SB2043 Enrolled LRB096 11169 DRJ 21882 b

1     AN ACT concerning public aid.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Public Aid Code is amended by
5 changing Sections 5-24 and 12-4.201 as follows:
 
6     (305 ILCS 5/5-24)
7     (Section scheduled to be repealed on January 1, 2014)
8     Sec. 5-24. Disease management programs and services for
9 chronic conditions; pilot project.
10     (a) In this Section, "disease management programs and
11 services" means services administered to patients in order to
12 improve their overall health and to prevent clinical
13 exacerbations and complications, using cost-effective,
14 evidence-based practice guidelines and patient self-management
15 strategies. Disease management programs and services include
16 all of the following:
17         (1) A population identification process.
18         (2) Evidence-based or consensus-based clinical
19     practice guidelines, risk identification, and matching of
20     interventions with clinical need.
21         (3) Patient self-management and disease education.
22         (4) Process and outcomes measurement, evaluation,
23     management, and reporting.

 

 

SB2043 Enrolled - 2 - LRB096 11169 DRJ 21882 b

1     (b) Subject to appropriations, the Department of
2 Healthcare and Family Services may undertake a pilot project to
3 study patient outcomes, for patients with chronic diseases or
4 patients at risk of low birth weight or premature birth,
5 associated with the use of disease management programs and
6 services for chronic condition management. "Chronic diseases"
7 include, but are not limited to, diabetes, congestive heart
8 failure, and chronic obstructive pulmonary disease. Low birth
9 weight and premature birth include all medical and other
10 conditions that lead to poor birth outcomes or problematic
11 pregnancies.
12     (c) The disease management programs and services pilot
13 project shall examine whether chronic disease management
14 programs and services for patients with specific chronic
15 conditions do any or all of the following:
16         (1) Improve the patient's overall health in a more
17     expeditious manner.
18         (2) Lower costs in other aspects of the medical
19     assistance program, such as hospital admissions, days in
20     skilled nursing homes, emergency room visits, or more
21     frequent physician office visits.
22     (d) In carrying out the pilot project, the Department of
23 Healthcare and Family Services shall examine all relevant
24 scientific literature and shall consult with health care
25 practitioners including, but not limited to, physicians,
26 surgeons, registered pharmacists, and registered nurses.

 

 

SB2043 Enrolled - 3 - LRB096 11169 DRJ 21882 b

1     (e) The Department of Healthcare and Family Services shall
2 consult with medical experts, disease advocacy groups, and
3 academic institutions to develop criteria to be used in
4 selecting a vendor for the pilot project.
5     (f) The Department of Healthcare and Family Services may
6 adopt rules to implement this Section.
7     (g) This Section is repealed 10 years after the effective
8 date of this amendatory Act of the 93rd General Assembly.
9 (Source: P.A. 95-331, eff. 8-21-07.)
 
10     (305 ILCS 5/12-4.201)
11     Sec. 12-4.201. (a) Data warehouse concerning medical and
12 related services. The Department of Healthcare and Family
13 Services may purchase services and materials associated with
14 the costs of developing and implementing a data warehouse
15 comprised of management and decision making information in
16 regard to the liability associated with, and utilization of,
17 medical and related services, out of moneys available for that
18 purpose.
19     (b) The Department of Healthcare and Family Services shall
20 perform all necessary administrative functions to expand its
21 linearly-scalable data warehouse to encompass other healthcare
22 data sources at both the Department of Human Services and the
23 Department of Public Health. The Department of Healthcare and
24 Family Services shall leverage the inherent capabilities of the
25 data warehouse to accomplish this expansion with marginal

 

 

