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90_HB3143
305 ILCS 5/5-19 from Ch. 23, par. 5-19
305 ILCS 5/9A-11 from Ch. 23, par. 9A-11
Amends the Illinois Public Aid by making technical
changes to Sections concerning the Healthy Kids Program and
child care services.
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1 AN ACT to amend the Public Aid Code by changing Sections
2 5-19 and 9A-11.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Public Aid Code is amended by
6 changing Sections 5-19 and 9A-11 as follows:
7 (305 ILCS 5/5-19) (from Ch. 23, par. 5-19)
8 Sec. 5-19. Healthy Kids Program.
9 (a) Any child under the age of 21 eligible to receive
10 Medical Assistance from the Illinois Department under Article
11 V of this Code shall be eligible for Early and Periodic
12 Screening, Diagnosis and Treatment services provided by the
13 Healthy Kids Program of the Illinois Department under the
14 Social Security Act, 42 U.S.C. 1396d(r).
15 (b) Enrollment of Children in Medicaid. The Illinois
16 Department shall provide for receipt and initial processing
17 of applications for Medical Assistance for all pregnant women
18 and children under the age of 21 at locations in addition to
19 those used for processing applications for cash assistance,
20 including disproportionate share hospitals, federally
21 qualified health centers and other sites as selected by the
22 Illinois Department.
23 (c) Healthy Kids Examinations. The Illinois Department
24 shall consider any examination of a child eligible for the
25 Healthy Kids services provided by a medical provider meeting
26 the requirements and complying with the rules and regulations
27 of the Illinois Department to be reimbursed as a Healthy Kids
28 examination.
29 (d) Medical Screening Examinations.
30 (1) The Illinois Department shall insure Medicaid
31 coverage for periodic health, vision, hearing, and dental
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1 screenings for children eligible for Healthy Kids
2 services scheduled from a child's birth up until the
3 child turns 21 years. The Illinois Department shall pay
4 for vision, hearing, dental and health screening
5 examinations for any child eligible for Healthy Kids
6 services by qualified providers at intervals established
7 by Department rules.
8 (2) The Illinois Department shall pay for an
9 interperiodic health, vision, hearing, or dental
10 screening examination for any child eligible for Healthy
11 Kids services whenever an examination is:
12 (A) requested by a child's parent, guardian,
13 or custodian, or is determined to be necessary or
14 appropriate by social services, developmental,
15 health, or educational personnel; or
16 (B) necessary for enrollment in school; or
17 (C) necessary for enrollment in a licensed day
18 care program, including Head Start; or
19 (D) necessary for placement in a licensed
20 child welfare facility, including a foster home,
21 group home or child care institution; or
22 (E) necessary for attendance at a camping
23 program; or
24 (F) necessary for participation in an
25 organized athletic program; or
26 (G) necessary for enrollment in an early
27 childhood education program recognized by the
28 Illinois State Board of Education; or
29 (H) necessary for participation in a Women,
30 Infant, and Children (WIC) program; or
31 (I) deemed appropriate by the Illinois
32 Department.
33 (e) Minimum Screening Protocols For Periodic Health
34 Screening Examinations. Health Screening Examinations must
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1 include the following services:
2 (1) Comprehensive Health and Development Assessment
3 including:
4 (A) Development/Mental Health/Psychosocial
5 Assessment; and
6 (B) Assessment of nutritional status including
7 tests for iron deficiency and anemia for children at
8 the following ages: 9 months, 2 years, 8 years, and
9 18 years;
10 (2) Comprehensive unclothed physical exam;
11 (3) Appropriate immunizations at a minimum, as
12 required by the Secretary of the United States U.S.
13 Department of Health and Human Services under 42 U.S.C.
14 1396d(r).
15 (4) Appropriate laboratory tests including blood
16 lead levels appropriate for age and risk factors.
17 (A) Anemia test.
18 (B) Sickle cell test.
19 (C) Tuberculin test at 12 months of age and
20 every 1-2 years thereafter unless the treating
21 health care professional determines that testing is
22 medically contraindicated.
23 (D) Other -- The Illinois Department shall
24 insure that testing for HIV, drug exposure, and
25 sexually transmitted diseases is provided for as
26 clinically indicated.
27 (5) Health Education. The Illinois Department
28 shall require providers to provide anticipatory guidance
29 as recommended by the American Academy of Pediatrics.
