the
16    applicable hospital class by the total inpatient days
17    contained on all encounter claims received during the
18    Determination Quarter, for all hospitals in the class.
19            (A) Each hospital in the class shall have a
20        quarterly inpatient directed payment calculated that
21        is equal to the product of the number of inpatient days
22        attributable to the hospital used in the calculation of
23        the quarterly uniform class per diem add-on,
24        multiplied by the calculated applicable quarterly
25        uniform class per diem add-on of the hospital class.
26            (B) Each hospital shall be paid 1/3 of its

 

 

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

 

 

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1        quarter, beginning July 1, 2020.
2            (B) "Determination Quarter" means each 3 month
3        calendar quarter, which ends 3 months prior to the
4        first day of each Payout Quarter.
5        (5) For the period July 1, 2020 through December 2020,
6    the following amounts shall be allocated to the following
7    hospital class directed payment pools for the quarterly
8    development of a uniform per unit add-on:
9            (A) $2,894,500 for hospital inpatient services for
10        critical access hospitals.
11            (B) $4,294,374 for hospital outpatient services
12        for critical access hospitals.
13            (C) $29,109,330 for hospital inpatient services
14        for safety-net hospitals.
15            (D) $35,041,218 for hospital outpatient services
16        for safety-net hospitals.
17    (h) Fixed rate directed payments. Effective July 1, 2020,
18the Department shall issue payments to MCOs which shall be used
19to issue directed payments to Illinois hospitals not identified
20in paragraph (g) on a monthly basis. Prior to the beginning of
21each Payout Quarter beginning July 1, 2020, the Department
22shall use encounter claims data from the Determination Quarter,
23accepted by the Department's Medicaid Management Information
24System for inpatient and outpatient services rendered by
25hospitals in each hospital class identified in paragraph (f)
26and not identified in paragraph (g). For the period July 1,

 

 

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12020 through December 2020, the Department shall direct MCOs to
2make payments as follows:
3        (1) For general acute care hospitals an amount equal to
4    $1,750 multiplied by the hospital's category of service 20
5    case mix index for the determination quarter multiplied by
6    the hospital's total number of inpatient admissions for
7    category of service 20 for the determination quarter.
8        (2) For general acute care hospitals an amount equal to
9    $160 multiplied by the hospital's category of service 21
10    case mix index for the determination quarter multiplied by
11    the hospital's total number of inpatient admissions for
12    category of service 21 for the determination quarter.
13        (3) For general acute care hospitals an amount equal to
14    $80 multiplied by the hospital's category of service 22
15    case mix index for the determination quarter multiplied by
16    the hospital's total number of inpatient admissions for
17    category of service 22 for the determination quarter.
18        (4) For general acute care hospitals an amount equal to
19    $375 multiplied by the hospital's category of service 24
20    case mix index for the determination quarter multiplied by
21    the hospital's total number of category of service 24 paid
22    EAPG (EAPGs) for the determination quarter.
23        (5) For general acute care hospitals an amount equal to
24    $240 multiplied by the hospital's category of service 27
25    and 28 case mix index for the determination quarter
26    multiplied by the hospital's total number of category of

 

 

10100SB0558ham003- 102 -LRB101 04319 CPF 74762 a

1    service 27 and 28 paid EAPGs for the determination quarter.
2        (6) For general acute care hospitals an amount equal to
3    $290 multiplied by the hospital's category of service 29
4    case mix index for the determination quarter multiplied by
5    the hospital's total number of category of service 29 paid
6    EAPGs for the determination quarter.
7        (7) For high Medicaid hospitals an amount equal to
8    $1,800 multiplied by the hospital's category of service 20
9    case mix index for the determination quarter multiplied by
10    the hospital's total number of inpatient admissions for
11    category of service 20 for the determination quarter.
12        (8) For high Medicaid hospitals an amount equal to $160
13    multiplied by the hospital's category of service 21 case
14    mix index for the determination quarter multiplied by the
15    hospital's total number of inpatient admissions for
16    category of service 21 for the determination quarter.
17        (9) For high Medicaid hospitals an amount equal to $80
18    multiplied by the hospital's category of service 22 case
19    mix index for the determination quarter multiplied by the
20    hospital's total number of inpatient admissions for
21    category of service 22 for the determination quarter.
22        (10) For high Medicaid hospitals an amount equal to
23    $400 multiplied by the hospital's category of service 24
24    case mix index for the determination quarter multiplied by
25    the hospital's total number of category of service 24 paid
26    EAPG outpatient claims for the determination quarter.

 

 

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1        (11) For high Medicaid hospitals an amount equal to
2    $240 multiplied by the hospital's category of service 27
3    and 28 case mix index for the determination quarter
4    multiplied by the hospital's total number of category of
5    service 27 and 28 paid EAPGs for the determination quarter.
6        (12) For high Medicaid hospitals an amount equal to
7    $290 multiplied by the hospital's category of service 29
8    case mix index for the determination quarter multiplied by
9    the hospital's total number of category of service 29 paid
10    EAPGs for the determination quarter.
11        (13) For long term acute care hospitals the amount of
12    $495 multiplied by the hospital's total number of inpatient
13    days for the determination quarter.
14        (14) For psychiatric hospitals the amount of $210
15    multiplied by the hospital's total number of inpatient days
16    for category of service 21 for the determination quarter.
17        (15) For psychiatric hospitals the amount of $250
18    multiplied by the hospital's total number of outpatient
19    claims for category of service 27 and 28 for the
20    determination quarter.
21        (16) For rehabilitation hospitals the amount of $410
22    multiplied by the hospital's total number of inpatient days
23    for category of service 22 for the determination quarter.
24        (17) For rehabilitation hospitals the amount of $100
25    multiplied by the hospital's total number of outpatient
26    claims for category of service 29 for the determination

 

 

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1    quarter.
2        (18) Each hospital shall be paid 1/3 of their quarterly
3    inpatient and outpatient directed payment in each of the 3
4    months of the Payout Quarter, in accordance with directions
5    provided to each MCO by the Department.
6        (19) Each MCO shall pay each hospital the Monthly
7    Directed Payment amount as identified by the Department on
8    its quarterly determination report.
9    Notwithstanding any other provision of this subsection, if
10the Department determines that the actual total hospital
11utilization data that is used to calculate the fixed rate
12directed payments is substantially different than anticipated
13when the rates in this subsection were initially determined
14(for unforeseeable circumstances such as the COVID-19
15pandemic), the Department may adjust the rates specified in
16this subsection so that the total directed payments approximate
17the total spending amount anticipated when the rates were
18initially established.
19    Definitions. As used in this subsection:
20            (A) "Payout Quarter" means each calendar quarter,
21        beginning July 1, 2020.
22            (B) "Determination Quarter" means each calendar
23        quarter which ends 3 months prior to the first day of
24        each Payout Quarter.
25            (C) "Case mix index" means a hospital specific
26        calculation. For inpatient claims the case mix index is

 

 

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1        calculated each quarter by summing the relative weight
2        of all inpatient Diagnosis-Related Group (DRG) claims
3        for a category of service in the applicable
4        Determination Quarter and dividing the sum by the
5        number of sum total of all inpatient DRG admissions for
6        the category of service for the associated claims. The
7        case mix index for outpatient claims is calculated each
8        quarter by summing the relative weight of all paid
9        EAPGs in the applicable Determination Quarter and
10        dividing the sum by the sum total of paid EAPGs for the
11        associated claims.
12    (i) Beginning January 1, 2021, the rates for directed
13payments shall be recalculated in order to spend the additional
14funds for directed payments that result from reduction in the
15amount of pass-through payments allowed under federal
16regulations. The additional funds for directed payments shall
17be allocated proportionally to each class of hospitals based on
18that class' proportion of services.
19    (j) Pass-through payments.
20        (1) For the period July 1, 2020 through December 31,
21    2020, the Department shall assign quarterly pass-through
22    payments to each class of hospitals equal to one-fourth of
23    the following annual allocations:
24            (A) $390,487,095 to safety-net hospitals.
25            (B) $62,553,886 to critical access hospitals.
26            (C) $345,021,438 to high Medicaid hospitals.

 

 

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1            (D) $551,429,071 to general acute care hospitals.
2            (E) $27,283,870 to long term acute care hospitals.
3            (F) $40,825,444 to freestanding psychiatric
4        hospitals.
5            (G) $9,652,108 to freestanding rehabilitation
6        hospitals.
7        (2) The pass-through payments shall at a minimum ensure
8    hospitals receive a total amount of monthly payments under
9    this Section as received in calendar year 2019 in
10    accordance with this Article and paragraph (1) of
11    subsection (d-5) of Section 14-12, exclusive of amounts
12    received through payments referenced in subsection (b).
13        (3) For the calendar year beginning January 1, 2021,
14    and each calendar year thereafter, each hospital's
15    pass-through payment amount shall be reduced
16    proportionally to the reduction of all pass-through
17    payments required by federal regulations.
18    (k) At least 30 days prior to each calendar year, the
19Department shall notify each hospital of changes to the payment
20methodologies in this Section, including, but not limited to,
21changes in the fixed rate directed payment rates, the aggregate
22pass-through payment amount for all hospitals, and the
23hospital's pass-through payment amount for the upcoming
24calendar year.
25    (l) Notwithstanding any other provisions of this Section,
26the Department may adopt rules to change the methodology for

 

 

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1directed and pass-through payments as set forth in this
2Section, but only to the extent necessary to obtain federal
3approval of a necessary State Plan amendment or Directed
4Payment Preprint or to otherwise conform to federal law or
5federal regulation.
6    (m) As used in this subsection, "managed care organization"
7or "MCO" means an entity which contracts with the Department to
8provide services where payment for medical services is made on
9a capitated basis, excluding contracted entities for dual
10eligible or Department of Children and Family Services youth
11populations.
12    (n) In order to address the escalating infant mortality
13rates among minority communities in Illinois, the State shall,
14subject to appropriation, create a pool of funding of at least
15$50,000,000 annually to be dispersed among community
16safety-net hospitals that maintain perinatal designation from
17the Department of Public Health. The funding shall be used to
18preserve or enhance OB/GYN services or other specialty services
19at the receiving hospital.
20(Source: P.A. 101-650, eff. 7-7-20.)
 
