Sen. M. Maggie Crotty

Filed: 4/24/2012





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2    AMENDMENT NO. ______. Amend House Bill 3893 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Alcoholism and Other Drug Abuse and
5Dependency Act is amended by changing Section 1-10 as follows:
6    (20 ILCS 301/1-10)
7    Sec. 1-10. Definitions. As used in this Act, unless the
8context clearly indicates otherwise, the following words and
9terms have the following meanings:
10    "Act" means the Alcoholism and Other Drug Abuse and
11Dependency Act.
12    "Addict" means a person who exhibits the disease known as
14    "Addiction" means a disease process characterized by the
15continued use of a specific psycho-active substance despite
16physical, psychological or social harm. The term also describes



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1the advanced stages of chemical dependency.
2    "Administrator" means a person responsible for
3administration of a program.
4    "Alcoholic" means a person who exhibits the disease known
5as "alcoholism".
6    "Alcoholism" means a chronic and progressive disease or
7illness characterized by preoccupation with and loss of control
8over the consumption of alcohol, and the use of alcohol despite
9adverse consequences. Typically, combinations of the following
10tendencies are also present: periodic or chronic intoxication;
11physical disability; impaired emotional, occupational or
12social adjustment; tendency toward relapse; a detrimental
13effect on the individual, his family and society; psychological
14dependence; and physical dependence. Alcoholism is also known
15as addiction to alcohol. Alcoholism is described and further
16categorized in clinical detail in the DSM and the ICD.
17    "Array of services" means assistance to individuals,
18families and communities in response to alcohol or other drug
19abuse or dependency. The array of services includes, but is not
20limited to: prevention assistance for communities and schools;
21case finding, assessment and intervention to help individuals
22stop abusing alcohol or other drugs; a uniform screening,
23assessment, and evaluation process including criteria for
24substance use disorders and mental disorders or co-occurring
25substance use and mental health disorders; case management;
26detoxification to aid individuals in physically withdrawing



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1from alcohol or other drugs; short-term and long-term treatment
2and support services to help individuals and family members
3begin the process of recovery; prescription and dispensing of
4the drug methadone or other medications as an adjunct to
5treatment; relapse prevention services; education and
6counseling for children or other co-dependents of alcoholics or
7other drug abusers or addicts.
8    "Case management" means those services which will assist
9individuals in gaining access to needed social, educational,
10medical, treatment and other services.
11    "Children of alcoholics or drug addicts or abusers of
12alcohol and other drugs" means the minor or adult children of
13individuals who have abused or been dependent upon alcohol or
14other drugs. These children may or may not become dependent
15upon alcohol or other drugs themselves; however, they are
16physically, psychologically, and behaviorally at high risk of
17developing the illness. Children of alcoholics and other drug
18abusers experience emotional and other problems, and benefit
19from prevention and treatment services provided by funded and
20non-funded agencies licensed by the Department.
21    "Co-dependents" means individuals who are involved in the
22lives of and are affected by people who are dependent upon
23alcohol and other drugs. Co-dependents compulsively engage in
24behaviors that cause them to suffer adverse physical,
25emotional, familial, social, behavioral, vocational, and legal
26consequences as they attempt to cope with the alcohol or drug



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1dependent person. People who become co-dependents include
2spouses, parents, siblings, and friends of alcohol or drug
3dependent people. Co-dependents benefit from prevention and
4treatment services provided by agencies licensed by the
6    "Controlled substance" means any substance or immediate
7precursor which is enumerated in the schedules of Article II of
8the Illinois Controlled Substances Act or the Cannabis Control
10    "Crime of violence" means any of the following crimes:
11murder, voluntary manslaughter, criminal sexual assault,
12aggravated criminal sexual assault, predatory criminal sexual
13assault of a child, armed robbery, robbery, arson, kidnapping,
14aggravated battery, aggravated arson, or any other felony which
15involves the use or threat of physical force or violence
16against another individual.
17    "Department" means the Illinois Department of Human
18Services as successor to the former Department of Alcoholism
19and Substance Abuse.
20    "Designated program" means a program designated by the
21Department to provide services described in subsection (c) or
22(d) of Section 15-10 of this Act. A designated program's
23primary function is screening, assessing, referring and
24tracking clients identified by the criminal justice system, and
25the program agrees to apply statewide the standards, uniform
26criteria and procedures established by the Department pursuant