30 (6) Vision Screening. The Illinois Department
31 shall require providers to provide vision screenings
32 consistent with those set forth in the Department of
33 Public Health's Administrative Rules.
34 (7) Hearing Screening. The Illinois Department
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1 shall require providers to provide hearing screenings
2 consistent with those set forth in the Department of
3 Public Health's Administrative Rules.
4 (8) Dental Screening. The Illinois Department
5 shall require providers to provide dental screenings
6 consistent with those set forth in the Department of
7 Public Health's Administrative Rules.
8 (f) Covered Medical Services. The Illinois Department
9 shall provide coverage for all necessary health care,
10 diagnostic services, treatment and other measures to correct
11 or ameliorate defects, physical and mental illnesses, and
12 conditions whether discovered by the screening services or
13 not for all children eligible for Medical Assistance under
14 Article V of this Code.
15 (g) Notice of Healthy Kids Services.
16 (1) The Illinois Department shall inform any child
17 eligible for Healthy Kids services and the child's family
18 about the benefits provided under the Healthy Kids
19 Program, including, but not limited to, the following:
20 what services are available under Healthy Kids, including
21 discussion of the periodicity schedules and immunization
22 schedules, that services are provided at no cost to
23 eligible children, the benefits of preventive health
24 care, where the services are available, how to obtain
25 them, and that necessary transportation and scheduling
26 assistance is available.
27 (2) The Illinois Department shall widely
28 disseminate information regarding the availability of the
29 Healthy Kids Program throughout the State by outreach
30 activities which shall include, but not be limited to,
31 (i) the development of cooperation agreements with local
32 school districts, public health agencies, clinics,
33 hospitals and other health care providers, including
34 developmental disability and mental health providers, and
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1 with charities, to notify the constituents of each of the
2 Program and assist individuals, as feasible, with
3 applying for the Program, (ii) using the media for public
4 service announcements and advertisements of the Program,
5 and (iii) developing posters advertising the Program for
6 display in hospital and clinic waiting rooms.
7 (3) The Illinois Department shall utilize accepted
8 methods for informing persons who are illiterate, blind,
9 deaf, or cannot understand the English language,
10 including but not limited to public services
11 announcements and advertisements in the foreign language
12 media of radio, television and newspapers.
13 (4) The Illinois Department shall provide notice of
14 the Healthy Kids Program to every child eligible for
15 Healthy Kids services and his or her family at the
16 following times:
17 (A) orally by the intake worker and in writing
18 at the time of application for Medical Assistance;
19 (B) at the time the applicant is informed that
20 he or she is eligible for Medical Assistance
21 benefits; and
22 (C) at least 20 days before the date of any
23 periodic health, vision, hearing, and dental
24 examination for any child eligible for Healthy Kids
25 services. Notice given under this subparagraph (C)
26 must state that a screening examination is due under
27 the periodicity schedules and must advise the
28 eligible child and his or her family that the
29 Illinois Department will provide assistance in
30 scheduling an appointment and arranging medical
31 transportation.
32 (h) Data Collection. The Illinois Department shall
33 collect data in a usable form to track utilization of Healthy
34 Kids screening examinations by children eligible for Healthy
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1 Kids services, including but not limited to data showing
2 screening examinations and immunizations received, a summary
3 of follow-up treatment received by children eligible for
4 Healthy Kids services and the number of children receiving
5 dental, hearing and vision services.
6 (Source: P.A. 87-630; 87-895.)
7 (305 ILCS 5/9A-11) (from Ch. 23, par. 9A-11)
8 Sec. 9A-11. Child Care.
9 (a) The General Assembly recognizes that families with
10 children need child care in order to work. Child care is
11 expensive and families with low incomes, including those who
12 are transitioning from welfare to work, often struggle to pay
13 the costs of day care. The General Assembly understands the
14 importance of helping low income working families become and
15 remain self-sufficient. The General Assembly also believes
16 that it is the responsibility of families to share in the
17 costs of child care. It is also the preference of the
18 General Assembly that all working poor families should be
19 treated equally, regardless of their welfare status.
20 (b) To the extent resources permit, the Illinois
21 Department shall provide child care services to parents or
22 other relatives as defined by rule who are working or
23 participating in employment or Department approved education
24 or training programs. At a minimum, the Illinois Department
25 shall cover the following categories of families:
26 (1) recipients of TANF under Article IV
27 participating in work and training activities as
28 specified in the personal plan for employment and
29 self-sufficiency;
30 (2) families transitioning from TANF to work;
31 (3) families at risk of becoming recipients of
32 TANF;
33 (4) families with special needs as defined by rule;
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1 and
2 (5) working families with very low incomes as
3 defined by rule.
