HB0158ham001 102ND GENERAL ASSEMBLY

Rep. Camille Y. Lilly

Filed: 3/10/2021

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1 AMENDMENT TO HOUSE BILL 158

2 AMENDMENT NO. ______. Amend House Bill 158 by replacing

3 everything after the enacting clause with the following:

4 "Title I. General Provisions

5 Article 1.

6 Section 1-1. This Act may be referred to as the Illinois

7 Health Care and Human Service Reform Act.

8 Section 1-5. Findings.

9 "We, the People of the State of Illinois in order to

10 provide for the health, safety and welfare of the people;

11 maintain a representative and orderly government; eliminate

12 poverty and inequality; assure legal, social and economic

13 justice; provide opportunity for the fullest development of

14 the individual; insure domestic tranquility; provide for the

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1 common defense; and secure the blessings of freedom and

2 liberty to ourselves and our posterity - do ordain and

3 establish this Constitution for the State of Illinois."

4 The Illinois Legislative Black Caucus finds that, in order

5 to improve the health outcomes of Black residents in the State

6 of Illinois, it is essential to dramatically reform the

7 State's health and human service system. For over 3 decades,

8 multiple health studies have found that health inequities at

9 their very core are due to racism. As early as 1998 research

10 demonstrated that Black Americans received less health care

11 than white Americans because doctors treated patients

12 differently on the basis of race. Yet, Illinois' health and

13 human service system disappointingly continues to perpetuate

14 health disparities among Black Illinoisans of all ages,

15 genders, and socioeconomic status.

16 In July 2020, Trinity Health announced its plans to close

17 Mercy Hospital, an essential resource serving the Chicago

18 South Side's predominantly Black residents. Trinity Health

19 argued that this closure would have no impact on health access

20 but failed to understand the community's needs. Closure of

21 Mercy Hospital would only serve to create a health access

22 desert and exacerbate existing health disparities. On December

23 15, 2020, after hearing from community members and advocates,

24 the Health Facilities and Services Review Board unanimously

25 voted to deny closure efforts, yet Trinity still seeks to

26 cease Mercy's operations.

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1 Prior to COVID-19, much of the social and political

2 attention surrounding the nationwide opioid epidemic focused

3 on the increase in overdose deaths among white, middle-class,

4 suburban and rural users; the impact of the epidemic in Black

5 communities was largely unrecognized. Research has shown rates

6 of opioid use at the national scale are higher for whites than

7 they are for Blacks, yet rates of opioid deaths are higher

8 among Blacks (43%) than whites (22%). The COVID-19 pandemic

9 will likely exacerbate this situation due to job loss,

10 stay-at-home orders, and ongoing mitigation efforts creating a

11 lack of physical access to addiction support and harm

12 reduction groups.

13 In 2018, the Illinois Department of Public Health reported

14 that Black women were about 6 times as likely to die from a

15 pregnancy-related cause as white women. Of those, 72% of

16 pregnancy-related deaths and 93% of violent

17 pregnancy-associated deaths were deemed preventable. Between

18 2016 and 2017, Black women had the highest rate of severe

19 maternal morbidity with a rate of 101.5 per 10,000 deliveries,

20 which is almost 3 times as high as the rate for white women.

21 In the City of Chicago, African American and Latinx

22 populations are suffering from higher rates of AIDS/HIV

23 compared to the general population. Recent data places HIV as

24 one of the top 5 leading causes of death in African American

25 women between the ages of 35 to 44 and the seventh ranking

26 cause in African American women between the ages of 20 to 34.

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1 Among the Latinx population, nearly 20% with HIV exclusively

2 depend on indigenous-led and staffed organizations for

3 services.

4 Cardiovascular disease (CVD) accounts for more deaths in

5 Illinois than any other cause of death, according to the

6 Illinois Department of Public Health; CVD is the leading cause

7 of death among Black residents. According to the Kaiser Family

8 Foundation (KFF), for every 100,000 people, 224 Black

9 Illinoisans die of CVD compared to 158 white Illinoisans.

10 Cancer, the second leading cause of death in Illinois, too is

11 pervasive among African Americans. In 2019, an estimated

12 606,880 Americans, or 1,660 people a day, died of cancer; the

13 American Cancer Society estimated 24,410 deaths occurred in

14 Illinois. KFF estimates that, out of every 100,000 people, 191

15 Black Illinoisans die of cancer compared to 152 white

16 Illinoisans.

17 Black Americans suffer at much higher rates from chronic

18 diseases, including diabetes, hypertension, heart disease,

19 asthma, and many cancers. Utilizing community health workers

20 in patient education and chronic disease management is needed

21 to close these health disparities. Studies have shown that

22 diabetes patients in the care of a community health worker

23 demonstrate improved knowledge and lifestyle and

24 self-management behaviors, as well as decreases in the use of

25 the emergency department. A study of asthma control among

26 black adolescents concluded that asthma control was reduced by

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1 35% among adolescents working with community health workers,

2 resulting in a savings of $5.58 per dollar spent on the

3 intervention. A study of the return on investment for

4 community health workers employed in Colorado showed that,

5 after a 9-month period, patients working with community health

6 workers had an increased number of primary care visits and a

7 decrease in urgent and inpatient care. Utilization of

8 community health workers led to a $2.38 return on investment

9 for every dollar invested in community health workers.

10 Adverse childhood experiences (ACEs) are traumatic

11 experiences occurring during childhood that have been found to

12 have a profound effect on a child's developing brain structure

13 and body which may result in poor health during a person's

14 adulthood. ACEs studies have found a strong correlation

15 between the number of ACEs and a person's risk for disease and

16 negative health behaviors, including suicide, depression,

17 cancer, stroke, ischemic heart disease, diabetes, autoimmune

18 disease, smoking, substance abuse, interpersonal violence,

19 obesity, unplanned pregnancies, lower educational achievement,

20 workplace absenteeism, and lower wages. Data also shows that

21 approximately 20% of African American and Hispanic adults in

22 Illinois reported 4 or more ACEs, compared to 13% of

23 non-Hispanic whites. Long-standing ACE interventions include

24 tools such as trauma-informed care. Trauma-informed care has

25 been promoted and established in communities across the

26 country on a bipartisan basis, including in the states of

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1 California, Florida, Massachusetts, Missouri, Oregon,

2 Pennsylvania, Washington, and Wisconsin. Several federal

3 agencies have integrated trauma-informed approaches in their

4 programs and grants which should be leveraged by the State.

5 According to a 2019 Rush University report, a Black

6 person's life expectancy on average is less when compared to a

7 white person's life expectancy. For instance, when comparing

8 life expectancy in Chicago's Austin neighborhood to the

9 Chicago Loop, there is a difference of 11 years between Black

10 life expectancy (71 years) and white life expectancy (82

11 years).

12 In a 2015 literature review of implicit racial and ethnic

13 bias among medical professionals, it was concluded that there

14 is a moderate level of implicit bias in most medical

15 professionals. Further, the literature review showed that

16 implicit bias has negative consequences for patients,

17 including strained patient relationships and negative health

18 outcomes. It is critical for medical professionals to be aware

19 of implicit racial and ethnic bias and work to eliminate bias

20 through training.

21 In the field of medicine, a historically racist

22 profession, Black medical professionals have commonly been

23 ostracized. In 1934, Dr. Roland B. Scott was the first African

24 American to pass the pediatric board exam, yet when he applied

25 for membership with the American Academy of Pediatrics he was

26 rejected multiple times. Few medical organizations have

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1 confronted the roles they played in blocking opportunities for

2 Black advancement in the medical profession until the formal

3 apologies of the American Medical Association in 2008. For

4 decades, organizations like the AMA predicated their

5 membership on joining a local state medical society, several

6 of which excluded Black physicians.

