Rep. Camille Y. Lilly
Filed: 1/10/2021
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1 | AMENDMENT TO SENATE BILL 558
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2 | AMENDMENT NO. ______. Amend Senate Bill 558, AS AMENDED, by | ||||||
3 | replacing everything after the enacting clause with the | ||||||
4 | following:
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5 | "Title I. General Provisions | ||||||
6 | Article 1. | ||||||
7 | Section 1-1. This Act may be referred to as the Illinois | ||||||
8 | Health Care and Human Service Reform Act. | ||||||
9 | Section 1-5. Findings. | ||||||
10 | "We, the People of the State of Illinois - grateful to | ||||||
11 | Almighty God for the civil, political and religious liberty | ||||||
12 | which He has permitted us to enjoy and seeking His blessing | ||||||
13 | upon our endeavors - in order to provide for the health, safety | ||||||
14 | and welfare of the people; maintain a representative and |
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1 | orderly government; eliminate poverty and inequality; assure | ||||||
2 | legal, social and economic justice; provide opportunity for the | ||||||
3 | fullest development of the individual; insure domestic | ||||||
4 | tranquility; provide for the common defense; and secure the | ||||||
5 | blessings of freedom and liberty to ourselves and our posterity - | ||||||
6 | do ordain and establish this Constitution for the State of | ||||||
7 | Illinois." | ||||||
8 | The Illinois Legislative Black Caucus finds that, in order | ||||||
9 | to improve the health outcomes of Black residents in the State | ||||||
10 | of Illinois, it is essential to dramatically reform the State's | ||||||
11 | health and human service system. For over 3 decades. multiple | ||||||
12 | health studies have found that health inequities at their very | ||||||
13 | core are due to racism. As early as 1998 research demonstrated | ||||||
14 | that Black Americans received less health care than white | ||||||
15 | Americans because doctors treated patients differently on the | ||||||
16 | basis of race. Yet, Illinois' health and human service system | ||||||
17 | disappointingly continues to perpetuate health disparities | ||||||
18 | among Black Illinoisans of all ages, genders, and socioeconomic | ||||||
19 | status. | ||||||
20 | In July 2020, Trinity Health announced its plans to close | ||||||
21 | Mercy Hospital, an essential resource serving the Chicago South | ||||||
22 | Side's predominantly Black residents. Trinity Health argued | ||||||
23 | that this closure would have no impact on health access but | ||||||
24 | failed to understand the community's needs. Closure of Mercy | ||||||
25 | Hospital would only serve to create a health access desert and | ||||||
26 | exacerbate existing health disparities. On December 15, 2020, |
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1 | after hearing from community members and advocates, the Health | ||||||
2 | Facilities and Services Review Board unanimously voted to deny | ||||||
3 | closure efforts, yet Trinity still seeks to cease Mercy's | ||||||
4 | operations. | ||||||
5 | Prior to COVID-19, much of the social and political | ||||||
6 | attention surrounding the nationwide opioid epidemic focused | ||||||
7 | on the increase in overdose deaths among white, middle-class, | ||||||
8 | suburban and rural users; the impact of the epidemic in Black | ||||||
9 | communities was largely unrecognized. Research has shown rates | ||||||
10 | of opioid use at the national scale are higher for whites than | ||||||
11 | they are for Blacks, yet rates of opioid deaths are higher | ||||||
12 | among Blacks (43%) than whites (22%). The COVID-19 pandemic | ||||||
13 | will likely exacerbate this situation due to job loss, | ||||||
14 | stay-at-home orders, and ongoing mitigation efforts creating a | ||||||
15 | lack of physical access to addiction support and harm reduction | ||||||
16 | groups. | ||||||
17 | In 2018, the Illinois Department of Public Health reported | ||||||
18 | that Black women were about 6 times as likely to die from a | ||||||
19 | pregnancy-related cause as white women. Of those, 72% of | ||||||
20 | pregnancy-related deaths and 93% of violent | ||||||
21 | pregnancy-associated deaths were deemed preventable. Between | ||||||
22 | 2016 and 2017, Black women had the highest rate of severe | ||||||
23 | maternal morbidity with a rate of 101.5 per 10,000 deliveries, | ||||||
24 | which is almost 3 times as high as the rate for white women. | ||||||
25 | In the City of Chicago, African American and Latinx | ||||||
26 | populations are suffering from higher rates of AIDS/HIV |
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1 | compared to the general population. Recent data places HIV as | ||||||
2 | one of the top 5 leading causes of death in African American | ||||||
3 | women between the ages of 35 to 44 and the seventh ranking | ||||||
4 | cause in African American women between the ages of 20 to 34. | ||||||
5 | Among the Latinx population, nearly 20% with HIV exclusively | ||||||
6 | depend on indigenous-led and staffed organizations for | ||||||
7 | services. | ||||||
8 | Cardiovascular disease (CVD) accounts for more deaths in | ||||||
9 | Illinois than any other cause of death, according to the | ||||||
10 | Illinois Department of Public Health; CVD is the leading cause | ||||||
11 | of death among Black residents. According to the Kaiser Family | ||||||
12 | Foundation (KFF), for every 100,000 people, 224 Black | ||||||
13 | Illinoisans die of CVD compared to 158 white Illinoisans. | ||||||
14 | Cancer, the second leading cause of death in Illinois, too is | ||||||
15 | pervasive among African Americans. In 2019, an estimated | ||||||
16 | 606,880 Americans, or 1,660 people a day, died of cancer; the | ||||||
17 | American Cancer Society estimated 24,410 deaths occurred in | ||||||
18 | Illinois. KFF estimates that, out of every 100,000 people, 191 | ||||||
19 | Black Illinoisans die of cancer compared to 152 white | ||||||
20 | Illinoisans. | ||||||
21 | Black Americans suffer at much higher rates from chronic | ||||||
22 | diseases, including diabetes, hypertension, heart disease, | ||||||
23 | asthma, and many cancers. Utilizing community health workers in | ||||||
24 | patient education and chronic disease management is needed to | ||||||
25 | close these health disparities. Studies have shown that | ||||||
26 | diabetes patients in the care of a community health worker |
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1 | demonstrate improved knowledge and lifestyle and | ||||||
2 | self-management behaviors, as well as decreases in the use of | ||||||
3 | the emergency department. A study of asthma control among black | ||||||
4 | adolescents concluded that asthma control was reduced by 35% | ||||||
5 | among adolescents working with community health workers, | ||||||
6 | resulting in a savings of $5.58 per dollar spent on the | ||||||
7 | intervention. A study of the return on investment for community | ||||||
8 | health workers employed in Colorado showed that, after a | ||||||
9 | 9-month period, patients working with community health workers | ||||||
10 | had an increased number of primary care visits and a decrease | ||||||
11 | in urgent and inpatient care. Utilization of community health | ||||||
12 | workers led to a $2.38 return on investment for every dollar | ||||||
13 | invested in community health workers. | ||||||
14 | Adverse childhood experiences (ACEs) are traumatic | ||||||
15 | experiences occurring during childhood that have been found to | ||||||
16 | have a profound effect on a child's developing brain structure | ||||||
17 | and body which may result in poor health during a person's | ||||||
18 | adulthood. ACEs studies have found a strong correlation between | ||||||
19 | the number of ACEs and a person's risk for disease and negative | ||||||
20 | health behaviors, including suicide, depression, cancer, | ||||||
21 | stroke, ischemic heart disease, diabetes, autoimmune disease, | ||||||
22 | smoking, substance abuse, interpersonal violence, obesity, | ||||||
23 | unplanned pregnancies, lower educational achievement, | ||||||
24 | workplace absenteeism, and lower wages. Data also shows that | ||||||
25 | approximately 20% of African American and Hispanic adults in | ||||||
26 | Illinois reported 4 or more ACEs, compared to 13% of |
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1 | non-Hispanic whites. Long-standing ACE interventions include | ||||||
2 | tools such as trauma-informed care. Trauma-informed care has | ||||||
3 | been promoted and established in communities across the country | ||||||
4 | on a bipartisan basis, including in the states of California, | ||||||
5 | Florida, Massachusetts, Missouri, Oregon, Pennsylvania, | ||||||
6 | Washington, and Wisconsin. Several federal agencies have | ||||||
7 | integrated trauma-informed approaches in their programs and | ||||||
8 | grants which should be leveraged by the State. | ||||||
9 | According to a 2019 Rush University report, a Black | ||||||
10 | person's life expectancy on average is less when compared to a | ||||||
11 | white person's life expectancy. For instance, when comparing | ||||||
12 | life expectancy in Chicago's Austin neighborhood to the Chicago | ||||||
13 | Loop, there is a difference of 11 years between Black life | ||||||
14 | expectancy (71 years) and white life expectancy (82 years).
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15 | In a 2015 literature review of implicit racial and ethnic | ||||||
16 | bias among medical professionals, it was concluded that there | ||||||
17 | is a moderate level of implicit bias in most medical | ||||||
18 | professionals. Further, the literature review showed that | ||||||
19 | implicit bias has negative consequences for patients, | ||||||
20 | including strained patient relationships and negative health | ||||||
21 | outcomes. It is critical for medical professionals to be aware | ||||||
22 | of implicit racial and ethnic bias and work to eliminate bias | ||||||
23 | through training. | ||||||
24 | In the field of medicine, a historically racist profession, | ||||||
25 | Black medical professionals have commonly been ostracized. In | ||||||
26 | 1934, Dr. Roland B. Scott was the first African American to |
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1 | pass the pediatric board exam, yet when he applied for | ||||||
2 | membership with the American Academy of Pediatrics he was | ||||||
3 | rejected multiple times. Few medical organizations have | ||||||
4 | confronted the roles they played in blocking opportunities for | ||||||
5 | Black advancement in the medical profession until the formal | ||||||
6 | apologies of the American Medical Association in 2008. For | ||||||
7 | decades, organizations like the AMA predicated their | ||||||
8 | membership on joining a local state medical society, several of | ||||||
9 | which excluded Black physicians. | ||||||
10 | In 2010, the General Assembly, in partnership with | ||||||
11 | Treatment Alternatives for Safe Communities, published the | ||||||
12 | Disproportionate Justice Impact Study. The study examined the | ||||||
13 | impact of Illinois drug laws on racial and ethnic groups and | ||||||
14 | the resulting over-representation of racial and ethic minority | ||||||
15 | groups in the Illinois criminal justice system. Unsurprisingly | ||||||
16 | and disappointingly, the study confirmed decades long | ||||||
17 | injustices, such as nonwhites being arrested at a higher rate | ||||||
18 | than whites relative to their representation in the general | ||||||
19 | population throughout Illinois. | ||||||
20 | All together, the above mentioned only begins to capture a | ||||||
21 | part of a larger system of racial injustices and inequities. | ||||||
22 | The General Assembly and the people of Illinois are urged to | ||||||
23 | recognize while racism is a core fault of the current health | ||||||
24 | and human service system, that it is a pervasive disease | ||||||
25 | affecting a multiplitude of institutions which truly drive | ||||||
26 | systematic health inequities: education, child care, criminal |
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1 | justice, affordable housing, environmental justice, and job | ||||||
2 | security and so forth. For persons to live up to their full | ||||||
3 | human potential, their rights to quality of life, health care, | ||||||
4 | a quality job, a fair wage, housing, and education must not be | ||||||
5 | inhibited. | ||||||
6 | Therefore, the Illinois Legislative Black Caucus, as | ||||||
7 | informed by the Senate's Health and Human Service Pillar | ||||||
8 | subject matter hearings, seeks to remedy a fraction of a much | ||||||
9 | larger broken system by addressing access to health care, | ||||||
10 | hospital closures, managed care organization reform, community | ||||||
11 | health worker certification, maternal and infant mortality, | ||||||
12 | mental and substance abuse treatment, hospital reform, and | ||||||
13 | medical implicit bias in the Illinois Health Care and Human | ||||||
14 | Service Reform Act. This Act shall achieve needed change | ||||||
15 | through the use of, but not limited to, the Medicaid Managed | ||||||
16 | Care Oversight Commission, the Health and Human Services Task | ||||||
17 | Force, and a hospital closure moratorium, in order to address | ||||||
18 | Illinois' long-standing health inequities.
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19 | Title II. Community Health Workers | ||||||
20 | Article 5. | ||||||
21 | Section 5-1. Short title. This Article may be cited as the | ||||||
22 | Community Health Worker Certification and Reimbursement Act. | ||||||
23 | References in this Article to "this Act" mean this Article. |
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1 | Section 5-5. Definition. In this Act, "community health | ||||||
2 | worker" means a frontline public health worker who is a trusted | ||||||
3 | member or has an unusually close understanding of the community | ||||||
4 | served. This trusting relationship enables the community | ||||||
5 | health worker to serve as a liaison, link, and intermediary | ||||||
6 | between health and social services and the community to | ||||||
7 | facilitate access to services and improve the quality and | ||||||
8 | cultural competence of service delivery. A community health | ||||||
9 | worker also builds individual and community capacity by | ||||||
10 | increasing health knowledge and self-sufficiency through a | ||||||
11 | range of activities, including outreach, community education, | ||||||
12 | informal counseling, social support, and advocacy. A community | ||||||
13 | health 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 | ||||||
2 | a community health worker to provide direct care or treatment | ||||||
3 | to any person or to perform any act or service for which a | ||||||
4 | license 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 | ||||||
7 | multi-tiered academic and community-based training | ||||||
8 | opportunities that lead to the mastery of community health | ||||||
9 | worker core competencies. | ||||||
10 | (b) For academic-based training programs, the Department | ||||||
11 | of Public Health shall collaborate with the Illinois State | ||||||
12 | Board of Education, the Illinois Community College Board, and | ||||||
13 | the Illinois Board of Higher Education to adopt a process to | ||||||
14 | certify academic-based training programs that students can | ||||||
15 | attend to obtain individual community health worker | ||||||
16 | certification. Certified training programs shall reflect the | ||||||
17 | approved core competencies and roles for community health | ||||||
18 | workers. | ||||||
19 | (c) For community-based training programs, the Department | ||||||
20 | of Public Health shall collaborate with a statewide association | ||||||
21 | representing community health workers to adopt a process to | ||||||
22 | certify community-based programs that students can attend to | ||||||
23 | obtain individual community health worker certification. | ||||||
24 | (d) Community health workers may need to undergo additional | ||||||
25 | training, including, but not limited to, asthma, diabetes, |
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1 | maternal child health, behavioral health, and social | ||||||
2 | determinants of health training. Multi-tiered training | ||||||
3 | approaches shall provide opportunities that build on each other | ||||||
4 | and prepare community health workers for career pathways both | ||||||
5 | within the community health worker profession and within allied | ||||||
6 | professions. | ||||||
7 | Section 5-15. Illinois Community Health Worker | ||||||
8 | Certification Board. | ||||||
9 | (a) There is created within the Department of Public | ||||||
10 | Health, in shared leadership with a statewide association | ||||||
11 | representing community health workers, the Illinois Community | ||||||
12 | Health Worker Certification Board. The Board shall serve as the | ||||||
13 | regulatory body that develops and has oversight of initial | ||||||
14 | community health workers certification and certification | ||||||
15 | renewals for both individuals and academic and community-based | ||||||
16 | training programs | ||||||
17 | (b) A representative from the Department of Public Health, | ||||||
18 | the Department of Financial and Professional Regulation and the | ||||||
19 | Department of Healthcare and Family Services shall serve on the | ||||||
20 | Board. At least one full-time professional shall be assigned to | ||||||
21 | staff the Board with additional administrative support | ||||||
22 | available as needed. The Board shall have balanced | ||||||
23 | representation from the community health worker workforce, | ||||||
24 | community health worker employers, community health worker | ||||||
25 | training and educational organizations, and other engaged |
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1 | stakeholders. | ||||||
2 | (c) The Board shall propose a certification process for and | ||||||
3 | be authorized to approve training from community-based | ||||||
4 | organizations, in conjunction with a statewide organization | ||||||
5 | representing community health workers, and academic | ||||||
6 | institutions, in consultation with the Illinois State Board of | ||||||
7 | Education, the Illinois Community College Board and the | ||||||
8 | Illinois Board of Higher Education. The Board shall base | ||||||
9 | training approval on core competencies, best practices, and | ||||||
10 | affordability. In addition, the Board shall maintain a registry | ||||||
11 | of certification records for individually certified community | ||||||
12 | health workers. | ||||||
13 | (d) All training programs that are deemed certifiable by | ||||||
14 | the Board shall go through a renewal process, which will be | ||||||
15 | determined by the Board once established. The Board shall | ||||||
16 | establish criteria to grandfather in any community health | ||||||
17 | workers who were practicing prior to the establishment of a | ||||||
18 | certification program. | ||||||
19 | Section 5-20. Reimbursement. Community health worker | ||||||
20 | services shall be covered under the medical assistance program | ||||||
21 | for persons who are otherwise eligible for medical assistance. | ||||||
22 | The Department of Healthcare and Family Services shall develop | ||||||
23 | services, including but not limited to, care coordination and | ||||||
24 | diagnostic-related patient education services, for which | ||||||
25 | community health workers will be eligible for reimbursement and |
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1 | shall submit a State Plan Amendment (SPA) to the Centers for | ||||||
2 | Medicare and Medicaid Services (CMS) to amend the agreement | ||||||
3 | between Illinois and the Federal government to include | ||||||
4 | community health workers as practitioners under Medicaid. | ||||||
5 | Certification shall not be required for reimbursement. In | ||||||
6 | addition, the Department of Healthcare and Family Services | ||||||
7 | shall amend its contracts with managed care entities to allow | ||||||
8 | managed care entities to employ community health workers or | ||||||
9 | subcontract with community-based organizations that employ | ||||||
10 | community health workers. | ||||||
11 | Title III. Hospital Reform | ||||||
12 | Article 10. | ||||||
13 | Section 10-5. The University of Illinois Hospital Act is | ||||||
14 | amended by adding Section 12 as follows: | ||||||
15 | (110 ILCS 330/12 new) | ||||||
16 | Sec. 12. Credentials and certificates. The University of | ||||||
17 | Illinois Hospital shall require an intern, resident, or | ||||||
18 | physician who provides medical services at the University of | ||||||
19 | Illinois Hospital to have proper credentials and any required | ||||||
20 | certificates for ongoing training at the time the intern, | ||||||
21 | resident, or physician renews his or her license. |
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1 | Section 10-10. The Hospital Licensing Act is amended by | ||||||
2 | adding Section 10.12 as follows: | ||||||
3 | (210 ILCS 85/10.12 new) | ||||||
4 | Sec. 10.12. Credentials and certificates. A hospital | ||||||
5 | licensed under this Act shall require an intern, resident, or | ||||||
6 | physician who provides medical services at the hospital to have | ||||||
7 | proper credentials and any required certificates for ongoing | ||||||
8 | training at the time the intern, resident, or physician renews | ||||||
9 | his or her license. | ||||||
10 | Section 10-15. The Hospital Report Card Act is amended by | ||||||
11 | changing Section 25 as follows:
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12 | (210 ILCS 86/25)
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13 | Sec. 25. Hospital reports.
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14 | (a) Individual hospitals shall prepare a quarterly report | ||||||
15 | including all of
the
following:
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16 | (1) Nursing hours per patient day, average daily | ||||||
17 | census, and average daily
hours worked
for each clinical | ||||||
18 | service area.
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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:
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23 | (A) Surgical procedure outcome measures. |
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1 | (B) Surgical procedure infection control process | ||||||
2 | measures.
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3 | (C)
Outcome or process measures related to | ||||||
4 | ventilator-associated pneumonia.
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5 | (D) Central vascular catheter-related bloodstream | ||||||
6 | infection rates in designated critical care units.
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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.
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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 | ||||||
8 | shall be based upon measures and methods developed by the | ||||||
9 | Centers for Disease Control and Prevention, the Centers for | ||||||
10 | Medicare and Medicaid Services, the Agency for Healthcare | ||||||
11 | Research and Quality, the Joint Commission on Accreditation of | ||||||
12 | Healthcare Organizations, or the National Quality Forum. The | ||||||
13 | Department may align the infection-related measures with the | ||||||
14 | measures and methods developed by the Centers for Disease | ||||||
15 | Control and Prevention, the Centers for Medicare and Medicaid | ||||||
16 | Services, the Agency for Healthcare Research and Quality, the | ||||||
17 | Joint Commission on Accreditation of Healthcare Organizations, | ||||||
18 | and the National Quality Forum by adding reporting measures | ||||||
19 | based on national health care strategies and measures deemed | ||||||
20 | scientifically reliable and valid for public reporting. The | ||||||
21 | Department shall receive approval from the State Board of | ||||||
22 | Health to retire measures deemed no longer scientifically valid | ||||||
23 | or valuable for informing quality improvement or infection | ||||||
24 | prevention efforts. The Department shall notify the Chairs and | ||||||
25 | Minority Spokespersons of the House Human Services Committee | ||||||
26 | and the Senate Public Health Committee of its intent to have |
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1 | the State Board of Health take action to retire measures no | ||||||
2 | later than 7 business days before the meeting of the State | ||||||
3 | Board of Health. | ||||||
4 | The Department shall include interpretive guidelines for | ||||||
5 | infection-related indicators and, when available, shall | ||||||
6 | include relevant benchmark information published by national | ||||||
7 | organizations.
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8 | The Department shall collect the information reported | ||||||
9 | under paragraphs (5) and (6) and shall use it to illustrate the | ||||||
10 | disparity of those occurrences across different racial and | ||||||
11 | ethnic groups. | ||||||
12 | (b) Individual hospitals shall prepare annual reports | ||||||
13 | including vacancy and
turnover rates
for licensed nurses per | ||||||
14 | clinical service area.
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15 | (c) None of the information the Department discloses to the | ||||||
16 | public may be
made
available
in any form or fashion unless the | ||||||
17 | information has been reviewed, adjusted, and
validated
| ||||||
18 | according to the following process:
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19 | (1) The Department shall organize an advisory | ||||||
20 | committee, including
representatives
from the Department, | ||||||
21 | public and private hospitals, direct care nursing staff,
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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
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4 | dissemination.
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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.
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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.
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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,
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17 | including but not
limited to the appropriate and | ||||||
18 | inappropriate uses of the data.
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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.
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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 | ||||||
26 | forth in rules
adopted
by the
Department, to the Department by |
| |||||||
| |||||||
1 | April 30, July 31, October 31, and January 31
each year
for the | ||||||
2 | previous quarter. Data in quarterly reports must cover a period | ||||||
3 | ending
not earlier than
one month prior to submission of the | ||||||
4 | report. Annual reports shall be submitted
by December
31 in a | ||||||
5 | format set forth in rules adopted by the Department to the | ||||||
6 | Department.