4 The Department shall specify by rule the conditions of
5 eligibility, the application process, and the types, amounts,
6 and duration of services. Eligibility for child care
7 benefits and the amount of child care provided may vary based
8 on family size, income, and other factors as specified by
9 rule. In determining income eligibility for child care
10 benefits, the Department shall establish, by rule, one income
11 threshold for each family size, in relation to percentage of
12 State median income for a family of that size, that makes
13 families with incomes below the specified threshold eligible
14 for assistance and families with incomes above the specified
15 threshold ineligible for assistance. In determining
16 eligibility for assistance, the Department shall not give
17 preference to any category of recipients or give preference
18 to individuals based on their receipt of benefits under this
19 Code. It is the intent of the General Assembly that, for
20 fiscal year 1998, to the extent resources permit, the
21 Department shall establish an income eligibility threshold of
22 50% of the State median income. Notwithstanding the income
23 level at which families become eligible to receive child care
24 assistance, any family that is already receiving child care
25 assistance on July 1, 1997 the effective date of this
26 amendatory Act of 1997 shall remain eligible for assistance
27 for fiscal year 1998. Nothing in this Section shall be
28 construed as conferring entitlement status to eligible
29 families. The Illinois Department is authorized to lower
30 income eligibility ceilings, raise parent co-payments, create
31 waiting lists, or take such other actions during a fiscal
32 year as are necessary to ensure that child care benefits paid
33 under this Article do not exceed the amounts appropriated for
34 those child care benefits. These changes may be accomplished
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1 by emergency rule under Section 5-45 of the Illinois
2 Administrative Procedure Act, except that the limitation on
3 the number of emergency rules that may be adopted in a
4 24-month period shall not apply. The Illinois Department may
5 contract with other State agencies or child care
6 organizations for the administration of child care services.
7 (c) Payment shall be made for child care that otherwise
8 meets the requirements of this Section and applicable
9 standards of State and local law and regulation, including
10 any requirements the Illinois Department promulgates by rule
11 in addition to the licensure requirements promulgated by the
12 Department of Children and Family Services and Fire
13 Prevention and Safety requirements promulgated by the Office
14 of the State Fire Marshal and is provided in any of the
15 following:
16 (1) a child care center which is licensed or exempt
17 from licensure pursuant to Section 2.09 of the Child Care
18 Act of 1969;
19 (2) a licensed child care home or home exempt from
20 licensing;
21 (3) a licensed group child care home;
22 (4) other types of child care, including child care
23 provided by relatives or persons living in the same home
24 as the child, as determined by the Illinois Department by
25 rule.
26 (d) The Illinois Department shall, by rule, require
27 co-payments for child care services by any parent, including
28 parents whose only income is from assistance under this Code.
29 The co-payment shall be assessed based on a sliding scale
30 based on family income, family size, and the number of
31 children in care.
32 (e) The Illinois Department shall conduct a market rate
33 survey based on the cost of care and other relevant factors
34 which shall be completed by July 1, 1998.
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1 (f) The Illinois Department shall, by rule, set rates to
2 be paid for the various types of child care. Child care may
3 be provided through one of the following methods:
4 (1) arranging the child care through eligible
5 providers by use of purchase of service contracts or
6 vouchers;
7 (2) arranging with other agencies and community
8 volunteer groups for non-reimbursed child care;
9 (3) (blank); or
10 (4) adopting such other arrangements as the
11 Department determines appropriate.
12 (g) Families eligible for assistance under this Section
13 shall be given the following options:
14 (1) receiving a child care certificate issued by
15 the Department or a subcontractor of the Department that
16 may be used by the parents as payment for child care and
17 development services only; or
18 (2) if space is available, enrolling the child with
19 a child care provider that has a purchase of service
20 contract with the Department or a subcontractor of the
21 Department for the provision of child care and
22 development services. The Department may identify
23 particular priority populations for whom they may request
24 special consideration by a provider with purchase of
25 service contracts, provided that the providers shall be
26 permitted to maintain a balance of clients in terms of
27 household incomes and families and children with special
28 needs, as defined by rule.
29 (Source: P.A. 90-17, eff. 7-1-97.)