7 In 2010, the General Assembly, in partnership with

8 Treatment Alternatives for Safe Communities, published the

9 Disproportionate Justice Impact Study. The study examined the

10 impact of Illinois drug laws on racial and ethnic groups and

11 the resulting over-representation of racial and ethic minority

12 groups in the Illinois criminal justice system. Unsurprisingly

13 and disappointingly, the study confirmed decades long

14 injustices, such as nonwhites being arrested at a higher rate

15 than whites relative to their representation in the general

16 population throughout Illinois.

17 All together, the above mentioned only begins to capture a

18 part of a larger system of racial injustices and inequities.

19 The General Assembly and the people of Illinois are urged to

20 recognize while racism is a core fault of the current health

21 and human service system, that it is a pervasive disease

22 affecting a multiplitude of institutions which truly drive

23 systematic health inequities: education, child care, criminal

24 justice, affordable housing, environmental justice, and job

25 security and so forth. For persons to live up to their full

26 human potential, their rights to quality of life, health care,

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1 a quality job, a fair wage, housing, and education must not be

2 inhibited.

3 Therefore, the Illinois Legislative Black Caucus, as

4 informed by the Senate's Health and Human Service Pillar

5 subject matter hearings, seeks to remedy a fraction of a much

6 larger broken system by addressing access to health care,

7 hospital closures, managed care organization reform, community

8 health worker certification, maternal and infant mortality,

9 mental and substance abuse treatment, hospital reform, and

10 medical implicit bias in the Illinois Health Care and Human

11 Service Reform Act. This Act shall achieve needed change

12 through the use of, but not limited to, the Medicaid Managed

13 Care Oversight Commission, the Health and Human Services Task

14 Force, and a hospital closure moratorium, in order to address

15 Illinois' long-standing health inequities.

16 Title II. Community Health Workers

17 Article 5.

18 Section 5-1. Short title. This Article may be cited as the

19 Community Health Worker Certification and Reimbursement Act.

20 References in this Article to "this Act" mean this Article.

21 Section 5-5. Definition. In this Act, "community health

22 worker" means a frontline public health worker who is a

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1 trusted member or has an unusually close understanding of the

2 community served. This trusting relationship enables the

3 community health worker to serve as a liaison, link, and

4 intermediary between health and social services and the

5 community to facilitate access to services and improve the

6 quality and cultural competence of service delivery. A

7 community health worker also builds individual and community

8 capacity by increasing health knowledge and self-sufficiency

9 through a range of activities, including outreach, community

10 education, informal counseling, social support, and advocacy.

11 A community health worker shall have the following core

12 competencies:

13 (1) communication;

14 (2) interpersonal skills and relationship building;

15 (3) service coordination and navigation skills;

16 (4) capacity-building;

17 (5) advocacy;

18 (6) presentation and facilitation skills;

19 (7) organizational skills; cultural competency;

20 (8) public health knowledge;

21 (9) understanding of health systems and basic

22 diseases;

23 (10) behavioral health issues; and

24 (11) field experience.

25 Nothing in this definition shall be construed to authorize

26 a community health worker to provide direct care or treatment

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1 to any person or to perform any act or service for which a

2 license issued by a professional licensing board is required.

3 Section 5-10. Community health worker training.

4 (a) Community health workers shall be provided with

5 multi-tiered academic and community-based training

6 opportunities that lead to the mastery of community health

7 worker core competencies.

8 (b) For academic-based training programs, the Department

9 of Public Health shall collaborate with the Illinois State

10 Board of Education, the Illinois Community College Board, and

11 the Illinois Board of Higher Education to adopt a process to

12 certify academic-based training programs that students can

13 attend to obtain individual community health worker

14 certification. Certified training programs shall reflect the

15 approved core competencies and roles for community health

16 workers.

17 (c) For community-based training programs, the Department

18 of Public Health shall collaborate with a statewide

19 association representing community health workers to adopt a

20 process to certify community-based programs that students can

21 attend to obtain individual community health worker

22 certification.

23 (d) Community health workers may need to undergo

24 additional training, including, but not limited to, asthma,

25 diabetes, maternal child health, behavioral health, and social

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1 determinants of health training. Multi-tiered training

2 approaches shall provide opportunities that build on each

3 other and prepare community health workers for career pathways

4 both within the community health worker profession and within

5 allied professions.

6 Section 5-15. Illinois Community Health Worker

7 Certification Board.

8 (a) There is created within the Department of Public

9 Health, in shared leadership with a statewide association

10 representing community health workers, the Illinois Community

11 Health Worker Certification Board. The Board shall serve as

12 the regulatory body that develops and has oversight of initial

13 community health workers certification and certification

14 renewals for both individuals and academic and community-based

15 training programs.

16 (b) A representative from the Department of Public Health,

17 the Department of Financial and Professional Regulation, the

18 Department of Healthcare and Family Services, and the

19 Department of Human Services shall serve on the Board. At

20 least one full-time professional shall be assigned to staff

21 the Board with additional administrative support available as

22 needed. The Board shall have balanced representation from the

23 community health worker workforce, community health worker

24 employers, community health worker training and educational

25 organizations, and other engaged stakeholders.

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1 (c) The Board shall propose a certification process for

2 and be authorized to approve training from community-based

3 organizations, in conjunction with a statewide organization

4 representing community health workers, and academic

5 institutions, in consultation with the Illinois State Board of

6 Education, the Illinois Community College Board and the

7 Illinois Board of Higher Education. The Board shall base

8 training approval on core competencies, best practices, and

9 affordability. In addition, the Board shall maintain a

10 registry of certification records for individually certified

11 community health workers.

12 (d) All training programs that are deemed certifiable by

13 the Board shall go through a renewal process, which will be

14 determined by the Board once established. The Board shall

15 establish criteria to grandfather in any community health

16 workers who were practicing prior to the establishment of a

17 certification program.

18 (e) To ensure high-quality service, the Illinois Community

19 Health Worker Certification Board shall examine and consider

20 for adoption best practices from other states that have

21 implemented policies to allow for alternative opportunities to

22 demonstrate competency in core skills and knowledge in

23 addition to certification.

24 (f) The Department of Public Health shall explore ways to

25 compensate members of the Board.

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1 Section 5-20. Reimbursement. Community health worker

2 services shall be covered under the medical assistance

3 program, subject to appropriation, for persons who are

4 otherwise eligible for medical assistance. The Department of

5 Healthcare and Family Services shall develop services,

6 including, but not limited to, care coordination and

7 diagnosis-related patient services, for which community health

8 workers will be eligible for reimbursement and shall request

9 approval from the federal Centers for Medicare and Medicaid

10 Services to reimburse community health worker services under

11 the medical assistance program. For reimbursement under the

12 medical assistance program, a community health worker must

13 work under the supervision of an enrolled medical program

14 provider, as specified by the Department, and certification

15 shall be required for reimbursement. The supervision of

16 enrolled medical program providers and certification are not

17 required for community health workers who receive

18 reimbursement through managed care administrative moneys.

19 Noncertified community health workers are reimbursable at the

20 discretion of managed care entities following availability of

21 community health worker certification. In addition, the

22 Department of Healthcare and Family Services shall amend its

23 contracts with managed care entities to allow managed care

24 entities to employ community health workers or subcontract

25 with community-based organizations that employ community

26 health workers.

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1 Section 5-23. Certification. Certification shall not be

2 required for employment of community health workers.

3 Noncertified community health workers may be employed through

4 funding sources outside of the medical assistance program.

5 Section 5-25. Rules. The Department of Public Health and

6 the Department of Healthcare and Family Services may adopt

7 rules for the implementation and administration of this Act.