All reports
shall be made available to the public | ||||||
7 | on-site and through the Department.
| ||||||
8 | (e) If the hospital is a division or subsidiary of another | ||||||
9 | entity that owns
or
operates other
hospitals or related | ||||||
10 | organizations, the annual public disclosure report shall
be for | ||||||
11 | the specific
division or subsidiary and not for the other | ||||||
12 | entity.
| ||||||
13 | (f) The Department shall disclose information under this | ||||||
14 | Section in
accordance with provisions for inspection and | ||||||
15 | copying of public records
required by the Freedom of
| ||||||
16 | Information Act provided that such information satisfies the | ||||||
17 | provisions of
subsection (c) of this Section.
| ||||||
18 | (g) Notwithstanding any other provision of law, under no | ||||||
19 | circumstances shall
the
Department disclose information | ||||||
20 | obtained from a hospital that is confidential
under Part 21
of | ||||||
21 | Article VIII of the Code of Civil Procedure.
| ||||||
22 | (h) No hospital report or Department disclosure may contain | ||||||
23 | information
identifying a patient, employee, or licensed | ||||||
24 | professional.
| ||||||
25 | (Source: P.A. 101-446, eff. 8-23-19.)
|
| |||||||
| |||||||
1 | Article 15. | ||||||
2 | Section 15-5. The Hospital Licensing Act is amended by | ||||||
3 | adding Section 6.30 as follows: | ||||||
4 | (210 ILCS 85/6.30 new) | ||||||
5 | Sec. 6.30. Posting charity care policy, financial | ||||||
6 | counselor. A hospital that receives a property tax exemption | ||||||
7 | under Section 15-86 of the Property Tax Code must post the | ||||||
8 | hospital's charity care policy and the contact information of a | ||||||
9 | financial counselor in a reasonably viewable area in the | ||||||
10 | hospital's emergency room. | ||||||
11 | Article 20. | ||||||
12 | Section 20-5. The University of Illinois Hospital Act is | ||||||
13 | amended by adding Section 8d as follows: | ||||||
14 | (110 ILCS 330/8d new) | ||||||
15 | Sec. 8d. N95 masks. The University of Illinois Hospital | ||||||
16 | shall provide N95 masks to all physicians licensed under the | ||||||
17 | Medical Practice Act of 1987 and registered nurses and advanced | ||||||
18 | practice registered nurses licensed under the Nurse Licensing | ||||||
19 | Act if the physician, registered nurse, or advanced practice | ||||||
20 | registered nurse is employed by or providing services for | ||||||
21 | another employer at the University of Illinois Hospital. |
| |||||||
| |||||||
1 | Section 20-10. The Hospital Licensing Act is amended by | ||||||
2 | adding Section 6.28 as follows: | ||||||
3 | (210 ILCS 85/6.28 new) | ||||||
4 | Sec. 6.28. N95 masks. A hospital licensed under this Act | ||||||
5 | shall provide N95 masks to all physicians licensed under the | ||||||
6 | Medical Practice Act of 1987 and registered nurses and advanced | ||||||
7 | practice registered nurses licensed under the Nurse Licensing | ||||||
8 | Act if the physician, registered nurse, or advanced practice | ||||||
9 | registered nurse is employed by or providing services for | ||||||
10 | another employer at the hospital. | ||||||
11 | Article 25. | ||||||
12 | Section 25-5. The University of Illinois Hospital Act is | ||||||
13 | amended by adding Section 11 as follows: | ||||||
14 | (110 ILCS 330/11 new) | ||||||
15 | Sec. 11. Demographic data; release of individuals with | ||||||
16 | symptoms of COVID-19. The University of Illinois Hospital shall | ||||||
17 | report to the Department of Public Health the demographic data | ||||||
18 | of individuals who have symptoms of COVID-19 and are released | ||||||
19 | from, not admitted to, the University of Illinois Hospital. | ||||||
20 | Section 25-10. The Hospital Licensing Act is amended by |
| |||||||
| |||||||
1 | adding Section 6.31 as follows: | ||||||
2 | (210 ILCS 85/6.31 new) | ||||||
3 | Sec. 6.31. Demographic data; release of individuals with | ||||||
4 | symptoms of COVID-19. A hospital licensed under this Act shall | ||||||
5 | report to the Department the demographic data of individuals | ||||||
6 | who have symptoms of COVID-19 and are released from, not | ||||||
7 | admitted to, the hospital. | ||||||
8 | Article 35. | ||||||
9 | Section 35-5. The Illinois Public Aid Code is amended by | ||||||
10 | changing 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 | ||||||
14 | to be paid to a hospital for inpatient psychiatric services | ||||||
15 | shall be $363.77. | ||||||
16 | (b) For purposes of this Section, "hospital" means the | ||||||
17 | following: | ||||||
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. |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 | ||||||
21 | services" means those services provided to patients who are in | ||||||
22 | need of short-term acute inpatient hospitalization for active | ||||||
23 | treatment of an emotional or mental disorder. | ||||||
24 | (b-5) Notwithstanding any other provision of this Section, | ||||||
25 | the inpatient, per diem rate to be paid to all community | ||||||
26 | safety-net hospitals for inpatient psychiatric services on and |
| |||||||
| |||||||
1 | after January 1, 2021 shall be at least $630. | ||||||
2 | (c) No rules shall be promulgated to implement this | ||||||
3 | Section. For purposes of this Section, "rules" is given the | ||||||
4 | meaning contained in Section 1-70 of the Illinois | ||||||
5 | Administrative Procedure Act. | ||||||
6 | (d) This Section shall not be in effect during any period | ||||||
7 | of time that the State has in place a fully operational | ||||||
8 | hospital assessment plan that has been approved by the Centers | ||||||
9 | for Medicare and Medicaid Services of the U.S. Department of | ||||||
10 | Health and Human Services.
| ||||||
11 | (e) On and after July 1, 2012, the Department shall reduce | ||||||
12 | any rate of reimbursement for services or other payments or | ||||||
13 | alter any methodologies authorized by this Code to reduce any | ||||||
14 | rate of reimbursement for services or other payments in | ||||||
15 | accordance 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 | ||||||
20 | declares all of the following: | ||||||
21 | (a) Implicit bias, meaning the attitudes or internalized | ||||||
22 | stereotypes that affect our perceptions, actions, and | ||||||
23 | decisions in an unconscious manner, exists and often |
| |||||||
| |||||||
1 | contributes to unequal treatment of people based on race, | ||||||
2 | ethnicity, gender identity, sexual orientation, age, | ||||||
3 | disability, and other characteristics.
| ||||||
4 | (b) Implicit bias contributes to health disparities by | ||||||
5 | affecting the behavior of physicians and surgeons, nurses, | ||||||
6 | physician assistants, and other healing arts licensees.
| ||||||
7 | (c) African American women are 3 to 4 times more likely | ||||||
8 | than white women to die from pregnancy-related causes | ||||||
9 | nationwide. African American patients often are prescribed | ||||||
10 | less pain medication than white patients who present the same | ||||||
11 | complaints. African American patients with signs of heart | ||||||
12 | problems are not referred for advanced cardiovascular | ||||||
13 | procedures as often as white patients with the same symptoms.
| ||||||
14 | (d) Implicit gender bias also impacts treatment decisions | ||||||
15 | and outcomes. Women are less likely to survive a heart attack | ||||||
16 | when they are treated by a male physician and surgeon. LGBTQ | ||||||
17 | and gender-nonconforming patients are less likely to seek | ||||||
18 | timely medical care because they experience disrespect and | ||||||
19 | discrimination from health care staff, with one out of 5 | ||||||
20 | transgender patients nationwide reporting that they were | ||||||
21 | outright denied medical care due to bias.
| ||||||
22 | (e) The General Assembly intends to reduce disparate | ||||||
23 | outcomes and ensure that all patients receive fair treatment | ||||||
24 | and quality health care.
| ||||||
25 | Section 45-5. The Medical Practice Act of 1987 is amended |
| |||||||
| |||||||
1 | by 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 | ||||||
6 | education for persons licensed under
this Act that require an | ||||||
7 | average of 50 hours of
continuing education per license year. | ||||||
8 | These rules
shall be consistent with
requirements of relevant | ||||||
9 | professional associations, specialty
societies, or boards. The | ||||||
10 | rules shall also address variances in part or in
whole for good | ||||||
11 | cause, including, but not limited to, temporary illness
or
| ||||||
12 | hardship. In establishing these rules, the
Department shall | ||||||
13 | consider educational requirements for
medical staffs, | ||||||
14 | requirements for specialty society board
certification or for | ||||||
15 | continuing education requirements as a
condition of membership | ||||||
16 | in societies representing the 2
categories of licensee under | ||||||
17 | this Act. These rules shall
assure that licensees are given the | ||||||
18 | opportunity to
participate in those programs sponsored by or | ||||||
19 | through their
professional associations or hospitals which are | ||||||
20 | relevant to
their practice. | ||||||
21 | (b) Except as otherwise provided in this subsection, the | ||||||
22 | rules adopted under this Section shall require that, on and | ||||||
23 | after January 1, 2022, all continuing education courses for | ||||||
24 | persons licensed under this Act contain curriculum that | ||||||
25 | includes the understanding of implicit bias. Beginning January |
| |||||||
| |||||||
1 | 1, 2023, continuing education providers shall ensure | ||||||
2 | compliance with this Section. Beginning January 1, 2023, the | ||||||
3 | Department shall audit continuing education providers at least | ||||||
4 | once every 5 years to ensure adherence to regulatory | ||||||
5 | requirements and shall withhold or rescind approval from any | ||||||
6 | provider that is in violation of the requirements of this | ||||||
7 | subsection. | ||||||
8 | A continuing education course dedicated solely to research | ||||||
9 | or other issues that does not include a direct patient care | ||||||
10 | component is not required to contain curriculum that includes | ||||||
11 | implicit bias in the practice of medicine. | ||||||
12 | To satisfy the requirements of this subsection, continuing | ||||||
13 | education 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
| ||||||
24 | completion of continuing education and shall be prepared to | ||||||
25 | produce the
records when requested by the Department.
| ||||||
26 | (Source: P.A. 97-622, eff. 11-23-11 .)
|
| |||||||
| |||||||
1 | Section 45-10. The Nurse Practice Act is amended by | ||||||
2 | changing 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 | ||||||
7 | for licensed practical nurses that require 20 hours of | ||||||
8 | continuing education per 2-year license renewal cycle. The | ||||||
9 | rules shall address variances in part or in whole for good | ||||||
10 | cause, including without limitation illness or hardship. The | ||||||
11 | continuing education rules must ensure that licensees are given | ||||||
12 | the opportunity to participate in programs sponsored by or | ||||||
13 | through their State or national professional associations, | ||||||
14 | hospitals, or other providers of continuing education. | ||||||
15 | (b) For license renewals occurring on or after January 1, | ||||||
16 | 2022, all licensed practical nurses must complete at least one | ||||||
17 | hour of implicit bias training per 2-year license renewal | ||||||
18 | cycle. The Department may adopt rules for the implementation of | ||||||
19 | this subsection. | ||||||
20 | (c) Each licensee is responsible for maintaining records of | ||||||
21 | completion of continuing education and shall be prepared to | ||||||
22 | produce the records when requested by the Department.
| ||||||
23 | (Source: P.A. 95-639, eff. 10-5-07 .) |
| |||||||
| |||||||
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 | ||||||
5 | for registered professional nurses licensed under this Act that | ||||||
6 | require 20 hours of continuing education per 2-year license | ||||||
7 | renewal cycle. The rules shall address variances in part or in | ||||||
8 | whole for good cause, including without limitation illness or | ||||||
9 | hardship. The continuing education rules must ensure that | ||||||
10 | licensees are given the opportunity to participate in programs | ||||||
11 | sponsored by or through their State or national professional | ||||||
12 | associations, hospitals, or other providers of continuing | ||||||
13 | education. | ||||||
14 | (b) For license renewals occurring on or after January 1, | ||||||
15 | 2022, all registered professional nurses must complete at least | ||||||
16 | one hour of implicit bias training per 2-year license renewal | ||||||
17 | cycle. The Department may adopt rules for the implementation of | ||||||
18 | this subsection. | ||||||
19 | (c) Each licensee is responsible for maintaining records of | ||||||
20 | completion of continuing education and shall be prepared to | ||||||
21 | produce 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. |
| |||||||
| |||||||
1 | (a) The Department shall
adopt rules of continuing | ||||||
2 | education for persons licensed
under this Article as advanced | ||||||
3 | practice registered nurses that require 80 hours of
continuing | ||||||
4 | education per 2-year license renewal cycle. Completion of the | ||||||
5 | 80 hours of continuing education shall be deemed to satisfy the | ||||||
6 | continuing education requirements for renewal of a registered | ||||||
7 | professional nurse license as required by this Act. | ||||||
8 | The 80 hours of continuing education required under this | ||||||
9 | Section 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 |
| |||||||
| |||||||
1 | consistent to the extent possible with requirements of relevant | ||||||
2 | national certifying bodies or State or national professional | ||||||
3 | associations. | ||||||
4 | (b) The
rules shall not be inconsistent with requirements | ||||||
5 | of relevant national
certifying bodies or
State or national | ||||||
6 | professional associations.
The rules shall also address | ||||||
7 | variances in part or in whole for good
cause, including but not | ||||||
8 | limited to illness or
hardship.
The continuing education rules | ||||||
9 | shall assure that licensees are given the
opportunity to | ||||||
10 | participate in programs sponsored by or
through their State or | ||||||
11 | national professional associations, hospitals,
or other | ||||||
12 | providers of continuing education. | ||||||
13 | (c) For license renewals occurring on or after January 1, | ||||||
14 | 2022, all advanced practice registered nurses must complete at | ||||||
15 | least one hour of implicit bias training per 2-year license | ||||||
16 | renewal cycle. The Department may adopt rules for the | ||||||
17 | implementation of this subsection. | ||||||
18 | (d) Each licensee is
responsible
for maintaining records of | ||||||
19 | completion of continuing education
and shall be prepared to | ||||||
20 | produce 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 | ||||||
23 | is amended by changing Section 11.5 as follows: | ||||||
24 | (225 ILCS 95/11.5) |
| |||||||
| |||||||
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 | ||||||
4 | education for persons licensed under this Act that require 50 | ||||||
5 | hours of continuing education per 2-year license renewal cycle. | ||||||
6 | Completion of the 50 hours of continuing education shall be | ||||||
7 | deemed to satisfy the continuing education requirements for | ||||||
8 | renewal of a physician assistant license as required by this | ||||||
9 | Act. The rules shall not be inconsistent with requirements of | ||||||
10 | relevant national certifying bodies or State or national | ||||||
11 | professional associations. The rules shall also address | ||||||
12 | variances in part or in whole for good cause, including, but | ||||||
13 | not limited to, illness or hardship. The continuing education | ||||||
14 | rules shall ensure that licensees are given the opportunity to | ||||||
15 | participate in programs sponsored by or through their State or | ||||||
16 | national professional associations, hospitals, or other | ||||||
17 | providers of continuing education. | ||||||
18 | (b) Except as otherwise provided in this subsection, the | ||||||
19 | rules adopted under this Section shall require that, on and | ||||||
20 | after January 1, 2022, all continuing education courses for | ||||||
21 | persons licensed under this Act contain curriculum that | ||||||
22 | includes the understanding of implicit bias. Beginning January | ||||||
23 | 1, 2023, continuing education providers shall ensure | ||||||
24 | compliance with this Section. Beginning January 1, 2023, the | ||||||
25 | Department shall audit continuing education providers at least | ||||||
26 | once every 5 years to ensure adherence to regulatory |
| |||||||
| |||||||
1 | requirements and shall withhold or rescind approval from any | ||||||
2 | provider that is in violation of the regulatory requirements. | ||||||
3 | A continuing education course dedicated solely to research | ||||||
4 | or other issues that does not include a direct patient care | ||||||
5 | component is not required to contain curriculum that includes | ||||||
6 | implicit bias in the practice of medicine. | ||||||
7 | To satisfy the requirements of subsection (a) of this | ||||||
8 | Section, continuing education courses shall address at least | ||||||
9 | one 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 | ||||||
20 | completion of continuing education and shall be prepared to | ||||||
21 | produce 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. |
| |||||||
| |||||||
1 | Section 50-5. The Illinois Controlled Substances Act is | ||||||
2 | amended 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 | ||||||
6 | controlled substance-induced physiological event that results | ||||||
7 | in a life-threatening emergency to the individual who ingested, | ||||||
8 | inhaled, injected or otherwise bodily absorbed a controlled, | ||||||
9 | counterfeit, or look-alike substance or a controlled substance | ||||||
10 | analog. | ||||||
11 | (b) A person who, in good faith, seeks or obtains emergency | ||||||
12 | medical assistance for someone experiencing an overdose shall | ||||||
13 | not be arrested, charged , or prosecuted for a violation of | ||||||
14 | Section 401 or 402 of the Illinois Controlled Substances Act, | ||||||
15 | Section 3.5 of the Drug Paraphernalia Control Act, Section 55 | ||||||
16 | or 60 of the Methamphetamine Control and Community Protection | ||||||
17 | Act, 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 | ||||||
19 | of 2012 Class 4 felony possession of a controlled, counterfeit, | ||||||
20 | or look-alike substance or a controlled substance analog if | ||||||
21 | evidence for the violation Class 4 felony possession charge was | ||||||
22 | acquired as a result of the person seeking or obtaining | ||||||
23 | emergency medical assistance and providing the amount of | ||||||
24 | substance recovered is within the amount identified in |
| |||||||
| |||||||
1 | subsection (d) of this Section. The violations listed in this | ||||||
2 | subsection (b) must not serve as the sole basis of a violation | ||||||
3 | of parole, mandatory supervised release, probation, or | ||||||
4 | conditional discharge, a Department of Children and Family | ||||||
5 | Services investigation, or any seizure of property under any | ||||||
6 | State law authorizing civil forfeiture so long as the evidence | ||||||
7 | for the violation was acquired as a result of the person | ||||||
8 | seeking or obtaining emergency medical assistance in the event | ||||||
9 | of an overdose. | ||||||
10 | (c) A person who is experiencing an overdose shall not be | ||||||
11 | arrested, charged , or prosecuted for a violation of Section 401 | ||||||
12 | or 402 of the Illinois Controlled Substances Act, Section 3.5 | ||||||
13 | of the Drug Paraphernalia Control Act, Section 9-3.3 of the | ||||||
14 | Criminal Code of 2012, or paragraph (1) of subsection (g) of | ||||||
15 | Section 12-3.05 of the Criminal Code of 2012 Class 4 felony | ||||||
16 | possession of a controlled, counterfeit, or look-alike | ||||||
17 | substance or a controlled substance analog if evidence for the | ||||||
18 | violation Class 4 felony possession charge was acquired as a | ||||||
19 | result of the person seeking or obtaining emergency medical | ||||||
20 | assistance and providing the amount of substance recovered is | ||||||
21 | within the amount identified in subsection (d) of this Section. | ||||||
22 | The violations listed in this subsection (c) must not serve as | ||||||
23 | the sole basis of a violation of parole, mandatory supervised | ||||||
24 | release, probation, or conditional discharge, a Department of | ||||||
25 | Children and Family Services investigation, or any seizure of | ||||||
26 | property under any State law authorizing civil forfeiture so |
| |||||||
| |||||||
1 | long as the evidence for the violation was acquired as a result | ||||||
2 | of the person seeking or obtaining emergency medical assistance | ||||||
3 | in the event of an overdose. | ||||||
4 | (d) For the purposes of subsections (b) and (c), the | ||||||
5 | limited immunity shall only apply to a person possessing the | ||||||
6 | following 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 |
| |||||||
| |||||||
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 | ||||||
14 | has reasonable suspicion or probable cause to detain, arrest, | ||||||
15 | or search the person described in subsection (b) or (c) of this | ||||||
16 | Section for criminal activity and the reasonable suspicion or | ||||||
17 | probable cause is based on information obtained prior to or | ||||||
18 | independent of the individual described in subsection (b) or | ||||||
19 | (c) taking action to seek or obtain emergency medical | ||||||
20 | assistance and not obtained as a direct result of the action of | ||||||
21 | seeking or obtaining emergency medical assistance. Nothing in | ||||||
22 | this Section is intended to interfere with or prevent the | ||||||
23 | investigation, arrest, or prosecution of any person for the | ||||||
24 | delivery or distribution of cannabis, methamphetamine or other | ||||||
25 | controlled substances, drug-induced homicide, or any other | ||||||
26 | crime if the evidence of the violation is not acquired as a |
| |||||||
| |||||||
1 | result of the person seeking or obtaining emergency medical | ||||||
2 | assistance 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 | ||||||
5 | Protection 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 | ||||||
9 | methamphetamine-induced physiological event that results in a | ||||||
10 | life-threatening emergency to the individual who ingested, | ||||||
11 | inhaled, injected, or otherwise bodily absorbed | ||||||
12 | methamphetamine. | ||||||
13 | (b) A person who, in good faith, seeks emergency medical | ||||||
14 | assistance for someone experiencing an overdose shall not be | ||||||
15 | arrested, charged or prosecuted for a violation of Section 55 | ||||||
16 | or 60 of this Act or Section 3.5 of the Drug Paraphernalia | ||||||
17 | Control Act, Section 9-3.3 of the Criminal Code of 2012, or | ||||||
18 | paragraph (1) of subsection (g) of Section 12-3.05 of the | ||||||
19 | Criminal Code of 2012 Class 3 felony possession of | ||||||
20 | methamphetamine if evidence for the violation Class 3 felony | ||||||
21 | possession charge was acquired as a result of the person | ||||||
22 | seeking or obtaining emergency medical assistance and | ||||||
23 | providing the amount of substance recovered is less than 3 | ||||||
24 | grams one gram of methamphetamine or a substance containing |
| |||||||
| |||||||
1 | methamphetamine. The violations listed in this subsection (b) | ||||||
2 | must not serve as the sole basis of a violation of parole, | ||||||
3 | mandatory supervised release, probation, or conditional | ||||||
4 | discharge, a Department of Children and Family Services | ||||||
5 | investigation, or any seizure of property under any State law | ||||||
6 | authorizing civil forfeiture so long as the evidence for the | ||||||
7 | violation was acquired as a result of the person seeking or | ||||||
8 | obtaining emergency medical assistance in the event of an | ||||||
9 | overdose. | ||||||
10 | (c) A person who is experiencing an overdose shall not be | ||||||
11 | arrested, charged , or prosecuted for a violation of Section 55 | ||||||
12 | or 60 of this Act or Section 3.5 of the Drug Paraphernalia | ||||||
13 | Control Act, Section 9-3.3 of the Criminal Code of 2012, or | ||||||
14 | paragraph (1) of subsection (g) of Section 12-3.05 of the | ||||||
15 | Criminal Code of 2012 Class 3 felony possession of | ||||||
16 | methamphetamine if evidence for the Class 3 felony possession | ||||||
17 | charge was acquired as a result of the person seeking or | ||||||
18 | obtaining emergency medical assistance and providing the | ||||||
19 | amount of substance recovered is less than one gram of | ||||||
20 | methamphetamine or a substance containing methamphetamine. The | ||||||
21 | violations listed in this subsection (c) must not serve as the | ||||||
22 | sole basis of a violation of parole, mandatory supervised | ||||||
23 | release, probation, or conditional discharge, a Department of | ||||||
24 | Children and Family Services investigation, or any seizure of | ||||||
25 | property under any State law authorizing civil forfeiture so | ||||||
26 | long as the evidence for the violation was acquired as a result |
| |||||||
| |||||||
1 | of the person seeking or obtaining emergency medical assistance | ||||||
2 | in 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 | ||||||
5 | has reasonable suspicion or probable cause to detain, arrest, | ||||||
6 | or search the person described in subsection (b) or (c) of this | ||||||
7 | Section for criminal activity and the reasonable suspicion or | ||||||
8 | probable cause is based on information obtained prior to or | ||||||
9 | independent of the individual described in subsection (b) or | ||||||
10 | (c) taking action to seek or obtain emergency medical | ||||||
11 | assistance and not obtained as a direct result of the action of | ||||||
12 | seeking or obtaining emergency medical assistance. Nothing in | ||||||
13 | this Section is intended to interfere with or prevent the | ||||||
14 | investigation, arrest, or prosecution of any person for the | ||||||
15 | delivery or distribution of cannabis, methamphetamine or other | ||||||
16 | controlled substances, drug-induced homicide, or any other | ||||||
17 | crime if the evidence of the violation is not acquired as a | ||||||
18 | result of the person seeking or obtaining emergency medical | ||||||
19 | assistance 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 | ||||||
23 | amended by changing Section 316 as follows:
|
| |||||||
| |||||||
1 | (720 ILCS 570/316)
| ||||||
2 | Sec. 316. Prescription Monitoring Program. | ||||||
3 | (a) The Department must provide for a
Prescription | ||||||
4 | Monitoring Program for Schedule II, III, IV, and V controlled | ||||||
5 | substances that includes the following components and | ||||||
6 | requirements:
| ||||||
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). |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
10 | veterinarian is exempt from the reporting requirements of this | ||||||
11 | Section. If a person who is presenting an animal for treatment | ||||||
12 | is suspected of fraudulently obtaining any controlled | ||||||
13 | substance or prescription for a controlled substance, the | ||||||
14 | licensed veterinarian shall report that information to the | ||||||
15 | local law enforcement agency. | ||||||
16 | (b) The Department, by rule, may include in the | ||||||
17 | Prescription Monitoring Program certain other select drugs | ||||||
18 | that are not included in Schedule II, III, IV, or V. The | ||||||
19 | Prescription Monitoring Program does not apply to
controlled | ||||||
20 | substance prescriptions as exempted under Section
313.