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1to such designation.
2    "Detoxification" means the process of allowing an
3individual to safely withdraw from a drug in a controlled
5    "DSM" means the most current edition of the Diagnostic and
6Statistical Manual of Mental Disorders.
7    "D.U.I." means driving under the influence of alcohol or
8other substances which may cause impairment of driving ability.
9    "Facility" means the building or premises which are used
10for the provision of licensable program services, including
11support services, as set forth by rule.
12    "ICD" means the most current edition of the International
13Classification of Diseases.
14    "Incapacitated" means that a person is unconscious or
15otherwise exhibits, by overt behavior or by extreme physical
16debilitation, an inability to care for his own needs or to
17recognize the obvious danger of his situation or to make
18rational decisions with respect to his need for treatment.
19    "Intermediary person" means a person with expertise
20relative to addiction, alcoholism, and the abuse of alcohol or
21other drugs who may be called on to assist the police in
22carrying out enforcement or other activities with respect to
23persons who abuse or are dependent on alcohol or other drugs.
24    "Intervention" means readily accessible activities which
25assist individuals and their partners or family members in
26coping with the immediate problems of alcohol and other drug



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1abuse or dependency, and in reducing their alcohol and other
2drug use. Intervention can facilitate emotional and social
3stability, and involves referring people for further treatment
4as needed.
5    "Intoxicated person" means a person whose mental or
6physical functioning is substantially impaired as a result of
7the current effects of alcohol or other drugs within the body.
8    "Local advisory council" means an alcohol and substance
9abuse body established in a county, township or community area,
10which represents public and private entities having an interest
11in the prevention and treatment of alcoholism or other drug
13    "Off-site services" means licensable program services or
14activities which are conducted at a location separate from the
15primary service location of the provider, and which services
16are operated by a program or entity licensed under this Act.
17    "Person" means any individual, firm, group, association,
18partnership, corporation, trust, government or governmental
19subdivision or agency.
20    "Prevention" means an interactive process of individuals,
21families, schools, religious organizations, communities and
22regional, state and national organizations to reduce
23alcoholism, prevent the use of illegal drugs and the abuse of
24legal drugs by persons of all ages, prevent the use of alcohol
25by minors, build the capacities of individuals and systems, and
26promote healthy environments, lifestyles and behaviors.



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1    "Program" means a licensable or fundable activity or
2service, or a coordinated range of such activities or services,
3as the Department may establish by rule.
4    "Recovery" means the long-term, often life-long, process
5in which an addicted person changes the way in which he makes
6decisions and establishes personal and life priorities. The
7evolution of this decision-making and priority-setting process
8is generally manifested by an obvious improvement in the
9individual's life and lifestyle and by his overcoming the abuse
10of or dependence on alcohol or other drugs. Recovery is also
11generally manifested by prolonged periods of abstinence from
12addictive chemicals which are not medically supervised.
13Recovery is the goal of treatment.
14    "Rehabilitation" means a process whereby those clinical
15services necessary and appropriate for improving an
16individual's life and lifestyle and for overcoming his or her
17abuse of or dependency upon alcohol or other drugs, or both,
18are delivered in an appropriate setting and manner as defined
19in rules established by the Department.
20    "Relapse" means a process which is manifested by a
21progressive pattern of behavior that reactivates the symptoms
22of a disease or creates debilitating conditions in an
23individual who has experienced remission from addiction or
25    "Secretary" means the Secretary of Human Services or his or
26her designee.



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1    "Substance abuse" or "abuse" means a pattern of use of
2alcohol or other drugs with the potential of leading to
3immediate functional problems or to alcoholism or other drug
4dependency, or to the use of alcohol and/or other drugs solely
5for purposes of intoxication. The term also means the use of
6illegal drugs by persons of any age, and the use of alcohol by
7persons under the age of 21.
8    "Treatment" means the broad range of emergency,
9outpatient, intermediate and residential services and care
10(including assessment, diagnosis, medical, psychiatric,
11psychological and social services, care and counseling, and
12aftercare) which may be extended to individuals who abuse or
13are dependent on alcohol or other drugs or families of those
15(Source: P.A. 89-202, eff. 7-21-95; 89-428, eff. 12-13-95;
1689-462, eff. 5-29-96; 89-507, eff. 7-1-97; 90-14, eff. 7-1-97;
1790-135, eff. 7-22-97.)
18    Section 8. The Illinois Public Aid Code is amended by
19changing Section 5-5 as follows:
20    (305 ILCS 5/5-5)  (from Ch. 23, par. 5-5)
21    Sec. 5-5. Medical services. The Illinois Department, by
22rule, shall determine the quantity and quality of and the rate
23of reimbursement for the medical assistance for which payment
24will be authorized, and the medical services to be provided,