8 Title III. Hospital Reform

9 Article 10.

10 Section 10-5. The Hospital Licensing Act is amended by

11 changing Section 10.4 as follows:

12 (210 ILCS 85/10.4) (from Ch. 111 1/2, par. 151.4)

13 Sec. 10.4. Medical staff privileges.

14 (a) Any hospital licensed under this Act or any hospital

15 organized under the University of Illinois Hospital Act shall,

16 prior to the granting of any medical staff privileges to an

17 applicant, or renewing a current medical staff member's

18 privileges, request of the Director of Professional Regulation

19 information concerning the licensure status, proper

20 credentials, required certificates, and any disciplinary

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1 action taken against the applicant's or medical staff member's

2 license, except: (1) for medical personnel who enter a

3 hospital to obtain organs and tissues for transplant from a

4 donor in accordance with the Illinois Anatomical Gift Act; or

5 (2) for medical personnel who have been granted disaster

6 privileges pursuant to the procedures and requirements

7 established by rules adopted by the Department. Any hospital

8 and any employees of the hospital or others involved in

9 granting privileges who, in good faith, grant disaster

10 privileges pursuant to this Section to respond to an emergency

11 shall not, as a result of their acts or omissions, be liable

12 for civil damages for granting or denying disaster privileges

13 except in the event of willful and wanton misconduct, as that

14 term is defined in Section 10.2 of this Act. Individuals

15 granted privileges who provide care in an emergency situation,

16 in good faith and without direct compensation, shall not, as a

17 result of their acts or omissions, except for acts or

18 omissions involving willful and wanton misconduct, as that

19 term is defined in Section 10.2 of this Act, on the part of the

20 person, be liable for civil damages. The Director of

21 Professional Regulation shall transmit, in writing and in a

22 timely fashion, such information regarding the license of the

23 applicant or the medical staff member, including the record of

24 imposition of any periods of supervision or monitoring as a

25 result of alcohol or substance abuse, as provided by Section

26 23 of the Medical Practice Act of 1987, and such information as

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1 may have been submitted to the Department indicating that the

2 application or medical staff member has been denied, or has

3 surrendered, medical staff privileges at a hospital licensed

4 under this Act, or any equivalent facility in another state or

5 territory of the United States. The Director of Professional

6 Regulation shall define by rule the period for timely response

7 to such requests.

8 No transmittal of information by the Director of

9 Professional Regulation, under this Section shall be to other

10 than the president, chief operating officer, chief

11 administrative officer, or chief of the medical staff of a

12 hospital licensed under this Act, a hospital organized under

13 the University of Illinois Hospital Act, or a hospital

14 operated by the United States, or any of its

15 instrumentalities. The information so transmitted shall be

16 afforded the same status as is information concerning medical

17 studies by Part 21 of Article VIII of the Code of Civil

18 Procedure, as now or hereafter amended.

19 (b) All hospitals licensed under this Act, except county

20 hospitals as defined in subsection (c) of Section 15-1 of the

21 Illinois Public Aid Code, shall comply with, and the medical

22 staff bylaws of these hospitals shall include rules consistent

23 with, the provisions of this Section in granting, limiting,

24 renewing, or denying medical staff membership and clinical

25 staff privileges. Hospitals that require medical staff members

26 to possess faculty status with a specific institution of

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1 higher education are not required to comply with subsection

2 (1) below when the physician does not possess faculty status.

3 (1) Minimum procedures for pre-applicants and

4 applicants for medical staff membership shall include the

5 following:

6 (A) Written procedures relating to the acceptance

7 and processing of pre-applicants or applicants for

8 medical staff membership, which should be contained in

9 medical staff bylaws.

10 (B) Written procedures to be followed in

11 determining a pre-applicant's or an applicant's

12 qualifications for being granted medical staff

13 membership and privileges.

14 (C) Written criteria to be followed in evaluating

15 a pre-applicant's or an applicant's qualifications.

16 (D) An evaluation of a pre-applicant's or an

17 applicant's current health status and current license

18 status in Illinois.

19 (E) A written response to each pre-applicant or

20 applicant that explains the reason or reasons for any

21 adverse decision (including all reasons based in whole

22 or in part on the applicant's medical qualifications

23 or any other basis, including economic factors).

24 (2) Minimum procedures with respect to medical staff

25 and clinical privilege determinations concerning current

26 members of the medical staff shall include the following:

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1 (A) A written notice of an adverse decision.

2 (B) An explanation of the reasons for an adverse

3 decision including all reasons based on the quality of

4 medical care or any other basis, including economic

5 factors.

6 (C) A statement of the medical staff member's

7 right to request a fair hearing on the adverse

8 decision before a hearing panel whose membership is

9 mutually agreed upon by the medical staff and the

10 hospital governing board. The hearing panel shall have

11 independent authority to recommend action to the

12 hospital governing board. Upon the request of the

13 medical staff member or the hospital governing board,

14 the hearing panel shall make findings concerning the

15 nature of each basis for any adverse decision

16 recommended to and accepted by the hospital governing

17 board.

18 (i) Nothing in this subparagraph (C) limits a

19 hospital's or medical staff's right to summarily

20 suspend, without a prior hearing, a person's

21 medical staff membership or clinical privileges if

22 the continuation of practice of a medical staff

23 member constitutes an immediate danger to the

24 public, including patients, visitors, and hospital

25 employees and staff. In the event that a hospital

26 or the medical staff imposes a summary suspension,

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1 the Medical Executive Committee, or other

2 comparable governance committee of the medical

3 staff as specified in the bylaws, must meet as

4 soon as is reasonably possible to review the

5 suspension and to recommend whether it should be

6 affirmed, lifted, expunged, or modified if the

7 suspended physician requests such review. A

8 summary suspension may not be implemented unless

9 there is actual documentation or other reliable

10 information that an immediate danger exists. This

11 documentation or information must be available at

12 the time the summary suspension decision is made

13 and when the decision is reviewed by the Medical

14 Executive Committee. If the Medical Executive

15 Committee recommends that the summary suspension

16 should be lifted, expunged, or modified, this

17 recommendation must be reviewed and considered by

18 the hospital governing board, or a committee of

19 the board, on an expedited basis. Nothing in this

20 subparagraph (C) shall affect the requirement that

21 any requested hearing must be commenced within 15

22 days after the summary suspension and completed

23 without delay unless otherwise agreed to by the

24 parties. A fair hearing shall be commenced within

25 15 days after the suspension and completed without

26 delay, except that when the medical staff member's

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1 license to practice has been suspended or revoked

2 by the State's licensing authority, no hearing

3 shall be necessary.

4 (ii) Nothing in this subparagraph (C) limits a

5 medical staff's right to permit, in the medical

6 staff bylaws, summary suspension of membership or

7 clinical privileges in designated administrative

8 circumstances as specifically approved by the

9 medical staff. This bylaw provision must

10 specifically describe both the administrative

11 circumstance that can result in a summary

12 suspension and the length of the summary

13 suspension. The opportunity for a fair hearing is

14 required for any administrative summary

15 suspension. Any requested hearing must be

16 commenced within 15 days after the summary

17 suspension and completed without delay. Adverse

18 decisions other than suspension or other

19 restrictions on the treatment or admission of

20 patients may be imposed summarily and without a

21 hearing under designated administrative

22 circumstances as specifically provided for in the

23 medical staff bylaws as approved by the medical

24 staff.

25 (iii) If a hospital exercises its option to

26 enter into an exclusive contract and that contract

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1 results in the total or partial termination or

2 reduction of medical staff membership or clinical

3 privileges of a current medical staff member, the

4 hospital shall provide the affected medical staff

5 member 60 days prior notice of the effect on his or

6 her medical staff membership or privileges. An

7 affected medical staff member desiring a hearing

8 under subparagraph (C) of this paragraph (2) must

9 request the hearing within 14 days after the date

10 he or she is so notified. The requested hearing

11 shall be commenced and completed (with a report

12 and recommendation to the affected medical staff

13 member, hospital governing board, and medical

14 staff) within 30 days after the date of the

15 medical staff member's request. If agreed upon by

16 both the medical staff and the hospital governing

17 board, the medical staff bylaws may provide for

18 longer time periods.