21
Article 110.

 
22    Section 110-1. Short title. This Article may be cited as
23the Racial Impact Note Act.
 

 

 

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1    Section 110-5. Racial impact note.
2    (a) Every bill which has or could have a disparate impact
3on racial and ethnic minorities, upon the request of any
4member, shall have prepared for it, before second reading in
5the house of introduction, a brief explanatory statement or
6note that shall include a reliable estimate of the anticipated
7impact on those racial and ethnic minorities likely to be
8impacted by the bill. Each racial impact note must include, for
9racial and ethnic minorities for which data are available: (i)
10an estimate of how the proposed legislation would impact racial
11and ethnic minorities; (ii) a statement of the methodologies
12and assumptions used in preparing the estimate; (iii) an
13estimate of the racial and ethnic composition of the population
14who may be impacted by the proposed legislation, including
15those persons who may be negatively impacted and those persons
16who may benefit from the proposed legislation; and (iv) any
17other matter that a responding agency considers appropriate in
18relation to the racial and ethnic minorities likely to be
19affected by the bill.
 
20    Section 110-10. Preparation.
21    (a) The sponsor of each bill for which a request under
22Section 110-5 has been made shall present a copy of the bill
23with the request for a racial impact note to the appropriate
24responding agency or agencies under subsection (b). The
25responding agency or agencies shall prepare and submit the note

 

 

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1to the sponsor of the bill within 5 calendar days, except that
2whenever, because of the complexity of the measure, additional
3time is required for the preparation of the racial impact note,
4the responding agency or agencies may inform the sponsor of the
5bill, and the sponsor may approve an extension of the time
6within which the note is to be submitted, not to extend,
7however, beyond June 15, following the date of the request. If,
8in the opinion of the responding agency or agencies, there is
9insufficient information to prepare a reliable estimate of the
10anticipated impact, a statement to that effect can be filed and
11shall meet the requirements of this Act.
12    (b) If a bill concerns arrests, convictions, or law
13enforcement, a statement shall be prepared by the Illinois
14Criminal Justice Information Authority specifying the impact
15on racial and ethnic minorities. If a bill concerns
16corrections, sentencing, or the placement of individuals
17within the Department of Corrections, a statement shall be
18prepared by the Department of Corrections specifying the impact
19on racial and ethnic minorities. If a bill concerns local
20government, a statement shall be prepared by the Department of
21Commerce and Economic Opportunity specifying the impact on
22racial and ethnic minorities. If a bill concerns education, one
23of the following agencies shall prepare a statement specifying
24the impact on racial and ethnic minorities: (i) the Illinois
25Community College Board, if the bill affects community
26colleges; (ii) the Illinois State Board of Education, if the

 

 

10100SB0558ham003- 110 -LRB101 04319 CPF 74762 a

1bill affects primary and secondary education; or (iii) the
2Illinois Board of Higher Education, if the bill affects State
3universities. Any other State agency impacted or responsible
4for implementing all or part of this bill shall prepare a
5statement of the racial and ethnic impact of the bill as it
6relates to that agency.
 
7    Section 110-15. Requisites and contents. The note shall be
8factual in nature, as brief and concise as may be, and, in
9addition, it shall include both the immediate effect and, if
10determinable or reasonably foreseeable, the long range effect
11of the measure on racial and ethnic minorities. If, after
12careful investigation, it is determined that such an effect is
13not ascertainable, the note shall contain a statement to that
14effect, setting forth the reasons why no ascertainable effect
15can be given.
 
16    Section 110-20. Comment or opinion; technical or
17mechanical defects. No comment or opinion shall be included in
18the racial impact note with regard to the merits of the measure
19for which the racial impact note is prepared; however,
20technical or mechanical defects may be noted.
 
21    Section 110-25. Appearance of State officials and
22employees in support or opposition of measure. The fact that a
23racial impact note is prepared for any bill shall not preclude

 

 

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1or restrict the appearance before any committee of the General
2Assembly of any official or authorized employee of the
3responding agency or agencies, or any other impacted State
4agency, who desires to be heard in support of or in opposition
5to the measure.
 
6
Article 115.

 
7    Section 115-5. The Department of Healthcare and Family
8Services Law of the Civil Administrative Code of Illinois is
9amended by adding Section 2205-35 as follows:
 
10    (20 ILCS 2205/2205-35 new)
11    Sec. 2205-35. Increasing access to primary care in
12hospitals. The Department of Healthcare and Family Services
13shall develop a program to increase the presence of Federally
14Qualified Health Centers (FQHCs) in hospitals, including, but
15not limited to, safety-net hospitals, with the goal of
16increasing care coordination, managing chronic diseases, and
17addressing the social determinants of health on or before
18December 31, 2021. In addition, the Department shall develop a
19payment methodology to allow FQHCs to provide care coordination
20services, including, but not limited to, chronic disease
21management and behavioral health services. The Department of
22Healthcare and Family Services shall develop a payment
23methodology to allow for care coordination services in FQHCs by

 

 

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1no later than December 31, 2021.
 
2
Article 120.

 
3    Section 120-5. The Civil Administrative Code of Illinois is
4amended by changing Section 5-565 as follows:
 
5    (20 ILCS 5/5-565)  (was 20 ILCS 5/6.06)
6    Sec. 5-565. In the Department of Public Health.
7    (a) The General Assembly declares it to be the public
8policy of this State that all residents citizens of Illinois
9are entitled to lead healthy lives. Governmental public health
10has a specific responsibility to ensure that a public health
11system is in place to allow the public health mission to be
12achieved. The public health system is the collection of public,
13private, and voluntary entities as well as individuals and
14informal associations that contribute to the public's health
15within the State. To develop a public health system requires
16certain core functions to be performed by government. The State
17Board of Health is to assume the leadership role in advising
18the Director in meeting the following functions:
19        (1) Needs assessment.
20        (2) Statewide health objectives.
21        (3) Policy development.
22        (4) Assurance of access to necessary services.
23    There shall be a State Board of Health composed of 20

 

 

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1persons, all of whom shall be appointed by the Governor, with
2the advice and consent of the Senate for those appointed by the
3Governor on and after June 30, 1998, and one of whom shall be a
4senior citizen age 60 or over. Five members shall be physicians
5licensed to practice medicine in all its branches, one
6representing a medical school faculty, one who is board
7certified in preventive medicine, and one who is engaged in
8private practice. One member shall be a chiropractic physician.
9One member shall be a dentist; one an environmental health
10practitioner; one a local public health administrator; one a
11local board of health member; one a registered nurse; one a
12physical therapist; one an optometrist; one a veterinarian; one
13a public health academician; one a health care industry
14representative; one a representative of the business
15community; one a representative of the non-profit public
16interest community; and 2 shall be citizens at large.
17    The terms of Board of Health members shall be 3 years,
18except that members shall continue to serve on the Board of
19Health until a replacement is appointed. Upon the effective
20date of Public Act 93-975 (January 1, 2005) this amendatory Act
21of the 93rd General Assembly, in the appointment of the Board
22of Health members appointed to vacancies or positions with
23terms expiring on or before December 31, 2004, the Governor
24shall appoint up to 6 members to serve for terms of 3 years; up
25to 6 members to serve for terms of 2 years; and up to 5 members
26to serve for a term of one year, so that the term of no more

 

 

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1than 6 members expire in the same year. All members shall be
2legal residents of the State of Illinois. The duties of the
3Board shall include, but not be limited to, the following:
4        (1) To advise the Department of ways to encourage
5    public understanding and support of the Department's
6    programs.
7        (2) To evaluate all boards, councils, committees,
8    authorities, and bodies advisory to, or an adjunct of, the
9    Department of Public Health or its Director for the purpose
10    of recommending to the Director one or more of the
11    following:
12            (i) The elimination of bodies whose activities are
13        not consistent with goals and objectives of the
14        Department.
15            (ii) The consolidation of bodies whose activities
16        encompass compatible programmatic subjects.
17            (iii) The restructuring of the relationship
18        between the various bodies and their integration
19        within the organizational structure of the Department.
20            (iv) The establishment of new bodies deemed
21        essential to the functioning of the Department.
22        (3) To serve as an advisory group to the Director for
23    public health emergencies and control of health hazards.
24        (4) To advise the Director regarding public health
25    policy, and to make health policy recommendations
26    regarding priorities to the Governor through the Director.

