Sen. Dale A. Righter
Filed: 3/18/2014
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1 | AMENDMENT TO SENATE BILL 3415
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2 | AMENDMENT NO. ______. Amend Senate Bill 3415 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Illinois Public Aid Code is amended by | ||||||
5 | changing Sections 11-5.2 and 11-5.3 as follows: | ||||||
6 | (305 ILCS 5/11-5.2) | ||||||
7 | Sec. 11-5.2. Income, Residency, and Identity Verification | ||||||
8 | System. The General Assembly finds that the Department of Human | ||||||
9 | Services has made every reasonable effort to utilize State | ||||||
10 | employees to perform eligibility determinations and | ||||||
11 | redeterminations on applicants and recipients of assistance | ||||||
12 | provided under Article V of this Code. However, the General | ||||||
13 | Assembly declares that there exist conditions in the State that | ||||||
14 | require the Department of Healthcare and Family Services to | ||||||
15 | procure a vendor to verify eligibility. | ||||||
16 | (a) The Department shall ensure that its proposed |
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1 | integrated eligibility system shall include the computerized | ||||||
2 | functions of income, residency, and identity eligibility | ||||||
3 | verification to verify eligibility, eliminate duplication of | ||||||
4 | medical assistance, and deter fraud. The Governor or his or her | ||||||
5 | designee shall meet with the exclusive representative as that | ||||||
6 | term is defined in the Illinois Public Labor Relations Act | ||||||
7 | within 14 days after the effective date of this amendatory Act | ||||||
8 | of the 98th General Assembly for the purpose of discussing the | ||||||
9 | reasons for a potential proposal to subcontract bargaining unit | ||||||
10 | work under this Section. Beginning on the 15th day after the | ||||||
11 | effective date of this amendatory Act of the 98th General | ||||||
12 | Assembly, the Department of Human Services shall begin the | ||||||
13 | process of determining whether or not labor relations between | ||||||
14 | the State of Illinois and the Department of Human Services' | ||||||
15 | public employees are currently governed by a collective | ||||||
16 | bargaining agreement as authorized by the Illinois Public Labor | ||||||
17 | Relations Act and shall make a final determination by the 16th | ||||||
18 | day after the effective date of this amendatory Act. Until the | ||||||
19 | integrated eligibility system is operational and in order to | ||||||
20 | achieve greater efficiency and economy, if, after review of | ||||||
21 | existing bargaining agreements the Department of Human | ||||||
22 | Services determines that relations between the State of | ||||||
23 | Illinois and the Department of Human Services' public employees | ||||||
24 | are currently governed by a collective bargaining agreement , | ||||||
25 | the Department shall may enter into a contract with the vendor | ||||||
26 | selected pursuant to Section 11-5.3 as necessary to obtain the |
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1 | electronic data matching described in this Section. This | ||||||
2 | contract shall be exempt from the Illinois Procurement Code | ||||||
3 | pursuant to subsection (h) of Section 1-10 of that Code. | ||||||
4 | Prior to fulfilling their obligations under this | ||||||
5 | subsection, the Department of Human Services and the Department | ||||||
6 | of Healthcare and Family Services shall comply with all notice | ||||||
7 | and procedural requirements mandated by any labor agreement, if | ||||||
8 | any exists. | ||||||
9 | Prior to issuing a request for services pursuant to their | ||||||
10 | obligations under this subsection, the Department of Human | ||||||
11 | Services and the Department of Healthcare and Family Services | ||||||
12 | shall provide advance notice, which shall not be less than 45 | ||||||
13 | days, except in emergency situations, in writing, to the | ||||||
14 | exclusive representative as that term is defined in the | ||||||
15 | Illinois Public Labor Relations Act. | ||||||
16 | (b) Prior to awarding medical assistance at application | ||||||
17 | under Article V of this Code, the Department shall, to the | ||||||
18 | extent such databases are available to the Department, conduct | ||||||
19 | data matches using the name, date of birth, address, and Social | ||||||
20 | Security Number of each applicant or recipient or responsible | ||||||
21 | relative of an applicant or recipient against the following: | ||||||
22 | (1) Income tax information. | ||||||
23 | (2) Employer reports of income and unemployment | ||||||