19 (C-5) All peer review used for the purpose of

20 credentialing, privileging, disciplinary action, or

21 other recommendations affecting medical staff

22 membership or exercise of clinical privileges, whether

23 relying in whole or in part on internal or external

24 reviews, shall be conducted in accordance with the

25 medical staff bylaws and applicable rules,

26 regulations, or policies of the medical staff. If

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1 external review is obtained, any adverse report

2 utilized shall be in writing and shall be made part of

3 the internal peer review process under the bylaws. The

4 report shall also be shared with a medical staff peer

5 review committee and the individual under review. If

6 the medical staff peer review committee or the

7 individual under review prepares a written response to

8 the report of the external peer review within 30 days

9 after receiving such report, the governing board shall

10 consider the response prior to the implementation of

11 any final actions by the governing board which may

12 affect the individual's medical staff membership or

13 clinical privileges. Any peer review that involves

14 willful or wanton misconduct shall be subject to civil

15 damages as provided for under Section 10.2 of this

16 Act.

17 (D) A statement of the member's right to inspect

18 all pertinent information in the hospital's possession

19 with respect to the decision.

20 (E) A statement of the member's right to present

21 witnesses and other evidence at the hearing on the

22 decision.

23 (E-5) The right to be represented by a personal

24 attorney.

25 (F) A written notice and written explanation of

26 the decision resulting from the hearing.

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1 (F-5) A written notice of a final adverse decision

2 by a hospital governing board.

3 (G) Notice given 15 days before implementation of

4 an adverse medical staff membership or clinical

5 privileges decision based substantially on economic

6 factors. This notice shall be given after the medical

7 staff member exhausts all applicable procedures under

8 this Section, including item (iii) of subparagraph (C)

9 of this paragraph (2), and under the medical staff

10 bylaws in order to allow sufficient time for the

11 orderly provision of patient care.

12 (H) Nothing in this paragraph (2) of this

13 subsection (b) limits a medical staff member's right

14 to waive, in writing, the rights provided in

15 subparagraphs (A) through (G) of this paragraph (2) of

16 this subsection (b) upon being granted the written

17 exclusive right to provide particular services at a

18 hospital, either individually or as a member of a

19 group. If an exclusive contract is signed by a

20 representative of a group of physicians, a waiver

21 contained in the contract shall apply to all members

22 of the group unless stated otherwise in the contract.

23 (3) Every adverse medical staff membership and

24 clinical privilege decision based substantially on

25 economic factors shall be reported to the Hospital

26 Licensing Board before the decision takes effect. These

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1 reports shall not be disclosed in any form that reveals

2 the identity of any hospital or physician. These reports

3 shall be utilized to study the effects that hospital

4 medical staff membership and clinical privilege decisions

5 based upon economic factors have on access to care and the

6 availability of physician services. The Hospital Licensing

7 Board shall submit an initial study to the Governor and

8 the General Assembly by January 1, 1996, and subsequent

9 reports shall be submitted periodically thereafter.

10 (4) As used in this Section:

11 "Adverse decision" means a decision reducing,

12 restricting, suspending, revoking, denying, or not

13 renewing medical staff membership or clinical privileges.

14 "Economic factor" means any information or reasons for

15 decisions unrelated to quality of care or professional

16 competency.

17 "Pre-applicant" means a physician licensed to practice

18 medicine in all its branches who requests an application

19 for medical staff membership or privileges.

20 "Privilege" means permission to provide medical or

21 other patient care services and permission to use hospital

22 resources, including equipment, facilities and personnel

23 that are necessary to effectively provide medical or other

24 patient care services. This definition shall not be

25 construed to require a hospital to acquire additional

26 equipment, facilities, or personnel to accommodate the

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1 granting of privileges.

2 (5) Any amendment to medical staff bylaws required

3 because of this amendatory Act of the 91st General

4 Assembly shall be adopted on or before July 1, 2001.

5 (c) All hospitals shall consult with the medical staff

6 prior to closing membership in the entire or any portion of the

7 medical staff or a department. If the hospital closes

8 membership in the medical staff, any portion of the medical

9 staff, or the department over the objections of the medical

10 staff, then the hospital shall provide a detailed written

11 explanation for the decision to the medical staff 10 days

12 prior to the effective date of any closure. No applications

13 need to be provided when membership in the medical staff or any

14 relevant portion of the medical staff is closed.

15 (Source: P.A. 96-445, eff. 8-14-09; 97-1006, eff. 8-17-12.)

16 Article 15.

17 Section 15-3. The Illinois Health Finance Reform Act is

18 amended by changing Section 4-4 as follows:

19 (20 ILCS 2215/4-4) (from Ch. 111 1/2, par. 6504-4)

20 Sec. 4-4. (a) Hospitals shall make available to

21 prospective patients information on the normal charge incurred

22 for any procedure or operation the prospective patient is

23 considering.

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1 (b) The Department of Public Health shall require

2 hospitals to post, either by physical or electronic means, in

3 prominent letters, ~~in letters no more than one inch in height~~

4 the established charges for services, where applicable,

5 including but not limited to the hospital's private room

6 charge, semi-private room charge, charge for a room with 3 or

7 more beds, intensive care room charges, emergency room charge,

8 operating room charge, electrocardiogram charge, anesthesia

9 charge, chest x-ray charge, blood sugar charge, blood

10 chemistry charge, tissue exam charge, blood typing charge and

11 Rh factor charge. The definitions of each charge to be posted

12 shall be determined by the Department.

13 (Source: P.A. 92-597, eff. 7-1-02.)

14 Section 15-5. The Hospital Licensing Act is amended by

15 changing Sections 6, 6.14c, 10.10, and 11.5 as follows:

16 (210 ILCS 85/6) (from Ch. 111 1/2, par. 147)

17 Sec. 6. (a) Upon receipt of an application for a permit to

18 establish a hospital the Director shall issue a permit if he

19 finds (1) that the applicant is fit, willing, and able to

20 provide a proper standard of hospital service for the

21 community with particular regard to the qualification,

22 background, and character of the applicant, (2) that the

23 financial resources available to the applicant demonstrate an

24 ability to construct, maintain, and operate a hospital in

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1 accordance with the standards, rules, and regulations adopted

2 pursuant to this Act, and (3) that safeguards are provided

3 which assure hospital operation and maintenance consistent

4 with the public interest having particular regard to safe,

5 adequate, and efficient hospital facilities and services.

6 The Director may request the cooperation of county and

7 multiple-county health departments, municipal boards of

8 health, and other governmental and non-governmental agencies

9 in obtaining information and in conducting investigations

10 relating to such applications.

11 A permit to establish a hospital shall be valid only for

12 the premises and person named in the application for such

13 permit and shall not be transferable or assignable.

14 In the event the Director issues a permit to establish a

15 hospital the applicant shall thereafter submit plans and

16 specifications to the Department in accordance with Section 8

17 of this Act.

18 (b) Upon receipt of an application for license to open,

19 conduct, operate, and maintain a hospital, the Director shall

20 issue a license if he finds the applicant and the hospital

21 facilities comply with standards, rules, and regulations

22 promulgated under this Act. A license, unless sooner suspended

23 or revoked, shall be renewable annually upon approval by the

24 Department and payment of a license fee as established

25 pursuant to Section 5 of this Act. Each license shall be issued

26 only for the premises and persons named in the application and

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1 shall not be transferable or assignable. Licenses shall be

2 posted, either by physical or electronic means, in a

3 conspicuous place on the licensed premises. The Department

4 may, either before or after the issuance of a license, request

5 the cooperation of the State Fire Marshal, county and multiple

6 county health departments, or municipal boards of health to

7 make investigations to determine if the applicant or licensee

8 is complying with the minimum standards prescribed by the

9 Department. The report and recommendations of any such agency

10 shall be in writing and shall state with particularity its

11 findings with respect to compliance or noncompliance with such

12 minimum standards, rules, and regulations.