 

 

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1        (5) To present public health issues to the Director and
2    to make recommendations for the resolution of those issues.
3        (6) To recommend studies to delineate public health
4    problems.
5        (7) To make recommendations to the Governor through the
6    Director regarding the coordination of State public health
7    activities with other State and local public health
8    agencies and organizations.
9        (8) To report on or before February 1 of each year on
10    the health of the residents of Illinois to the Governor,
11    the General Assembly, and the public.
12        (9) To review the final draft of all proposed
13    administrative rules, other than emergency or peremptory
14    preemptory rules and those rules that another advisory body
15    must approve or review within a statutorily defined time
16    period, of the Department after September 19, 1991 (the
17    effective date of Public Act 87-633). The Board shall
18    review the proposed rules within 90 days of submission by
19    the Department. The Department shall take into
20    consideration any comments and recommendations of the
21    Board regarding the proposed rules prior to submission to
22    the Secretary of State for initial publication. If the
23    Department disagrees with the recommendations of the
24    Board, it shall submit a written response outlining the
25    reasons for not accepting the recommendations.
26        In the case of proposed administrative rules or

 

 

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1    amendments to administrative rules regarding immunization
2    of children against preventable communicable diseases
3    designated by the Director under the Communicable Disease
4    Prevention Act, after the Immunization Advisory Committee
5    has made its recommendations, the Board shall conduct 3
6    public hearings, geographically distributed throughout the
7    State. At the conclusion of the hearings, the State Board
8    of Health shall issue a report, including its
9    recommendations, to the Director. The Director shall take
10    into consideration any comments or recommendations made by
11    the Board based on these hearings.
12        (10) To deliver to the Governor for presentation to the
13    General Assembly a State Health Assessment (SHA) and a
14    State Health Improvement Plan (SHIP). The first 5 3 such
15    plans shall be delivered to the Governor on January 1,
16    2006, January 1, 2009, and January 1, 2016, January 1,
17    2021, and June 30, 2022, and then every 5 years thereafter.
18        The State Health Assessment and State Health
19    Improvement Plan Plan shall assess and recommend
20    priorities and strategies to improve the public health
21    system, and the health status of Illinois residents, reduce
22    health disparities and inequities, and promote health
23    equity. The State Health Assessment and State Health
24    Improvement Plan development and implementation shall
25    conform to national Public Health Accreditation Board
26    Standards. The State Health Assessment and State Health

 

 

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1    Improvement Plan development and implementation process
2    shall be carried out with the administrative and
3    operational support of the Department of Public Health
4    taking into consideration national health objectives and
5    system standards as frameworks for assessment.
6        The State Health Assessment shall include
7    comprehensive, broad-based data and information from a
8    variety of sources on health status and the public health
9    system including:
10            (i) quantitative data on the demographics and
11        health status of the population, including data over
12        time on health by gender, sex, race, ethnicity, age,
13        socio-economic factors, geographic region, and other
14        indicators of disparity;
15            (ii) quantitative data on social and structural
16        issues affecting health (social and structural
17        determinants of health), including, but not limited
18        to, housing, transportation, educational attainment,
19        employment, and income inequality;
20            (iii) priorities and strategies developed at the
21        community level through the Illinois Project for Local
22        Assessment of Needs (IPLAN) and other local and
23        regional community health needs assessments;
24            (iv) qualitative data representing the
25        population's input on health concerns and well-being,
26        including the perceptions of people experiencing

 

 

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

 

 

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1    socio-economic, and geographic disparities. The State
2    Health Improvement Plan shall make recommendations
3    regarding social determinants of health, such as housing,
4    transportation, educational attainment, employment, and
5    income inequality.
6        The development and implementation of the State Health
7    Assessment and State Health Improvement Plan shall be a
8    collaborative public-private cross-agency effort overseen
9    by the SHA and SHIP Partnership. The Director of Public
10    Health shall consult with the Governor to ensure
11    participation by the head of State agencies with public
12    health responsibilities (or their designees) in the SHA and
13    SHIP Partnership, including, but not limited to, the
14    Department of Public Health, the Department of Human
15    Services, the Department of Healthcare and Family
16    Services, the Department of Children and Family Services,
17    the Environmental Protection Agency, the Illinois State
18    Board of Education, the Department on Aging, the Illinois
19    Housing Development Authority, the Illinois Criminal
20    Justice Information Authority, the Department of
21    Agriculture, the Department of Transportation, the
22    Department of Corrections, the Department of Commerce and
23    Economic Opportunity, and the Chair of the State Board of
24    Health to also serve on the Partnership. A member of the
25    Governors' staff shall participate in the Partnership and
26    serve as a liaison to the Governors' office.

 

 

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1        The Director of the Illinois Department of Public
2    Health shall appoint a minimum of 20 other members of the
3    SHA and SHIP Partnership representing a Planning Team that
4    includes a range of public, private, and voluntary sector
5    stakeholders and participants in the public health system.
6    For the first SHA and SHIP Partnership after the effective
7    date of this amendatory Act of the 101st General Assembly,
8    one-half of the members shall be appointed for a 3-year
9    term, and one-half of the members shall be appointed for a
10    5-year term. Subsequently, members shall be appointed to
11    5-year terms. Should any member not be able to fulfill his
12    or her term, the Director may appoint a replacement to
13    complete that term. The Director, in consultation with the
14    SHA and SHIP Partnership, may engage additional
15    individuals and organizations to serve on subcommittees
16    and ad hoc efforts to conduct the State Health Assessment
17    and develop and implement the State Health Improvement
18    Plan. Members of the SHA and SHIP Partnership shall receive
19    no compensation for serving as members, but may be
20    reimbursed for their necessary expenses.
21        The SHA and SHIP Partnership This Team shall include:
22    the directors of State agencies with public health
23    responsibilities (or their designees), including but not
24    limited to the Illinois Departments of Public Health and
25    Department of Human Services, representatives of local
26    health departments, representatives of local community

 

 

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1    health partnerships, and individuals with expertise who
2    represent an array of organizations and constituencies
3    engaged in public health improvement and prevention, such
4    as non-profit public interest groups, groups serving
5    populations that experience health disparities and health
6    inequities, groups addressing social determinants of
7    health, health issue groups, faith community groups,
8    health care providers, businesses and employers, academic
9    institutions, and community-based organizations.
10        The Director shall endeavor to make the membership of
11    the Partnership diverse and inclusive of the racial,
12    ethnic, gender, socio-economic, and geographic diversity
13    of the State. The SHA and SHIP Partnership shall be chaired
14    by the Director of Public Health or his or her designee.
15        The SHA and SHIP Partnership shall develop and
16    implement a community engagement process that facilitates
17    input into the development of the State Health Assessment
18    and State Health Improvement Plan. This engagement process
19    shall ensure that individuals with lived experience in the
20    issues addressed in the State Health Assessment and State
21    Health Improvement Plan are meaningfully engaged in the
22    development and implementation of the State Health
23    Assessment and State Health Improvement Plan.
24        The State Board of Health shall hold at least 3 public
25    hearings addressing a draft of the State Health Improvement
26    Plan drafts of the Plan in representative geographic areas

 

 

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1    of the State. Members of the Planning Team shall receive no
2    compensation for their services, but may be reimbursed for
3    their necessary expenses.
4        Upon the delivery of each State Health Improvement
5    Plan, the Governor shall appoint a SHIP Implementation
6    Coordination Council that includes a range of public,
7    private, and voluntary sector stakeholders and
8    participants in the public health system. The Council shall
9    include the directors of State agencies and entities with
10    public health system responsibilities (or their
11    designees), including but not limited to the Department of
12    Public Health, Department of Human Services, Department of
13    Healthcare and Family Services, Environmental Protection
14    Agency, Illinois State Board of Education, Department on
15    Aging, Illinois Violence Prevention Authority, Department
16    of Agriculture, Department of Insurance, Department of
17    Financial and Professional Regulation, Department of
18    Transportation, and Department of Commerce and Economic
19    Opportunity and the Chair of the State Board of Health. The
20    Council shall include representatives of local health
21    departments and individuals with expertise who represent
22    an array of organizations and constituencies engaged in
23    public health improvement and prevention, including
24    non-profit public interest groups, health issue groups,
25    faith community groups, health care providers, businesses
26    and employers, academic institutions, and community-based

 

 

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1    organizations. The Governor shall endeavor to make the
2    membership of the Council representative of the racial,
3    ethnic, gender, socio-economic, and geographic diversity
4    of the State. The Governor shall designate one State agency
5    representative and one other non-governmental member as
6    co-chairs of the Council. The Governor shall designate a
7    member of the Governor's office to serve as liaison to the
8    Council and one or more State agencies to provide or
9    arrange for support to the Council. The members of the SHIP
10    Implementation Coordination Council for each State Health
11    Improvement Plan shall serve until the delivery of the
12    subsequent State Health Improvement Plan, whereupon a new
13    Council shall be appointed. Members of the SHIP Planning
14    Team may serve on the SHIP Implementation Coordination
15    Council if so appointed by the Governor.
16        Upon the delivery of each State Health Assessment and
17    State Health Improvement Plan, the SHA and SHIP Partnership
18    The SHIP Implementation Coordination Council shall
19    coordinate the efforts and engagement of the public,
20    private, and voluntary sector stakeholders and
21    participants in the public health system to implement each
22    SHIP. The Partnership Council shall serve as a forum for
23    collaborative action; coordinate existing and new
24    initiatives; develop detailed implementation steps, with
25    mechanisms for action; implement specific projects;
26    identify public and private funding sources at the local,

 

 