24 | insurance payment information maintained by the Department | ||||||
25 | of Employment Security. | ||||||
26 | (3) Earned and unearned income, citizenship and death, |
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1 | and other relevant information maintained by the Social | ||||||
2 | Security Administration. | ||||||
3 | (4) Immigration status information maintained by the | ||||||
4 | United States Citizenship and Immigration Services. | ||||||
5 | (5) Wage reporting and similar information maintained | ||||||
6 | by states contiguous to this State. | ||||||
7 | (6) Employment information maintained by the | ||||||
8 | Department of Employment Security in its New Hire Directory | ||||||
9 | database. | ||||||
10 | (7) Employment information maintained by the United | ||||||
11 | States Department of Health and Human Services in its | ||||||
12 | National Directory of New Hires database. | ||||||
13 | (8) Veterans' benefits information maintained by the | ||||||
14 | United States Department of Health and Human Services, in | ||||||
15 | coordination with the Department of Health and Human | ||||||
16 | Services and the Department of Veterans' Affairs, in the | ||||||
17 | federal Public Assistance Reporting Information System | ||||||
18 | (PARIS) database. | ||||||
19 | (9) Residency information maintained by the Illinois | ||||||
20 | Secretary of State. | ||||||
21 | (10) A database which is substantially similar to or a | ||||||
22 | successor of a database described in this Section that | ||||||
23 | contains information relevant for verifying eligibility | ||||||
24 | for medical assistance. | ||||||
25 | (c) (Blank). | ||||||
26 | (d) If a discrepancy results between information provided |
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1 | by an applicant, recipient, or responsible relative and | ||||||
2 | information contained in one or more of the databases or | ||||||
3 | information tools listed under subsection (b) or (c) of this | ||||||
4 | Section or subsection (c) of Section 11-5.3 and that | ||||||
5 | discrepancy calls into question the accuracy of information | ||||||
6 | relevant to a condition of eligibility provided by the | ||||||
7 | applicant, recipient, or responsible relative, the Department | ||||||
8 | or its contractor shall review the applicant's or recipient's | ||||||
9 | case using the following procedures: | ||||||
10 | (1) If the information discovered under subsection (b) | ||||||
11 | (c) of this Section or subsection (c) of Section 11-5.3 | ||||||
12 | does not result in the Department finding the applicant or | ||||||
13 | recipient ineligible for assistance under Article V of this | ||||||
14 | Code, the Department shall finalize the determination or | ||||||
15 | redetermination of eligibility. | ||||||
16 | (2) If the information discovered results in the | ||||||
17 | Department finding the applicant or recipient ineligible | ||||||
18 | for assistance, the Department shall provide notice as set | ||||||
19 | forth in Section 11-7 of this Article. | ||||||
20 | (3) If the information discovered is insufficient to | ||||||
21 | determine that the applicant or recipient is eligible or | ||||||
22 | ineligible, the Department shall provide written notice to | ||||||
23 | the applicant or recipient which shall describe in | ||||||
24 | sufficient detail the circumstances of the discrepancy, | ||||||
25 | the information or documentation required, the manner in | ||||||
26 | which the applicant or recipient may respond, and the |
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1 | consequences of failing to take action. The applicant or | ||||||
2 | recipient shall have 10 business days to respond. | ||||||
3 | (4) If the applicant or recipient does not respond to | ||||||
4 | the notice, the Department shall deny assistance for | ||||||
5 | failure to cooperate, in which case the Department shall | ||||||
6 | provide notice as set forth in Section 11-7. Eligibility | ||||||
7 | for assistance shall not be established until the | ||||||
8 | discrepancy has been resolved. | ||||||
9 | (5) If an applicant or recipient responds to the | ||||||
10 | notice, the Department shall determine the effect of the | ||||||
11 | information or documentation provided on the applicant's | ||||||
12 | or recipient's case and shall take appropriate action. | ||||||
13 | Written notice of the Department's action shall be provided | ||||||
14 | as set forth in Section 11-7 of this Article. | ||||||
15 | (6) Suspected cases of fraud shall be referred to the | ||||||
16 | Department's Inspector General. | ||||||
17 | (e) The Department shall adopt any rules necessary to | ||||||
18 | implement this Section.