13 The Director may issue a provisional license to any

14 hospital which does not substantially comply with the

15 provisions of this Act and the standards, rules, and

16 regulations promulgated by virtue thereof provided that he

17 finds that such hospital has undertaken changes and

18 corrections which upon completion will render the hospital in

19 substantial compliance with the provisions of this Act, and

20 the standards, rules, and regulations adopted hereunder, and

21 provided that the health and safety of the patients of the

22 hospital will be protected during the period for which such

23 provisional license is issued. The Director shall advise the

24 licensee of the conditions under which such provisional

25 license is issued, including the manner in which the hospital

26 facilities fail to comply with the provisions of the Act,

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1 standards, rules, and regulations, and the time within which

2 the changes and corrections necessary for such hospital

3 facilities to substantially comply with this Act, and the

4 standards, rules, and regulations of the Department relating

5 thereto shall be completed.

6 (Source: P.A. 98-683, eff. 6-30-14.)

7 (210 ILCS 85/6.14c)

8 Sec. 6.14c. Posting of information. Every hospital shall

9 conspicuously post, either by physical or electronic means,

10 for display in an area of its offices accessible to patients,

11 employees, and visitors the following:

12 (1) its current license;

13 (2) a description, provided by the Department, of

14 complaint procedures established under this Act and the

15 name, address, and telephone number of a person authorized

16 by the Department to receive complaints;

17 (3) a list of any orders pertaining to the hospital

18 issued by the Department during the past year and any

19 court orders reviewing such Department orders issued

20 during the past year; and

21 (4) a list of the material available for public

22 inspection under Section 6.14d.

23 Each hospital shall post, either by physical or electronic

24 means, in each facility that has an emergency room, a notice in

25 a conspicuous location in the emergency room with information

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1 about how to enroll in health insurance through the Illinois

2 health insurance marketplace in accordance with Sections 1311

3 and 1321 of the federal Patient Protection and Affordable Care

4 Act.

5 (Source: P.A. 101-117, eff. 1-1-20.)

6 (210 ILCS 85/10.10)

7 Sec. 10.10. Nurse Staffing by Patient Acuity.

8 (a) Findings. The Legislature finds and declares all of

9 the following:

10 (1) The State of Illinois has a substantial interest

11 in promoting quality care and improving the delivery of

12 health care services.

13 (2) Evidence-based studies have shown that the basic

14 principles of staffing in the acute care setting should be

15 based on the complexity of patients' care needs aligned

16 with available nursing skills to promote quality patient

17 care consistent with professional nursing standards.

18 (3) Compliance with this Section promotes an

19 organizational climate that values registered nurses'

20 input in meeting the health care needs of hospital

21 patients.

22 (b) Definitions. As used in this Section:

23 "Acuity model" means an assessment tool selected and

24 implemented by a hospital, as recommended by a nursing care

25 committee, that assesses the complexity of patient care needs

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1 requiring professional nursing care and skills and aligns

2 patient care needs and nursing skills consistent with

3 professional nursing standards.

4 "Department" means the Department of Public Health.

5 "Direct patient care" means care provided by a registered

6 professional nurse with direct responsibility to oversee or

7 carry out medical regimens or nursing care for one or more

8 patients.

9 "Nursing care committee" means an existing or newly

10 created hospital-wide committee or committees of nurses whose

11 functions, in part or in whole, contribute to the development,

12 recommendation, and review of the hospital's nurse staffing

13 plan established pursuant to subsection (d).

14 "Registered professional nurse" means a person licensed as

15 a Registered Nurse under the Nurse Practice Act.

16 "Written staffing plan for nursing care services" means a

17 written plan for guiding the assignment of patient care

18 nursing staff based on multiple nurse and patient

19 considerations that yield minimum staffing levels for

20 inpatient care units and the adopted acuity model aligning

21 patient care needs with nursing skills required for quality

22 patient care consistent with professional nursing standards.

23 (c) Written staffing plan.

24 (1) Every hospital shall implement a written

25 hospital-wide staffing plan, recommended by a nursing care

26 committee or committees, that provides for minimum direct

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1 care professional registered nurse-to-patient staffing

2 needs for each inpatient care unit. The written

3 hospital-wide staffing plan shall include, but need not be

4 limited to, the following considerations:

5 (A) The complexity of complete care, assessment on

6 patient admission, volume of patient admissions,

7 discharges and transfers, evaluation of the progress

8 of a patient's problems, ongoing physical assessments,

9 planning for a patient's discharge, assessment after a

10 change in patient condition, and assessment of the

11 need for patient referrals.

12 (B) The complexity of clinical professional

13 nursing judgment needed to design and implement a

14 patient's nursing care plan, the need for specialized

15 equipment and technology, the skill mix of other

16 personnel providing or supporting direct patient care,

17 and involvement in quality improvement activities,

18 professional preparation, and experience.

19 (C) Patient acuity and the number of patients for

20 whom care is being provided.

21 (D) The ongoing assessments of a unit's patient

22 acuity levels and nursing staff needed shall be

23 routinely made by the unit nurse manager or his or her

24 designee.

25 (E) The identification of additional registered

26 nurses available for direct patient care when

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1 patients' unexpected needs exceed the planned workload

2 for direct care staff.

3 (2) In order to provide staffing flexibility to meet

4 patient needs, every hospital shall identify an acuity

5 model for adjusting the staffing plan for each inpatient

6 care unit.

7 (3) The written staffing plan shall be posted, either

8 by physical or electronic means, in a conspicuous and

9 accessible location for both patients and direct care

10 staff, as required under the Hospital Report Card Act. A

11 copy of the written staffing plan shall be provided to any

12 member of the general public upon request.

13 (d) Nursing care committee.

14 (1) Every hospital shall have a nursing care

15 committee. A hospital shall appoint members of a committee

16 whereby at least 50% of the members are registered

17 professional nurses providing direct patient care.

18 (2) A nursing care committee's recommendations must be

19 given significant regard and weight in the hospital's

20 adoption and implementation of a written staffing plan.

21 (3) A nursing care committee or committees shall

22 recommend a written staffing plan for the hospital based

23 on the principles from the staffing components set forth

24 in subsection (c). In particular, a committee or

25 committees shall provide input and feedback on the

26 following:

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1 (A) Selection, implementation, and evaluation of

2 minimum staffing levels for inpatient care units.

3 (B) Selection, implementation, and evaluation of

4 an acuity model to provide staffing flexibility that

5 aligns changing patient acuity with nursing skills

6 required.

7 (C) Selection, implementation, and evaluation of a

8 written staffing plan incorporating the items

9 described in subdivisions (c)(1) and (c)(2) of this

10 Section.

11 (D) Review the following: nurse-to-patient

12 staffing guidelines for all inpatient areas; and

13 current acuity tools and measures in use.

14 (4) A nursing care committee must address the items

15 described in subparagraphs (A) through (D) of paragraph

16 (3) semi-annually.

17 (e) Nothing in this Section 10.10 shall be construed to

18 limit, alter, or modify any of the terms, conditions, or

19 provisions of a collective bargaining agreement entered into

20 by the hospital.

21 (Source: P.A. 96-328, eff. 8-11-09; 97-423, eff. 1-1-12;

22 97-813, eff. 7-13-12.)

23 (210 ILCS 85/11.5)

24 Sec. 11.5. Uniform standards of obstetrical care

25 regardless of ability to pay.

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1 (a) No hospital may promulgate policies or implement

2 practices that determine differing standards of obstetrical

3 care based upon a patient's source of payment or ability to pay

4 for medical services.

5 (b) Each hospital shall develop a written policy statement

6 reflecting the requirements of subsection (a) and shall post,

7 either by physical or electronic means, written notices of

8 this policy in the obstetrical admitting areas of the hospital

9 by July 1, 2004. Notices posted pursuant to this Section shall

10 be posted in the predominant language or languages spoken in

11 the hospital's service area.

12 (Source: P.A. 93-981, eff. 8-23-04.)