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1    State and federal level; promote public awareness of the
2    SHIP; and advocate for the implementation of the SHIP. The
3    SHA and SHIP Partnership shall implement strategies to
4    ensure that individuals and communities affected by health
5    disparities and health inequities are engaged in the
6    process throughout the 5-year cycle. The SHA and SHIP
7    Partnership shall not have the authority to direct any
8    public or private entity to take specific action to
9    implement the SHIP. ; and develop an annual report to the
10    Governor, General Assembly, and public regarding the
11    status of implementation of the SHIP. The Council shall
12    not, however, have the authority to direct any public or
13    private entity to take specific action to implement the
14    SHIP.
15        The SHA and SHIP Partnership shall regularly evaluate
16    and update the State Health Assessment and track
17    implementation of the State Health Improvement Plan with
18    revisions as necessary. The State Board of Health shall
19    submit a report by January 31 of each year on the status of
20    State Health Improvement Plan implementation and community
21    engagement activities to the Governor, General Assembly,
22    and public. In the fifth year, the report may be
23    consolidated into the new State Health Assessment and State
24    Health Improvement Plan.
25        (11) Upon the request of the Governor, to recommend to
26    the Governor candidates for Director of Public Health when

 

 

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1    vacancies occur in the position.
2        (12) To adopt bylaws for the conduct of its own
3    business, including the authority to establish ad hoc
4    committees to address specific public health programs
5    requiring resolution.
6        (13) (Blank).
7    Upon appointment, the Board shall elect a chairperson from
8among its members.
9    Members of the Board shall receive compensation for their
10services at the rate of $150 per day, not to exceed $10,000 per
11year, as designated by the Director for each day required for
12transacting the business of the Board and shall be reimbursed
13for necessary expenses incurred in the performance of their
14duties. The Board shall meet from time to time at the call of
15the Department, at the call of the chairperson, or upon the
16request of 3 of its members, but shall not meet less than 4
17times per year.
18    (b) (Blank).
19    (c) An Advisory Board on Necropsy Service to Coroners,
20which shall counsel and advise with the Director on the
21administration of the Autopsy Act. The Advisory Board shall
22consist of 11 members, including a senior citizen age 60 or
23over, appointed by the Governor, one of whom shall be
24designated as chairman by a majority of the members of the
25Board. In the appointment of the first Board the Governor shall
26appoint 3 members to serve for terms of 1 year, 3 for terms of 2

 

 

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1years, and 3 for terms of 3 years. The members first appointed
2under Public Act 83-1538 shall serve for a term of 3 years. All
3members appointed thereafter shall be appointed for terms of 3
4years, except that when an appointment is made to fill a
5vacancy, the appointment shall be for the remaining term of the
6position vacant. The members of the Board shall be citizens of
7the State of Illinois. In the appointment of members of the
8Advisory Board the Governor shall appoint 3 members who shall
9be persons licensed to practice medicine and surgery in the
10State of Illinois, at least 2 of whom shall have received
11post-graduate training in the field of pathology; 3 members who
12are duly elected coroners in this State; and 5 members who
13shall have interest and abilities in the field of forensic
14medicine but who shall be neither persons licensed to practice
15any branch of medicine in this State nor coroners. In the
16appointment of medical and coroner members of the Board, the
17Governor shall invite nominations from recognized medical and
18coroners organizations in this State respectively. Board
19members, while serving on business of the Board, shall receive
20actual necessary travel and subsistence expenses while so
21serving away from their places of residence.
22(Source: P.A. 98-463, eff. 8-16-13; 99-527, eff. 1-1-17;
23revised 7-17-19.)
 
24
Article 125.

 

 

 

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

 

 

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1    they need to heal.
2        (8) Research has shown that people who are repeatedly
3    victimized are more likely to face mental health problems
4    such as depression, anxiety, and symptoms related to
5    post-traumatic stress disorder and chronic trauma.
6        (9) Trauma-informed care has been promoted and
7    established in communities across the country on a
8    bipartisan basis, and numerous federal agencies have
9    integrated trauma-informed approaches into their programs
10    and grants, which should be leveraged by the State of
11    Illinois.
12        (10) Infants, children, and youth and their families
13    who have experienced or are at risk of experiencing trauma,
14    including those who are low-income, homeless, involved
15    with the child welfare system, involved in the juvenile or
16    adult justice system, unemployed, or not enrolled in or at
17    risk of dropping out of an educational institution and live
18    in a community that has faced acute or long-term exposure
19    to substantial discrimination, historical oppression,
20    intergenerational poverty, a high rate of violence or drug
21    overdose deaths, should have an opportunity for improved
22    outcomes; this means increasing access to greater
23    opportunities to meet educational, employment, health,
24    developmental, community reentry, permanency from foster
25    care, or other key goals.
 

 

 

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1    Section 125-10. Health and Human Services Task Force. The
2Health and Human Services Task Force is created within the
3Department of Human Services to undertake a systematic review
4of health and human service departments and programs with the
5goal of improving health and human service outcomes for
6Illinois residents.
 
7    Section 125-15. Study.
8    (1) The Task Force shall review all health and human
9service departments and programs and make recommendations for
10achieving a system that will improve interagency
11interoperability with respect to improving access to
12healthcare, healthcare disparities, workforce competency and
13diversity, social determinants of health, and data sharing and
14collection. These recommendations shall include, but are not
15limited to, the following elements:
16        (i) impact on infant and maternal mortality;
17        (ii) impact of hospital closures, including safety-net
18    hospitals, on local communities; and
19        (iii) impact on Medicaid Managed Care Organizations.
20    (2) The Task Force shall review and make recommendations on
21ways the Medicaid program can partner and cooperate with other
22agencies, including but not limited to the Department of
23Agriculture, the Department of Insurance, the Department of
24Human Services, the Department of Labor, the Environmental
25Protection Agency, and the Department of Public Health, to

 

 

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

 

 

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1    Section 125-20. Membership; appointments; meetings;
2support.
3    (1) The Task Force shall include representation from both
4public and private organizations, and its membership shall
5reflect regional, racial, and cultural diversity to ensure
6representation of the needs of all Illinois citizens. Task
7Force members shall include one member appointed by the
8President of the Senate, one member appointed by the Minority
9Leader of the Senate, one member appointed by the Speaker of
10the House of Representatives, one member appointed by the
11Minority Leader of the House of Representatives, and other
12members appointed by the Governor. The Governor's appointments
13shall include, without limitation, the following:
14        (A) One member of the Senate, appointed by the Senate
15    President, who shall serve as Co-Chair;
16        (B) One member of the House of Representatives,
17    appointed by the Speaker of the House, who shall serve as
18    Co-Chair;
19        (C) Eight members of the General Assembly representing
20    each of the majority and minority caucuses of each chamber.
21        (D) The Directors or Secretaries of the following State
22    agencies or their designees:
23            (i) Department of Human Services.
24            (ii) Department of Children and Family Services.
25            (iii) Department of Healthcare and Family

 

 

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1        Services.
2            (iv) State Board of Education.
3            (v) Department on Aging.
4            (vi) Department of Public Health.
5            (vii) Department of Veterans' Affairs.
6            (viii) Department of Insurance.
7        (E) Local government stakeholders and nongovernmental
8    stakeholders with an interest in human services, including
9    representation among the following private-sector fields
10    and constituencies:
11            (i) Early childhood education and development.
12            (ii) Child care.
13            (iii) Child welfare.
14            (iv) Youth services.
15            (v) Developmental disabilities.
16            (vi) Mental health.
17            (vii) Employment and training.
18            (viii) Sexual and domestic violence.
19            (ix) Alcohol and substance abuse.
20            (x) Local community collaborations among human
21        services programs.
22            (xi) Immigrant services.
23            (xii) Affordable housing.
24            (xiii) Food and nutrition.
25            (xiv) Homelessness.
26            (xv) Older adults.

 

 

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1            (xvi) Physical disabilities.
2            (xvii) Maternal and child health.
3            (xviii) Medicaid managed care organizations.
4            (xix) Healthcare delivery.
5            (xx) Health insurance.
6    (2) Members shall serve without compensation for the
7duration of the Task Force.
8    (3) In the event of a vacancy, the appointment to fill the
9vacancy shall be made in the same manner as the original
10appointment.
11    (4) The Task Force shall convene within 60 days after the
12effective date of this Act. The initial meeting of the Task
13Force shall be convened by the co-chair selected by the
14Governor. Subsequent meetings shall convene at the call of the
15co-chairs. The Task Force shall meet on a quarterly basis, or
16more often if necessary.
17    (5) The Department of Human Services shall provide
18administrative support to the Task Force.
 
19    Section 125-25. Report. The Task Force shall report to the
20Governor and the General Assembly on the Task Force's progress
21toward its goals and objectives by June 30, 2021, and every
22June 30 thereafter.
 
23    Section 125-30. Transparency. In addition to whatever
24policies or procedures it may adopt, all operations of the Task

 

 

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1Force shall be subject to the provisions of the Freedom of
2Information Act and the Open Meetings Act. This Section shall
3not be construed so as to preclude other State laws from
4applying to the Task Force and its activities.
 
5    Section 125-40. Repeal. This Article is repealed June 30,
62023.
 
7
Article 130.

 
8    Section 130-1. Short title. This Article may be cited as
9the Anti-Racism Commission Act. References in this Article to
10"this Act" mean this Article.
 
11    Section 130-5. Findings. The General Assembly finds and
12declares all of the following:
13        (1) Public health is the science and art of preventing
14    disease, of protecting and improving the health of people,
15    entire populations, and their communities; this work is
16    achieved by promoting healthy lifestyles and choices,
17    researching disease, and preventing injury.
18        (2) Public health professionals try to prevent
19    problems from happening or recurring through implementing
20    educational programs, recommending policies, administering
21    services, and limiting health disparities through the
22    promotion of equitable and accessible healthcare.