| ||||||
21 | (c) The collection of data on select drugs and scheduled | ||||||
22 | substances by the Prescription Monitoring Program may be used | ||||||
23 | as a tool for addressing oversight requirements of long-term | ||||||
24 | care institutions as set forth by Public Act 96-1372. Long-term | ||||||
25 | care pharmacies shall transmit patient medication profiles to | ||||||
26 | the Prescription Monitoring Program monthly or more frequently |
| |||||||
| |||||||
1 | as established by administrative rule. | ||||||
2 | (d) The Department of Human Services shall appoint a | ||||||
3 | full-time Clinical Director of the Prescription Monitoring | ||||||
4 | Program. | ||||||
5 | (e) (Blank). | ||||||
6 | (f) Within one year of January 1, 2018 (the effective date | ||||||
7 | of Public Act 100-564), the Department shall adopt rules | ||||||
8 | requiring all Electronic Health Records Systems to interface | ||||||
9 | with the Prescription Monitoring Program application program | ||||||
10 | on or before January 1, 2021 to ensure that all providers have | ||||||
11 | access to specific patient records during the treatment of | ||||||
12 | their patients. These rules shall also address the electronic | ||||||
13 | integration of pharmacy records with the Prescription | ||||||
14 | Monitoring Program to allow for faster transmission of the | ||||||
15 | information required under this Section. The Department shall | ||||||
16 | establish actions to be taken if a prescriber's Electronic | ||||||
17 | Health Records System does not effectively interface with the | ||||||
18 | Prescription Monitoring Program within the required timeline. | ||||||
19 | (g) The Department, in consultation with the Advisory | ||||||
20 | Committee, shall adopt rules allowing licensed prescribers or | ||||||
21 | pharmacists who have registered to access the Prescription | ||||||
22 | Monitoring Program to authorize a licensed or non-licensed | ||||||
23 | designee employed in that licensed prescriber's office or a | ||||||
24 | licensed designee in a licensed pharmacist's pharmacy who has | ||||||
25 | received training in the federal Health Insurance Portability | ||||||
26 | and Accountability Act to consult the Prescription Monitoring |
| |||||||
| |||||||
1 | Program on their behalf. The rules shall include reasonable | ||||||
2 | parameters concerning a practitioner's authority to authorize | ||||||
3 | a designee, and the eligibility of a person to be selected as a | ||||||
4 | designee. In this subsection (g), "pharmacist" shall include a | ||||||
5 | clinical pharmacist employed by and designated by a Medicaid | ||||||
6 | Managed Care Organization providing services under Article V of | ||||||
7 | the Illinois Public Aid Code under a contract with the | ||||||
8 | Department of Healthcare and Family Services for the sole | ||||||
9 | purpose of clinical review of services provided to persons | ||||||
10 | covered by the entity under the contract to determine | ||||||
11 | compliance with subsections (a) and (b) of Section 314.5 of | ||||||
12 | this Act. A managed care entity pharmacist shall notify | ||||||
13 | prescribers of review activities. | ||||||
14 | (Source: P.A. 100-564, eff. 1-1-18; 100-861, eff. 8-14-18; | ||||||
15 | 100-1005, eff. 8-21-18; 100-1093, eff. 8-26-18; 101-81, eff. | ||||||
16 | 7-12-19; 101-414, eff. 8-16-19.)
| ||||||
17 | Article 60. | ||||||
18 | Section 60-5. The Adult Protective Services Act is amended | ||||||
19 | by 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 | ||||||
23 | by the Department in the Adult Protective Services division who |
| |||||||
| |||||||
1 | works on the development and implementation of social services | ||||||
2 | to respond to and prevent adult abuse, neglect, or | ||||||
3 | exploitation. | ||||||
4 | (b) The Department shall develop and implement a dementia | ||||||
5 | training program that must include instruction on the | ||||||
6 | identification of people with dementia, risks such as | ||||||
7 | wandering, communication impairments, elder abuse, and the | ||||||
8 | best practices for interacting with people with dementia. | ||||||
9 | (c) Initial training of 4 hours shall be completed at the | ||||||
10 | start of employment with the Adult Protective Services division | ||||||
11 | and 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. |
| |||||||
| |||||||
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 | ||||||
6 | dementia training covering the subjects described in | ||||||
7 | subsection (c). | ||||||
8 | (e) This Section is designed to address gaps in current | ||||||
9 | dementia training requirements for Adult Protective Services | ||||||
10 | officials and improve the quality of training. If currently | ||||||
11 | existing law or rules contain more rigorous training | ||||||
12 | requirements for Adult Protective Service officials, those | ||||||
13 | laws or rules shall apply. Where there is overlap between this | ||||||
14 | Section and other laws and rules, the Department shall | ||||||
15 | interpret this Section to avoid duplication of requirements | ||||||
16 | while ensuring that the minimum requirements set in this | ||||||
17 | Section are met. | ||||||
18 | (f) The Department may adopt rules for the administration | ||||||
19 | of this Section. | ||||||
20 | Title VI. Access to Health Care | ||||||
21 | Article 70. | ||||||
22 | Section 70-5. The Use Tax Act is amended by changing | ||||||
23 | Section 3-10 as follows:
|
| |||||||
| |||||||
1 | (35 ILCS 105/3-10)
| ||||||
2 | Sec. 3-10. Rate of tax. Unless otherwise provided in this | ||||||
3 | Section, the tax
imposed by this Act is at the rate of 6.25% of | ||||||
4 | either the selling price or the
fair market value, if any, of | ||||||
5 | the tangible personal property. In all cases
where property | ||||||
6 | functionally used or consumed is the same as the property that
| ||||||
7 | was purchased at retail, then the tax is imposed on the selling | ||||||
8 | price of the
property. In all cases where property functionally | ||||||
9 | used or consumed is a
by-product or waste product that has been | ||||||
10 | refined, manufactured, or produced
from property purchased at | ||||||
11 | retail, then the tax is imposed on the lower of the
fair market | ||||||
12 | value, if any, of the specific property so used in this State | ||||||
13 | or on
the selling price of the property purchased at retail. | ||||||
14 | For purposes of this
Section "fair market value" means the | ||||||
15 | price at which property would change
hands between a willing | ||||||
16 | buyer and a willing seller, neither being under any
compulsion | ||||||
17 | to buy or sell and both having reasonable knowledge of the
| ||||||
18 | relevant facts. The fair market value shall be established by | ||||||
19 | Illinois sales by
the taxpayer of the same property as that | ||||||
20 | functionally used or consumed, or if
there are no such sales by | ||||||
21 | the taxpayer, then comparable sales or purchases of
property of | ||||||
22 | like kind and character in Illinois.
| ||||||
23 | Beginning on July 1, 2000 and through December 31, 2000, | ||||||
24 | with respect to
motor fuel, as defined in Section 1.1 of the | ||||||
25 | Motor Fuel Tax
Law, and gasohol, as defined in Section 3-40 of |
| |||||||
| |||||||
1 | the Use Tax Act, the tax is
imposed at the rate of 1.25%.
| ||||||
2 | Beginning on August 6, 2010 through August 15, 2010, with | ||||||
3 | respect to sales tax holiday items as defined in Section 3-6 of | ||||||
4 | this Act, the
tax is imposed at the rate of 1.25%. | ||||||
5 | With respect to gasohol, the tax imposed by this Act | ||||||
6 | applies to (i) 70%
of the proceeds of sales made on or after | ||||||
7 | January 1, 1990, and before
July 1, 2003, (ii) 80% of the | ||||||
8 | proceeds of sales made
on or after July 1, 2003 and on or | ||||||
9 | before July 1, 2017, and (iii) 100% of the proceeds of sales | ||||||
10 | made
thereafter.
If, at any time, however, the tax under this | ||||||
11 | Act on sales of gasohol is
imposed at the
rate of 1.25%, then | ||||||
12 | the tax imposed by this Act applies to 100% of the proceeds
of | ||||||
13 | sales of gasohol made during that time.
| ||||||
14 | With respect to majority blended ethanol fuel, the tax | ||||||
15 | imposed by this Act
does
not apply
to the proceeds of sales | ||||||
16 | made on or after July 1, 2003 and on or before
December 31, | ||||||
17 | 2023 but applies to 100% of the proceeds of sales made | ||||||
18 | thereafter.
| ||||||
19 | With respect to biodiesel blends with no less than 1% and | ||||||
20 | no more than 10%
biodiesel, the tax imposed by this Act applies | ||||||
21 | to (i) 80% of the
proceeds of sales made on or after July 1, | ||||||
22 | 2003 and on or before December 31, 2018
and (ii) 100% of the | ||||||
23 | proceeds of sales made
thereafter.
If, at any time, however, | ||||||
24 | the tax under this Act on sales of biodiesel blends
with no | ||||||
25 | less than 1% and no more than 10% biodiesel
is imposed at the | ||||||
26 | rate of
1.25%, then the
tax imposed by this Act applies to 100% |
| |||||||
| |||||||
1 | of the proceeds of sales of biodiesel
blends with no less than | ||||||
2 | 1% and no more than 10% biodiesel
made
during that time.
| ||||||
3 | With respect to 100% biodiesel and biodiesel blends with | ||||||
4 | more than 10%
but no more than 99% biodiesel, the tax imposed | ||||||
5 | by this Act does not apply to
the
proceeds of sales made on or | ||||||
6 | after July 1, 2003 and on or before
December 31, 2023 but | ||||||
7 | applies to 100% of the proceeds of sales made
thereafter.
| ||||||
8 | With respect to food for human consumption that is to be | ||||||
9 | consumed off the
premises where it is sold (other than | ||||||
10 | alcoholic beverages, food consisting of or infused with adult | ||||||
11 | use cannabis, soft drinks, and
food that has been prepared for | ||||||
12 | immediate consumption) and prescription and
nonprescription | ||||||
13 | medicines, drugs, medical appliances, products classified as | ||||||
14 | Class III medical devices by the United States Food and Drug | ||||||
15 | Administration that are used for cancer treatment pursuant to a | ||||||
16 | prescription, as well as any accessories and components related | ||||||
17 | to those devices, modifications to a motor
vehicle for the | ||||||
18 | purpose of rendering it usable by a person with a disability, | ||||||
19 | and
insulin, blood sugar urine testing materials, syringes, and | ||||||
20 | needles used by human diabetics, for
human use, the tax is | ||||||
21 | imposed at the rate of 1%. For the purposes of this
Section, | ||||||
22 | until September 1, 2009: the term "soft drinks" means any | ||||||
23 | complete, finished, ready-to-use,
non-alcoholic drink, whether | ||||||
24 | carbonated or not, including but not limited to
soda water, | ||||||
25 | cola, fruit juice, vegetable juice, carbonated water, and all | ||||||
26 | other
preparations commonly known as soft drinks of whatever |
| |||||||
| |||||||
1 | kind or description that
are contained in any closed or sealed | ||||||
2 | bottle, can, carton, or container,
regardless of size; but | ||||||
3 | "soft drinks" does not include coffee, tea, non-carbonated
| ||||||
4 | water, infant formula, milk or milk products as defined in the | ||||||
5 | Grade A
Pasteurized Milk and Milk Products Act, or drinks | ||||||
6 | containing 50% or more
natural fruit or vegetable juice.
| ||||||
7 | Notwithstanding any other provisions of this
Act, | ||||||
8 | beginning September 1, 2009, "soft drinks" means non-alcoholic | ||||||
9 | beverages that contain natural or artificial sweeteners. "Soft | ||||||
10 | drinks" do not include beverages that contain milk or milk | ||||||
11 | products, soy, rice or similar milk substitutes, or greater | ||||||
12 | than 50% of vegetable or fruit juice by volume. | ||||||
13 | Until August 1, 2009, and notwithstanding any other | ||||||
14 | provisions of this
Act, "food for human consumption that is to | ||||||
15 | be consumed off the premises where
it is sold" includes all | ||||||
16 | food sold through a vending machine, except soft
drinks and | ||||||
17 | food products that are dispensed hot from a vending machine,
| ||||||
18 | regardless of the location of the vending machine. Beginning | ||||||
19 | August 1, 2009, and notwithstanding any other provisions of | ||||||
20 | this Act, "food for human consumption that is to be consumed | ||||||
21 | off the premises where it is sold" includes all food sold | ||||||
22 | through a vending machine, except soft drinks, candy, and food | ||||||
23 | products that are dispensed hot from a vending machine, | ||||||
24 | regardless of the location of the vending machine.
| ||||||
25 | Notwithstanding any other provisions of this
Act, | ||||||
26 | beginning September 1, 2009, "food for human consumption that |
| |||||||
| |||||||
1 | is to be consumed off the premises where
it is sold" does not | ||||||
2 | include candy. For purposes of this Section, "candy" means a | ||||||
3 | preparation of sugar, honey, or other natural or artificial | ||||||
4 | sweeteners in combination with chocolate, fruits, nuts or other | ||||||
5 | ingredients or flavorings in the form of bars, drops, or | ||||||
6 | pieces. "Candy" does not include any preparation that contains | ||||||
7 | flour or requires refrigeration. | ||||||
8 | Notwithstanding any other provisions of this
Act, | ||||||
9 | beginning September 1, 2009, "nonprescription medicines and | ||||||
10 | drugs" does not include grooming and hygiene products. For | ||||||
11 | purposes of this Section, "grooming and hygiene products" | ||||||
12 | includes, but is not limited to, soaps and cleaning solutions, | ||||||
13 | shampoo, toothpaste, mouthwash, antiperspirants, and sun tan | ||||||
14 | lotions and screens, unless those products are available by | ||||||
15 | prescription only, regardless of whether the products meet the | ||||||
16 | definition of "over-the-counter-drugs". For the purposes of | ||||||
17 | this paragraph, "over-the-counter-drug" means a drug for human | ||||||
18 | use that contains a label that identifies the product as a drug | ||||||
19 | as required by 21 C.F.R. § 201.66. The "over-the-counter-drug" | ||||||
20 | label 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 | ||||||
26 | the 98th General Assembly, "prescription and nonprescription |
| |||||||
| |||||||
1 | medicines and drugs" includes medical cannabis purchased from a | ||||||
2 | registered dispensing organization under the Compassionate Use | ||||||
3 | of Medical Cannabis Program Act. | ||||||
4 | As used in this Section, "adult use cannabis" means | ||||||
5 | cannabis subject to tax under the Cannabis Cultivation | ||||||
6 | Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and | ||||||
7 | does not include cannabis subject to tax under the | ||||||
8 | Compassionate Use of Medical Cannabis Program Act. | ||||||
9 | If the property that is purchased at retail from a retailer | ||||||
10 | is acquired
outside Illinois and used outside Illinois before | ||||||
11 | being brought to Illinois
for use here and is taxable under | ||||||
12 | this Act, the "selling price" on which
the tax is computed | ||||||
13 | shall be reduced by an amount that represents a
reasonable | ||||||
14 | allowance for depreciation for the period of prior out-of-state | ||||||
15 | use.
| ||||||
16 | (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19; | ||||||
17 | 101-593, eff. 12-4-19.)
| ||||||
18 | Section 70-10. The Service Use Tax Act is amended by | ||||||
19 | changing 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 | ||||||
22 | Section,
the tax imposed by this Act is at the rate of 6.25% of | ||||||
23 | the selling
price of tangible personal property transferred as | ||||||
24 | an incident to the sale
of service, but, for the purpose of |
| |||||||
| |||||||
1 | computing this tax, in no event shall
the selling price be less | ||||||
2 | than the cost price of the property to the
serviceman.
| ||||||
3 | Beginning on July 1, 2000 and through December 31, 2000, | ||||||
4 | with respect to
motor fuel, as defined in Section 1.1 of the | ||||||
5 | Motor Fuel Tax
Law, and gasohol, as defined in Section 3-40 of | ||||||
6 | the 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 | ||||||
8 | tax imposed
by this Act applies to (i) 70% of the selling price | ||||||
9 | of property transferred
as an incident to the sale of service | ||||||
10 | on or after January 1, 1990,
and before July 1, 2003, (ii) 80% | ||||||
11 | of the selling price of
property transferred as an incident to | ||||||
12 | the sale of service on or after July
1, 2003 and on or before | ||||||
13 | July 1, 2017, and (iii)
100% of the selling price thereafter.
| ||||||
14 | If, at any time, however, the tax under this Act on sales of | ||||||
15 | gasohol, as
defined in
the Use Tax Act, is imposed at the rate | ||||||
16 | of 1.25%, then the
tax imposed by this Act applies to 100% of | ||||||
17 | the proceeds of sales of gasohol
made during that time.
| ||||||
18 | With respect to majority blended ethanol fuel, as defined | ||||||
19 | in the Use Tax Act,
the
tax
imposed by this Act does not apply | ||||||
20 | to the selling price of property transferred
as an incident to | ||||||
21 | the sale of service on or after July 1, 2003 and on or before
| ||||||
22 | December 31, 2023 but applies to 100% of the selling price | ||||||
23 | thereafter.
| ||||||
24 | With respect to biodiesel blends, as defined in the Use Tax | ||||||
25 | Act, with no less
than 1% and no
more than 10% biodiesel, the | ||||||
26 | tax imposed by this Act
applies to (i) 80% of the selling price |
| |||||||
| |||||||
1 | of property transferred as an incident
to the sale of service | ||||||
2 | on 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, | ||||||
4 | at any time, however, the tax under this Act on sales of | ||||||
5 | biodiesel blends,
as
defined in the Use Tax Act, with no less | ||||||
6 | than 1% and no more than 10% biodiesel
is imposed at the rate | ||||||
7 | of 1.25%, then the
tax imposed by this Act applies to 100% of | ||||||
8 | the proceeds of sales of biodiesel
blends with no less than 1% | ||||||
9 | and no more than 10% biodiesel
made
during that time.
| ||||||
10 | With respect to 100% biodiesel, as defined in the Use Tax | ||||||
11 | Act, and biodiesel
blends, as defined in the Use Tax Act, with
| ||||||
12 | more than 10% but no more than 99% biodiesel, the tax imposed | ||||||
13 | by this Act
does not apply to the proceeds of the selling price | ||||||
14 | of property transferred
as an incident to the sale of service | ||||||
15 | on or after July 1, 2003 and on or before
December 31, 2023 but | ||||||
16 | applies to 100% of the selling price thereafter.
| ||||||
17 | At the election of any registered serviceman made for each | ||||||
18 | fiscal year,
sales of service in which the aggregate annual | ||||||
19 | cost price of tangible
personal property transferred as an | ||||||
20 | incident to the sales of service is
less than 35%, or 75% in | ||||||
21 | the case of servicemen transferring prescription
drugs or | ||||||
22 | servicemen engaged in graphic arts production, of the aggregate
| ||||||
23 | annual total gross receipts from all sales of service, the tax | ||||||
24 | imposed by
this Act shall be based on the serviceman's cost | ||||||
25 | price of the tangible
personal property transferred as an | ||||||
26 | incident to the sale of those services.
|
| |||||||
| |||||||
1 | The tax shall be imposed at the rate of 1% on food prepared | ||||||
2 | for
immediate consumption and transferred incident to a sale of | ||||||
3 | service subject
to this Act or the Service Occupation Tax Act | ||||||
4 | by an entity licensed under
the Hospital Licensing Act, the | ||||||
5 | Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD | ||||||
6 | Act, the Specialized Mental Health Rehabilitation Act of 2013, | ||||||
7 | or the
Child Care
Act of 1969. The tax shall
also be imposed at | ||||||
8 | the rate of 1% on food for human consumption that is to be
| ||||||
9 | consumed off the premises where it is sold (other than | ||||||
10 | alcoholic beverages, food consisting of or infused with adult | ||||||
11 | use cannabis,
soft drinks, and food that has been prepared for | ||||||
12 | immediate consumption and is
not otherwise included in this | ||||||
13 | paragraph) and prescription and nonprescription
medicines, | ||||||
14 | drugs, medical appliances, products classified as Class III | ||||||
15 | medical devices by the United States Food and Drug | ||||||
16 | Administration that are used for cancer treatment pursuant to a | ||||||
17 | prescription, as well as any accessories and components related | ||||||
18 | to those devices, modifications to a motor vehicle for the
| ||||||
19 | purpose of rendering it usable by a person with a disability, | ||||||
20 | and insulin, blood sugar urine testing
materials,
syringes, and | ||||||
21 | needles used by human diabetics , for
human use . For the | ||||||
22 | purposes of this Section, until September 1, 2009: the term | ||||||
23 | "soft drinks" means any
complete, finished, ready-to-use, | ||||||
24 | non-alcoholic drink, whether carbonated or
not, including but | ||||||
25 | not limited to soda water, cola, fruit juice, vegetable
juice, | ||||||
26 | carbonated water, and all other preparations commonly known as |
| |||||||
| |||||||
1 | soft
drinks of whatever kind or description that are contained | ||||||
2 | in any closed or
sealed bottle, can, carton, or container, | ||||||
3 | regardless of size; but "soft drinks"
does not include coffee, | ||||||
4 | tea, non-carbonated water, infant formula, milk or
milk | ||||||
5 | products as defined in the Grade A Pasteurized Milk and Milk | ||||||
6 | Products Act,
or drinks containing 50% or more natural fruit or | ||||||
7 | vegetable juice.