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1which may include all or part of the following: (1) inpatient
2hospital services; (2) outpatient hospital services; (3) other
3laboratory and X-ray services; (4) skilled nursing home
4services; (5) physicians' services whether furnished in the
5office, the patient's home, a hospital, a skilled nursing home,
6or elsewhere; (6) medical care, or any other type of remedial
7care furnished by licensed practitioners; (7) home health care
8services; (8) private duty nursing service; (9) clinic
9services; (10) dental services, including prevention and
10treatment of periodontal disease and dental caries disease for
11pregnant women, provided by an individual licensed to practice
12dentistry or dental surgery; for purposes of this item (10),
13"dental services" means diagnostic, preventive, or corrective
14procedures provided by or under the supervision of a dentist in
15the practice of his or her profession; (11) physical therapy
16and related services; (12) prescribed drugs, dentures, and
17prosthetic devices; and eyeglasses prescribed by a physician
18skilled in the diseases of the eye, or by an optometrist,
19whichever the person may select; (13) other diagnostic,
20screening, preventive, and rehabilitative services, including
21to ensure that the individual's need for intervention or
22treatment of mental disorders or substance use disorders or
23co-occurring mental health and substance use disorders is
24determined using a uniform screening, assessment, and
25evaluation process inclusive of criteria, for children and
26adults; (14) transportation and such other expenses as may be



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1necessary; (15) medical treatment of sexual assault survivors,
2as defined in Section 1a of the Sexual Assault Survivors
3Emergency Treatment Act, for injuries sustained as a result of
4the sexual assault, including examinations and laboratory
5tests to discover evidence which may be used in criminal
6proceedings arising from the sexual assault; (16) the diagnosis
7and treatment of sickle cell anemia; and (17) any other medical
8care, and any other type of remedial care recognized under the
9laws of this State, but not including abortions, or induced
10miscarriages or premature births, unless, in the opinion of a
11physician, such procedures are necessary for the preservation
12of the life of the woman seeking such treatment, or except an
13induced premature birth intended to produce a live viable child
14and such procedure is necessary for the health of the mother or
15her unborn child. The Illinois Department, by rule, shall
16prohibit any physician from providing medical assistance to
17anyone eligible therefor under this Code where such physician
18has been found guilty of performing an abortion procedure in a
19wilful and wanton manner upon a woman who was not pregnant at
20the time such abortion procedure was performed. The term "any
21other type of remedial care" shall include nursing care and
22nursing home service for persons who rely on treatment by
23spiritual means alone through prayer for healing.
24    Notwithstanding any other provision of this Section, a
25comprehensive tobacco use cessation program that includes
26purchasing prescription drugs or prescription medical devices



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1approved by the Food and Drug Administration shall be covered
2under the medical assistance program under this Article for
3persons who are otherwise eligible for assistance under this
5    Notwithstanding any other provision of this Code, the
6Illinois Department may not require, as a condition of payment
7for any laboratory test authorized under this Article, that a
8physician's handwritten signature appear on the laboratory
9test order form. The Illinois Department may, however, impose
10other appropriate requirements regarding laboratory test order
12    The Department of Healthcare and Family Services shall
13provide the following services to persons eligible for
14assistance under this Article who are participating in
15education, training or employment programs operated by the
16Department of Human Services as successor to the Department of
17Public Aid:
18        (1) dental services provided by or under the
19    supervision of a dentist; and
20        (2) eyeglasses prescribed by a physician skilled in the
21    diseases of the eye, or by an optometrist, whichever the
22    person may select.
23    Notwithstanding any other provision of this Code and
24subject to federal approval, the Department may adopt rules to
25allow a dentist who is volunteering his or her service at no
26cost to render dental services through an enrolled