 

 

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1        (3) According to the Centers for Disease Control and
2    Prevention, racism and segregation in the State of Illinois
3    have exacerbated a health divide, resulting in Black
4    residents having lower life expectancies than white
5    citizens of this State and being far more likely than other
6    races to die prematurely (before the age of 75) and to die
7    of heart disease or stroke; Black residents of Illinois
8    have a higher level of infant mortality, lower birth weight
9    babies, and are more likely to be overweight or obese as
10    adults, have adult diabetes, and have long-term
11    complications from diabetes that exacerbate other
12    conditions, including the susceptibility to COVID-19.
13        (4) Black and Brown people are more likely to
14    experience poor health outcomes as a consequence of their
15    social determinants of health, health inequities stemming
16    from economic instability, education, physical
17    environment, food, and access to health care systems.
18        (5) Black residents in Illinois are more likely than
19    white residents to experience violence-related trauma as a
20    result of socioeconomic conditions resulting from systemic
21    racism.
22        (6) Racism is a social system with multiple dimensions
23    in which individual racism is internalized or
24    interpersonal and systemic racism is institutional or
25    structural and is a system of structuring opportunity and
26    assigning value based on the social interpretation of how

 

 

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1    one looks; this unfairly disadvantages specific
2    individuals and communities, while unfairly giving
3    advantages to other individuals and communities; it saps
4    the strength of the whole society through the waste of
5    human resources.
6        (7) Racism causes persistent racial discrimination
7    that influences many areas of life, including housing,
8    education, employment, and criminal justice; an emerging
9    body of research demonstrates that racism itself is a
10    social determinant of health.
11        (8) More than 100 studies have linked racism to worse
12    health outcomes.
13        (9) The American Public Health Association launched a
14    National Campaign against Racism.
15        (10) Public health's responsibilities to address
16    racism include reshaping our discourse and agenda so that
17    we all actively engage in racial justice work.
 
18    Section 130-10. Anti-Racism Commission.
19    (a) The Anti-Racism Commission is hereby created to
20identify and propose statewide policies to eliminate systemic
21racism and advance equitable solutions for Black and Brown
22people in Illinois.
23    (b) The Anti-Racism Commission shall consist of the
24following members, who shall serve without compensation:
25        (1) one member of the House of Representatives,

 

 

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1    appointed by the Speaker of the House of Representatives,
2    who shall serve as co-chair;
3        (2) one member of the Senate, appointed by the Senate
4    President, who shall serve as co-chair;
5        (3) one member of the House of Representatives,
6    appointed by the Minority Leader of the House of
7    Representatives;
8        (4) one member of the Senate, appointed by the Minority
9    Leader of the Senate;
10        (5) the Director of Public Health, or his or her
11    designee;
12        (6) the Chair of the House Black Caucus;
13        (7) the Chair of the Senate Black Caucus;
14        (8) the Chair of the Joint Legislative Black Caucus;
15        (9) the director of a statewide association
16    representing public health departments, appointed by the
17    Speaker of the House of Representatives;
18        (10) the Chair of the House Latino Caucus;
19        (11) the Chair of the Senate Latino Caucus;
20        (12) one community member appointed by the House Black
21    Caucus Chair;
22        (13) one community member appointed by the Senate Black
23    Caucus Chair;
24        (14) one community member appointed by the House Latino
25    Caucus Chair; and
26        (15) one community member appointed by the Senate

 

 

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

 

 

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1        (7) Reviewing all portions of codified State laws
2    through the lens of racial equity.
3        (8) Working with the Department of Central Management
4    Services to update policies that encourage diversity in
5    human resources, including hiring, board appointments, and
6    vendor selection by agencies, and to review all grant
7    management activities with an eye toward equity and
8    workforce development.
9        (9) Recommending policies that promote racially
10    equitable economic and workforce development practices.
11        (10) Promoting and supporting all policies that
12    prioritize the health of all people, especially people of
13    color, by mitigating exposure to adverse childhood
14    experiences and trauma in childhood and ensuring
15    implementation of health and equity in all policies.
16        (11) Encouraging community partners and stakeholders
17    in the education, employment, housing, criminal justice,
18    and safety arenas to recognize racism as a public health
19    crisis and to implement policy recommendations.
20        (12) Identifying clear goals and objectives, including
21    specific benchmarks, to assess progress.
22        (13) Holding public hearings across Illinois to
23    continue to explore and to recommend needed action by the
24    General Assembly.
25        (14) Working with the Governor and the General Assembly
26    to identify the necessary funds to support the Anti-Racism

 

 

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1    Commission and its endeavors.
2        (15) Identifying resources to allocate to Black and
3    Brown communities on an annual basis.
4        (16) Encouraging corporate investment in anti-racism
5    policies in Black and Brown communities.
6    (e) The Commission shall submit its final report to the
7Governor and the General Assembly no later than December 31,
82021. The Commission is dissolved upon the filing of its
9report.
 
10    Section 130-15. Repeal. This Article is repealed on January
111, 2023.
 
12
Article 131.

 
13    Section 131-1. Short title. This Article may be cited as
14the Sickle Cell Prevention, Care, and Treatment Program Act.
15References in this Article to "this Act" mean this Article.
 
16    Section 131-5. Definitions. As used in this Act:
17    "Department" means the Department of Public Health.
18    "Program" means the Sickle Cell Prevention, Care, and
19Treatment Program.
 
20    Section 131-10. Sickle Cell Prevention, Care, and
21Treatment Program. The Department shall establish a grant

 

 

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1program for the purpose of providing for the prevention, care,
2and treatment of sickle cell disease and for educational
3programs concerning the disease.
 
4    Section 131-15. Grants; eligibility standards.
5    (a) The Department shall do the following:
6        (1)(A) Develop application criteria and standards of
7    eligibility for groups or organizations who apply for funds
8    under the program.
9        (B) Make available grants to groups and organizations
10    who meet the eligibility standards set by the Department.
11    However:
12            (i) the highest priority for grants shall be
13        accorded to established sickle cell disease
14        community-based organizations throughout Illinois; and
15            (ii) priority shall also be given to ensuring the
16        establishment of sickle cell disease centers in
17        underserved areas that have a higher population of
18        sickle cell disease patients.
19        (2) Determine the maximum amount available for each
20    grant provided under subparagraph (B) of paragraph (1).
21        (3) Determine policies for the expiration and renewal
22    of grants provided under subparagraph (B) of paragraph (1).
23        (4) Require that all grant funds be used for the
24    purpose of prevention, care, and treatment of sickle cell
25    disease or for educational programs concerning the

 

 

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1    disease. Grant funds shall be used for one or more of the
2    following purposes:
3            (A) Assisting in the development and expansion of
4        care for the treatment of individuals with sickle cell
5        disease, particularly for adults, including the
6        following types of care:
7                (i) Self-administered care.
8                (ii) Preventive care.
9                (iii) Home care.
10                (iv) Other evidence-based medical procedures
11            and techniques designed to provide maximum control
12            over sickling episodes typical of occurring to an
13            individual with the disease.
14            (B) Increasing access to health care for
15        individuals with sickle cell disease.
16            (C) Establishing additional sickle cell disease
17        infusion centers.
18            (D) Increasing access to mental health resources
19        and pain management therapies for individuals with
20        sickle cell disease.
21            (E) Providing counseling to any individual, at no
22        cost, concerning sickle cell disease and sickle cell
23        trait, and the characteristics, symptoms, and
24        treatment of the disease.
25                (i) The counseling described in this
26            subparagraph (E) may consist of any of the

 

 

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1            following:
2                    (I) Genetic counseling for an individual
3                who tests positive for the sickle cell trait.
4                    (II) Psychosocial counseling for an
5                individual who tests positive for sickle cell
6                disease, including any of the following:
7                        (aa) Social service counseling.
8                        (bb) Psychological counseling.
9                        (cc) Psychiatric counseling.
10        (5) Develop a sickle cell disease educational outreach
11    program that includes the dissemination of educational
12    materials to the following concerning sickle cell disease
13    and sickle cell trait:
14            (A) Medical residents.
15            (B) Immigrants.
16            (C) Schools and universities.
17        (6) Adopt any rules necessary to implement the
18    provisions of this Act.
19    (b) The Department may contract with an entity to implement
20the sickle cell disease educational outreach program described
21in paragraph (5) of subsection (a).
 
22    Section 131-20. Sickle Cell Chronic Disease Fund.
23    (a) The Sickle Cell Chronic Disease Fund is created as a
24special fund in the State treasury for the purpose of carrying
25out the provisions of this Act and for no other purpose. The

 

 

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1Fund shall be administered by the Department.
2    (b) The Fund shall consist of:
3        (1) Any moneys appropriated to the Department for the
4    Sickle Cell Prevention, Care, and Treatment Program.
5        (2) Gifts, bequests, and other sources of funding.
6        (3) All interest earned on moneys in the Fund.
 