| ||||||
8 | Notwithstanding any other provisions of this
Act, | ||||||
9 | beginning September 1, 2009, "soft drinks" means non-alcoholic | ||||||
10 | beverages that contain natural or artificial sweeteners. "Soft | ||||||
11 | drinks" do not include beverages that contain milk or milk | ||||||
12 | products, soy, rice or similar milk substitutes, or greater | ||||||
13 | than 50% of vegetable or fruit juice by volume. | ||||||
14 | Until August 1, 2009, and notwithstanding any other | ||||||
15 | provisions of this Act, "food for human
consumption that is to | ||||||
16 | be consumed off the premises where it is sold" includes
all | ||||||
17 | food sold through a vending machine, except soft drinks and | ||||||
18 | food products
that are dispensed hot from a vending machine, | ||||||
19 | regardless of the location of
the vending machine. Beginning | ||||||
20 | August 1, 2009, and notwithstanding any other provisions of | ||||||
21 | this Act, "food for human consumption that is to be consumed | ||||||
22 | off the premises where it is sold" includes all food sold | ||||||
23 | through a vending machine, except soft drinks, candy, and food | ||||||
24 | products that are dispensed hot from a vending machine, | ||||||
25 | regardless of the location of the vending machine.
| ||||||
26 | Notwithstanding any other provisions of this
Act, |
| |||||||
| |||||||
1 | beginning September 1, 2009, "food for human consumption that | ||||||
2 | is to be consumed off the premises where
it is sold" does not | ||||||
3 | include candy. For purposes of this Section, "candy" means a | ||||||
4 | preparation of sugar, honey, or other natural or artificial | ||||||
5 | sweeteners in combination with chocolate, fruits, nuts or other | ||||||
6 | ingredients or flavorings in the form of bars, drops, or | ||||||
7 | pieces. "Candy" does not include any preparation that contains | ||||||
8 | flour or requires refrigeration. | ||||||
9 | Notwithstanding any other provisions of this
Act, | ||||||
10 | beginning September 1, 2009, "nonprescription medicines and | ||||||
11 | drugs" does not include grooming and hygiene products. For | ||||||
12 | purposes of this Section, "grooming and hygiene products" | ||||||
13 | includes, but is not limited to, soaps and cleaning solutions, | ||||||
14 | shampoo, toothpaste, mouthwash, antiperspirants, and sun tan | ||||||
15 | lotions and screens, unless those products are available by | ||||||
16 | prescription only, regardless of whether the products meet the | ||||||
17 | definition of "over-the-counter-drugs". For the purposes of | ||||||
18 | this paragraph, "over-the-counter-drug" means a drug for human | ||||||
19 | use that contains a label that identifies the product as a drug | ||||||
20 | as required by 21 C.F.R. § 201.66. The "over-the-counter-drug" | ||||||
21 | label 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 |
| |||||||
| |||||||
1 | Act 98-122), "prescription and nonprescription medicines and | ||||||
2 | drugs" includes medical cannabis purchased from a registered | ||||||
3 | dispensing organization under the Compassionate Use of Medical | ||||||
4 | Cannabis Program Act. | ||||||
5 | As used in this Section, "adult use cannabis" means | ||||||
6 | cannabis subject to tax under the Cannabis Cultivation | ||||||
7 | Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and | ||||||
8 | does not include cannabis subject to tax under the | ||||||
9 | Compassionate Use of Medical Cannabis Program Act. | ||||||
10 | If the property that is acquired from a serviceman is | ||||||
11 | acquired outside
Illinois and used outside Illinois before | ||||||
12 | being brought to Illinois for use
here and is taxable under | ||||||
13 | this Act, the "selling price" on which the tax
is computed | ||||||
14 | shall be reduced by an amount that represents a reasonable
| ||||||
15 | allowance for depreciation for the period of prior out-of-state | ||||||
16 | use.
| ||||||
17 | (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19; | ||||||
18 | 101-593, eff. 12-4-19.) | ||||||
19 | Section 70-15. The Service Occupation Tax Act is amended by | ||||||
20 | changing 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 | ||||||
23 | Section,
the tax imposed by this Act is at the rate of 6.25% of | ||||||
24 | the "selling price",
as defined in Section 2 of the Service Use |
| |||||||
| |||||||
1 | Tax Act, of the tangible
personal property. For the purpose of | ||||||
2 | computing this tax, in no event
shall the "selling price" be | ||||||
3 | less than the cost price to the serviceman of
the tangible | ||||||
4 | personal property transferred. The selling price of each item
| ||||||
5 | of tangible personal property transferred as an incident of a | ||||||
6 | sale of
service may be shown as a distinct and separate item on | ||||||
7 | the serviceman's
billing to the service customer. If the | ||||||
8 | selling price is not so shown, the
selling price of the | ||||||
9 | tangible personal property is deemed to be 50% of the
| ||||||
10 | serviceman's entire billing to the service customer. When, | ||||||
11 | however, a
serviceman contracts to design, develop, and produce | ||||||
12 | special order machinery or
equipment, the tax imposed by this | ||||||
13 | Act shall be based on the serviceman's
cost price of the | ||||||
14 | tangible personal property transferred incident to the
| ||||||
15 | completion of the contract.
| ||||||
16 | Beginning on July 1, 2000 and through December 31, 2000, | ||||||
17 | with respect to
motor fuel, as defined in Section 1.1 of the | ||||||
18 | Motor Fuel Tax
Law, and gasohol, as defined in Section 3-40 of | ||||||
19 | the 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 | ||||||
21 | tax imposed
by this Act shall apply to (i) 70% of the cost | ||||||
22 | price of property
transferred as
an incident to the sale of | ||||||
23 | service on or after January 1, 1990, and before
July 1, 2003, | ||||||
24 | (ii) 80% of the selling price of property transferred as an
| ||||||
25 | incident to the sale of service on or after July
1, 2003 and on | ||||||
26 | or before July 1, 2017, and (iii) 100%
of
the cost price
|
| |||||||
| |||||||
1 | thereafter.
If, at any time, however, the tax under this Act on | ||||||
2 | sales of gasohol, as
defined in
the Use Tax Act, is imposed at | ||||||
3 | the rate of 1.25%, then the
tax imposed by this Act applies to | ||||||
4 | 100% of the proceeds of sales of gasohol
made during that time.
| ||||||
5 | With respect to majority blended ethanol fuel, as defined | ||||||
6 | in the Use Tax Act,
the
tax
imposed by this Act does not apply | ||||||
7 | to the selling price of property transferred
as an incident to | ||||||
8 | the sale of service on or after July 1, 2003 and on or before
| ||||||
9 | December 31, 2023 but applies to 100% of the selling price | ||||||
10 | thereafter.
| ||||||
11 | With respect to biodiesel blends, as defined in the Use Tax | ||||||
12 | Act, with no less
than 1% and no
more than 10% biodiesel, the | ||||||
13 | tax imposed by this Act
applies to (i) 80% of the selling price | ||||||
14 | of property transferred as an incident
to the sale of service | ||||||
15 | on 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, | ||||||
17 | at any time, however, the tax under this Act on sales of | ||||||
18 | biodiesel blends,
as
defined in the Use Tax Act, with no less | ||||||
19 | than 1% and no more than 10% biodiesel
is imposed at the rate | ||||||
20 | of 1.25%, then the
tax imposed by this Act applies to 100% of | ||||||
21 | the proceeds of sales of biodiesel
blends with no less than 1% | ||||||
22 | and no more than 10% biodiesel
made
during that time.
| ||||||
23 | With respect to 100% biodiesel, as defined in the Use Tax | ||||||
24 | Act, and biodiesel
blends, as defined in the Use Tax Act, with
| ||||||
25 | more than 10% but no more than 99% biodiesel material, the tax | ||||||
26 | imposed by this
Act
does not apply to the proceeds of the |
| |||||||
| |||||||
1 | selling price of property transferred
as an incident to the | ||||||
2 | sale of service on or after July 1, 2003 and on or before
| ||||||
3 | December 31, 2023 but applies to 100% of the selling price | ||||||
4 | thereafter.
| ||||||
5 | At the election of any registered serviceman made for each | ||||||
6 | fiscal year,
sales of service in which the aggregate annual | ||||||
7 | cost price of tangible
personal property transferred as an | ||||||
8 | incident to the sales of service is
less than 35%, or 75% in | ||||||
9 | the case of servicemen transferring prescription
drugs or | ||||||
10 | servicemen engaged in graphic arts production, of the aggregate
| ||||||
11 | annual total gross receipts from all sales of service, the tax | ||||||
12 | imposed by
this Act shall be based on the serviceman's cost | ||||||
13 | price of the tangible
personal property transferred incident to | ||||||
14 | the sale of those services.
| ||||||
15 | The tax shall be imposed at the rate of 1% on food prepared | ||||||
16 | for
immediate consumption and transferred incident to a sale of | ||||||
17 | service subject
to this Act or the Service Occupation Tax Act | ||||||
18 | by an entity licensed under
the Hospital Licensing Act, the | ||||||
19 | Nursing Home Care Act, the ID/DD Community Care Act, the MC/DD | ||||||
20 | Act, the Specialized Mental Health Rehabilitation Act of 2013, | ||||||
21 | or the
Child Care Act of 1969. The tax shall
also be imposed at | ||||||
22 | the rate of 1% on food for human consumption that is
to be | ||||||
23 | consumed off the
premises where it is sold (other than | ||||||
24 | alcoholic beverages, food consisting of or infused with adult | ||||||
25 | use cannabis, soft drinks, and
food that has been prepared for | ||||||
26 | immediate consumption and is not
otherwise included in this |
| |||||||
| |||||||
1 | paragraph) and prescription and
nonprescription medicines, | ||||||
2 | drugs, medical appliances, products classified as Class III | ||||||
3 | medical devices by the United States Food and Drug | ||||||
4 | Administration that are used for cancer treatment pursuant to a | ||||||
5 | prescription, as well as any accessories and components related | ||||||
6 | to those devices, modifications to a motor
vehicle for the | ||||||
7 | purpose of rendering it usable by a person with a disability, | ||||||
8 | and
insulin, blood sugar urine testing materials, syringes, and | ||||||
9 | needles used by human diabetics , for
human use . For the | ||||||
10 | purposes of this Section, until September 1, 2009: the term | ||||||
11 | "soft drinks" means any
complete, finished, ready-to-use, | ||||||
12 | non-alcoholic drink, whether carbonated or
not, including but | ||||||
13 | not limited to soda water, cola, fruit juice, vegetable
juice, | ||||||
14 | carbonated water, and all other preparations commonly known as | ||||||
15 | soft
drinks of whatever kind or description that are contained | ||||||
16 | in any closed or
sealed can, carton, or container, regardless | ||||||
17 | of size; but "soft drinks" does not
include coffee, tea, | ||||||
18 | non-carbonated water, infant formula, milk or milk
products as | ||||||
19 | defined in the Grade A Pasteurized Milk and Milk Products Act, | ||||||
20 | or
drinks containing 50% or more natural fruit or vegetable | ||||||
21 | juice.
| ||||||
22 | Notwithstanding any other provisions of this
Act, | ||||||
23 | beginning September 1, 2009, "soft drinks" means non-alcoholic | ||||||
24 | beverages that contain natural or artificial sweeteners. "Soft | ||||||
25 | drinks" do not include beverages that contain milk or milk | ||||||
26 | products, soy, rice or similar milk substitutes, or greater |
| |||||||
| |||||||
1 | than 50% of vegetable or fruit juice by volume. | ||||||
2 | Until August 1, 2009, and notwithstanding any other | ||||||
3 | provisions of this Act, "food for human consumption
that is to | ||||||
4 | be consumed off the premises where it is sold" includes all | ||||||
5 | food
sold through a vending machine, except soft drinks and | ||||||
6 | food products that are
dispensed hot from a vending machine, | ||||||
7 | regardless of the location of the vending
machine. Beginning | ||||||
8 | August 1, 2009, and notwithstanding any other provisions of | ||||||
9 | this Act, "food for human consumption that is to be consumed | ||||||
10 | off the premises where it is sold" includes all food sold | ||||||
11 | through a vending machine, except soft drinks, candy, and food | ||||||
12 | products that are dispensed hot from a vending machine, | ||||||
13 | regardless of the location of the vending machine.
| ||||||
14 | Notwithstanding any other provisions of this
Act, | ||||||
15 | beginning September 1, 2009, "food for human consumption that | ||||||
16 | is to be consumed off the premises where
it is sold" does not | ||||||
17 | include candy. For purposes of this Section, "candy" means a | ||||||
18 | preparation of sugar, honey, or other natural or artificial | ||||||
19 | sweeteners in combination with chocolate, fruits, nuts or other | ||||||
20 | ingredients or flavorings in the form of bars, drops, or | ||||||
21 | pieces. "Candy" does not include any preparation that contains | ||||||
22 | flour or requires refrigeration. | ||||||
23 | Notwithstanding any other provisions of this
Act, | ||||||
24 | beginning September 1, 2009, "nonprescription medicines and | ||||||
25 | drugs" does not include grooming and hygiene products. For | ||||||
26 | purposes of this Section, "grooming and hygiene products" |
| |||||||
| |||||||
1 | includes, but is not limited to, soaps and cleaning solutions, | ||||||
2 | shampoo, toothpaste, mouthwash, antiperspirants, and sun tan | ||||||
3 | lotions and screens, unless those products are available by | ||||||
4 | prescription only, regardless of whether the products meet the | ||||||
5 | definition of "over-the-counter-drugs". For the purposes of | ||||||
6 | this paragraph, "over-the-counter-drug" means a drug for human | ||||||
7 | use that contains a label that identifies the product as a drug | ||||||
8 | as required by 21 C.F.R. § 201.66. The "over-the-counter-drug" | ||||||
9 | label 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 | ||||||
15 | Act 98-122), "prescription and nonprescription medicines and | ||||||
16 | drugs" includes medical cannabis purchased from a registered | ||||||
17 | dispensing organization under the Compassionate Use of Medical | ||||||
18 | Cannabis Program Act. | ||||||
19 | As used in this Section, "adult use cannabis" means | ||||||
20 | cannabis subject to tax under the Cannabis Cultivation | ||||||
21 | Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and | ||||||
22 | does not include cannabis subject to tax under the | ||||||
23 | Compassionate Use of Medical Cannabis Program Act. | ||||||
24 | (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19; | ||||||
25 | 101-593, eff. 12-4-19.) |
| |||||||
| |||||||
1 | Section 70-20. The Retailers' Occupation Tax Act is amended | ||||||
2 | by changing Section 2-10 as follows:
| ||||||
3 | (35 ILCS 120/2-10)
| ||||||
4 | Sec. 2-10. Rate of tax. Unless otherwise provided in this | ||||||
5 | Section,
the tax imposed by this Act is at the rate of 6.25% of | ||||||
6 | gross receipts
from sales of tangible personal property made in | ||||||
7 | the course of business.
| ||||||
8 | Beginning on July 1, 2000 and through December 31, 2000, | ||||||
9 | with respect to
motor fuel, as defined in Section 1.1 of the | ||||||
10 | Motor Fuel Tax
Law, and gasohol, as defined in Section 3-40 of | ||||||
11 | the Use Tax Act, the tax is
imposed at the rate of 1.25%.
| ||||||
12 | Beginning on August 6, 2010 through August 15, 2010, with | ||||||
13 | respect to sales tax holiday items as defined in Section 2-8 of | ||||||
14 | this Act, the
tax is imposed at the rate of 1.25%. | ||||||
15 | Within 14 days after the effective date of this amendatory | ||||||
16 | Act of the 91st
General Assembly, each retailer of motor fuel | ||||||
17 | and gasohol shall cause the
following notice to be posted in a | ||||||
18 | prominently visible place on each retail
dispensing device that | ||||||
19 | is used to dispense motor
fuel or gasohol in the State of | ||||||
20 | Illinois: "As of July 1, 2000, the State of
Illinois has | ||||||
21 | eliminated the State's share of sales tax on motor fuel and
| ||||||
22 | gasohol through December 31, 2000. The price on this pump | ||||||
23 | should reflect the
elimination of the tax." The notice shall be | ||||||
24 | printed in bold print on a sign
that is no smaller than 4 | ||||||
25 | inches by 8 inches. The sign shall be clearly
visible to |
| |||||||
| |||||||
1 | customers. Any retailer who fails to post or maintain a | ||||||
2 | required
sign through December 31, 2000 is guilty of a petty | ||||||
3 | offense for which the fine
shall be $500 per day per each | ||||||
4 | retail premises where a violation occurs.
| ||||||
5 | With respect to gasohol, as defined in the Use Tax Act, the | ||||||
6 | tax imposed
by this Act applies to (i) 70% of the proceeds of | ||||||
7 | sales made on or after
January 1, 1990, and before July 1, | ||||||
8 | 2003, (ii) 80% of the proceeds of
sales made on or after July | ||||||
9 | 1, 2003 and on or before July 1, 2017, and (iii) 100% of the | ||||||
10 | proceeds of sales
made thereafter.
If, at any time, however, | ||||||
11 | the tax under this Act on sales of gasohol, as
defined in
the | ||||||
12 | Use Tax Act, is imposed at the rate of 1.25%, then the
tax | ||||||
13 | imposed by this Act applies to 100% of the proceeds of sales of | ||||||
14 | gasohol
made during that time.
| ||||||
15 | With respect to majority blended ethanol fuel, as defined | ||||||
16 | in the Use Tax Act,
the
tax
imposed by this Act does not apply | ||||||
17 | to the proceeds of sales made on or after
July 1, 2003 and on or | ||||||
18 | before December 31, 2023 but applies to 100% of the
proceeds of | ||||||
19 | sales made thereafter.
| ||||||
20 | With respect to biodiesel blends, as defined in the Use Tax | ||||||
21 | Act, with no less
than 1% and no
more than 10% biodiesel, the | ||||||
22 | tax imposed by this Act
applies to (i) 80% of the proceeds of | ||||||
23 | sales made on or after July 1, 2003
and on or before December | ||||||
24 | 31, 2018 and (ii) 100% of the
proceeds of sales made | ||||||
25 | thereafter.
If, at any time, however, the tax under this Act on | ||||||
26 | sales of biodiesel blends,
as
defined in the Use Tax Act, with |
| |||||||
| |||||||
1 | no less than 1% and no more than 10% biodiesel
is imposed at | ||||||
2 | the rate of 1.25%, then the
tax imposed by this Act applies to | ||||||
3 | 100% of the proceeds of sales of biodiesel
blends with no less | ||||||
4 | than 1% and no more than 10% biodiesel
made
during that time.
| ||||||
5 | With respect to 100% biodiesel, as defined in the Use Tax | ||||||
6 | Act, and biodiesel
blends, as defined in the Use Tax Act, with
| ||||||
7 | more than 10% but no more than 99% biodiesel, the tax imposed | ||||||
8 | by this Act
does not apply to the proceeds of sales made on or | ||||||
9 | after July 1, 2003
and on or before December 31, 2023 but | ||||||
10 | applies to 100% of the
proceeds of sales made thereafter.
| ||||||
11 | With respect to food for human consumption that is to be | ||||||
12 | consumed off the
premises where it is sold (other than | ||||||
13 | alcoholic beverages, food consisting of or infused with adult | ||||||
14 | use cannabis, soft drinks, and
food that has been prepared for | ||||||
15 | immediate consumption) and prescription and
nonprescription | ||||||
16 | medicines, drugs, medical appliances, products classified as | ||||||
17 | Class III medical devices by the United States Food and Drug | ||||||
18 | Administration that are used for cancer treatment pursuant to a | ||||||
19 | prescription, as well as any accessories and components related | ||||||
20 | to those devices, modifications to a motor
vehicle for the | ||||||
21 | purpose of rendering it usable by a person with a disability, | ||||||
22 | and
insulin, blood sugar urine testing materials, syringes, and | ||||||
23 | needles used by human diabetics, for
human use, the tax is | ||||||
24 | imposed at the rate of 1%. For the purposes of this
Section, | ||||||
25 | until September 1, 2009: the term "soft drinks" means any | ||||||
26 | complete, finished, ready-to-use,
non-alcoholic drink, whether |
| |||||||
| |||||||
1 | carbonated or not, including but not limited to
soda water, | ||||||
2 | cola, fruit juice, vegetable juice, carbonated water, and all | ||||||
3 | other
preparations commonly known as soft drinks of whatever | ||||||
4 | kind or description that
are contained in any closed or sealed | ||||||
5 | bottle, can, carton, or container,
regardless of size; but | ||||||
6 | "soft drinks" does not include coffee, tea, non-carbonated
| ||||||
7 | water, infant formula, milk or milk products as defined in the | ||||||
8 | Grade A
Pasteurized Milk and Milk Products Act, or drinks | ||||||
9 | containing 50% or more
natural fruit or vegetable juice.
| ||||||
10 | Notwithstanding any other provisions of this
Act, | ||||||
11 | beginning September 1, 2009, "soft drinks" means non-alcoholic | ||||||
12 | beverages that contain natural or artificial sweeteners. "Soft | ||||||
13 | drinks" do not include beverages that contain milk or milk | ||||||
14 | products, soy, rice or similar milk substitutes, or greater | ||||||
15 | than 50% of vegetable or fruit juice by volume. | ||||||
16 | Until August 1, 2009, and notwithstanding any other | ||||||
17 | provisions of this
Act, "food for human consumption that is to | ||||||
18 | be consumed off the premises where
it is sold" includes all | ||||||
19 | food sold through a vending machine, except soft
drinks and | ||||||
20 | food products that are dispensed hot from a vending machine,
| ||||||
21 | regardless of the location of the vending machine. Beginning | ||||||
22 | August 1, 2009, and notwithstanding any other provisions of | ||||||
23 | this Act, "food for human consumption that is to be consumed | ||||||
24 | off the premises where it is sold" includes all food sold | ||||||
25 | through a vending machine, except soft drinks, candy, and food | ||||||
26 | products that are dispensed hot from a vending machine, |
| |||||||
| |||||||
1 | regardless of the location of the vending machine.
| ||||||
2 | Notwithstanding any other provisions of this
Act, | ||||||
3 | beginning September 1, 2009, "food for human consumption that | ||||||
4 | is to be consumed off the premises where
it is sold" does not | ||||||
5 | include candy. For purposes of this Section, "candy" means a | ||||||
6 | preparation of sugar, honey, or other natural or artificial | ||||||
7 | sweeteners in combination with chocolate, fruits, nuts or other | ||||||
8 | ingredients or flavorings in the form of bars, drops, or | ||||||
9 | pieces. "Candy" does not include any preparation that contains | ||||||
10 | flour or requires refrigeration. | ||||||
11 | Notwithstanding any other provisions of this
Act, | ||||||
12 | beginning September 1, 2009, "nonprescription medicines and | ||||||
13 | drugs" does not include grooming and hygiene products. For | ||||||
14 | purposes of this Section, "grooming and hygiene products" | ||||||
15 | includes, but is not limited to, soaps and cleaning solutions, | ||||||
16 | shampoo, toothpaste, mouthwash, antiperspirants, and sun tan | ||||||
17 | lotions and screens, unless those products are available by | ||||||
18 | prescription only, regardless of whether the products meet the | ||||||
19 | definition of "over-the-counter-drugs". For the purposes of | ||||||
20 | this paragraph, "over-the-counter-drug" means a drug for human | ||||||
21 | use that contains a label that identifies the product as a drug | ||||||
22 | as required by 21 C.F.R. § 201.66. The "over-the-counter-drug" | ||||||
23 | label 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, |
| |||||||
| |||||||
1 | substance or preparation.
| ||||||
2 | Beginning on the effective date of this amendatory Act of | ||||||
3 | the 98th General Assembly, "prescription and nonprescription | ||||||
4 | medicines and drugs" includes medical cannabis purchased from a | ||||||
5 | registered dispensing organization under the Compassionate Use | ||||||
6 | of Medical Cannabis Program Act. | ||||||
7 | As used in this Section, "adult use cannabis" means | ||||||
8 | cannabis subject to tax under the Cannabis Cultivation | ||||||
9 | Privilege Tax Law and the Cannabis Purchaser Excise Tax Law and | ||||||
10 | does not include cannabis subject to tax under the | ||||||
11 | Compassionate Use of Medical Cannabis Program Act. | ||||||
12 | (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19; | ||||||
13 | 101-593, eff. 12-4-19.)
| ||||||
14 | Article 75. | ||||||
15 | Section 75-5. The Illinois Public Aid Code is amended by | ||||||
16 | changing 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 | ||||||
20 | children need child
care in order to work. Child care is | ||||||
21 | expensive and families with low incomes,
including those who | ||||||
22 | are transitioning from welfare to work, often struggle to
pay | ||||||
23 | the costs of day care. The
General Assembly understands the |
| |||||||
| |||||||
1 | importance of helping low-income working
families become and | ||||||
2 | remain self-sufficient. The General Assembly also believes
| ||||||
3 | that it is the responsibility of families to share in the costs | ||||||
4 | of child care.