13 Section 15-10. The Language Assistance Services Act is

14 amended by changing Section 15 as follows:

15 (210 ILCS 87/15)

16 Sec. 15. Language assistance services.

17 (a) To ensure access to health care information and

18 services for limited-English-speaking or non-English-speaking

19 residents and deaf residents, a health facility must do the

20 following:

21 (1) Adopt and review annually a policy for providing

22 language assistance services to patients with language or

23 communication barriers. The policy shall include

24 procedures for providing, to the extent possible as

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1 determined by the facility, the use of an interpreter

2 whenever a language or communication barrier exists,

3 except where the patient, after being informed of the

4 availability of the interpreter service, chooses to use a

5 family member or friend who volunteers to interpret. The

6 procedures shall be designed to maximize efficient use of

7 interpreters and minimize delays in providing interpreters

8 to patients. The procedures shall insure, to the extent

9 possible as determined by the facility, that interpreters

10 are available, either on the premises or accessible by

11 telephone, 24 hours a day. The facility shall annually

12 transmit to the Department of Public Health a copy of the

13 updated policy and shall include a description of the

14 facility's efforts to insure adequate and speedy

15 communication between patients with language or

16 communication barriers and staff.

17 (2) Develop, and post, either by physical or

18 electronic means, in conspicuous locations, notices that

19 advise patients and their families of the availability of

20 interpreters, the procedure for obtaining an interpreter,

21 and the telephone numbers to call for filing complaints

22 concerning interpreter service problems, including, but

23 not limited to, a TTY number for persons who are deaf or

24 hard of hearing. The notices shall be posted, at a

25 minimum, in the emergency room, the admitting area, the

26 facility entrance, and the outpatient area. Notices shall

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1 inform patients that interpreter services are available on

2 request, shall list the languages most commonly

3 encountered at the facility for which interpreter services

4 are available, and shall instruct patients to direct

5 complaints regarding interpreter services to the

6 Department of Public Health, including the telephone

7 numbers to call for that purpose.

8 (3) Notify the facility's employees of the language

9 services available at the facility and train them on how

10 to make those language services available to patients.

11 (b) In addition, a health facility may do one or more of

12 the following:

13 (1) Identify and record a patient's primary language

14 and dialect on one or more of the following: a patient

15 medical chart, hospital bracelet, bedside notice, or

16 nursing card.

17 (2) Prepare and maintain, as needed, a list of

18 interpreters who have been identified as proficient in

19 sign language according to the Interpreter for the Deaf

20 Licensure Act of 2007 and a list of the languages of the

21 population of the geographical area served by the

22 facility.

23 (3) Review all standardized written forms, waivers,

24 documents, and informational materials available to

25 patients on admission to determine which to translate into

26 languages other than English.

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1 (4) Consider providing its nonbilingual staff with

2 standardized picture and phrase sheets for use in routine

3 communications with patients who have language or

4 communication barriers.

5 (5) Develop community liaison groups to enable the

6 facility and the limited-English-speaking,

7 non-English-speaking, and deaf communities to ensure the

8 adequacy of the interpreter services.

9 (Source: P.A. 98-756, eff. 7-16-14.)

10 Section 15-15. The Fair Patient Billing Act is amended by

11 changing Section 15 as follows:

12 (210 ILCS 88/15)

13 Sec. 15. Patient notification.

14 (a) Each hospital shall post a sign with the following

15 notice:

16 "You may be eligible for financial assistance under

17 the terms and conditions the hospital offers to qualified

18 patients. For more information contact [hospital financial

19 assistance representative]".

20 (b) The sign under subsection (a) shall be posted, either

21 by physical or electronic means, conspicuously in the

22 admission and registration areas of the hospital.

23 (c) The sign shall be in English, and in any other language

24 that is the primary language of at least 5% of the patients

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1 served by the hospital annually.

2 (d) Each hospital that has a website must post a notice in

3 a prominent place on its website that financial assistance is

4 available at the hospital, a description of the financial

5 assistance application process, and a copy of the financial

6 assistance application.

7 (e) Within 180 days after the effective date of this

8 amendatory Act of the 102nd General Assembly, each ~~Each~~

9 hospital must make available information regarding financial

10 assistance from the hospital in the form of either a brochure,

11 an application for financial assistance, or other written or

12 electronic material in the emergency room, ~~material in the~~

13 hospital admission, or registration area.

14 (Source: P.A. 94-885, eff. 1-1-07.)

15 Section 15-16. The Health Care Violence Prevention Act is

16 amended by changing Section 15 as follows:

17 (210 ILCS 160/15)

18 Sec. 15. Workplace safety.

19 (a) A health care worker who contacts law enforcement or

20 files a report with law enforcement against a patient or

21 individual because of workplace violence shall provide notice

22 to management of the health care provider by which he or she is

23 employed within 3 days after contacting law enforcement or

24 filing the report.

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1 (b) No management of a health care provider may discourage

2 a health care worker from exercising his or her right to

3 contact law enforcement or file a report with law enforcement

4 because of workplace violence.

5 (c) A health care provider that employs a health care

6 worker shall display a notice, either by physical or

7 electronic means, stating that verbal aggression will not be

8 tolerated and physical assault will be reported to law

9 enforcement.

10 (d) The health care provider shall offer immediate

11 post-incident services for a health care worker directly

12 involved in a workplace violence incident caused by patients

13 or their visitors, including acute treatment and access to

14 psychological evaluation.

15 (Source: P.A. 100-1051, eff. 1-1-19.)

16 Section 15-17. The Medical Patient Rights Act is amended

17 by changing Sections 3.4 and 5.2 as follows:

18 (410 ILCS 50/3.4)

19 Sec. 3.4. Rights of women; pregnancy and childbirth.

20 (a) In addition to any other right provided under this

21 Act, every woman has the following rights with regard to

22 pregnancy and childbirth:

23 (1) The right to receive health care before, during,

24 and after pregnancy and childbirth.

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1 (2) The right to receive care for her and her infant

2 that is consistent with generally accepted medical

3 standards.

4 (3) The right to choose a certified nurse midwife or

5 physician as her maternity care professional.

6 (4) The right to choose her birth setting from the

7 full range of birthing options available in her community.

8 (5) The right to leave her maternity care professional

9 and select another if she becomes dissatisfied with her

10 care, except as otherwise provided by law.

11 (6) The right to receive information about the names

12 of those health care professionals involved in her care.

13 (7) The right to privacy and confidentiality of

14 records, except as provided by law.

15 (8) The right to receive information concerning her

16 condition and proposed treatment, including methods of

17 relieving pain.

18 (9) The right to accept or refuse any treatment, to

19 the extent medically possible.

20 (10) The right to be informed if her caregivers wish

21 to enroll her or her infant in a research study in

22 accordance with Section 3.1 of this Act.

23 (11) The right to access her medical records in

24 accordance with Section 8-2001 of the Code of Civil

25 Procedure.

26 (12) The right to receive information in a language in

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1 which she can communicate in accordance with federal law.

2 (13) The right to receive emotional and physical

3 support during labor and birth.

4 (14) The right to freedom of movement during labor and

5 to give birth in the position of her choice, within

6 generally accepted medical standards.

7 (15) The right to contact with her newborn, except

8 where necessary care must be provided to the mother or

9 infant.

10 (16) The right to receive information about

11 breastfeeding.

12 (17) The right to decide collaboratively with

13 caregivers when she and her baby will leave the birth site

14 for home, based on their conditions and circumstances.

15 (18) The right to be treated with respect at all times

16 before, during, and after pregnancy by her health care

17 professionals.

18 (19) The right of each patient, regardless of source

19 of payment, to examine and receive a reasonable

20 explanation of her total bill for services rendered by her

21 maternity care professional or health care provider,

22 including itemized charges for specific services received.

23 Each maternity care professional or health care provider

24 shall be responsible only for a reasonable explanation of

25 those specific services provided by the maternity care

26 professional or health care provider.

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1 (b) The Department of Public Health, Department of

2 Healthcare and Family Services, Department of Children and

3 Family Services, and Department of Human Services shall post,

4 either by physical or electronic means, information about

5 these rights on their publicly available websites. Every

6 health care provider, day care center licensed under the Child

7 Care Act of 1969, Head Start, and community center shall post

8 information about these rights in a prominent place and on

9 their websites, if applicable.