7    Section 131-25. Study.
8    (a) Before July 1, 2022, and on a biennial basis
9thereafter, the Department, with the assistance of:
10        (1) the Center for Minority Health Services;
11        (2) health care providers that treat individuals with
12    sickle cell disease;
13        (3) individuals diagnosed with sickle cell disease;
14        (4) representatives of community-based organizations
15    that serve individuals with sickle cell disease; and
16        (5) data collected via newborn screening for sickle
17    cell disease;
18shall perform a study to determine the prevalence, impact, and
19needs of individuals with sickle cell disease and the sickle
20cell trait in Illinois.
21    (b) The study must include the following:
22        (1) The prevalence, by geographic location, of
23    individuals diagnosed with sickle cell disease in
24    Illinois.
25        (2) The prevalence, by geographic location, of

 

 

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1    individuals diagnosed as sickle cell trait carriers in
2    Illinois.
3        (3) The availability and affordability of screening
4    services in Illinois for the sickle cell trait.
5        (4) The location and capacity of the following for the
6    treatment of sickle cell disease and sickle cell trait
7    carriers:
8            (A) Treatment centers.
9            (B) Clinics.
10            (C) Community-based social service organizations.
11            (D) Medical specialists.
12        (5) The unmet medical, psychological, and social needs
13    encountered by individuals in Illinois with sickle cell
14    disease.
15        (6) The underserved areas of Illinois for the treatment
16    of sickle cell disease.
17        (7) Recommendations for actions to address any
18    shortcomings in the State identified under this Section.
19    (c) The Department shall submit a report on the study
20performed under this Section to the General Assembly.
 
21    Section 131-30. Implementation subject to appropriation.
22Implementation of this Act is subject to appropriation.
 
23    Section 131-90. The State Finance Act is amended by adding
24Section 5.936 as follows:
 

 

 

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1    (30 ILCS 105/5.936 new)
2    Sec. 5.936. The Sickle Cell Chronic Disease Fund.
 
3
Article 132.

 
4    Section 132-5. The School Code is amended by adding Section
534-18.67 as follows:
 
6    (105 ILCS 5/34-18.67 new)
7    Sec. 34-18.67. School nurse pilot program. The board shall
8establish a school nurse pilot program. Under the program, the
9board shall require the top 20% of the lowest performing
10schools in the district, as determined by the board, to employ
11a school nurse in conformance with Section 10-22.23 of this
12Code. The board shall implement this program beginning with the
132021-2022 school year.
 
14
Title VII. Hospital Closure

 
15
Article 135.

 
16    Section 135-5. The Illinois Health Facilities Planning Act
17is amended by changing Sections 4 and 8.7 and by adding Section
185.5 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
26knowledgeable about health care delivery systems, health

 

 

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

 

 

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1amendatory Act of the 96th General Assembly, have been
2appointed and can begin to take action as a Board.
3    (c) The State Board shall be appointed by the Governor,
4with the advice and consent of the Senate. Not more than 5 of
5the appointments shall be of the same political party at the
6time of the appointment.
7    The Secretary of Human Services, the Director of Healthcare
8and Family Services, and the Director of Public Health, or
9their designated representatives, shall serve as ex-officio,
10non-voting members of the State Board.
11    (d) Of those 9 members initially appointed by the Governor
12following the effective date of this amendatory Act of the 96th
13General Assembly, 3 shall serve for terms expiring July 1,
142011, 3 shall serve for terms expiring July 1, 2012, and 3
15shall serve for terms expiring July 1, 2013. Thereafter, each
16appointed member shall hold office for a term of 3 years,
17provided that any member appointed to fill a vacancy occurring
18prior to the expiration of the term for which his or her
19predecessor was appointed shall be appointed for the remainder
20of such term and the term of office of each successor shall
21commence on July 1 of the year in which his predecessor's term
22expires. Each member shall hold office until his or her
23successor is appointed and qualified. The Governor may
24reappoint a member for additional terms, but no member shall
25serve more than 3 terms, subject to review and re-approval
26every 3 years.

 

 

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

 

 

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1taken by the State Board. A vacancy in the membership of the
2State Board shall not impair the right of a quorum to exercise
3all the rights and perform all the duties of the State Board as
4provided by this Act.
5    (j) A State Board member shall disqualify himself or
6herself from the consideration of any application for a permit
7or exemption in which the State Board member or the State Board
8member's spouse, parent, sibling, or child: (i) has an economic
9interest in the matter; or (ii) is employed by, serves as a
10consultant for, or is a member of the governing board of the
11applicant or a party opposing the application.
12    (k) The Chairman, Board members, and Board staff must
13comply with the Illinois Governmental Ethics Act.
14(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
15    (20 ILCS 3960/5.5 new)
16    Sec. 5.5. Moratorium on hospital closures.    
17Notwithstanding any law or rule to the contrary, due to the
18COVID-19 pandemic, the State shall institute a moratorium on
19the closure of hospitals until December 31, 2023. As such, no
20hospital shall close or reduce capacity below the hospital's
21capacity as of January 1, 2020 before the end of such
22moratorium.
23    (b) This Section is repealed on January 1, 2024.
 
24    (20 ILCS 3960/8.7)

 

 

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

 

 

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1service on racial and ethnic minorities. The results of the
2racial equity impact assessment shall be made available to the
3public.
4    An application to close a health care facility shall only
5be deemed complete if it includes evidence that the health care
6facility provided written notice at least 30 days prior to
7filing the application of its intent to do so to the
8municipality in which it is located, the State Representative
9and State Senator of the district in which the health care
10facility is located, the State Board, the Director of Public
11Health, and the Director of Healthcare and Family Services. The
12changes made to this subsection by this amendatory Act of the
13101st General Assembly shall apply to all applications
14submitted after the effective date of this amendatory Act of
15the 101st General Assembly.
16    (b) No later than 30 days after issuance of a permit to
17close a health care facility or discontinue a category of
18service, the permit holder shall give written notice of the
19closure or discontinuation to the State Senator and State
20Representative serving the legislative district in which the
21health care facility is located.
22    (c) If there is a pending lawsuit that challenges an
23application to discontinue a health care facility that either
24names the Board as a party or alleges fraud in the filing of
25the application, the Board may defer action on the application
26for up to 6 months after the date of the initial deferral of

 

 

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

 
8
Article 145.

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

 

 

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

 

 

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

 

 

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

 

 

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1        treating physician reach an agreement concerning the
2        enrollee's care; or
3            (D) the enrollee is discharged.
4    (f) Network adequacy and transparency.
5        (1) The Department shall:
6            (A) ensure that an adequate provider network is in
7        place, taking into consideration health professional
8        shortage areas and medically underserved areas;
9            (B) publicly release an explanation of its process
10        for analyzing network adequacy;
11            (C) periodically ensure that an MCO continues to
12        have an adequate network in place; and
13            (D) require MCOs, including Medicaid Managed Care
14        Entities as defined in Section 5-30.2, to meet provider
15        directory requirements under Section 5-30.3.
16        (2) Each MCO shall confirm its receipt of information
17    submitted specific to physician or dentist additions or
18    physician or dentist deletions from the MCO's provider
19    network within 3 days after receiving all required
20    information from contracted physicians or dentists, and
21    electronic physician and dental directories must be
22    updated consistent with current rules as published by the
23    Centers for Medicare and Medicaid Services or its successor
24    agency.
25    (g) Timely payment of claims.
26        (1) The MCO shall pay a claim within 30 days of

 

 

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

 

 

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

 

 

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

 

 

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1    current, as of the date of service, fee-for-service rate,
2    plus all applicable add-ons, when the resulting service
3    relationship is out of network.
4    The rules shall be applicable for both MCO coverage and
5fee-for-service coverage.
6    If the fee-for-service system is ultimately determined to
7have been responsible for coverage on the date of service, the
8Department shall provide for an extended period for claims
9submission outside the standard timely filing requirements.
10    (g-6) MCO Performance Metrics Report.
11        (1) The Department shall publish, on at least a
12    quarterly basis, each MCO's operational performance,
13    including, but not limited to, the following categories of
14    metrics:
15            (A) claims payment, including timeliness and
16        accuracy;
17            (B) prior authorizations;
18            (C) grievance and appeals;
19            (D) utilization statistics;
20            (E) provider disputes;
21            (F) provider credentialing; and
22            (G) member and provider customer service.
23        (2) The Department shall ensure that the metrics report
24    is accessible to providers online by January 1, 2017.
25        (3) The metrics shall be developed in consultation with
26    industry representatives of the Medicaid managed care

 

 

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1    health plans and representatives of associations
2    representing the majority of providers within the
3    identified industry.
4        (4) Metrics shall be defined and incorporated into the
5    applicable Managed Care Policy Manual issued by the
6    Department.
7    (g-7) MCO claims processing and performance analysis. In
8order to monitor MCO payments to hospital providers, pursuant
9to this amendatory Act of the 100th General Assembly, the
10Department shall post an analysis of MCO claims processing and
11payment performance on its website every 6 months. Such
12analysis shall include a review and evaluation of a
13representative sample of hospital claims that are rejected and
14denied for clean and unclean claims and the top 5 reasons for
15such actions and timeliness of claims adjudication, which
16identifies the percentage of claims adjudicated within 30, 60,
1790, and over 90 days, and the dollar amounts associated with
18those claims. The Department shall post the contracted claims
19report required by HealthChoice Illinois on its website every 3
20months.
21    (g-8) Dispute resolution process. The Department shall
22maintain a provider complaint portal through which a provider
23can submit to the Department unresolved disputes with an MCO.
24An unresolved dispute means an MCO's decision that denies in
25whole or in part a claim for reimbursement to a provider for
26health care services rendered by the provider to an enrollee of

 

 