It is also the preference of the General | ||||||
5 | Assembly that all working poor
families should be treated | ||||||
6 | equally, regardless of their welfare status.
| ||||||
7 | (b) To the extent resources permit, the Illinois Department | ||||||
8 | shall provide
child care services to parents or other relatives | ||||||
9 | as defined by rule who are
working or participating in | ||||||
10 | employment or Department approved
education or training | ||||||
11 | programs. At a minimum, the Illinois Department shall
cover the | ||||||
12 | following 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 |
| |||||||
| |||||||
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 | ||||||
18 | eligibility, the
application process, and the types, amounts, | ||||||
19 | and duration of services.
Eligibility for
child care benefits | ||||||
20 | and the amount of child care provided may vary based on
family | ||||||
21 | size, income,
and other factors as specified by rule.
| ||||||
22 | The Department shall update the Child Care Assistance | ||||||
23 | Program Eligibility Calculator posted on its website to include | ||||||
24 | a question on whether a family is applying for child care | ||||||
25 | assistance for the first time or is applying for a | ||||||
26 | redetermination of eligibility. |
| |||||||
| |||||||
1 | A family's eligibility for child care services shall be | ||||||
2 | redetermined no sooner than 12 months following the initial | ||||||
3 | determination or most recent redetermination. During the | ||||||
4 | 12-month periods, the family shall remain eligible for child | ||||||
5 | care services regardless of (i) a change in family income, | ||||||
6 | unless family income exceeds 85% of State median income, or | ||||||
7 | (ii) a temporary change in the ongoing status of the parents or | ||||||
8 | other relatives, as defined by rule, as working or attending a | ||||||
9 | job training or educational program. | ||||||
10 | In determining income eligibility for child care benefits, | ||||||
11 | the Department
annually, at the beginning of each fiscal year, | ||||||
12 | shall
establish, by rule, one income threshold for each family | ||||||
13 | size, in relation to
percentage of State median income for a | ||||||
14 | family of that size, that makes
families with incomes below the | ||||||
15 | specified threshold eligible for assistance
and families with | ||||||
16 | incomes above the specified threshold ineligible for
| ||||||
17 | assistance. Through and including fiscal year 2007, the | ||||||
18 | specified threshold must be no less than 50% of the
| ||||||
19 | then-current State median income for each family size. | ||||||
20 | Beginning in fiscal year 2008, the specified threshold must be | ||||||
21 | no less than 185% of the then-current federal poverty level for | ||||||
22 | each family size. Notwithstanding any other provision of law or | ||||||
23 | administrative rule to the contrary, beginning in fiscal year | ||||||
24 | 2019, the specified threshold for working families with very | ||||||
25 | low incomes as defined by rule must be no less than 185% of the | ||||||
26 | then-current federal poverty level for each family size.
|
| |||||||
| |||||||
1 | In determining eligibility for
assistance, the Department | ||||||
2 | shall not give preference to any category of
recipients
or give | ||||||
3 | preference to individuals based on their receipt of benefits | ||||||
4 | under this
Code.
| ||||||
5 | Nothing in this Section shall be
construed as conferring | ||||||
6 | entitlement status to eligible families.
| ||||||
7 | The Illinois
Department is authorized to lower income | ||||||
8 | eligibility ceilings, raise parent
co-payments, create waiting | ||||||
9 | lists, or take such other actions during a fiscal
year as are | ||||||
10 | necessary to ensure that child care benefits paid under this
| ||||||
11 | Article do not exceed the amounts appropriated for those child | ||||||
12 | care benefits.
These changes may be accomplished by emergency | ||||||
13 | rule under Section 5-45 of the
Illinois Administrative | ||||||
14 | Procedure Act, except that the limitation on the number
of | ||||||
15 | emergency rules that may be adopted in a 24-month period shall | ||||||
16 | not apply.
| ||||||
17 | The Illinois Department may contract with other State | ||||||
18 | agencies or child care
organizations for the administration of | ||||||
19 | child care services.
| ||||||
20 | (c) Payment shall be made for child care that otherwise | ||||||
21 | meets the
requirements of this Section and applicable standards | ||||||
22 | of State and local
law and regulation, including any | ||||||
23 | requirements the Illinois Department
promulgates by rule in | ||||||
24 | addition to the licensure
requirements
promulgated by the | ||||||
25 | Department of Children and Family Services and Fire
Prevention | ||||||
26 | and Safety requirements promulgated by the Office of the State
|
| |||||||
| |||||||
1 | Fire 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 | ||||||
13 | Illinois Public Labor Relations Act, child and day care home | ||||||
14 | providers, including licensed and license exempt, | ||||||
15 | participating in the Department's child care assistance | ||||||
16 | program shall be considered to be public employees and the | ||||||
17 | State of Illinois shall be considered to be their employer as | ||||||
18 | of January 1, 2006 (the effective date of Public Act 94-320), | ||||||
19 | but not before. The State shall engage in collective bargaining | ||||||
20 | with an exclusive representative of child and day care home | ||||||
21 | providers participating in the child care assistance program | ||||||
22 | concerning their terms and conditions of employment that are | ||||||
23 | within the State's control. Nothing in this subsection shall be | ||||||
24 | understood to limit the right of families receiving services | ||||||
25 | defined in this Section to select child and day care home | ||||||
26 | providers or supervise them within the limits of this Section. |
| |||||||
| |||||||
1 | The State shall not be considered to be the employer of child | ||||||
2 | and day care home providers for any purposes not specifically | ||||||
3 | provided in Public Act 94-320, including, but not limited to, | ||||||
4 | purposes of vicarious liability in tort and purposes of | ||||||
5 | statutory retirement or health insurance benefits. Child and | ||||||
6 | day care home providers shall not be covered by the State | ||||||
7 | Employees Group Insurance Act of 1971. | ||||||
8 | In according child and day care home providers and their | ||||||
9 | selected representative rights under the Illinois Public Labor | ||||||
10 | Relations Act, the State intends that the State action | ||||||
11 | exemption to application of federal and State antitrust laws be | ||||||
12 | fully available to the extent that their activities are | ||||||
13 | authorized by Public Act 94-320.
| ||||||
14 | (d) The Illinois Department shall establish, by rule, a | ||||||
15 | co-payment scale that provides for cost sharing by families | ||||||
16 | that receive
child care services, including parents whose only | ||||||
17 | income is from
assistance under this Code. The co-payment shall | ||||||
18 | be based on family income and family size and may be based on | ||||||
19 | other factors as appropriate. Co-payments may be waived for | ||||||
20 | families whose incomes are at or below the federal poverty | ||||||
21 | level.
| ||||||
22 | (d-5) The Illinois Department, in consultation with its | ||||||
23 | Child Care and Development Advisory Council, shall develop a | ||||||
24 | plan to revise the child care assistance program's co-payment | ||||||
25 | scale. The plan shall be completed no later than February 1, | ||||||
26 | 2008, and shall include: |
| |||||||
| |||||||
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 | ||||||
16 | paid for the
various types of child care. Child care may be | ||||||
17 | provided 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 |
| |||||||
| |||||||
1 | of Public Act 100-587), the Department of Human Services shall | ||||||
2 | establish rates for child care providers that are no less than | ||||||
3 | the rates in effect on January 1, 2018 increased by 4.26%. | ||||||
4 | (f-5) (Blank). | ||||||
5 | (g) Families eligible for assistance under this Section | ||||||
6 | shall 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; | ||||||
23 | 100-860, eff. 2-14-19; 100-909, eff. 10-1-18; 100-916, eff. | ||||||
24 | 8-17-18; 101-81, eff. 7-12-19.)
| ||||||
25 | Article 80. |
| |||||||
| |||||||
1 | Section 80-5. The Employee Sick Leave Act is amended by | ||||||
2 | changing 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 | ||||||
7 | time available to an employee as provided through an employment | ||||||
8 | benefit plan or paid time off policy to be used as a result of | ||||||
9 | absence from work due to personal illness, injury, or medical | ||||||
10 | appointment or for the personal care of a parent, | ||||||
11 | mother-in-law, father-in-law, grandparent, or stepparent . An | ||||||
12 | employment benefit plan or paid time off policy does not | ||||||
13 | include long term disability, short term disability, an | ||||||
14 | insurance 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 | ||||||
19 | provided by the employer for absences due to an illness, | ||||||
20 | injury, or medical appointment of the employee's child, | ||||||
21 | stepchild, spouse, domestic partner, sibling, parent, | ||||||
22 | mother-in-law, father-in-law, grandchild, grandparent, or | ||||||
23 | stepparent, or for the personal care of a parent, |
| |||||||
| |||||||
1 | mother-in-law, father-in-law, grandparent, or stepparent on | ||||||
2 | the same terms upon which the employee is able to use personal | ||||||
3 | sick leave benefits for the employee's own illness or injury. | ||||||
4 | An employer may request written verification of the employee's | ||||||
5 | absence from a health care professional if such verification is | ||||||
6 | required under the employer's employment benefit plan or paid | ||||||
7 | time off policy. | ||||||
8 | (b) An employer may limit the use of personal sick leave | ||||||
9 | benefits provided by the employer for absences due to an | ||||||
10 | illness, injury, or medical appointment of the employee's | ||||||
11 | child, stepchild, spouse, domestic partner, sibling, parent, | ||||||
12 | mother-in-law, father-in-law, grandchild, grandparent, or | ||||||
13 | stepparent to an amount not less than the personal sick leave | ||||||
14 | that would be earned or accrued during 6 months at the | ||||||
15 | employee's then current rate of entitlement. For employers who | ||||||
16 | base personal sick leave benefits on an employee's years of | ||||||
17 | service instead of annual or monthly accrual, such employer may | ||||||
18 | limit the amount of sick leave to be used under this Act to | ||||||
19 | half of the employee's maximum annual grant. | ||||||
20 | (c) An employer who provides personal sick leave benefits | ||||||
21 | or a paid time off policy that would otherwise provide benefits | ||||||
22 | as required under subsections (a) and (b) shall not be required | ||||||
23 | to modify such benefits.
| ||||||
24 | (Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.) | ||||||
25 | Article 90. |
| |||||||
| |||||||
1 | Section 90-5. The Nursing Home Care Act is amended by | ||||||
2 | adding Section 3-206.06 as follows: | ||||||
3 | (210 ILCS 45/3-206.06 new) | ||||||
4 | Sec. 3-206.06. Testing for Legionnaires' disease. A | ||||||
5 | facility licensed under this Act must prove upon inspection by | ||||||
6 | the Department that it has provided testing for Legionnaires' | ||||||
7 | disease. The facility must also provide the results of that | ||||||
8 | testing to the Department. | ||||||
9 | Section 90-10. The Hospital Licensing Act is amended by | ||||||
10 | adding Section 6.29 as follows: | ||||||
11 | (210 ILCS 85/6.29 new) | ||||||
12 | Sec. 6.29. Testing for Legionnaires' disease. A hospital | ||||||
13 | licensed under this Act must prove upon inspection by the | ||||||
14 | Department that it has provided testing for Legionnaires' | ||||||
15 | disease. The hospital must also provide the results of that | ||||||
16 | testing to the Department. | ||||||
17 | Article 95. | ||||||
18 | Section 95-1. Short title. This Article may be cited as the | ||||||
19 | Child Trauma Counseling Act. References in this Article to | ||||||
20 | "this Act" mean this Article. |
| |||||||
| |||||||
1 | Section 95-5. Definitions. As used in this Act: | ||||||
2 | "Day care center" has the meaning given to that term in | ||||||
3 | Section 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 | ||||||
6 | counselor, as that term is defined in Section 10 of the | ||||||
7 | Professional Counselor and Clinical Professional Counselor | ||||||
8 | Licensing and Practice Act, who has experience in treating | ||||||
9 | childhood trauma or who has a certification relating to | ||||||
10 | treating 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 | ||||||
22 | parents or guardians of the child. | ||||||
23 | (b) A child is identified as needing trauma counseling | ||||||
24 | under subsection (a) if the child reports trauma to a day care |
| |||||||
| |||||||
1 | center or a school or a parent or guardian of the child or | ||||||
2 | employee of a day care center or a school reports that the | ||||||
3 | child has experienced trauma. | ||||||
4 | Section 95-15. Rules. | ||||||
5 | (a) The Department of Children and Family Services shall | ||||||
6 | adopt rules to implement this Act. The Department shall seek | ||||||
7 | recommendations and advice from the State Board of Education as | ||||||
8 | to adoption of the Department's rules as they relate to | ||||||
9 | schools. | ||||||
10 | (b) The Department of Financial and Professional | ||||||
11 | Regulation may adopt rules regarding the qualifications of | ||||||
12 | trauma counselors working with children under this Act.
| ||||||
13 | Section 95-90. The State Mandates Act is amended by adding | ||||||
14 | Section 8.45 as follows: | ||||||
15 | (30 ILCS 805/8.45 new) | ||||||
16 | Sec. 8.45. Exempt mandate. Notwithstanding Sections 6 and 8 | ||||||
17 | of this Act, no reimbursement by the State is required for the | ||||||
18 | implementation of any mandate created by the Child Trauma | ||||||
19 | Counseling Act. | ||||||
20 | Article 100. | ||||||
21 | Section 100-1. Short title. This Article may be cited as |
| |||||||
| |||||||
1 | the Special Commission on Gynecologic Cancers Act. | ||||||
2 | Section 100-5. Creation; members; duties; report. | ||||||
3 | (a) The Special Commission on Gynecologic Cancers is | ||||||
4 | created. 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 |
| |||||||
| |||||||
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 | ||||||
23 | compensation or reimbursement from the Commission. Members | ||||||
24 | shall select a Chair from among themselves and the Chair shall | ||||||
25 | set the meeting schedule. | ||||||
26 | (c) The Illinois Department of Public Health shall provide |
| |||||||
| |||||||
1 | administrative support to the Commission. | ||||||
2 | (d) The Commission is charged with the study of the | ||||||
3 | following: | ||||||
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 | ||||||
22 | General Assembly no later than December 31, 2021 and, upon the | ||||||
23 | filing of its report, is dissolved. | ||||||
24 | Section 100-90. Repeal. This Article is repealed on January | ||||||
25 | 1, 2023.
|
| |||||||
| |||||||
1 | Article 105. | ||||||
2 | Section 5. The Illinois Public Aid Code is amended by | ||||||
3 | changing 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 | ||||||
7 | and after July 1, 2020. | ||||||
8 | (a) To preserve and improve access to hospital services, | ||||||
9 | for hospital services rendered on and after July 1, 2020, the | ||||||
10 | Department shall, except for hospitals described in subsection | ||||||
11 | (b) of Section 5A-3, make payments to hospitals or require | ||||||
12 | capitated managed care organizations to make payments as set | ||||||
13 | forth in this Section. Payments under this Section are not due | ||||||
14 | and payable, however, until: (i) the methodologies described in | ||||||
15 | this Section are approved by the federal government in an | ||||||
16 | appropriate State Plan amendment or directed payment preprint; | ||||||
17 | and (ii) the assessment imposed under this Article is | ||||||
18 | determined to be a permissible tax under Title XIX of the | ||||||
19 | Social Security Act. In determining the hospital access | ||||||
20 | payments authorized under subsection (g) of this Section, if a | ||||||
21 | hospital ceases to qualify for payments from the pool, the | ||||||
22 | payments for all hospitals continuing to qualify for payments | ||||||
23 | from such pool shall be uniformly adjusted to fully expend the |
| |||||||
| |||||||
1 | aggregate net amount of the pool, with such adjustment being | ||||||
2 | effective on the first day of the second month following the | ||||||
3 | date the hospital ceases to receive payments from such pool. | ||||||
4 | (b) Amounts moved into claims-based rates and distributed | ||||||
5 | in accordance with Section 14-12 shall remain in those | ||||||
6 | claims-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 |
| |||||||
| |||||||
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 | ||||||
22 | hospital shall receive an annual payment equal to the amounts | ||||||
23 | below, to be paid in 12 equal installments on or before the | ||||||
24 | seventh State business day of each month, except that no | ||||||
25 | payment shall be due within 30 days after the later of the date | ||||||
26 | of notification of federal approval of the payment |
| |||||||
| |||||||
1 | methodologies required under this Section or any waiver | ||||||
2 | required under 42 CFR 433.68, at which time the sum of amounts | ||||||
3 | required under this Section prior to the date of notification | ||||||
4 | is 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 |
| |||||||
| |||||||
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 | ||||||
24 | organizations (MCOs) to make directed payments and | ||||||
25 | pass-through payments according to this Section. Each calendar | ||||||
26 | year, the Department shall require MCOs to pay the maximum |
| |||||||
| |||||||
1 | amount out of these funds as allowed as pass-through payments | ||||||
2 | under federal regulations. The Department shall require MCOs to | ||||||
3 | make such pass-through payments as specified in this Section. | ||||||
4 | The Department shall require the MCOs to pay the remaining | ||||||
5 | amounts as directed Payments as specified in this Section. The | ||||||
6 | Department shall issue payments to the Comptroller by the | ||||||
7 | seventh business day of each month for all MCOs that are | ||||||
8 | sufficient for MCOs to make the directed payments and | ||||||
9 | pass-through payments according to this Section. The | ||||||
10 | Department shall require the MCOs to make pass-through payments | ||||||
11 | and directed payments using electronic funds transfers (EFT), | ||||||
12 | if the hospital provides the information necessary to process | ||||||
13 | such EFTs, in accordance with directions provided monthly by | ||||||
14 | the Department, within 7 business days of the date the funds | ||||||
15 | are paid to the MCOs, as indicated by the "Paid Date" on the | ||||||
16 | website of the Office of the Comptroller if the funds are paid | ||||||
17 | by EFT and the MCOs have received directed payment | ||||||
18 | instructions. If funds are not paid through the Comptroller by | ||||||
19 | EFT, payment must be made within 7 business days of the date | ||||||
20 | actually received by the MCO. The MCO will be considered to | ||||||
21 | have paid the pass-through payments when the payment remittance | ||||||
22 | number is generated or the date the MCO sends the check to the | ||||||
23 | hospital, if EFT information is not supplied. If an MCO is late | ||||||
24 | in paying a pass-through payment or directed payment as | ||||||
25 | required under this Section (including any extensions granted | ||||||
26 | by the Department), it shall pay a penalty, unless waived by |
| |||||||
| |||||||
1 | the Department for reasonable cause, to the Department equal to | ||||||
2 | 5% of the amount of the pass-through payment or directed | ||||||
3 | payment not paid on or before the due date plus 5% of the | ||||||
4 | portion thereof remaining unpaid on the last day of each 30-day | ||||||
5 | period thereafter. Payments to MCOs that would be paid | ||||||
6 | consistent with actuarial certification and enrollment in the | ||||||
7 | absence of the increased capitation payments under this Section | ||||||
8 | shall not be reduced as a consequence of payments made under | ||||||
9 | this subsection. The Department shall publish and maintain on | ||||||
10 | its website for a period of no less than 8 calendar quarters, | ||||||
11 | the quarterly calculation of directed payments and | ||||||
12 | pass-through payments owed to each hospital from each MCO. All | ||||||
13 | calculations and reports shall be posted no later than the | ||||||
14 | first day of the quarter for which the payments are to be | ||||||
15 | issued. | ||||||
16 | (f)(1) For purposes of allocating the funds included in | ||||||
17 | capitation payments to MCOs, Illinois hospitals shall be | ||||||
18 | divided into the following classes as defined in administrative | ||||||
19 | rules: | ||||||
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. |
| |||||||
| |||||||
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 | ||||||
24 | assessed prior to the beginning of each calendar year and the | ||||||
25 | new class designation shall be effective January 1 of the next | ||||||
26 | year. The Department shall publish by rule the process for |
| |||||||
| |||||||
1 | establishing class determination. | ||||||
2 | (g) Fixed pool directed payments. Beginning July 1, 2020, | ||||||
3 | the Department shall issue payments to MCOs which shall be used | ||||||
4 | to issue directed payments to qualified Illinois safety-net | ||||||
5 | hospitals and critical access hospitals on a monthly basis in | ||||||
6 | accordance with this subsection. Prior to the beginning of each | ||||||
7 | Payout Quarter beginning July 1, 2020, the Department shall use | ||||||
8 | encounter claims data from the Determination Quarter, accepted | ||||||
9 | by the Department's Medicaid Management Information System for | ||||||
10 | inpatient and outpatient services rendered by safety-net | ||||||
11 | hospitals and critical access hospitals to determine a | ||||||
12 | quarterly 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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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, | ||||||
18 | the Department shall issue payments to MCOs which shall be used | ||||||
19 | to issue directed payments to Illinois hospitals not identified | ||||||
20 | in paragraph (g) on a monthly basis. Prior to the beginning of | ||||||
21 | each Payout Quarter beginning July 1, 2020, the Department | ||||||
22 | shall use encounter claims data from the Determination Quarter, | ||||||
23 | accepted by the Department's Medicaid Management Information | ||||||
24 | System for inpatient and outpatient services rendered by | ||||||
25 | hospitals in each hospital class identified in paragraph (f) | ||||||
26 | and not identified in paragraph (g). For the period July 1, |
| |||||||
| |||||||
1 | 2020 through December 2020, the Department shall direct MCOs to | ||||||
2 | make 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 |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
10 | the Department determines that the actual total hospital | ||||||
11 | utilization data that is used to calculate the fixed rate | ||||||
12 | directed payments is substantially different than anticipated | ||||||
13 | when the rates in this subsection were initially determined | ||||||
14 | (for unforeseeable circumstances such as the COVID-19 | ||||||
15 | pandemic), the Department may adjust the rates specified in | ||||||
16 | this subsection so that the total directed payments approximate | ||||||
17 | the total spending amount anticipated when the rates were | ||||||
18 | initially 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 |
| |||||||
| |||||||
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 | ||||||
13 | payments shall be recalculated in order to spend the additional | ||||||
14 | funds for directed payments that result from reduction in the | ||||||
15 | amount of pass-through payments allowed under federal | ||||||
16 | regulations. The additional funds for directed payments shall | ||||||
17 | be allocated proportionally to each class of hospitals based on | ||||||
18 | that 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. |
| |||||||
| |||||||
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 | ||||||
19 | Department shall notify each hospital of changes to the payment | ||||||
20 | methodologies in this Section, including, but not limited to, | ||||||
21 | changes in the fixed rate directed payment rates, the aggregate | ||||||
22 | pass-through payment amount for all hospitals, and the | ||||||
23 | hospital's pass-through payment amount for the upcoming | ||||||
24 | calendar year. | ||||||
25 | (l) Notwithstanding any other provisions of this Section, | ||||||
26 | the Department may adopt rules to change the methodology for |
| |||||||
| |||||||
1 | directed and pass-through payments as set forth in this | ||||||
2 | Section, but only to the extent necessary to obtain federal | ||||||
3 | approval of a necessary State Plan amendment or Directed | ||||||
4 | Payment Preprint or to otherwise conform to federal law or | ||||||
5 | federal regulation. | ||||||
6 | (m) As used in this subsection, "managed care organization" | ||||||
7 | or "MCO" means an entity which contracts with the Department to | ||||||
8 | provide services where payment for medical services is made on | ||||||
9 | a capitated basis, excluding contracted entities for dual | ||||||
10 | eligible or Department of Children and Family Services youth | ||||||
11 | populations.