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1not-for-profit health clinic without the dentist personally
2enrolling as a participating provider in the medical assistance
3program. A not-for-profit health clinic shall include a public
4health clinic or Federally Qualified Health Center or other
5enrolled provider, as determined by the Department, through
6which dental services covered under this Section are performed.
7The Department shall establish a process for payment of claims
8for reimbursement for covered dental services rendered under
9this provision.
10    The Illinois Department, by rule, may distinguish and
11classify the medical services to be provided only in accordance
12with the classes of persons designated in Section 5-2.
13    The Department of Healthcare and Family Services must
14provide coverage and reimbursement for amino acid-based
15elemental formulas, regardless of delivery method, for the
16diagnosis and treatment of (i) eosinophilic disorders and (ii)
17short bowel syndrome when the prescribing physician has issued
18a written order stating that the amino acid-based elemental
19formula is medically necessary.
20    The Illinois Department shall authorize the provision of,
21and shall authorize payment for, screening by low-dose
22mammography for the presence of occult breast cancer for women
2335 years of age or older who are eligible for medical
24assistance under this Article, as follows:
25        (A) A baseline mammogram for women 35 to 39 years of
26    age.



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1        (B) An annual mammogram for women 40 years of age or
2    older.
3        (C) A mammogram at the age and intervals considered
4    medically necessary by the woman's health care provider for
5    women under 40 years of age and having a family history of
6    breast cancer, prior personal history of breast cancer,
7    positive genetic testing, or other risk factors.
8        (D) A comprehensive ultrasound screening of an entire
9    breast or breasts if a mammogram demonstrates
10    heterogeneous or dense breast tissue, when medically
11    necessary as determined by a physician licensed to practice
12    medicine in all of its branches.
13    All screenings shall include a physical breast exam,
14instruction on self-examination and information regarding the
15frequency of self-examination and its value as a preventative
16tool. For purposes of this Section, "low-dose mammography"
17means the x-ray examination of the breast using equipment
18dedicated specifically for mammography, including the x-ray
19tube, filter, compression device, and image receptor, with an
20average radiation exposure delivery of less than one rad per
21breast for 2 views of an average size breast. The term also
22includes digital mammography.
23    On and after January 1, 2012, providers participating in a
24quality improvement program approved by the Department shall be
25reimbursed for screening and diagnostic mammography at the same
26rate as the Medicare program's rates, including the increased



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1reimbursement for digital mammography.
2    The Department shall convene an expert panel including
3representatives of hospitals, free-standing mammography
4facilities, and doctors, including radiologists, to establish
5quality standards.
6    Subject to federal approval, the Department shall
7establish a rate methodology for mammography at federally
8qualified health centers and other encounter-rate clinics.
9These clinics or centers may also collaborate with other
10hospital-based mammography facilities.
11    The Department shall establish a methodology to remind
12women who are age-appropriate for screening mammography, but
13who have not received a mammogram within the previous 18
14months, of the importance and benefit of screening mammography.
15    The Department shall establish a performance goal for
16primary care providers with respect to their female patients
17over age 40 receiving an annual mammogram. This performance
18goal shall be used to provide additional reimbursement in the
19form of a quality performance bonus to primary care providers
20who meet that goal.
21    The Department shall devise a means of case-managing or
22patient navigation for beneficiaries diagnosed with breast
23cancer. This program shall initially operate as a pilot program
24in areas of the State with the highest incidence of mortality
25related to breast cancer. At least one pilot program site shall
26be in the metropolitan Chicago area and at least one site shall



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1be outside the metropolitan Chicago area. An evaluation of the
2pilot program shall be carried out measuring health outcomes
3and cost of care for those served by the pilot program compared
4to similarly situated patients who are not served by the pilot
6    Any medical or health care provider shall immediately
7recommend, to any pregnant woman who is being provided prenatal
8services and is suspected of drug abuse or is addicted as
9defined in the Alcoholism and Other Drug Abuse and Dependency
10Act, referral to a local substance abuse treatment provider
11licensed by the Department of Human Services or to a licensed
12hospital which provides substance abuse treatment services.
13The Department of Healthcare and Family Services shall assure
14coverage for the cost of treatment of the drug abuse or
15addiction for pregnant recipients in accordance with the
16Illinois Medicaid Program in conjunction with the Department of
17Human Services.
18    All medical providers providing medical assistance to
19pregnant women under this Code shall receive information from
20the Department on the availability of services under the Drug
21Free Families with a Future or any comparable program providing
22case management services for addicted women, including
23information on appropriate referrals for other social services
24that may be needed by addicted women in addition to treatment
25for addiction.
26    The Illinois Department, in cooperation with the