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1the MCO with which the provider disagrees. Disputes shall not
2be submitted to the portal until the provider has availed
3itself of the MCO's internal dispute resolution process.
4Disputes that are submitted to the MCO internal dispute
5resolution process may be submitted to the Department of
6Healthcare and Family Services' complaint portal no sooner than
730 days after submitting to the MCO's internal process and not
8later than 30 days after the unsatisfactory resolution of the
9internal MCO process or 60 days after submitting the dispute to
10the MCO internal process. Multiple claim disputes involving the
11same MCO may be submitted in one complaint, regardless of
12whether the claims are for different enrollees, when the
13specific reason for non-payment of the claims involves a common
14question of fact or policy. Within 10 business days of receipt
15of a complaint, the Department shall present such disputes to
16the appropriate MCO, which shall then have 30 days to issue its
17written proposal to resolve the dispute. The Department may
18grant one 30-day extension of this time frame to one of the
19parties to resolve the dispute. If the dispute remains
20unresolved at the end of this time frame or the provider is not
21satisfied with the MCO's written proposal to resolve the
22dispute, the provider may, within 30 days, request the
23Department to review the dispute and make a final
24determination. Within 30 days of the request for Department
25review of the dispute, both the provider and the MCO shall
26present all relevant information to the Department for

 

 

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

 

 

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

 

 

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

 

 

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1entities and MCOs to participate in such newly designated
2counties.
3    (h-5) MCOs shall be required to publish, at least quarterly
4for the preceding quarter, on their websites:
5        (1) the total number of claims received by the MCO;
6        (2) the number and monetary amount of claims payments
7    made to a service provider as defined in Section 2-16 of
8    this Code;
9        (3) the dates of services rendered for the claims
10    payments made under paragraph (2);
11        (4) the dates the claims were received by the MCO for
12    the claims payments made under paragraph (2); and
13        (5) the dates on which claims payments under paragraph
14    (2) were released.
15    (i) The requirements of this Section apply to contracts
16with accountable care entities and MCOs entered into, amended,
17or renewed after June 16, 2014 (the effective date of Public
18Act 98-651).
19    (j) Health care information released to managed care
20organizations. A health care provider shall release to a
21Medicaid managed care organization, upon request, and subject
22to the Health Insurance Portability and Accountability Act of
231996 and any other law applicable to the release of health
24information, the health care information of the MCO's enrollee,
25if the enrollee has completed and signed a general release form
26that grants to the health care provider permission to release

 

 

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1the recipient's health care information to the recipient's
2insurance carrier.
3(Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18;
4100-587, eff. 6-4-18; 101-209, eff. 8-5-19.)
 
5
Article 150.

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

10100SB0558ham003- 179 -LRB101 04319 CPF 74762 a

1such actions and timeliness of claims adjudication, which
2identifies the percentage of claims adjudicated within 30, 60,
390, and over 90 days, and the dollar amounts associated with
4those claims. The Department shall post the contracted claims
5report required by HealthChoice Illinois on its website every 3
6months.
7    (g-8) Dispute resolution process. The Department shall
8maintain a provider complaint portal through which a provider
9can submit to the Department unresolved disputes with an MCO.
10An unresolved dispute means an MCO's decision that denies in
11whole or in part a claim for reimbursement to a provider for
12health care services rendered by the provider to an enrollee of
13the MCO with which the provider disagrees. Disputes shall not
14be submitted to the portal until the provider has availed
15itself of the MCO's internal dispute resolution process.
16Disputes that are submitted to the MCO internal dispute
17resolution process may be submitted to the Department of
18Healthcare and Family Services' complaint portal no sooner than
1930 days after submitting to the MCO's internal process and not
20later than 30 days after the unsatisfactory resolution of the
21internal MCO process or 60 days after submitting the dispute to
22the MCO internal process. Multiple claim disputes involving the
23same MCO may be submitted in one complaint, regardless of
24whether the claims are for different enrollees, when the
25specific reason for non-payment of the claims involves a common
26question of fact or policy. Within 10 business days of receipt

 

 

10100SB0558ham003- 180 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 181 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 182 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 183 -LRB101 04319 CPF 74762 a

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

 

 

10100SB0558ham003- 184 -LRB101 04319 CPF 74762 a

1seniors or people with disabilities population until the
2Department provides an opportunity for accountable care
3entities and MCOs to participate in such newly designated
4counties.
5    (h-5) MCOs shall be required to publish, at least quarterly
6for the preceding quarter, on their websites:
7        (1) the total number of claims received by the MCO;
8        (2) the number and monetary amount of claims payments
9    made to a service provider as defined in Section 2-16 of
10    this Code;
11        (3) the dates of services rendered for the claims
12    payments made under paragraph (2);
13        (4) the dates the claims were received by the MCO for
14    the claims payments made under paragraph (2); and
15        (5) the dates on which claims payments under paragraph
16    (2) were released.
17    (i) The requirements of this Section apply to contracts
18with accountable care entities and MCOs entered into, amended,
19or renewed after June 16, 2014 (the effective date of Public
20Act 98-651).
21    (j) Health care information released to managed care
22organizations. A health care provider shall release to a
23Medicaid managed care organization, upon request, and subject
24to the Health Insurance Portability and Accountability Act of
251996 and any other law applicable to the release of health
26information, the health care information of the MCO's enrollee,

 

 

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1if the enrollee has completed and signed a general release form
2that grants to the health care provider permission to release
3the recipient's health care information to the recipient's
4insurance carrier.
5    (k) The requirements of this Section added by this
6amendatory Act of the 101st General Assembly shall apply to
7services provided on or after the first day of the month that
8begins 60 days after the effective date of this amendatory Act
9of the 101st General Assembly.
10(Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18;
11100-587, eff. 6-4-18; 101-209, eff. 8-5-19.)
 
12    (305 ILCS 5/5-30.15 new)
13    Sec. 5-30.15. Discharge notification and facility
14placement of individuals; managed care. Whenever a hospital
15provides notice to a managed care organization (MCO) that an
16individual covered under the State's medical assistance
17program has received a discharge order from the attending
18physician and is ready for discharge from an inpatient hospital
19stay to another level of care, the MCO shall secure the
20individual's placement in or transfer to another facility
21within 24 hours of receiving the hospital's notification, or
22shall pay the hospital a daily rate equal to the hospital's
23daily rate associated with the stay ending, including all
24applicable add-on adjustment payments.
 

 

 

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1
Article 155.

 
2    Section 155-5. The Illinois Public Aid Code is amended by
3adding Section 5-30.17 as follows:
 
4    (305 ILCS 5/5-30.17 new)
5    Sec. 5-30.17. Medicaid Managed Care Oversight Commission.
6    (a) The Medicaid Managed Care Oversight Commission is
7created within the Department of Healthcare and Family Services
8to evaluate the effectiveness of Illinois' managed care
9program.
10    (b) The Commission shall consist of the following members:
11        (1) One member of the Senate, appointed by the Senate
12    President, who shall serve as co-chair.
13        (2) One member of the House of Representatives,
14    appointed by the Speaker of the House of Representatives,
15    who shall serve as co-chair.
16        (3) One member of the House of Representatives,
17    appointed by the Minority Leader of the House of
18    Representatives.
19        (4) One member of the Senate, appointed by the Senate
20    Minority Leader.
21        (5) One member representing the Department of
22    Healthcare and Family Services, appointed by the Governor.
23        (6) One member representing the Department of Public
24    Health, appointed by the Governor.

 

 

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1        (7) One member representing the Department of Human
2    Services, appointed by the Governor.
3        (8) One member representing the Department of Children
4    and Family Services, appointed by the Governor.
5        (9) One member of a statewide association representing
6    Medicaid managed care plans.
7        (10) One member of a statewide association
8    representing hospitals.
9        (11) Two academic experts on Medicaid managed care
10    programs.
11        (12) One member of a statewide association
12    representing primary care providers.
13        (13) One member of a statewide association
14    representing behavioral health providers.
15    (c) The Director of Healthcare and Family Services and
16chief of staff, or their designees, shall serve as the
17Commission's executive administrators in providing
18administrative support, research support, and other
19administrative tasks requested by the Commission's co-chairs.
20Any expenses, including, but not limited to, travel and
21housing, shall be paid for by the Department's existing budget.
22    (d) The members of the Commission shall receive no
23compensation for their services as members of the Commission.
24    (e) The Commission shall meet quarterly beginning as soon
25as is practicable after the effective date of this amendatory
26Act of the 101st General Assembly.

 

 

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1    (f) The Commission shall:
2        (1) review data on health outcomes of Medicaid managed
3    care members;
4        (2) review current care coordination and case
5    management efforts and make recommendations on expanding
6    care coordination to additional populations with a focus on
7    the social determinants of health;
8        (3) review and assess the appropriateness of metrics
9    used in the Pay-for-Performance programs;
10        (4) review the Department's prior authorization and
11    utilization management requirements and recommend
12    adaptations for the Medicaid population;
13        (5) review managed care performance in meeting
14    diversity contracting goals and the use of funds dedicated
15    to meeting such goals, including, but not limited to,
16    contracting requirements set forth in the Business
17    Enterprise for Minorities, Women, and Persons with
18    Disabilities Act; recommend strategies to increase
19    compliance with diversity contracting goals in
20    collaboration with the Chief Procurement Officer for
21    General Services and the Business Enterprise Council for
22    Minorities, Women, and Persons with Disabilities; and
23    recoup any misappropriated funds for diversity
24    contracting;
25        (6) review data on the effectiveness of claims
26    processing to medical providers;

 

 

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1        (7) review the adequacy of the Medicaid managed care
2    network and member access to health care services,
3    including specialty care services;
4        (8) review value-based and other alternative payment
5    methodologies to enhance program efficiency and improve
6    health outcomes;
7        (9) review the compliance of all managed care entities
8    in State contracts and recommend reasonable financial
9    penalties for any noncompliance; and
10        (10) produce an annual report detailing the
11    Commission's findings based upon its review of research
12    conducted under this Section, including specific
13    recommendations, if any, and any other information the
14    Commission may deem proper in furtherance of its duties
15    under this Section.
16    (g) The Department of Healthcare and Family Services shall
17impose financial penalties on any managed care entity that is
18found to not be in compliance with any provision of a State
19contract. In addition to any financial penalties imposed under
20this subsection, the Department shall recoup any
21misappropriated funds identified by the Commission for the
22purpose of meeting the Business Enterprise Program
23requirements set forth in contracts with managed care entities.
24Any financial penalty imposed or funds recouped in accordance
25with this Section shall be deposited into the Managed Care
26Oversight Fund.