| ||||||
12 | (n) In order to address the escalating infant mortality | ||||||
13 | rates among minority communities in Illinois, the State shall, | ||||||
14 | subject to appropriation, create a pool of funding of at least | ||||||
15 | $50,000,000 annually to be dispersed among community | ||||||
16 | safety-net hospitals that maintain perinatal designation from | ||||||
17 | the Department of Public Health. The funding shall be used to | ||||||
18 | preserve or enhance OB/GYN services or other specialty services | ||||||
19 | at 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 | ||||||
23 | the Racial Impact Note Act. |
| |||||||
| |||||||
1 | Section 110-5. Racial impact note. | ||||||
2 | (a) Every bill which has or could have a disparate impact | ||||||
3 | on racial and ethnic minorities, upon the request of any | ||||||
4 | member, shall have prepared for it, before second reading in | ||||||
5 | the house of introduction, a brief explanatory statement or | ||||||
6 | note that shall include a reliable estimate of the anticipated | ||||||
7 | impact on those racial and ethnic minorities likely to be | ||||||
8 | impacted by the bill. Each racial impact note must include, for | ||||||
9 | racial and ethnic minorities for which data are available: (i) | ||||||
10 | an estimate of how the proposed legislation would impact racial | ||||||
11 | and ethnic minorities; (ii) a statement of the methodologies | ||||||
12 | and assumptions used in preparing the estimate; (iii) an | ||||||
13 | estimate of the racial and ethnic composition of the population | ||||||
14 | who may be impacted by the proposed legislation, including | ||||||
15 | those persons who may be negatively impacted and those persons | ||||||
16 | who may benefit from the proposed legislation; and (iv) any | ||||||
17 | other matter that a responding agency considers appropriate in | ||||||
18 | relation to the racial and ethnic minorities likely to be | ||||||
19 | affected by the bill. | ||||||
20 | Section 110-10. Preparation. | ||||||
21 | (a) The sponsor of each bill for which a request under | ||||||
22 | Section 110-5 has been made shall present a copy of the bill | ||||||
23 | with the request for a racial impact note to the appropriate | ||||||
24 | responding agency or agencies under subsection (b). The | ||||||
25 | responding agency or agencies shall prepare and submit the note |
| |||||||
| |||||||
1 | to the sponsor of the bill within 5 calendar days, except that | ||||||
2 | whenever, because of the complexity of the measure, additional | ||||||
3 | time is required for the preparation of the racial impact note, | ||||||
4 | the responding agency or agencies may inform the sponsor of the | ||||||
5 | bill, and the sponsor may approve an extension of the time | ||||||
6 | within which the note is to be submitted, not to extend, | ||||||
7 | however, beyond June 15, following the date of the request. If, | ||||||
8 | in the opinion of the responding agency or agencies, there is | ||||||
9 | insufficient information to prepare a reliable estimate of the | ||||||
10 | anticipated impact, a statement to that effect can be filed and | ||||||
11 | shall meet the requirements of this Act. | ||||||
12 | (b) If a bill concerns arrests, convictions, or law | ||||||
13 | enforcement, a statement shall be prepared by the Illinois | ||||||
14 | Criminal Justice Information Authority specifying the impact | ||||||
15 | on racial and ethnic minorities. If a bill concerns | ||||||
16 | corrections, sentencing, or the placement of individuals | ||||||
17 | within the Department of Corrections, a statement shall be | ||||||
18 | prepared by the Department of Corrections specifying the impact | ||||||
19 | on racial and ethnic minorities. If a bill concerns local | ||||||
20 | government, a statement shall be prepared by the Department of | ||||||
21 | Commerce and Economic Opportunity specifying the impact on | ||||||
22 | racial and ethnic minorities. If a bill concerns education, one | ||||||
23 | of the following agencies shall prepare a statement specifying | ||||||
24 | the impact on racial and ethnic minorities: (i) the Illinois | ||||||
25 | Community College Board, if the bill affects community | ||||||
26 | colleges; (ii) the Illinois State Board of Education, if the |
| |||||||
| |||||||
1 | bill affects primary and secondary education; or (iii) the | ||||||
2 | Illinois Board of Higher Education, if the bill affects State | ||||||
3 | universities. Any other State agency impacted or responsible | ||||||
4 | for implementing all or part of this bill shall prepare a | ||||||
5 | statement of the racial and ethnic impact of the bill as it | ||||||
6 | relates to that agency. | ||||||
7 | Section 110-15. Requisites and contents. The note shall be | ||||||
8 | factual in nature, as brief and concise as may be, and, in | ||||||
9 | addition, it shall include both the immediate effect and, if | ||||||
10 | determinable or reasonably foreseeable, the long range effect | ||||||
11 | of the measure on racial and ethnic minorities. If, after | ||||||
12 | careful investigation, it is determined that such an effect is | ||||||
13 | not ascertainable, the note shall contain a statement to that | ||||||
14 | effect, setting forth the reasons why no ascertainable effect | ||||||
15 | can be given. | ||||||
16 | Section 110-20. Comment or opinion; technical or | ||||||
17 | mechanical defects. No comment or opinion shall be included in | ||||||
18 | the racial impact note with regard to the merits of the measure | ||||||
19 | for which the racial impact note is prepared; however, | ||||||
20 | technical or mechanical defects may be noted.
| ||||||
21 | Section 110-25. Appearance of State officials and | ||||||
22 | employees in support or opposition of measure. The fact that a | ||||||
23 | racial impact note is prepared for any bill shall not preclude |
| |||||||
| |||||||
1 | or restrict the appearance before any committee of the General | ||||||
2 | Assembly of any official or authorized employee of the | ||||||
3 | responding agency or agencies, or any other impacted State | ||||||
4 | agency, who desires to be heard in support of or in opposition | ||||||
5 | to the measure. | ||||||
6 | Article 115. | ||||||
7 | Section 115-5. The Department of Healthcare and Family | ||||||
8 | Services Law of the
Civil Administrative Code of Illinois is | ||||||
9 | amended by adding Section 2205-35 as follows: | ||||||
10 | (20 ILCS 2205/2205-35 new) | ||||||
11 | Sec. 2205-35. Increasing access to primary care in | ||||||
12 | hospitals. The Department of Healthcare and Family Services | ||||||
13 | shall develop a program to increase the presence of Federally | ||||||
14 | Qualified Health Centers (FQHCs) in hospitals, including, but | ||||||
15 | not limited to, safety-net hospitals, with the goal of | ||||||
16 | increasing care coordination, managing chronic diseases, and | ||||||
17 | addressing the social determinants of health on or before | ||||||
18 | December 31, 2021. In addition, the Department shall develop a | ||||||
19 | payment methodology to allow FQHCs to provide care coordination | ||||||
20 | services, including, but not limited to, chronic disease | ||||||
21 | management and behavioral health services. The Department of | ||||||
22 | Healthcare and Family Services shall develop a payment | ||||||
23 | methodology to allow for care coordination services in FQHCs by |
| |||||||
| |||||||
1 | no later than December 31, 2021. | ||||||
2 | Article 120. | ||||||
3 | Section 120-5. The Civil Administrative Code of Illinois is | ||||||
4 | amended 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 | ||||||
8 | policy of this
State that all residents citizens of Illinois | ||||||
9 | are entitled to lead healthy lives.
Governmental public health | ||||||
10 | has a specific responsibility to ensure that a
public health | ||||||
11 | system is in place to allow the public health mission to be | ||||||
12 | achieved. The public health system is the collection of public, | ||||||
13 | private, and voluntary entities as well as individuals and | ||||||
14 | informal associations that contribute to the public's health | ||||||
15 | within the State. To
develop a public health system requires | ||||||
16 | certain core functions to be performed by
government. The State | ||||||
17 | Board of Health is to assume the leadership role in
advising | ||||||
18 | the 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 |
| |||||||
| |||||||
1 | persons,
all of
whom shall be appointed by the Governor, with | ||||||
2 | the advice and consent of the
Senate for those appointed by the | ||||||
3 | Governor on and after June 30, 1998,
and one of whom shall be a
| ||||||
4 | senior citizen age 60 or over. Five members shall be physicians | ||||||
5 | licensed
to practice medicine in all its branches, one | ||||||
6 | representing a medical school
faculty, one who is board | ||||||
7 | certified in preventive medicine, and one who is
engaged in | ||||||
8 | private practice. One member shall be a chiropractic physician. | ||||||
9 | One member shall be a dentist; one an
environmental health | ||||||
10 | practitioner; one a local public health administrator;
one a | ||||||
11 | local board of health member; one a registered nurse; one a | ||||||
12 | physical therapist; one an optometrist; one a
veterinarian; one | ||||||
13 | a public health academician; one a health care industry
| ||||||
14 | representative; one a representative of the business | ||||||
15 | community; one a representative of the non-profit public | ||||||
16 | interest community; and 2 shall be citizens at large.
| ||||||
17 | The terms of Board of Health members shall be 3 years, | ||||||
18 | except that members shall continue to serve on the Board of | ||||||
19 | Health until a replacement is appointed. Upon the effective | ||||||
20 | date of Public Act 93-975 (January 1, 2005) this amendatory Act | ||||||
21 | of the 93rd General Assembly , in the appointment of the Board | ||||||
22 | of Health members appointed to vacancies or positions with | ||||||
23 | terms expiring on or before December 31, 2004, the Governor | ||||||
24 | shall appoint up to 6 members to serve for terms of 3 years; up | ||||||
25 | to 6 members to serve for terms of 2 years; and up to 5 members | ||||||
26 | to serve for a term of one year, so that the term of no more |
| |||||||
| |||||||
1 | than 6 members expire in the same year.
All members shall
be | ||||||
2 | legal residents of the State of Illinois. The duties of the | ||||||
3 | Board 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.
|
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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, |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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, |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
8 | among its
members.
| ||||||
9 | Members of the Board shall receive compensation for their | ||||||
10 | services at the
rate of $150 per day, not to exceed $10,000 per | ||||||
11 | year, as designated by the
Director for each day required for | ||||||
12 | transacting the business of the Board
and shall be reimbursed | ||||||
13 | for necessary expenses incurred in the performance
of their | ||||||
14 | duties. The Board shall meet from time to time at the call of | ||||||
15 | the
Department, at the call of the chairperson, or upon the | ||||||
16 | request of 3 of its
members, but shall not meet less than 4 | ||||||
17 | times per year.
| ||||||
18 | (b) (Blank).
| ||||||
19 | (c) An Advisory Board on Necropsy Service to Coroners, | ||||||
20 | which shall
counsel and advise with the Director on the | ||||||
21 | administration of the Autopsy
Act. The Advisory Board shall | ||||||
22 | consist of 11 members, including
a senior citizen age 60 or | ||||||
23 | over, appointed by the Governor, one of
whom shall be | ||||||
24 | designated as chairman by a majority of the members of the
| ||||||
25 | Board. In the appointment of the first Board the Governor shall | ||||||
26 | appoint 3
members to serve for terms of 1 year, 3 for terms of 2 |
| |||||||
| |||||||
1 | years, and 3 for
terms of 3 years. The members first appointed | ||||||
2 | under Public Act 83-1538 shall serve for a term of 3 years. All | ||||||
3 | members appointed thereafter
shall be appointed for terms of 3 | ||||||
4 | years, except that when an
appointment is made
to fill a | ||||||
5 | vacancy, the appointment shall be for the remaining
term of the | ||||||
6 | position vacant. The members of the Board shall be citizens of
| ||||||
7 | the State of Illinois. In the appointment of members of the | ||||||
8 | Advisory Board
the Governor shall appoint 3 members who shall | ||||||
9 | be persons licensed to
practice medicine and surgery in the | ||||||
10 | State of Illinois, at least 2 of whom
shall have received | ||||||
11 | post-graduate training in the field of pathology; 3
members who | ||||||
12 | are duly elected coroners in this State; and 5 members who
| ||||||
13 | shall have interest and abilities in the field of forensic | ||||||
14 | medicine but who
shall be neither persons licensed to practice | ||||||
15 | any branch of medicine in
this State nor coroners. In the | ||||||
16 | appointment of medical and coroner members
of the Board, the | ||||||
17 | Governor shall invite nominations from recognized medical
and | ||||||
18 | coroners organizations in this State respectively. Board | ||||||
19 | members, while
serving on business of the Board, shall receive | ||||||
20 | actual necessary travel and
subsistence expenses while so | ||||||
21 | serving away from their places of residence.
| ||||||
22 | (Source: P.A. 98-463, eff. 8-16-13; 99-527, eff. 1-1-17; | ||||||
23 | revised 7-17-19.)
| ||||||
24 | Article 125. |
| |||||||
| |||||||
1 | Section 125-1. Short title. This Article may be cited as | ||||||
2 | the Health and Human Services Task Force and Study Act. | ||||||
3 | References 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 |
| |||||||
| |||||||
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.
|
| |||||||
| |||||||
1 | Section 125-10. Health and Human Services Task Force. The | ||||||
2 | Health and Human Services Task Force is created within the | ||||||
3 | Department of Human Services to undertake a systematic review | ||||||
4 | of health and human service departments and programs with the | ||||||
5 | goal of improving health and human service outcomes for | ||||||
6 | Illinois residents. | ||||||
7 | Section 125-15. Study.
| ||||||
8 | (1) The Task Force shall review all health and human | ||||||
9 | service departments and programs and make recommendations for | ||||||
10 | achieving a system that will improve interagency | ||||||
11 | interoperability with respect to improving access to | ||||||
12 | healthcare, healthcare disparities, workforce competency and | ||||||
13 | diversity, social determinants of health, and data sharing and | ||||||
14 | collection. These recommendations shall include, but are not | ||||||
15 | limited 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 | ||||||
21 | ways the Medicaid program can partner and cooperate with other | ||||||
22 | agencies, including but not limited to the Department of | ||||||
23 | Agriculture, the Department of Insurance, the Department of | ||||||
24 | Human Services, the Department of Labor, the Environmental | ||||||
25 | Protection Agency, and the Department of Public Health, to |
| |||||||
| |||||||
1 | better address social determinants of public health, | ||||||
2 | including, but not limited to, food deserts, affordable | ||||||
3 | housing, environmental pollutions, employment, education, and | ||||||
4 | public support services. This shall include a review and | ||||||
5 | recommendations on ways Medicaid and the agencies can share | ||||||
6 | costs related to better health outcomes. | ||||||
7 | (3) The Task Force shall review the current partnership, | ||||||
8 | communication, and cooperation between Federally Qualified | ||||||
9 | Health Centers (FQHCs) and safety-net hospitals in Illinois and | ||||||
10 | make recommendations on public policies that will improve | ||||||
11 | interoperability and cooperations between these entities in | ||||||
12 | order to achieve improved coordinated care and better health | ||||||
13 | outcomes for vulnerable populations in the State. | ||||||
14 | (4) The Task Force shall review and examine public policies | ||||||
15 | affecting trauma and social determinants of health, including | ||||||
16 | trauma-informed care, and make recommendations on ways to | ||||||
17 | improve and integrate trauma-informed approaches into programs | ||||||
18 | and agencies in the State, including, but not limited to, | ||||||
19 | Medicaid and other health care programs administered by the | ||||||
20 | State, and increase awareness of trauma and its effects on | ||||||
21 | communities across Illinois.
| ||||||
22 | (5) The Task Force shall review and examine the connection | ||||||
23 | between access to education and health outcomes particularly in | ||||||
24 | African American and minority communities and make | ||||||
25 | recommendations on public policies to address any gaps or | ||||||
26 | deficiencies.
|
| |||||||
| |||||||
1 | Section 125-20. Membership; appointments; meetings; | ||||||
2 | support.
| ||||||
3 | (1) The Task Force shall include representation from both | ||||||
4 | public and private organizations, and its membership shall | ||||||
5 | reflect regional, racial, and cultural diversity to ensure | ||||||
6 | representation of the needs of all Illinois citizens. Task | ||||||
7 | Force members shall include one member appointed by the | ||||||
8 | President of the Senate, one member appointed by the Minority | ||||||
9 | Leader of the Senate, one member appointed by the Speaker of | ||||||
10 | the House of Representatives, one member appointed by the | ||||||
11 | Minority Leader of the House of Representatives, and other | ||||||
12 | members appointed by the Governor. The Governor's appointments | ||||||
13 | shall 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 |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 | ||||||
7 | duration of the Task Force. | ||||||
8 | (3) In the event of a vacancy, the appointment to fill the | ||||||
9 | vacancy shall be made in the same manner as the original | ||||||
10 | appointment. | ||||||
11 | (4) The Task Force shall convene within 60 days after the | ||||||
12 | effective date of this Act. The initial meeting of the Task | ||||||
13 | Force shall be convened by the co-chair selected by the | ||||||
14 | Governor. Subsequent meetings shall convene at the call of the | ||||||
15 | co-chairs. The Task Force shall meet on a quarterly basis, or | ||||||
16 | more often if necessary. | ||||||
17 | (5) The Department of Human Services shall provide | ||||||
18 | administrative support to the Task Force. | ||||||
19 | Section 125-25. Report. The Task Force shall report to the | ||||||
20 | Governor and the General Assembly on the Task Force's progress | ||||||
21 | toward its goals and objectives by June 30, 2021, and every | ||||||
22 | June 30 thereafter. | ||||||
23 | Section 125-30. Transparency. In addition to whatever | ||||||
24 | policies or procedures it may adopt, all operations of the Task |
| |||||||
| |||||||
1 | Force shall be subject to the provisions of the Freedom of | ||||||
2 | Information Act and the Open Meetings Act. This Section shall | ||||||
3 | not be construed so as to preclude other State laws from | ||||||
4 | applying to the Task Force and its activities. | ||||||
5 | Section 125-40. Repeal. This Article is repealed June 30, | ||||||
6 | 2023. | ||||||
7 | Article 130. | ||||||
8 | Section 130-1. Short title. This Article may be cited as | ||||||
9 | the 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 | ||||||
12 | declares 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.
|
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
20 | identify and propose statewide policies to eliminate systemic | ||||||
21 | racism and advance equitable solutions for Black and Brown | ||||||
22 | people in Illinois.
| ||||||
23 | (b) The Anti-Racism Commission shall consist of the | ||||||
24 | following members, who shall serve without compensation:
| ||||||
25 | (1) one member of the House of Representatives, |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
1 | Latino Caucus Chair.
| ||||||
2 | (c) The Department of Public Health shall provide | ||||||
3 | administrative support for the Commission.
| ||||||
4 | (d) The Commission is charged with, but not limited to, the | ||||||
5 | following 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.
|
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
7 | Governor and the General Assembly no later than December 31, | ||||||
8 | 2021. The Commission is dissolved upon the filing of its | ||||||
9 | report.