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19 | (Source: P.A. 97-689, eff. 6-14-12; revised 11-12-13.) | ||||||
20 | (305 ILCS 5/11-5.3) | ||||||
21 | Sec. 11-5.3. Procurement of vendor to verify eligibility | ||||||
22 | for assistance under Article V. | ||||||
23 | (a) No later than 70 60 days after the effective date of | ||||||
24 | this amendatory Act of the 98th 97th General Assembly, the | ||||||
25 | Chief Procurement Officer for General Services, in |
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1 | consultation with the Department of Healthcare and Family | ||||||
2 | Services, shall conduct and complete any procurement necessary | ||||||
3 | to procure a vendor to verify eligibility for assistance under | ||||||
4 | Article V of this Code. Such authority shall include procuring | ||||||
5 | a vendor to assist the Chief Procurement Officer in conducting | ||||||
6 | the procurement. The Chief Procurement Officer and the | ||||||
7 | Department shall jointly negotiate final contract terms with a | ||||||
8 | vendor selected by the Chief Procurement Officer. Within 30 | ||||||
9 | days of selection of an eligibility verification vendor, the | ||||||
10 | Department of Healthcare and Family Services shall enter into a | ||||||
11 | contract with the selected vendor. The Department of Healthcare | ||||||
12 | and Family Services and the Department of Human Services shall | ||||||
13 | cooperate with and provide any information requested by the | ||||||
14 | Chief Procurement Officer to conduct the procurement. | ||||||
15 | (b) Notwithstanding any other provision of law, any | ||||||
16 | procurement or contract necessary to comply with this Section | ||||||
17 | shall be exempt from: (i) the Illinois Procurement Code | ||||||
18 | pursuant to Section 1-10(h) of the Illinois Procurement Code, | ||||||
19 | except that bidders shall comply with the disclosure | ||||||
20 | requirement in Sections 50-10.5(a) through (d), 50-13, 50-35, | ||||||
21 | and 50-37 of the Illinois Procurement Code and a vendor awarded | ||||||
22 | a contract under this Section shall comply with Section 50-37 | ||||||
23 | of the Illinois Procurement Code; (ii) any administrative rules | ||||||
24 | of this State pertaining to procurement or contract formation; | ||||||
25 | and (iii) any State or Department policies or procedures | ||||||
26 | pertaining to procurement, contract formation, contract award, |
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1 | and Business Enterprise Program approval. | ||||||
2 | (c) Upon becoming operational, the contractor shall | ||||||
3 | conduct data matches using the name, date of birth, address, | ||||||
4 | and Social Security Number of each applicant and recipient | ||||||
5 | against public records to verify eligibility. The contractor, | ||||||
6 | upon preliminary determination that an enrollee is eligible or | ||||||
7 | ineligible, shall notify the Department, except that the | ||||||
8 | contractor shall not make preliminary determinations regarding | ||||||
9 | the eligibility of persons residing in long term care | ||||||
10 | facilities whose income and resources were at or below the | ||||||
11 | applicable financial eligibility standards at the time of their | ||||||
12 | last review. Within 20 business days of such notification, the | ||||||
13 | Department shall accept the recommendation or reject it with a | ||||||
14 | stated reason. The Department shall retain final authority over | ||||||
15 | eligibility determinations. The contractor shall keep a record | ||||||
16 | of all preliminary determinations of ineligibility | ||||||
17 | communicated to the Department. Within 30 days of the end of | ||||||
18 | each calendar quarter, the Department and contractor shall file | ||||||
19 | a joint report on a quarterly basis to the Governor, the | ||||||
20 | Speaker of the House of Representatives, the Minority Leader of | ||||||
21 | the House of Representatives, the Senate President, and the | ||||||
22 | Senate Minority Leader. The report shall include, but shall not | ||||||
23 | be limited to, monthly recommendations of preliminary | ||||||
24 | determinations of eligibility or ineligibility communicated by | ||||||
25 | the contractor, the actions taken on those preliminary | ||||||
26 | determinations by the Department, and the stated reasons for |
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1 | those recommendations that the Department rejected. | ||||||
2 | (d) An eligibility verification vendor contract shall be | ||||||
3 | awarded for an initial 2-year period with up to a maximum of 2 | ||||||
4 | one-year renewal options. Nothing in this Section shall compel | ||||||
5 | the award of a contract to a vendor that fails to meet the | ||||||
6 | needs of the Department. A contract with a vendor to assist in | ||||||
7 | the procurement shall be awarded for a period of time not to | ||||||
8 | exceed 6 months.
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9 | (e) The provisions of this Section shall be administered in | ||||||
10 | compliance with federal law. | ||||||
11 | (Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
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12 | Section 99. Effective date. This Act takes effect upon | ||||||
13 | becoming law.".
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