 

 

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1    When recommending reasonable financial penalties upon a
2finding of noncompliance under this subsection, the Commission
3shall consider the scope and nature of the noncompliance and
4whether or not it was intentional or unreasonable. In imposing
5a financial penalty on any managed care entity that is found to
6not be in compliance, the Department of Healthcare and Family
7Services shall consider the recommendations of the Commission.
8    Upon conclusion by the Department of Healthcare and Family
9Services that any managed care entity is not in compliance with
10its contract with the State based on the findings of the
11Commission, it shall issue the managed care entity a written
12notification of noncompliance. The written notice shall
13specify any financial penalty to be imposed and whether this
14penalty is consistent with the recommendation of the
15Commission. If the specified financial penalty differs from the
16Commission's recommendation, the Department of Healthcare and
17Family Services shall specify why the Department did not impose
18the recommended penalty and how the Department arrived at its
19determination of the reasonableness of the financial penalty
20imposed.
21    Within 14 calendar days after receipt of the notification
22of noncompliance, the managed care entity shall submit a
23written response to the Department of Healthcare and Family
24Services. The response shall indicate whether the managed care
25entity: (i) disputes the determination of noncompliance,
26including any facts or conduct to show compliance; (ii) agrees

 

 

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1to the determination of noncompliance and any financial penalty
2imposed; or (iii) agrees to the determination of noncompliance
3but disputes the financial penalty imposed.
4    Failure to respond to the notification of noncompliance
5shall be deemed acceptance of the Department of Healthcare and
6Family Services' determination of noncompliance.
7    If a managed care entity disputes any part of the
8Department of Healthcare and Family Services' determination of
9noncompliance, within 30 calendar days of receipt of the
10managed care entity's response the Department shall respond in
11writing whether it (i) agrees to review its determination of
12noncompliance or (ii) disagrees with the entity's disputation.
13    The Department of Healthcare and Family Services shall
14issue a written notice to the Commission of the dispute and its
15chosen response at the same time notice is made to the managed
16care entity.
17    Nothing in this Section limits or alters a person or
18entity's existing rights or protections under State or federal
19law.
20    (h) A decision of the Department of Healthcare and Family
21Services to impose a financial penalty on a managed care entity
22for noncompliance under subsection (g) is subject to judicial
23review under the Administrative Review Law.
24    (i) The Department shall issue quarterly reports to the
25Governor and the General Assembly indicating: (i) the number of
26determinations of noncompliance since the last quarter; (ii)

 

 

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1the number of financial penalties imposed; and (iii) the
2outcome or status of each determination.
3    (j) Beginning January 1, 2022, and for each year
4thereafter, the Commission shall submit a report of its
5findings and recommendations to the General Assembly. The
6report to the General Assembly shall be filed with the Clerk of
7the House of Representatives and the Secretary of the Senate in
8electronic form only, in the manner that the Clerk and the
9Secretary shall direct.
 
10
Article 160.

 
11    Section 160-5. The State Finance Act is amended by adding
12Sections 5.935 and 6z-124 as follows:
 
13    (30 ILCS 105/5.935 new)
14    Sec. 5.935. The Managed Care Oversight Fund.
 
15    (30 ILCS 105/6z-124 new)
16    Sec. 6z-124. Managed Care Oversight Fund. The Managed Care
17Oversight Fund is created as a special fund in the State
18treasury. Subject to appropriation, available annual moneys in
19the Fund shall be used by the Department of Healthcare and
20Family Services to support emergency procurement and sole
21source contracting with women and minority-owned businesses as
22part of the Department's Business Enterprise Program

 

 

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1requirements. The Department shall prioritize contracts for
2care coordination services in allocating funds. Funds may not
3be used for institutional overhead costs, indirect costs, or
4other organizational levies.
 
5
Article 165.

 
6    Section 165-5. The Illinois Public Aid Code is amended by
7adding Section 5-45 as follows:
 
8    (305 ILCS 5/5-45 new)
9    Sec. 5-45. Termination of managed care. The Department of
10Healthcare and Family Services shall not renew, re-enter,
11renegotiate, change orders, or amend any contract or agreement
12it entered with a managed care organization, as defined in
13Section 5-30.1, that was solicited under the State of Illinois
14Medicaid Managed Care Organization Request for Proposals
15(2018-24-001). Any care health plan administered by a managed
16care organization that entered a contract with the Department
17under the State of Illinois Medicaid Managed Care Organization
18Request for Proposals 2018-24-001) shall be transitioned to the
19State's fee-for-service medical assistance program upon the
20expiration of the managed care organization's contract with the
21Department until such time the Department enters a new contract
22in accordance with Section 5-30.6. Any new contract entered
23into by the Department with a Managed Care Organization in

 

 

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1accordance with Section 5-30.6 shall specify the patient
2diseases that require care planning and assessment, including,
3but not limited to, social determinants of health as determined
4by the Centers for Disease Control and Prevention.
 
5
Article 170.

 
6    Section 170-5. The Illinois Public Aid Code is amended by
7adding Section 5-30.16 as follows:
 
8    (305 ILCS 5/5-30.16 new)
9    Sec. 5-30.16. Managed care organizations; subcontracting
10diversity requirements.
11    (a) In this Section, "managed care organization" has the
12meaning given to that term in Section 5-30.1.
13    (b) The Illinois Department shall require each managed care
14organization participating in the medical assistance program
15established under this Article to satisfy any minority-owned or
16women-owned business subcontracting requirements to which the
17managed care organization is subject under the contract.
18    (c) The Illinois Department shall terminate its contract
19with any managed care organization that does not meet the
20minority-owned or women-owned business subcontracting
21requirements under its contract with the State. The Illinois
22Department shall terminate the contract no later than 60 days
23after receiving a contractually required report indicating

 

 

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1that the managed care organization has not met the
2subcontracting goals. To ensure there is no disruption of care
3to Medicaid recipients who are enrolled with a managed care
4organization whose contract is terminated as provided under
5this subsection, the Illinois Department shall reassign to
6another managed care plan any Medicaid recipient who will lose
7healthcare coverage as a result of the Illinois Department's
8decision to terminate its contract with the managed care
9organization.
 
10
Title IX. Maternal and Infant Mortality

 
11
Article 175.

 
12    Section 175-5. The Illinois Public Aid Code is amended by
13adding Section 5-18.5 as follows:
 
14    (305 ILCS 5/5-18.5 new)
15    Sec. 5-18.5. Perinatal doula and evidence-based home
16visiting services.
17    (a) As used in this Section:
18    "Home visiting" means a voluntary, evidence-based strategy
19used to support pregnant people, infants, and young children
20and their caregivers to promote infant, child, and maternal
21health, to foster educational development and school
22readiness, and to help prevent child abuse and neglect. Home

 

 

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1visitors are trained professionals whose visits and activities
2focus on promoting strong parent-child attachment to foster
3healthy child development.
4    "Perinatal doula" means a trained provider who provides
5regular, voluntary physical, emotional, and educational
6support, but not medical or midwife care, to pregnant and
7birthing persons before, during, and after childbirth,
8otherwise known as the perinatal period.
9    "Perinatal doula training" means any doula training that
10focuses on providing support throughout the prenatal, labor and
11delivery, or postpartum period, and reflects the type of doula
12care that the doula seeks to provide.
13    (b) Notwithstanding any other provision of this Article,
14perinatal doula services and evidence-based home visiting
15services shall be covered under the medical assistance program
16for persons who are otherwise eligible for medical assistance
17under this Article. Perinatal doula services include regular
18visits beginning in the prenatal period and continuing into the
19postnatal period, inclusive of continuous support during labor
20and delivery, that support healthy pregnancies and positive
21birth outcomes. Perinatal doula services may be embedded in an
22existing program, such as evidence-based home visiting.
23Perinatal doula services provided during the prenatal period
24may be provided weekly, services provided during the labor and
25delivery period may be provided for the entire duration of
26labor and the time immediately following birth, and services

 

 

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1provided during the postpartum period may be provided up to 12
2months postpartum.
3    (c) The Department of Healthcare and Family Services shall
4adopt rules to administer this Section. In this rulemaking, the
5Department shall consider the expertise of and consult with
6doula program experts, doula training providers, practicing
7doulas, and home visiting experts, along with State agencies
8implementing perinatal doula services and relevant bodies
9under the Illinois Early Learning Council. This body of experts
10shall inform the Department on the credentials necessary for
11perinatal doula and home visiting services to be eligible for
12Medicaid reimbursement and the rate of reimbursement for home
13visiting and perinatal doula services in the prenatal, labor
14and delivery, and postpartum periods. Every 2 years, the
15Department shall assess the rates of reimbursement for
16perinatal doula and home visiting services and adjust rates
17accordingly.
18    {d) The Department shall seek such State plan amendments or
19waivers as may be necessary to implement this Section and shall
20secure federal financial participation for expenditures made
21by the Department in accordance with this Section.
 
22
Title X. Miscellaneous

 
23
Article 999.

 

 

 

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1    Section 999-99. Effective date. This Act takes effect upon
2becoming law.".