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1Departments of Human Services (as successor to the Department
2of Alcoholism and Substance Abuse) and Public Health, through a
3public awareness campaign, may provide information concerning
4treatment for alcoholism and drug abuse and addiction, prenatal
5health care, and other pertinent programs directed at reducing
6the number of drug-affected infants born to recipients of
7medical assistance.
8    Neither the Department of Healthcare and Family Services
9nor the Department of Human Services shall sanction the
10recipient solely on the basis of her substance abuse.
11    The Illinois Department shall establish such regulations
12governing the dispensing of health services under this Article
13as it shall deem appropriate. The Department should seek the
14advice of formal professional advisory committees appointed by
15the Director of the Illinois Department for the purpose of
16providing regular advice on policy and administrative matters,
17information dissemination and educational activities for
18medical and health care providers, and consistency in
19procedures to the Illinois Department.
20    Notwithstanding any other provision of law, a health care
21provider under the medical assistance program may elect, in
22lieu of receiving direct payment for services provided under
23that program, to participate in the State Employees Deferred
24Compensation Plan adopted under Article 24 of the Illinois
25Pension Code. A health care provider who elects to participate
26in the plan does not have a cause of action against the State



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1for any damages allegedly suffered by the provider as a result
2of any delay by the State in crediting the amount of any
3contribution to the provider's plan account.
4    The Illinois Department may develop and contract with
5Partnerships of medical providers to arrange medical services
6for persons eligible under Section 5-2 of this Code.
7Implementation of this Section may be by demonstration projects
8in certain geographic areas. The Partnership shall be
9represented by a sponsor organization. The Department, by rule,
10shall develop qualifications for sponsors of Partnerships.
11Nothing in this Section shall be construed to require that the
12sponsor organization be a medical organization.
13    The sponsor must negotiate formal written contracts with
14medical providers for physician services, inpatient and
15outpatient hospital care, home health services, treatment for
16alcoholism and substance abuse, and other services determined
17necessary by the Illinois Department by rule for delivery by
18Partnerships. Physician services must include prenatal and
19obstetrical care. The Illinois Department shall reimburse
20medical services delivered by Partnership providers to clients
21in target areas according to provisions of this Article and the
22Illinois Health Finance Reform Act, except that:
23        (1) Physicians participating in a Partnership and
24    providing certain services, which shall be determined by
25    the Illinois Department, to persons in areas covered by the
26    Partnership may receive an additional surcharge for such



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1    services.
2        (2) The Department may elect to consider and negotiate
3    financial incentives to encourage the development of
4    Partnerships and the efficient delivery of medical care.
5        (3) Persons receiving medical services through
6    Partnerships may receive medical and case management
7    services above the level usually offered through the
8    medical assistance program.
9    Medical providers shall be required to meet certain
10qualifications to participate in Partnerships to ensure the
11delivery of high quality medical services. These
12qualifications shall be determined by rule of the Illinois
13Department and may be higher than qualifications for
14participation in the medical assistance program. Partnership
15sponsors may prescribe reasonable additional qualifications
16for participation by medical providers, only with the prior
17written approval of the Illinois Department.
18    Nothing in this Section shall limit the free choice of
19practitioners, hospitals, and other providers of medical
20services by clients. In order to ensure patient freedom of
21choice, the Illinois Department shall immediately promulgate
22all rules and take all other necessary actions so that provided
23services may be accessed from therapeutically certified
24optometrists to the full extent of the Illinois Optometric
25Practice Act of 1987 without discriminating between service