10 (c) The Department of Public Health shall adopt rules to

11 implement this Section.

12 (d) Nothing in this Section or any rules adopted under

13 subsection (c) shall be construed to require a physician,

14 health care professional, hospital, hospital affiliate, or

15 health care provider to provide care inconsistent with

16 generally accepted medical standards or available capabilities

17 or resources.

18 (Source: P.A. 101-445, eff. 1-1-20.)

19 (410 ILCS 50/5.2)

20 Sec. 5.2. Emergency room anti-discrimination notice. Every

21 hospital shall post, either by physical or electronic means, a

22 sign next to or in close proximity of its sign required by

23 Section 489.20 (q)(1) of Title 42 of the Code of Federal

24 Regulations stating the following:

25 "You have the right not to be discriminated against by the

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1 hospital due to your race, color, or national origin if these

2 characteristics are unrelated to your diagnosis or treatment.

3 If you believe this right has been violated, please call

4 (insert number for hospital grievance officer).".

5 (Source: P.A. 97-485, eff. 8-22-11.)

6 Section 15-25. The Abandoned Newborn Infant Protection Act

7 is amended by changing Section 22 as follows:

8 (325 ILCS 2/22)

9 Sec. 22. Signs. Every hospital, fire station, emergency

10 medical facility, and police station that is required to

11 accept a relinquished newborn infant in accordance with this

12 Act must post, either by physical or electronic means, a sign

13 in a conspicuous place on the exterior of the building housing

14 the facility informing persons that a newborn infant may be

15 relinquished at the facility in accordance with this Act. The

16 Department shall prescribe specifications for the signs and

17 for their placement that will ensure statewide uniformity.

18 This Section does not apply to a hospital, fire station,

19 emergency medical facility, or police station that has a sign

20 that is consistent with the requirements of this Section that

21 is posted on the effective date of this amendatory Act of the

22 95th General Assembly.

23 (Source: P.A. 95-275, eff. 8-17-07.)

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1 Section 15-30. The Crime Victims Compensation Act is

2 amended by changing Section 5.1 as follows:

3 (740 ILCS 45/5.1) (from Ch. 70, par. 75.1)

4 Sec. 5.1. (a) Every hospital licensed under the laws of

5 this State shall display prominently in its emergency room

6 posters giving notification of the existence and general

7 provisions of this Act. The posters may be displayed by

8 physical or electronic means.Such posters shall be provided

9 by the Attorney General.

10 (b) Any law enforcement agency that investigates an

11 offense committed in this State shall inform the victim of the

12 offense or his dependents concerning the availability of an

13 award of compensation and advise such persons that any

14 information concerning this Act and the filing of a claim may

15 be obtained from the office of the Attorney General.

16 (Source: P.A. 81-1013.)

17 Section 15-35. The Human Trafficking Resource Center

18 Notice Act is amended by changing Sections 5 and 10 as follows:

19 (775 ILCS 50/5)

20 Sec. 5. Posted notice required.

21 (a) Each of the following businesses and other

22 establishments shall, upon the availability of the model

23 notice described in Section 15 of this Act, post a notice that

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1 complies with the requirements of this Act in a conspicuous

2 place near the public entrance of the establishment or in

3 another conspicuous location in clear view of the public and

4 employees where similar notices are customarily posted:

5 (1) On premise consumption retailer licensees under

6 the Liquor Control Act of 1934 where the sale of alcoholic

7 liquor is the principal business carried on by the

8 licensee at the premises and primary to the sale of food.

9 (2) Adult entertainment facilities, as defined in

10 Section 5-1097.5 of the Counties Code.

11 (3) Primary airports, as defined in Section 47102(16)

12 of Title 49 of the United States Code.

13 (4) Intercity passenger rail or light rail stations.

14 (5) Bus stations.

15 (6) Truck stops. For purposes of this Act, "truck

16 stop" means a privately-owned and operated facility that

17 provides food, fuel, shower or other sanitary facilities,

18 and lawful overnight truck parking.

19 (7) Emergency rooms within general acute care

20 hospitals, in which case the notice may be posted by

21 electronic means.

22 (8) Urgent care centers, in which case the notice may

23 be posted by electronic means.

24 (9) Farm labor contractors. For purposes of this Act,

25 "farm labor contractor" means: (i) any person who for a

26 fee or other valuable consideration recruits, supplies, or

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1 hires, or transports in connection therewith, into or

2 within the State, any farmworker not of the contractor's

3 immediate family to work for, or under the direction,

4 supervision, or control of, a third person; or (ii) any

5 person who for a fee or other valuable consideration

6 recruits, supplies, or hires, or transports in connection

7 therewith, into or within the State, any farmworker not of

8 the contractor's immediate family, and who for a fee or

9 other valuable consideration directs, supervises, or

10 controls all or any part of the work of the farmworker or

11 who disburses wages to the farmworker. However, "farm

12 labor contractor" does not include full-time regular

13 employees of food processing companies when the employees

14 are engaged in recruiting for the companies if those

15 employees are not compensated according to the number of

16 farmworkers they recruit.

17 (10) Privately-operated job recruitment centers.

18 (11) Massage establishments. As used in this Act,

19 "massage establishment" means a place of business in which

20 any method of massage therapy is administered or practiced

21 for compensation. "Massage establishment" does not

22 include: an establishment at which persons licensed under

23 the Medical Practice Act of 1987, the Illinois Physical

24 Therapy Act, or the Naprapathic Practice Act engage in

25 practice under one of those Acts; a business owned by a

26 sole licensed massage therapist; or a cosmetology or

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1 esthetics salon registered under the Barber, Cosmetology,

2 Esthetics, Hair Braiding, and Nail Technology Act of 1985.

3 (b) The Department of Transportation shall, upon the

4 availability of the model notice described in Section 15 of

5 this Act, post a notice that complies with the requirements of

6 this Act in a conspicuous place near the public entrance of

7 each roadside rest area or in another conspicuous location in

8 clear view of the public and employees where similar notices

9 are customarily posted.

10 (c) The owner of a hotel or motel shall, upon the

11 availability of the model notice described in Section 15 of

12 this Act, post a notice that complies with the requirements of

13 this Act in a conspicuous and accessible place in or about the

14 premises in clear view of the employees where similar notices

15 are customarily posted.

16 (d) The organizer of a public gathering or special event

17 that is conducted on property open to the public and requires

18 the issuance of a permit from the unit of local government

19 shall post a notice that complies with the requirements of

20 this Act in a conspicuous and accessible place in or about the

21 premises in clear view of the public and employees where

22 similar notices are customarily posted.

23 (e) The administrator of a public or private elementary

24 school or public or private secondary school shall post a

25 printout of the downloadable notice provided by the Department

26 of Human Services under Section 15 that complies with the

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1 requirements of this Act in a conspicuous and accessible place

2 chosen by the administrator in the administrative office or

3 another location in view of school employees. School districts

4 and personnel are not subject to the penalties provided under

5 subsection (a) of Section 20.

6 (f) The owner of an establishment registered under the

7 Tattoo and Body Piercing Establishment Registration Act shall

8 post a notice that complies with the requirements of this Act

9 in a conspicuous and accessible place in clear view of

10 establishment employees.

11 (Source: P.A. 99-99, eff. 1-1-16; 99-565, eff. 7-1-17;

12 100-671, eff. 1-1-19.)

13 (775 ILCS 50/10)

14 Sec. 10. Form of posted notice.

15 (a) The notice required under this Act shall be at least 8

16 1/2 inches by 11 inches in size, written in a 16-point font,

17 except that when the notice is provided by electronic means

18 the size of the notice and font shall not be required to comply

19 with these specifications, and shall state the following:

20 "If you or someone you know is being forced to engage in any

21 activity and cannot leave, whether it is commercial sex,

22 housework, farm work, construction, factory, retail, or

23 restaurant work, or any other activity, call the National

24 Human Trafficking Resource Center at 1-888-373-7888 to access

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1 help and services.