| ||||||
10 | Section 130-15. Repeal. This Article is repealed on January | ||||||
11 | 1, 2023. | ||||||
12 | Article 131. | ||||||
13 | Section 131-1. Short title. This Article may be cited as | ||||||
14 | the Sickle Cell Prevention, Care, and Treatment Program Act. | ||||||
15 | References 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 | ||||||
19 | Treatment Program. | ||||||
20 | Section 131-10. Sickle Cell Prevention, Care, and | ||||||
21 | Treatment Program. The Department shall establish a grant |
| |||||||
| |||||||
1 | program for the purpose of providing for the prevention, care, | ||||||
2 | and treatment of sickle cell disease and for educational | ||||||
3 | programs 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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 | ||||||
20 | the sickle cell disease educational outreach program
described | ||||||
21 | in 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 | ||||||
24 | special fund in the State treasury for the purpose of carrying | ||||||
25 | out the provisions of this
Act and for no other
purpose. The |
| |||||||
| |||||||
1 | Fund 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 | ||||||
9 | thereafter, 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;
| ||||||
18 | shall perform a study to determine the prevalence, impact, and
| ||||||
19 | needs of individuals with sickle cell disease and the sickle | ||||||
20 | cell 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 |
| |||||||
| |||||||
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 | ||||||
20 | performed
under this Section to the General Assembly. | ||||||
21 | Section 131-30. Implementation subject to appropriation. | ||||||
22 | Implementation of this Act is subject to appropriation. | ||||||
23 | Section 131-90. The State Finance Act is amended by adding | ||||||
24 | Section 5.936 as follows: |
| |||||||
| |||||||
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 | ||||||
5 | 34-18.67 as follows: | ||||||
6 | (105 ILCS 5/34-18.67 new) | ||||||
7 | Sec. 34-18.67. School nurse pilot program. The board shall | ||||||
8 | establish a school nurse pilot program. Under the program, the | ||||||
9 | board shall require the top 20% of the lowest performing | ||||||
10 | schools in the district, as determined by the board, to employ | ||||||
11 | a school nurse in conformance with Section 10-22.23 of this | ||||||
12 | Code. The board shall implement this program beginning with the | ||||||
13 | 2021-2022 school year. | ||||||
14 | Title VII. Hospital Closure | ||||||
15 | Article 135. | ||||||
16 | Section 135-5. The Illinois Health Facilities Planning Act | ||||||
17 | is amended by changing Sections 4 and 8.7 and by adding Section | ||||||
18 | 5.5 as follows:
|
| |||||||
| |||||||
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; | ||||||
4 | membership; appointment; term;
compensation; quorum. | ||||||
5 | (a) There is created the Health
Facilities and Services | ||||||
6 | Review Board, which
shall perform the functions described in | ||||||
7 | this
Act. The Department shall provide operational support to | ||||||
8 | the Board as necessary, including the provision of office | ||||||
9 | space, supplies, and clerical, financial, and accounting | ||||||
10 | services. The Board may contract for functions or operational | ||||||
11 | support as needed. The Board may also contract with experts | ||||||
12 | related to specific health services or facilities and create | ||||||
13 | technical advisory panels to assist in the development of | ||||||
14 | criteria, standards, and procedures used in the evaluation of | ||||||
15 | applications for permit and exemption.
| ||||||
16 | (b) The State Board shall consist of 11 9 voting members. | ||||||
17 | All members shall be residents of Illinois and at least 4 shall | ||||||
18 | reside outside the Chicago Metropolitan Statistical Area. | ||||||
19 | Consideration shall be given to potential appointees who | ||||||
20 | reflect the ethnic and cultural diversity of the State. Neither | ||||||
21 | Board members nor Board staff shall be convicted felons or have | ||||||
22 | pled guilty to a felony. | ||||||
23 | Each member shall have a reasonable knowledge of the | ||||||
24 | practice, procedures and principles of the health care delivery | ||||||
25 | system in Illinois, including at least 5 members who shall be | ||||||
26 | knowledgeable about health care delivery systems, health |
| |||||||
| |||||||
1 | systems planning, finance, or the management of health care | ||||||
2 | facilities currently regulated under the Act. One member shall | ||||||
3 | be a representative of a non-profit health care consumer | ||||||
4 | advocacy organization. Two members shall be representatives | ||||||
5 | from the community with experience on the effects of | ||||||
6 | discontinuing health care services or the closure of health | ||||||
7 | care facilities on the surrounding community. A spouse, parent, | ||||||
8 | sibling, or child of a Board member cannot be an employee, | ||||||
9 | agent, or under contract with services or facilities subject to | ||||||
10 | the Act. Prior to appointment and in the course of service on | ||||||
11 | the Board, members of the Board shall disclose the employment | ||||||
12 | or other financial interest of any other relative of the | ||||||
13 | member, if known, in service or facilities subject to the Act. | ||||||
14 | Members of the Board shall declare any conflict of interest | ||||||
15 | that may exist with respect to the status of those relatives | ||||||
16 | and recuse themselves from voting on any issue for which a | ||||||
17 | conflict of interest is declared. No person shall be appointed | ||||||
18 | or continue to serve as a member of the State Board who is, or | ||||||
19 | whose spouse, parent, sibling, or child is, a member of the | ||||||
20 | Board of Directors of, has a financial interest in, or has a | ||||||
21 | business relationship with a health care facility. | ||||||
22 | Notwithstanding any provision of this Section to the | ||||||
23 | contrary, the term of
office of each member of the State Board | ||||||
24 | serving on the day before the effective date of this amendatory | ||||||
25 | Act of the 96th General Assembly is abolished on the date upon | ||||||
26 | which members of the 9-member Board, as established by this |
| |||||||
| |||||||
1 | amendatory Act of the 96th General Assembly, have been | ||||||
2 | appointed and can begin to take action as a Board.
| ||||||
3 | (c) The State Board shall be appointed by the Governor, | ||||||
4 | with the advice
and consent of the Senate. Not more than 5 of | ||||||
5 | the
appointments shall be of the same political party at the | ||||||
6 | time of the appointment.
| ||||||
7 | The Secretary of Human Services, the Director of Healthcare | ||||||
8 | and Family Services, and
the Director of Public Health, or | ||||||
9 | their designated representatives,
shall serve as ex-officio, | ||||||
10 | non-voting members of the State Board.
| ||||||
11 | (d) Of those 9 members initially appointed by the Governor | ||||||
12 | following the effective date of this
amendatory Act of the 96th | ||||||
13 | General Assembly, 3 shall serve for terms expiring
July 1, | ||||||
14 | 2011, 3 shall serve for terms expiring July 1, 2012, and 3 | ||||||
15 | shall serve
for terms expiring July 1, 2013. Thereafter, each
| ||||||
16 | appointed member shall
hold office for a term of 3 years, | ||||||
17 | provided that any member
appointed to fill a vacancy
occurring | ||||||
18 | prior to the expiration of the
term for which his or her | ||||||
19 | predecessor was appointed shall be appointed for the
remainder | ||||||
20 | of such term and the term of office of each successor shall
| ||||||
21 | commence on July 1 of the year in which his predecessor's term | ||||||
22 | expires. Each
member shall hold office until his or her | ||||||
23 | successor is appointed and qualified. The Governor may | ||||||
24 | reappoint a member for additional terms, but no member shall | ||||||
25 | serve more than 3 terms, subject to review and re-approval | ||||||
26 | every 3 years.
|
| |||||||
| |||||||
1 | (e) State Board members, while serving on business of the | ||||||
2 | State Board,
shall receive actual and necessary travel and | ||||||
3 | subsistence expenses while
so serving away from their places
of | ||||||
4 | residence. Until March 1, 2010, a
member of the State Board who | ||||||
5 | experiences a significant financial hardship
due to the loss of | ||||||
6 | income on days of attendance at meetings or while otherwise
| ||||||
7 | engaged in the business of the State Board may be paid a | ||||||
8 | hardship allowance, as
determined by and subject to the | ||||||
9 | approval of the Governor's Travel Control
Board.
| ||||||
10 | (f) The Governor shall designate one of the members to | ||||||
11 | serve as the Chairman of the Board, who shall be a person with | ||||||
12 | expertise in health care delivery system planning, finance or | ||||||
13 | management of health care facilities that are regulated under | ||||||
14 | the Act. The Chairman shall annually review Board member | ||||||
15 | performance and shall report the attendance record of each | ||||||
16 | Board member to the General Assembly. | ||||||
17 | (g) The State Board, through the Chairman, shall prepare a | ||||||
18 | separate and distinct budget approved by the General Assembly | ||||||
19 | and shall hire and supervise its own professional staff | ||||||
20 | responsible for carrying out the responsibilities of the Board.
| ||||||
21 | (h) The State Board shall meet at least every 45 days, or | ||||||
22 | as often as
the Chairman of the State Board deems necessary, or | ||||||
23 | upon the request of
a majority of the members.
| ||||||
24 | (i)
Five members of the State Board shall constitute a | ||||||
25 | quorum.
The affirmative vote of 5 of the members of the State | ||||||
26 | Board shall be
necessary for
any action requiring a vote to be |
| |||||||
| |||||||
1 | taken by the State
Board. A vacancy in the membership of the | ||||||
2 | State Board shall not impair the
right of a quorum to exercise | ||||||
3 | all the rights and perform all the duties of the
State Board as | ||||||
4 | provided by this Act.
| ||||||
5 | (j) A State Board member shall disqualify himself or | ||||||
6 | herself from the
consideration of any application for a permit | ||||||
7 | or
exemption in which the State Board member or the State Board | ||||||
8 | member's spouse,
parent, sibling, or child: (i) has
an economic | ||||||
9 | interest in the matter; or (ii) is employed by, serves as a
| ||||||
10 | consultant for, or is a member of the
governing board of the | ||||||
11 | applicant or a party opposing the application.
| ||||||
12 | (k) The Chairman, Board members, and Board staff must | ||||||
13 | comply 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. | ||||||
17 | Notwithstanding any law or rule to the contrary, due to the | ||||||
18 | COVID-19 pandemic, the State shall institute a moratorium on | ||||||
19 | the closure of hospitals
until December 31, 2023. As such, no | ||||||
20 | hospital shall close or reduce
capacity below the hospital's | ||||||
21 | capacity as of January 1, 2020 before the
end of such | ||||||
22 | moratorium. | ||||||
23 | (b) This Section is repealed on January 1, 2024. | ||||||
24 | (20 ILCS 3960/8.7) |
| |||||||
| |||||||
1 | (Section scheduled to be repealed on December 31, 2029) | ||||||
2 | Sec. 8.7. Application for permit for discontinuation of a | ||||||
3 | health care facility or category of service; public notice and | ||||||
4 | public hearing. | ||||||
5 | (a) Upon a finding that an application to close a health | ||||||
6 | care facility or discontinue a category of service is complete, | ||||||
7 | the State Board shall publish a legal notice on 3 consecutive | ||||||
8 | days in a newspaper of general circulation in the area or | ||||||
9 | community to be affected and afford the public an opportunity | ||||||
10 | to request a hearing. If the application is for a facility | ||||||
11 | located in a Metropolitan Statistical Area, an additional legal | ||||||
12 | notice shall be published in a newspaper of limited | ||||||
13 | circulation, if one exists, in the area in which the facility | ||||||
14 | is located. If the newspaper of limited circulation is | ||||||
15 | published on a daily basis, the additional legal notice shall | ||||||
16 | be published on 3 consecutive days. The legal notice shall also | ||||||
17 | be posted on the Health Facilities and Services Review Board's | ||||||
18 | website and sent to the State Representative and State Senator | ||||||
19 | of the district in which the health care facility is located. | ||||||
20 | In addition, the health care facility shall provide notice of | ||||||
21 | closure to the local media that the health care facility would | ||||||
22 | routinely notify about facility events. | ||||||
23 | Upon the completion of an application to close a health | ||||||
24 | care facility or discontinue a category of service, the State | ||||||
25 | Board shall conduct a racial equity impact assessment to | ||||||
26 | determine the effect of the closure or discontinuation of |
| |||||||
| |||||||
1 | service on racial and ethnic minorities. The results of the | ||||||
2 | racial equity impact assessment shall be made available to the | ||||||
3 | public. | ||||||
4 | An application to close a health care facility shall only | ||||||
5 | be deemed complete if it includes evidence that the health care | ||||||
6 | facility provided written notice at least 30 days prior to | ||||||
7 | filing the application of its intent to do so to the | ||||||
8 | municipality in which it is located, the State Representative | ||||||
9 | and State Senator of the district in which the health care | ||||||
10 | facility is located, the State Board, the Director of Public | ||||||
11 | Health, and the Director of Healthcare and Family Services. The | ||||||
12 | changes made to this subsection by this amendatory Act of the | ||||||
13 | 101st General Assembly shall apply to all applications | ||||||
14 | submitted after the effective date of this amendatory Act of | ||||||
15 | the 101st General Assembly. | ||||||
16 | (b) No later than 30 days after issuance of a permit to | ||||||
17 | close a health care facility or discontinue a category of | ||||||
18 | service, the permit holder shall give written notice of the | ||||||
19 | closure or discontinuation to the State Senator and State | ||||||
20 | Representative serving the legislative district in which the | ||||||
21 | health care facility is located. | ||||||
22 | (c) If there is a pending lawsuit that challenges an | ||||||
23 | application to discontinue a health care facility that either | ||||||
24 | names the Board as a party or alleges fraud in the filing of | ||||||
25 | the application, the Board may defer action on the application | ||||||
26 | for up to 6 months after the date of the initial deferral of |
| |||||||
| |||||||
1 | the application. | ||||||
2 | (d) The changes made to this Section by this amendatory Act | ||||||
3 | of the 101st General Assembly shall apply to all applications | ||||||
4 | submitted after the effective date of this amendatory Act of | ||||||
5 | the 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 | ||||||
10 | changing 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 | ||||||
15 | contracts with the Department to provide services where payment | ||||||
16 | for 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; |
| |||||||
| |||||||
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 | ||||||
8 | organizations are subject to the provisions of the Managed Care | ||||||
9 | Reform and Patient Rights Act. | ||||||
10 | (c) An MCO shall pay any provider of emergency services | ||||||
11 | that does not have in effect a contract with the contracted | ||||||
12 | Medicaid MCO. The default rate of reimbursement shall be the | ||||||
13 | rate paid under Illinois Medicaid fee-for-service program | ||||||
14 | methodology, including all policy adjusters, including but not | ||||||
15 | limited to Medicaid High Volume Adjustments, Medicaid | ||||||
16 | Percentage Adjustments, Outpatient High Volume Adjustments, | ||||||
17 | and all outlier add-on adjustments to the extent such | ||||||
18 | adjustments are incorporated in the development of the | ||||||
19 | applicable MCO capitated rates. | ||||||
20 | (d) An MCO shall pay for all post-stabilization services as | ||||||
21 | a 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; |
| |||||||
| |||||||
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 | ||||||
22 | payment 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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 | ||||||
15 | Illinois Medicaid program may have unintended operational | ||||||
16 | challenges 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 |
| |||||||
| |||||||
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 | ||||||
23 | limited 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 |
| |||||||
| |||||||
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 | ||||||
5 | fee-for-service coverage. | ||||||
6 | If the fee-for-service system is ultimately determined to | ||||||
7 | have been responsible for coverage on the date of service, the | ||||||
8 | Department shall provide for an extended period for claims | ||||||
9 | submission 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 |
| |||||||
| |||||||
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 | ||||||
8 | order to monitor MCO payments to hospital providers, pursuant | ||||||
9 | to this amendatory Act of the 100th General Assembly, the | ||||||
10 | Department shall post an analysis of MCO claims processing and | ||||||
11 | payment performance on its website every 6 months. Such | ||||||
12 | analysis shall include a review and evaluation of a | ||||||
13 | representative sample of hospital claims that are rejected and | ||||||
14 | denied for clean and unclean claims and the top 5 reasons for | ||||||
15 | such actions and timeliness of claims adjudication, which | ||||||
16 | identifies the percentage of claims adjudicated within 30, 60, | ||||||
17 | 90, and over 90 days, and the dollar amounts associated with | ||||||
18 | those claims. The Department shall post the contracted claims | ||||||
19 | report required by HealthChoice Illinois on its website every 3 | ||||||
20 | months. | ||||||
21 | (g-8) Dispute resolution process. The Department shall | ||||||
22 | maintain a provider complaint portal through which a provider | ||||||
23 | can submit to the Department unresolved disputes with an MCO. | ||||||
24 | An unresolved dispute means an MCO's decision that denies in | ||||||
25 | whole or in part a claim for reimbursement to a provider for | ||||||
26 | health care services rendered by the provider to an enrollee of |
| |||||||
| |||||||
1 | the MCO with which the provider disagrees. Disputes shall not | ||||||
2 | be submitted to the portal until the provider has availed | ||||||
3 | itself of the MCO's internal dispute resolution process. | ||||||
4 | Disputes that are submitted to the MCO internal dispute | ||||||
5 | resolution process may be submitted to the Department of | ||||||
6 | Healthcare and Family Services' complaint portal no sooner than | ||||||
7 | 30 days after submitting to the MCO's internal process and not | ||||||
8 | later than 30 days after the unsatisfactory resolution of the | ||||||
9 | internal MCO process or 60 days after submitting the dispute to | ||||||
10 | the MCO internal process. Multiple claim disputes involving the | ||||||
11 | same MCO may be submitted in one complaint, regardless of | ||||||
12 | whether the claims are for different enrollees, when the | ||||||
13 | specific reason for non-payment of the claims involves a common | ||||||
14 | question of fact or policy. Within 10 business days of receipt | ||||||
15 | of a complaint, the Department shall present such disputes to | ||||||
16 | the appropriate MCO, which shall then have 30 days to issue its | ||||||
17 | written proposal to resolve the dispute. The Department may | ||||||
18 | grant one 30-day extension of this time frame to one of the | ||||||
19 | parties to resolve the dispute. If the dispute remains | ||||||
20 | unresolved at the end of this time frame or the provider is not | ||||||
21 | satisfied with the MCO's written proposal to resolve the | ||||||
22 | dispute, the provider may, within 30 days, request the | ||||||
23 | Department to review the dispute and make a final | ||||||
24 | determination. Within 30 days of the request for Department | ||||||
25 | review of the dispute, both the provider and the MCO shall | ||||||
26 | present all relevant information to the Department for |
| |||||||
| |||||||
1 | resolution and make individuals with knowledge of the issues | ||||||
2 | available to the Department for further inquiry if needed. | ||||||
3 | Within 30 days of receiving the relevant information on the | ||||||
4 | dispute, or the lapse of the period for submitting such | ||||||
5 | information, the Department shall issue a written decision on | ||||||
6 | the dispute based on contractual terms between the provider and | ||||||
7 | the MCO, contractual terms between the MCO and the Department | ||||||
8 | of Healthcare and Family Services and applicable Medicaid | ||||||
9 | policy. The decision of the Department shall be final. By | ||||||
10 | January 1, 2020, the Department shall establish by rule further | ||||||
11 | details of this dispute resolution process. Disputes between | ||||||
12 | MCOs and providers presented to the Department for resolution | ||||||
13 | are not contested cases, as defined in Section 1-30 of the | ||||||
14 | Illinois Administrative Procedure Act, conferring any right to | ||||||
15 | an administrative hearing. | ||||||
16 | (g-9)(1) The Department shall publish annually on its | ||||||
17 | website a report on the calculation of each managed care | ||||||
18 | organization'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. |
| |||||||
| |||||||
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 | ||||||
4 | with federal law and regulation following a claims runout | ||||||
5 | period determined by the Department. | ||||||
6 | (g-10)(1) "Liability effective date" means the date on | ||||||
7 | which an MCO becomes responsible for payment for medically | ||||||
8 | necessary and covered services rendered by a provider to one of | ||||||
9 | its enrollees in accordance with the contract terms between the | ||||||
10 | MCO and the provider. The liability effective date shall be the | ||||||
11 | later 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 | ||||||
23 | MCO at the same time that the provider submits an enrollment | ||||||
24 | application to the Department through IMPACT. | ||||||
25 | (3) By October 1, 2019, the Department shall require all | ||||||
26 | MCOs to update their provider directory with information for |
| |||||||
| |||||||
1 | new practitioners of existing contracted providers within 30 | ||||||
2 | days of receipt of a complete and accurate standardized roster | ||||||
3 | template in the format approved by the Department provided that | ||||||
4 | the provider is effective in the Department's provider | ||||||
5 | enrollment subsystem within the IMPACT system. Such provider | ||||||
6 | directory shall be readily accessible for purposes of selecting | ||||||
7 | an approved health care provider and comply with all other | ||||||
8 | federal and State requirements. | ||||||
9 | (g-11) The Department shall work with relevant | ||||||
10 | stakeholders on the development of operational guidelines to | ||||||
11 | enhance and improve operational performance of Illinois' | ||||||
12 | Medicaid managed care program, including, but not limited to, | ||||||
13 | improving provider billing practices, reducing claim | ||||||
14 | rejections and inappropriate payment denials, and | ||||||
15 | standardizing processes, procedures, definitions, and response | ||||||
16 | timelines, with the goal of reducing provider and MCO | ||||||
17 | administrative burdens and conflict. The Department shall | ||||||
18 | include a report on the progress of these program improvements | ||||||
19 | and other topics in its Fiscal Year 2020 annual report to the | ||||||
20 | General Assembly. | ||||||
21 | (h) The Department shall not expand mandatory MCO | ||||||
22 | enrollment into new counties beyond those counties already | ||||||
23 | designated by the Department as of June 1, 2014 for the | ||||||
24 | individuals whose eligibility for medical assistance is not the | ||||||
25 | seniors or people with disabilities population until the | ||||||
26 | Department provides an opportunity for accountable care |
| |||||||
| |||||||
1 | entities and MCOs to participate in such newly designated | ||||||
2 | counties. | ||||||
3 | (h-5) MCOs shall be required to publish, at least quarterly | ||||||
4 | for 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 | ||||||
16 | with accountable care entities and MCOs entered into, amended, | ||||||
17 | or renewed after June 16, 2014 (the effective date of Public | ||||||
18 | Act 98-651).