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1    The Department shall apply for a waiver from the United
2States Health Care Financing Administration to allow for the
3implementation of Partnerships under this Section.
4    The Illinois Department shall require health care
5providers to maintain records that document the medical care
6and services provided to recipients of Medical Assistance under
7this Article. Such records must be retained for a period of not
8less than 6 years from the date of service or as provided by
9applicable State law, whichever period is longer, except that
10if an audit is initiated within the required retention period
11then the records must be retained until the audit is completed
12and every exception is resolved. The Illinois Department shall
13require health care providers to make available, when
14authorized by the patient, in writing, the medical records in a
15timely fashion to other health care providers who are treating
16or serving persons eligible for Medical Assistance under this
17Article. All dispensers of medical services shall be required
18to maintain and retain business and professional records
19sufficient to fully and accurately document the nature, scope,
20details and receipt of the health care provided to persons
21eligible for medical assistance under this Code, in accordance
22with regulations promulgated by the Illinois Department. The
23rules and regulations shall require that proof of the receipt
24of prescription drugs, dentures, prosthetic devices and
25eyeglasses by eligible persons under this Section accompany
26each claim for reimbursement submitted by the dispenser of such



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1medical services. No such claims for reimbursement shall be
2approved for payment by the Illinois Department without such
3proof of receipt, unless the Illinois Department shall have put
4into effect and shall be operating a system of post-payment
5audit and review which shall, on a sampling basis, be deemed
6adequate by the Illinois Department to assure that such drugs,
7dentures, prosthetic devices and eyeglasses for which payment
8is being made are actually being received by eligible
9recipients. Within 90 days after the effective date of this
10amendatory Act of 1984, the Illinois Department shall establish
11a current list of acquisition costs for all prosthetic devices
12and any other items recognized as medical equipment and
13supplies reimbursable under this Article and shall update such
14list on a quarterly basis, except that the acquisition costs of
15all prescription drugs shall be updated no less frequently than
16every 30 days as required by Section 5-5.12.
17    The rules and regulations of the Illinois Department shall
18require that a written statement including the required opinion
19of a physician shall accompany any claim for reimbursement for
20abortions, or induced miscarriages or premature births. This
21statement shall indicate what procedures were used in providing
22such medical services.
23    The Illinois Department shall require all dispensers of
24medical services, other than an individual practitioner or
25group of practitioners, desiring to participate in the Medical
26Assistance program established under this Article to disclose



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1all financial, beneficial, ownership, equity, surety or other
2interests in any and all firms, corporations, partnerships,
3associations, business enterprises, joint ventures, agencies,
4institutions or other legal entities providing any form of
5health care services in this State under this Article.
6    The Illinois Department may require that all dispensers of
7medical services desiring to participate in the medical
8assistance program established under this Article disclose,
9under such terms and conditions as the Illinois Department may
10by rule establish, all inquiries from clients and attorneys
11regarding medical bills paid by the Illinois Department, which
12inquiries could indicate potential existence of claims or liens
13for the Illinois Department.
14    Enrollment of a vendor that provides non-emergency medical
15transportation, defined by the Department by rule, shall be
16conditional for 180 days. During that time, the Department of
17Healthcare and Family Services may terminate the vendor's
18eligibility to participate in the medical assistance program
19without cause. That termination of eligibility is not subject
20to the Department's hearing process.
21    The Illinois Department shall establish policies,
22procedures, standards and criteria by rule for the acquisition,
23repair and replacement of orthotic and prosthetic devices and
24durable medical equipment. Such rules shall provide, but not be
25limited to, the following services: (1) immediate repair or
26replacement of such devices by recipients without medical



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1authorization; and (2) rental, lease, purchase or
2lease-purchase of durable medical equipment in a
3cost-effective manner, taking into consideration the
4recipient's medical prognosis, the extent of the recipient's
5needs, and the requirements and costs for maintaining such
6equipment. Such rules shall enable a recipient to temporarily
7acquire and use alternative or substitute devices or equipment
8pending repairs or replacements of any device or equipment
9previously authorized for such recipient by the Department.
10    The Department shall execute, relative to the nursing home
11prescreening project, written inter-agency agreements with the
12Department of Human Services and the Department on Aging, to
13effect the following: (i) intake procedures and common
14eligibility criteria for those persons who are receiving
15non-institutional services; and (ii) the establishment and
16development of non-institutional services in areas of the State
17where they are not currently available or are undeveloped.
18    The Illinois Department shall develop and operate, in
19cooperation with other State Departments and agencies and in
20compliance with applicable federal laws and regulations,
21appropriate and effective systems of health care evaluation and
22programs for monitoring of utilization of health care services
23and facilities, as it affects persons eligible for medical
24assistance under this Code.
25    The Illinois Department shall report annually to the
26General Assembly, no later than the second Friday in April of