SB2043 Enrolled - 4 - LRB096 11169 DRJ 21882 b

1 additional technical administration. The purpose of this
2 expansion is to allow for programmatic review and analysis
3 including the interrelatedness among the various healthcare
4 programs in order to ascertain effectiveness toward, and
5 ultimate impact on, clients. Beginning July 1, 2005, the
6 Department of Healthcare and Family Services (formerly
7 Department of Public Aid) shall supply quarterly reports to the
8 Commission on Government Forecasting and Accountability
9 detailing progress toward this mandate.
10     (c) The Department of Healthcare and Family Services (HFS),
11 the Illinois Department of Public Health, the Illinois
12 Department of Human Services, and the Division of Specialized
13 Care for Children, University of Illinois at Chicago, with
14 necessary support from the Department of Central Management
15 Services, shall integrate into the medical data warehouse
16 individual record level data owned by one of these agencies
17 that pertains to maternal and child health, including the
18 following data sets:
19         (1) Vital Records as they relate to births, birth
20     outcomes, and deaths.
21         (2) Adverse Pregnancy Outcomes Reporting System
22     (APORS).
23         (3) Genetics/Newborn Screenings/SIDS.
24         (4) Cornerstone (WIC, FCM, Teen Parents,
25     Immunization).
26         (5) HFS medical claims data.

 

 

SB2043 Enrolled - 5 - LRB096 11169 DRJ 21882 b

1         (6) I-CARE.
2         (7) Children with Special Healthcare Needs Data.
3     By September 1, 2009, the departments of Healthcare and
4 Family Services, Public Health, and Human Services and the
5 Division of Specialized Care for Children shall jointly prepare
6 a work plan for fully integrating these data sets into the
7 medical data warehouse. The work plan shall provide an overall
8 project design, including defining a mutually acceptable
9 transfer format for each discrete data set, the data update
10 frequency, and a single method of data transfer for each data
11 set. By October 1, 2009, the Department of Public Health shall
12 grant to the Department of Healthcare and Family Services
13 complete access to all vital records data. The Department of
14 Public Health shall prepare a report detailing that this task
15 has been accomplished and submit this report to the Commission
16 on Government Forecasting and Accountability by October 15,
17 2009. By March 1, 2010, the data sets shall be completely
18 loaded into the medical data warehouse. By July 1, 2010, data
19 from the various sources shall be processed so as to be
20 compatible with other data in the medical data warehouse and
21 available for analysis in an integrated manner.
22     With the cooperation of the other agencies, HFS shall
23 submit status reports on the progress of these efforts to the
24 Governor and the General Assembly no later than October 1, 2009
25 and April 1, 2010, with a final report due no later than
26 November 1, 2010.

 

 

SB2043 Enrolled - 6 - LRB096 11169 DRJ 21882 b

1     On an ongoing basis, the 4 agencies shall review the
2 feasibility of adding data from additional sources to the
3 warehouse. Such review may take into account the cost
4 effectiveness of adding the data, the utility of adding data
5 that is not available as identifiable individual record level
6 data, the requirements related to adding data owned by another
7 entity or not available in electronic form, whether sharing of
8 the data is otherwise prohibited by law and the resources
9 required and available for effecting the addition.
10     The departments shall use analysis of the data in the
11 medical data warehouse to improve maternal and child health
12 outcomes, and in particular improve birth outcomes, and to
13 reduce racial health disparities in this area.
14     All access and use of the data shall be in compliance with
15 all applicable federal and State laws, regulations, and
16 mandates.
17     Notwithstanding anything in this Section, data
18 incorporated into the data warehouse shall remain subject to
19 the same provisions of law regarding confidentiality and use
20 restrictions as they are subject to in the control of the
21 contributing agency. The Department of Healthcare and Family
22 Services shall develop measures to ensure that the interplay of
23 the several data sets contributed to the data warehouse does
24 not lead to the use or release of data from the data warehouse
25 that would not otherwise be subject to use or release under
26 State or federal law.

 

 

SB2043 Enrolled - 7 - LRB096 11169 DRJ 21882 b

1 (Source: P.A. 94-267, eff. 7-19-05; 95-331, eff. 8-21-07.)
 
2     Section 99. Effective date. This Act takes effect upon
3 becoming law.