| ||||||
19 | (j) Health care information released to managed care | ||||||
20 | organizations. A health care provider shall release to a | ||||||
21 | Medicaid managed care organization, upon request, and subject | ||||||
22 | to the Health Insurance Portability and Accountability Act of | ||||||
23 | 1996 and any other law applicable to the release of health | ||||||
24 | information, the health care information of the MCO's enrollee, | ||||||
25 | if the enrollee has completed and signed a general release form | ||||||
26 | that grants to the health care provider permission to release |
| |||||||
| |||||||
1 | the recipient's health care information to the recipient's | ||||||
2 | insurance carrier. | ||||||
3 | (Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18; | ||||||
4 | 100-587, 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 | ||||||
7 | changing Section 5-30.1 and by adding Section 5-30.15 as | ||||||
8 | follows: | ||||||
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 | ||||||
13 | contracts with the Department to provide services where payment | ||||||
14 | for 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 |
| |||||||
| |||||||
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 | ||||||
5 | organizations are subject to the provisions of the Managed Care | ||||||
6 | Reform and Patient Rights Act. | ||||||
7 | (c) An MCO shall pay any provider of emergency services | ||||||
8 | that does not have in effect a contract with the contracted | ||||||
9 | Medicaid MCO. The default rate of reimbursement shall be the | ||||||
10 | rate paid under Illinois Medicaid fee-for-service program | ||||||
11 | methodology, including all policy adjusters, including but not | ||||||
12 | limited to Medicaid High Volume Adjustments, Medicaid | ||||||
13 | Percentage Adjustments, Outpatient High Volume Adjustments, | ||||||
14 | and all outlier add-on adjustments to the extent such | ||||||
15 | adjustments are incorporated in the development of the | ||||||
16 | applicable MCO capitated rates. | ||||||
17 | (d) An MCO shall pay for all post-stabilization services as | ||||||
18 | a 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 |
| |||||||
| |||||||
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 | ||||||
19 | payment 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. |
| |||||||
| |||||||
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. |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
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 |
| |||||||
| |||||||
1 | Illinois Medicaid program may have unintended operational | ||||||
2 | challenges 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 |
| |||||||
| |||||||
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 | ||||||
9 | limited 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 | ||||||
17 | fee-for-service coverage. | ||||||
18 | If the fee-for-service system is ultimately determined to | ||||||
19 | have been responsible for coverage on the date of service, the | ||||||
20 | Department shall provide for an extended period for claims | ||||||
21 | submission 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: |
| |||||||
| |||||||
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 | ||||||
20 | order to monitor MCO payments to hospital providers, pursuant | ||||||
21 | to this amendatory Act of the 100th General Assembly, the | ||||||
22 | Department shall post an analysis of MCO claims processing and | ||||||
23 | payment performance on its website every 6 months. Such | ||||||
24 | analysis shall include a review and evaluation of a | ||||||
25 | representative sample of hospital claims that are rejected and | ||||||
26 | denied for clean and unclean claims and the top 5 reasons for |
| |||||||
| |||||||
1 | such actions and timeliness of claims adjudication, which | ||||||
2 | identifies the percentage of claims adjudicated within 30, 60, | ||||||
3 | 90, and over 90 days, and the dollar amounts associated with | ||||||
4 | those claims. The Department shall post the contracted claims | ||||||
5 | report required by HealthChoice Illinois on its website every 3 | ||||||
6 | months. | ||||||
7 | (g-8) Dispute resolution process. The Department shall | ||||||
8 | maintain a provider complaint portal through which a provider | ||||||
9 | can submit to the Department unresolved disputes with an MCO. | ||||||
10 | An unresolved dispute means an MCO's decision that denies in | ||||||
11 | whole or in part a claim for reimbursement to a provider for | ||||||
12 | health care services rendered by the provider to an enrollee of | ||||||
13 | the MCO with which the provider disagrees. Disputes shall not | ||||||
14 | be submitted to the portal until the provider has availed | ||||||
15 | itself of the MCO's internal dispute resolution process. | ||||||
16 | Disputes that are submitted to the MCO internal dispute | ||||||
17 | resolution process may be submitted to the Department of | ||||||
18 | Healthcare and Family Services' complaint portal no sooner than | ||||||
19 | 30 days after submitting to the MCO's internal process and not | ||||||
20 | later than 30 days after the unsatisfactory resolution of the | ||||||
21 | internal MCO process or 60 days after submitting the dispute to | ||||||
22 | the MCO internal process. Multiple claim disputes involving the | ||||||
23 | same MCO may be submitted in one complaint, regardless of | ||||||
24 | whether the claims are for different enrollees, when the | ||||||
25 | specific reason for non-payment of the claims involves a common | ||||||
26 | question of fact or policy. Within 10 business days of receipt |
| |||||||
| |||||||
1 | of a complaint, the Department shall present such disputes to | ||||||
2 | the appropriate MCO, which shall then have 30 days to issue its | ||||||
3 | written proposal to resolve the dispute. The Department may | ||||||
4 | grant one 30-day extension of this time frame to one of the | ||||||
5 | parties to resolve the dispute. If the dispute remains | ||||||
6 | unresolved at the end of this time frame or the provider is not | ||||||
7 | satisfied with the MCO's written proposal to resolve the | ||||||
8 | dispute, the provider may, within 30 days, request the | ||||||
9 | Department to review the dispute and make a final | ||||||
10 | determination. Within 30 days of the request for Department | ||||||
11 | review of the dispute, both the provider and the MCO shall | ||||||
12 | present all relevant information to the Department for | ||||||
13 | resolution and make individuals with knowledge of the issues | ||||||
14 | available to the Department for further inquiry if needed. | ||||||
15 | Within 30 days of receiving the relevant information on the | ||||||
16 | dispute, or the lapse of the period for submitting such | ||||||
17 | information, the Department shall issue a written decision on | ||||||
18 | the dispute based on contractual terms between the provider and | ||||||
19 | the MCO, contractual terms between the MCO and the Department | ||||||
20 | of Healthcare and Family Services and applicable Medicaid | ||||||
21 | policy. The decision of the Department shall be final. By | ||||||
22 | January 1, 2020, the Department shall establish by rule further | ||||||
23 | details of this dispute resolution process. Disputes between | ||||||
24 | MCOs and providers presented to the Department for resolution | ||||||
25 | are not contested cases, as defined in Section 1-30 of the | ||||||
26 | Illinois Administrative Procedure Act, conferring any right to |
| |||||||
| |||||||
1 | an administrative hearing. | ||||||
2 | (g-9)(1) The Department shall publish annually on its | ||||||
3 | website a report on the calculation of each managed care | ||||||
4 | organization'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 | ||||||
16 | with federal law and regulation following a claims runout | ||||||
17 | period determined by the Department. | ||||||
18 | (g-10)(1) "Liability effective date" means the date on | ||||||
19 | which an MCO becomes responsible for payment for medically | ||||||
20 | necessary and covered services rendered by a provider to one of | ||||||
21 | its enrollees in accordance with the contract terms between the | ||||||
22 | MCO and the provider. The liability effective date shall be the | ||||||
23 | later of: | ||||||
24 | (A) The execution date of a network participation | ||||||
25 | contract agreement. | ||||||
26 | (B) The date the provider or its representative submits |
| |||||||
| |||||||
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 | ||||||
9 | MCO at the same time that the provider submits an enrollment | ||||||
10 | application to the Department through IMPACT. | ||||||
11 | (3) By October 1, 2019, the Department shall require all | ||||||
12 | MCOs to update their provider directory with information for | ||||||
13 | new practitioners of existing contracted providers within 30 | ||||||
14 | days of receipt of a complete and accurate standardized roster | ||||||
15 | template in the format approved by the Department provided that | ||||||
16 | the provider is effective in the Department's provider | ||||||
17 | enrollment subsystem within the IMPACT system. Such provider | ||||||
18 | directory shall be readily accessible for purposes of selecting | ||||||
19 | an approved health care provider and comply with all other | ||||||
20 | federal and State requirements. | ||||||
21 | (g-11) The Department shall work with relevant | ||||||
22 | stakeholders on the development of operational guidelines to | ||||||
23 | enhance and improve operational performance of Illinois' | ||||||
24 | Medicaid managed care program, including, but not limited to, | ||||||
25 | improving provider billing practices, reducing claim | ||||||
26 | rejections and inappropriate payment denials, and |
| |||||||
| |||||||
1 | standardizing processes, procedures, definitions, and response | ||||||
2 | timelines, with the goal of reducing provider and MCO | ||||||
3 | administrative burdens and conflict. The Department shall | ||||||
4 | include a report on the progress of these program improvements | ||||||
5 | and other topics in its Fiscal Year 2020 annual report to the | ||||||
6 | General Assembly. | ||||||
7 | (g-12) Notwithstanding any other provision of law, if the
| ||||||
8 | Department or an MCO requires submission of a claim for payment
| ||||||
9 | in a non-electronic format, a provider shall always be afforded
| ||||||
10 | a period of no less than 90 business days, as a correction
| ||||||
11 | period, following any notification of rejection by either the
| ||||||
12 | Department or the MCO to correct errors or omissions in the
| ||||||
13 | original submission. | ||||||
14 | Under no circumstances, either by an MCO or under the
| ||||||
15 | State's fee-for-service system, shall a provider be denied
| ||||||
16 | payment for failure to comply with any timely claims submission
| ||||||
17 | requirements under this Code or under any existing contract,
| ||||||
18 | unless the non-electronic format claim submission occurs after
| ||||||
19 | the initial 180 days following the latest date of service on
| ||||||
20 | the claim, or after the 90 business days correction period
| ||||||
21 | following notification to the provider of rejection or denial
| ||||||
22 | of payment. | ||||||
23 | (h) The Department shall not expand mandatory MCO | ||||||
24 | enrollment into new counties beyond those counties already | ||||||
25 | designated by the Department as of June 1, 2014 for the | ||||||
26 | individuals whose eligibility for medical assistance is not the |
| |||||||
| |||||||
1 | seniors or people with disabilities population until the | ||||||
2 | Department provides an opportunity for accountable care | ||||||
3 | entities and MCOs to participate in such newly designated | ||||||
4 | counties. | ||||||
5 | (h-5) MCOs shall be required to publish, at least quarterly | ||||||
6 | for 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 | ||||||
18 | with accountable care entities and MCOs entered into, amended, | ||||||
19 | or renewed after June 16, 2014 (the effective date of Public | ||||||
20 | Act 98-651).
| ||||||
21 | (j) Health care information released to managed care | ||||||
22 | organizations. A health care provider shall release to a | ||||||
23 | Medicaid managed care organization, upon request, and subject | ||||||
24 | to the Health Insurance Portability and Accountability Act of | ||||||
25 | 1996 and any other law applicable to the release of health | ||||||
26 | information, the health care information of the MCO's enrollee, |
| |||||||
| |||||||
1 | if the enrollee has completed and signed a general release form | ||||||
2 | that grants to the health care provider permission to release | ||||||
3 | the recipient's health care information to the recipient's | ||||||
4 | insurance carrier. | ||||||
5 | (k) The requirements of this Section added by this
| ||||||
6 | amendatory Act of the 101st General Assembly shall apply to
| ||||||
7 | services provided on or after the first day of the month that
| ||||||
8 | begins 60 days after the effective date of this amendatory Act
| ||||||
9 | of the 101st General Assembly. | ||||||
10 | (Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18; | ||||||
11 | 100-587, 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 | ||||||
14 | placement of individuals; managed care. Whenever a hospital | ||||||
15 | provides notice to a managed care organization (MCO) that an | ||||||
16 | individual covered under the State's medical assistance | ||||||
17 | program has received a discharge order from the attending | ||||||
18 | physician and is ready for discharge from an inpatient hospital | ||||||
19 | stay to another level of care, the MCO shall secure the | ||||||
20 | individual's placement in or transfer to another facility | ||||||
21 | within 24 hours of receiving the hospital's notification, or | ||||||
22 | shall pay the hospital a daily rate equal to the hospital's | ||||||
23 | daily rate associated with the stay ending, including all | ||||||
24 | applicable add-on adjustment payments. |
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1 | Article 155. | ||||||
2 | Section 155-5. The Illinois Public Aid Code is amended by | ||||||
3 | adding 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 | ||||||
7 | created within the Department of Healthcare and Family Services | ||||||
8 | to evaluate the effectiveness of Illinois' managed care | ||||||
9 | program. | ||||||
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 | ||||||
16 | chief of staff, or their designees, shall serve as the | ||||||
17 | Commission's executive administrators in providing | ||||||
18 | administrative support, research support, and other | ||||||
19 | administrative tasks requested by the Commission's co-chairs. | ||||||
20 | Any expenses, including, but not limited to, travel and | ||||||
21 | housing, shall be paid for by the Department's existing budget. | ||||||
22 | (d) The members of the Commission shall receive no | ||||||
23 | compensation for their services as members of the Commission. | ||||||
24 | (e) The Commission shall meet quarterly beginning as soon | ||||||
25 | as is practicable after the effective date of this amendatory | ||||||
26 | Act 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 | ||||||
17 | impose financial penalties on any managed care entity that is | ||||||
18 | found to not be in compliance with any provision of a State | ||||||
19 | contract. In addition to any financial penalties imposed under | ||||||
20 | this subsection, the Department shall recoup any | ||||||
21 | misappropriated funds identified by the Commission for the | ||||||
22 | purpose of meeting the Business Enterprise Program | ||||||
23 | requirements set forth in contracts with managed care entities. | ||||||
24 | Any financial penalty imposed or funds recouped in accordance | ||||||
25 | with this Section shall be deposited into the Managed Care | ||||||
26 | Oversight Fund. |
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1 | When recommending reasonable financial penalties upon a | ||||||
2 | finding of noncompliance under this subsection, the Commission | ||||||
3 | shall consider the scope and nature of the noncompliance and | ||||||
4 | whether or not it was intentional or unreasonable. In imposing | ||||||
5 | a financial penalty on any managed care entity that is found to | ||||||
6 | not be in compliance, the Department of Healthcare and Family | ||||||
7 | Services shall consider the recommendations of the Commission. | ||||||
8 | Upon conclusion by the Department of Healthcare and Family | ||||||
9 | Services that any managed care entity is not in compliance with | ||||||
10 | its contract with the State based on the findings of the | ||||||
11 | Commission, it shall issue the managed care entity a written | ||||||
12 | notification of noncompliance. The written notice shall | ||||||
13 | specify any financial penalty to be imposed and whether this | ||||||
14 | penalty is consistent with the recommendation of the | ||||||
15 | Commission. If the specified financial penalty differs from the | ||||||
16 | Commission's recommendation, the Department of Healthcare and | ||||||
17 | Family Services shall specify why the Department did not impose | ||||||
18 | the recommended penalty and how the Department arrived at its | ||||||
19 | determination of the reasonableness of the financial penalty | ||||||
20 | imposed. | ||||||
21 | Within 14 calendar days after receipt of the notification | ||||||
22 | of noncompliance, the managed care entity shall submit a | ||||||
23 | written response to the Department of Healthcare and Family | ||||||
24 | Services. The response shall indicate whether the managed care | ||||||
25 | entity: (i) disputes the determination of noncompliance, | ||||||
26 | including any facts or conduct to show compliance; (ii) agrees |
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1 | to the determination of noncompliance and any financial penalty | ||||||
2 | imposed; or (iii) agrees to the determination of noncompliance | ||||||
3 | but disputes the financial penalty imposed. | ||||||
4 | Failure to respond to the notification of noncompliance | ||||||
5 | shall be deemed acceptance of the Department of Healthcare and | ||||||
6 | Family Services' determination of noncompliance. | ||||||
7 | If a managed care entity disputes any part of the | ||||||
8 | Department of Healthcare and Family Services' determination of | ||||||
9 | noncompliance, within 30 calendar days of receipt of the | ||||||
10 | managed care entity's response the Department shall respond in | ||||||
11 | writing whether it (i) agrees to review its determination of | ||||||
12 | noncompliance or (ii) disagrees with the entity's disputation. | ||||||
13 | The Department of Healthcare and Family Services shall | ||||||
14 | issue a written notice to the Commission of the dispute and its | ||||||
15 | chosen response at the same time notice is made to the managed | ||||||
16 | care entity. | ||||||
17 | Nothing in this Section limits or alters a person or | ||||||
18 | entity's existing rights or protections under State or federal | ||||||
19 | law. | ||||||
20 | (h) A decision of the Department of Healthcare and Family | ||||||
21 | Services to impose a financial penalty on a managed care entity | ||||||
22 | for noncompliance under subsection (g) is subject to judicial | ||||||
23 | review under the Administrative Review Law. | ||||||
24 | (i) The Department shall issue quarterly reports to the | ||||||
25 | Governor and the General Assembly indicating: (i) the number of | ||||||
26 | determinations of noncompliance since the last quarter; (ii) |
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1 | the number of financial penalties imposed; and (iii) the | ||||||
2 | outcome or status of each determination. | ||||||
3 | (j) Beginning January 1, 2022, and for each year | ||||||
4 | thereafter, the Commission shall submit a report of its | ||||||
5 | findings and recommendations to the General Assembly. The | ||||||
6 | report to the General Assembly shall be filed with the Clerk of | ||||||
7 | the House of Representatives and the Secretary of the Senate in | ||||||
8 | electronic form only, in the manner that the Clerk and the | ||||||
9 | Secretary shall direct. | ||||||
10 | Article 160. | ||||||
11 | Section 160-5. The State Finance Act is amended by adding | ||||||
12 | Sections 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 | ||||||
17 | Oversight Fund is created as a special fund in the State | ||||||
18 | treasury. Subject to appropriation, available annual moneys in | ||||||
19 | the Fund shall be used by the Department of Healthcare and | ||||||
20 | Family Services to support emergency procurement and sole | ||||||
21 | source contracting with women and minority-owned businesses as | ||||||
22 | part of the Department's Business Enterprise Program |
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1 | requirements. The Department shall prioritize contracts for | ||||||
2 | care coordination services in allocating funds. Funds may not | ||||||
3 | be used for institutional overhead costs, indirect costs, or | ||||||
4 | other organizational levies. | ||||||
5 | Article 165. | ||||||
6 | Section 165-5. The Illinois Public Aid Code is amended by | ||||||
7 | adding Section 5-45 as follows: | ||||||
8 | (305 ILCS 5/5-45 new) | ||||||
9 | Sec. 5-45. Termination of managed care. The Department of | ||||||
10 | Healthcare and Family Services shall not renew, re-enter, | ||||||
11 | renegotiate, change orders, or amend any contract or agreement | ||||||
12 | it entered with a managed care organization, as defined in | ||||||
13 | Section 5-30.1, that was solicited under the State of Illinois | ||||||
14 | Medicaid Managed Care Organization Request for Proposals | ||||||
15 | (2018-24-001). Any care health plan administered by a managed | ||||||
16 | care organization that entered a contract with the Department | ||||||
17 | under the State of Illinois Medicaid Managed Care Organization | ||||||
18 | Request for Proposals 2018-24-001) shall be transitioned to the | ||||||
19 | State's fee-for-service medical assistance program upon the | ||||||
20 | expiration of the managed care organization's contract with the | ||||||
21 | Department until such time the Department enters a new contract | ||||||
22 | in accordance with Section 5-30.6. Any new contract entered | ||||||
23 | into by the Department with a Managed Care Organization in |
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1 | accordance with Section 5-30.6 shall specify the patient | ||||||
2 | diseases that require care planning and assessment, including, | ||||||
3 | but not limited to, social determinants of health as determined | ||||||
4 | by the Centers for Disease Control and Prevention. | ||||||
5 | Article 170. | ||||||
6 | Section 170-5. The Illinois Public Aid Code is amended by | ||||||
7 | adding Section 5-30.16 as follows: | ||||||
8 | (305 ILCS 5/5-30.16 new) | ||||||
9 | Sec. 5-30.16. Managed care organizations; subcontracting | ||||||
10 | diversity requirements. | ||||||
11 | (a) In this Section, "managed care organization" has the | ||||||
12 | meaning given to that term in Section 5-30.1. | ||||||
13 | (b) The Illinois Department shall require each managed care | ||||||
14 | organization participating in the medical assistance program | ||||||
15 | established under this Article to satisfy any minority-owned or | ||||||
16 | women-owned business subcontracting requirements to which the | ||||||
17 | managed care organization is subject under the contract. | ||||||
18 | (c) The Illinois Department shall terminate its contract | ||||||
19 | with any managed care organization that does not meet the | ||||||
20 | minority-owned or women-owned business subcontracting | ||||||
21 | requirements under its contract with the State. The Illinois | ||||||
22 | Department shall terminate the contract no later than 60 days | ||||||
23 | after receiving a contractually required report indicating |
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1 | that the managed care organization has not met the | ||||||
2 | subcontracting goals. To ensure there is no disruption of care | ||||||
3 | to Medicaid recipients who are enrolled with a managed care | ||||||
4 | organization whose contract is terminated as provided under | ||||||
5 | this subsection, the Illinois Department shall reassign to | ||||||
6 | another managed care plan any Medicaid recipient who will lose | ||||||
7 | healthcare coverage as a result of the Illinois Department's | ||||||
8 | decision to terminate its contract with the managed care | ||||||
9 | organization. | ||||||
10 | Title IX. Maternal and Infant Mortality | ||||||
11 | Article 175. | ||||||
12 | Section 175-5. The Illinois Public Aid Code is amended by | ||||||
13 | adding 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 | ||||||
16 | visiting services. | ||||||
17 | (a) As used in this Section: | ||||||
18 | "Home visiting" means a voluntary, evidence-based strategy | ||||||
19 | used to support pregnant people, infants, and young children | ||||||
20 | and their caregivers to promote infant, child, and maternal | ||||||
21 | health, to foster educational development and school | ||||||
22 | readiness, and to help prevent child abuse and neglect. Home |
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1 | visitors are trained professionals whose visits and activities | ||||||
2 | focus on promoting strong parent-child attachment to foster | ||||||
3 | healthy child development. | ||||||
4 | "Perinatal doula" means a trained provider who provides | ||||||
5 | regular, voluntary physical, emotional, and educational | ||||||
6 | support, but not medical or midwife care, to pregnant and | ||||||
7 | birthing persons before, during, and after childbirth, | ||||||
8 | otherwise known as the perinatal period. | ||||||
9 | "Perinatal doula training" means any doula training that | ||||||
10 | focuses on providing support throughout the prenatal, labor and | ||||||
11 | delivery, or postpartum period, and reflects the type of doula | ||||||
12 | care that the doula seeks to provide. | ||||||
13 | (b) Notwithstanding any other provision of this Article, | ||||||
14 | perinatal doula services and evidence-based home visiting | ||||||
15 | services shall be covered under the medical assistance program | ||||||
16 | for persons who are otherwise eligible for medical assistance | ||||||
17 | under this Article. Perinatal doula services include regular | ||||||
18 | visits beginning in the prenatal period and continuing into the | ||||||
19 | postnatal period, inclusive of continuous support during labor | ||||||
20 | and delivery, that support healthy pregnancies and positive | ||||||
21 | birth outcomes. Perinatal doula services may be embedded in an | ||||||
22 | existing program, such as evidence-based home visiting. | ||||||
23 | Perinatal doula services provided during the prenatal period | ||||||
24 | may be provided weekly, services provided during the labor and | ||||||
25 | delivery period may be provided for the entire duration of | ||||||
26 | labor and the time immediately following birth, and services |
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1 | provided during the postpartum period may be provided up to 12 | ||||||
2 | months postpartum. | ||||||
3 | (c) The Department of Healthcare and Family Services shall | ||||||
4 | adopt rules to administer this Section. In this rulemaking, the | ||||||
5 | Department shall consider the expertise of and consult with | ||||||
6 | doula program experts, doula training providers, practicing | ||||||
7 | doulas, and home visiting experts, along with State agencies | ||||||
8 | implementing perinatal doula services and relevant bodies | ||||||
9 | under the Illinois Early Learning Council. This body of experts | ||||||
10 | shall inform the Department on the credentials necessary for | ||||||
11 | perinatal doula and home visiting services to be eligible for | ||||||
12 | Medicaid reimbursement and the rate of reimbursement for home | ||||||
13 | visiting and perinatal doula services in the prenatal, labor | ||||||
14 | and delivery, and postpartum periods. Every 2 years, the | ||||||
15 | Department shall assess the rates of reimbursement for | ||||||
16 | perinatal doula and home visiting services and adjust rates | ||||||
17 | accordingly. | ||||||
18 | {d) The Department shall seek such State plan amendments or | ||||||
19 | waivers as may be necessary to implement this Section and shall | ||||||
20 | secure federal financial participation for expenditures made | ||||||
21 | by 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 | ||||||
2 | becoming law.".
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