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11979 and each year thereafter, in regard to:
2        (a) actual statistics and trends in utilization of
3    medical services by public aid recipients;
4        (b) actual statistics and trends in the provision of
5    the various medical services by medical vendors;
6        (c) current rate structures and proposed changes in
7    those rate structures for the various medical vendors; and
8        (d) efforts at utilization review and control by the
9    Illinois Department.
10    The period covered by each report shall be the 3 years
11ending on the June 30 prior to the report. The report shall
12include suggested legislation for consideration by the General
13Assembly. The filing of one copy of the report with the
14Speaker, one copy with the Minority Leader and one copy with
15the Clerk of the House of Representatives, one copy with the
16President, one copy with the Minority Leader and one copy with
17the Secretary of the Senate, one copy with the Legislative
18Research Unit, and such additional copies with the State
19Government Report Distribution Center for the General Assembly
20as is required under paragraph (t) of Section 7 of the State
21Library Act shall be deemed sufficient to comply with this
23    Rulemaking authority to implement Public Act 95-1045, if
24any, is conditioned on the rules being adopted in accordance
25with all provisions of the Illinois Administrative Procedure
26Act and all rules and procedures of the Joint Committee on



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1Administrative Rules; any purported rule not so adopted, for
2whatever reason, is unauthorized.
3(Source: P.A. 96-156, eff. 1-1-10; 96-806, eff. 7-1-10; 96-926,
4eff. 1-1-11; 96-1000, eff. 7-2-10; 97-48, eff. 6-28-11; 97-638,
5eff. 1-1-12.)
6    Section 10. The Community Services Act is amended by
7changing Section 2 as follows:
8    (405 ILCS 30/2)  (from Ch. 91 1/2, par. 902)
9    Sec. 2. Community Services System. Services should be
10planned, developed, delivered and evaluated as part of a
11comprehensive and coordinated system. The Department of Human
12Services shall encourage the establishment of services in each
13area of the State which cover the services categories described
14below. What specific services are provided under each service
15category shall be based on local needs; special attention shall
16be given to unserved and underserved populations, including
17children and youth, racial and ethnic minorities, and the
18elderly. The service categories shall include:
19    (a) Prevention: services designed primarily to reduce the
20incidence and ameliorate the severity of developmental
21disabilities, mental illness and alcohol and drug dependence;
22    (b) Client Assessment and Diagnosis: services designed to
23identify persons with developmental disabilities, mental
24illness and alcohol and drug dependency; to determine the



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1extent of the disability and the level of functioning; to
2ensure that the individual's need for treatment of mental
3disorders or substance use disorders or co-occurring substance
4use and mental health disorders is determined using a uniform
5screening, assessment, and evaluation process inclusive of
6criteria; information obtained through client evaluation can
7be used in individual treatment and habilitation plans; to
8assure appropriate placement and to assist in program
10    (c) Case Coordination: services to provide information and
11assistance to disabled persons to insure that they obtain
12needed services provided by the private and public sectors;
13case coordination services should be available to individuals
14whose functioning level or history of institutional recidivism
15or long-term care indicate that such assistance is required for
16successful community living;
17    (d) Crisis and Emergency: services to assist individuals
18and their families through crisis periods, to stabilize
19individuals under stress and to prevent unnecessary
21    (e) Treatment, Habilitation and Support: services designed
22to help individuals develop skills which promote independence
23and improved levels of social and vocational functioning and
24personal growth; and to provide non-treatment support services
25which are necessary for successful community living;
26    (f) Community Residential Alternatives to Institutional



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1Settings: services to provide living arrangements for persons
2unable to live independently; the level of supervision,
3services provided and length of stay at community residential
4alternatives will vary by the type of program and the needs and
5functioning level of the residents; other services may be
6provided in a community residential alternative which promote
7the acquisition of independent living skills and integration
8with the community.
9(Source: P.A. 89-507, eff. 7-1-97.)
10    Section 99. Effective date. This Act takes effect upon
11becoming law.".