2 Victims of slavery and human trafficking are protected under

3 United States and Illinois law. The hotline is:

4 * Available 24 hours a day, 7 days a week.

5 * Toll-free.

6 * Operated by nonprofit nongovernmental organizations.

7 * Anonymous and confidential.

8 * Accessible in more than 160 languages.

9 * Able to provide help, referral to services,

10 training, and general information.".

11 (b) The notice shall be printed in English, Spanish, and

12 in one other language that is the most widely spoken language

13 in the county where the establishment is located and for which

14 translation is mandated by the federal Voting Rights Act, as

15 applicable. This subsection does not require a business or

16 other establishment in a county where a language other than

17 English or Spanish is the most widely spoken language to print

18 the notice in more than one language in addition to English and

19 Spanish.

20 (Source: P.A. 99-99, eff. 1-1-16.)

21 Article 20.

22 Section 20-5. The University of Illinois Hospital Act is

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1 amended by adding Section 8d as follows:

2 (110 ILCS 330/8d new)

3 Sec. 8d. N95 masks. Pursuant to and in accordance with

4 applicable local, State, and federal policies, guidance and

5 recommendations of public health and infection control

6 authorities, and taking into consideration the limitations on

7 access to N95 masks caused by disruptions in local, State,

8 national, and international supply chains, the University of

9 Illinois Hospital shall provide N95 masks to physicians

10 licensed under the Medical Practice Act of 1987, registered

11 nurses and advanced practice registered nurses licensed under

12 the Nurse Licensing Act, and any other employees or

13 contractual workers who provide direct patient care and who,

14 pursuant to such policies, guidance, and recommendations, are

15 recommended to have such a mask to safely provide such direct

16 patient care within a hospital setting. Nothing in this

17 Section shall be construed to impose any new duty or

18 obligation on the University of Illinois Hospital or employee

19 that is greater than that imposed under State and federal laws

20 in effect on the effective date of this amendatory Act of the

21 102nd General Assembly. This Section is repealed on December

22 31, 2021.

23 Section 20-10. The Hospital Licensing Act is amended by

24 adding Section 6.28 as follows:

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1 (210 ILCS 85/6.28 new)

2 Sec. 6.28. N95 masks. Pursuant to and in accordance with

3 applicable local, State, and federal policies, guidance and

4 recommendations of public health and infection control

5 authorities, and taking into consideration the limitations on

6 access to N95 masks caused by disruptions in local, State,

7 national, and international supply chains, a hospital licensed

8 under this Act shall provide N95 masks to physicians licensed

9 under the Medical Practice Act of 1987, registered nurses and

10 advanced practice registered nurses licensed under the Nurse

11 Licensing Act, and any other employees or contractual workers

12 who provide direct patient care and who, pursuant to such

13 policies, guidance, and recommendations, are recommended to

14 have such a mask to safely provide such direct patient care

15 within a hospital setting. Nothing in this Section shall be

16 construed to impose any new duty or obligation on the hospital

17 or employee that is greater than that imposed under State and

18 federal laws in effect on the effective date of this

19 amendatory Act of the 102nd General Assembly. This Section is

20 repealed on December 31, 2021.

21 Article 35.

22 Section 35-5. The Illinois Public Aid Code is amended by

23 changing Section 5-5.05 as follows:

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1 (305 ILCS 5/5-5.05)

2 Sec. 5-5.05. Hospitals; psychiatric services.

3 (a) On and after July 1, 2008, the inpatient, per diem rate

4 to be paid to a hospital for inpatient psychiatric services

5 shall be $363.77.

6 (b) For purposes of this Section, "hospital" means the

7 following:

8 (1) Advocate Christ Hospital, Oak Lawn, Illinois.

9 (2) Barnes-Jewish Hospital, St. Louis, Missouri.

10 (3) BroMenn Healthcare, Bloomington, Illinois.

11 (4) Jackson Park Hospital, Chicago, Illinois.

12 (5) Katherine Shaw Bethea Hospital, Dixon, Illinois.

13 (6) Lawrence County Memorial Hospital, Lawrenceville,

14 Illinois.

15 (7) Advocate Lutheran General Hospital, Park Ridge,

16 Illinois.

17 (8) Mercy Hospital and Medical Center, Chicago,

18 Illinois.

19 (9) Methodist Medical Center of Illinois, Peoria,

20 Illinois.

21 (10) Provena United Samaritans Medical Center,

22 Danville, Illinois.

23 (11) Rockford Memorial Hospital, Rockford, Illinois.

24 (12) Sarah Bush Lincoln Health Center, Mattoon,

25 Illinois.

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1 (13) Provena Covenant Medical Center, Urbana,

2 Illinois.

3 (14) Rush-Presbyterian-St. Luke's Medical Center,

4 Chicago, Illinois.

5 (15) Mt. Sinai Hospital, Chicago, Illinois.

6 (16) Gateway Regional Medical Center, Granite City,

7 Illinois.

8 (17) St. Mary of Nazareth Hospital, Chicago, Illinois.

9 (18) Provena St. Mary's Hospital, Kankakee, Illinois.

10 (19) St. Mary's Hospital, Decatur, Illinois.

11 (20) Memorial Hospital, Belleville, Illinois.

12 (21) Swedish Covenant Hospital, Chicago, Illinois.

13 (22) Trinity Medical Center, Rock Island, Illinois.

14 (23) St. Elizabeth Hospital, Chicago, Illinois.

15 (24) Richland Memorial Hospital, Olney, Illinois.

16 (25) St. Elizabeth's Hospital, Belleville, Illinois.

17 (26) Samaritan Health System, Clinton, Iowa.

18 (27) St. John's Hospital, Springfield, Illinois.

19 (28) St. Mary's Hospital, Centralia, Illinois.

20 (29) Loretto Hospital, Chicago, Illinois.

21 (30) Kenneth Hall Regional Hospital, East St. Louis,

22 Illinois.

23 (31) Hinsdale Hospital, Hinsdale, Illinois.

24 (32) Pekin Hospital, Pekin, Illinois.

25 (33) University of Chicago Medical Center, Chicago,

26 Illinois.

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1 (34) St. Anthony's Health Center, Alton, Illinois.

2 (35) OSF St. Francis Medical Center, Peoria, Illinois.

3 (36) Memorial Medical Center, Springfield, Illinois.

4 (37) A hospital with a distinct part unit for

5 psychiatric services that begins operating on or after

6 July 1, 2008.

7 For purposes of this Section, "inpatient psychiatric

8 services" means those services provided to patients who are in

9 need of short-term acute inpatient hospitalization for active

10 treatment of an emotional or mental disorder.

11 (b-5) Notwithstanding any other provision of this Section,

12 and subject to appropriation, the inpatient, per diem rate to

13 be paid to all safety-net hospitals for inpatient psychiatric

14 services on and after January 1, 2021 shall be at least $630.

15 (c) No rules shall be promulgated to implement this

16 Section. For purposes of this Section, "rules" is given the

17 meaning contained in Section 1-70 of the Illinois

18 Administrative Procedure Act.

19 (d) This Section shall not be in effect during any period

20 of time that the State has in place a fully operational

21 hospital assessment plan that has been approved by the Centers

22 for Medicare and Medicaid Services of the U.S. Department of

23 Health and Human Services.

24 (e) On and after July 1, 2012, the Department shall reduce

25 any rate of reimbursement for services or other payments or

26 alter any methodologies authorized by this Code to reduce any

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1 rate of reimbursement for services or other payments in

2 accordance with Section 5-5e.

3 (Source: P.A. 97-689, eff. 6-14-12.)

4 Title IV. Medical Implicit Bias

5 Article 45.

6 Section 45-5. The Department of Professional Regulation

7 Law of the Civil Administrative Code of Illinois is amended by

8 adding Section 2105-15.7 as follows:

9 (20 ILCS 2105/2105-15.7 new)

10 Sec. 2105-15.7. Implicit bias awareness training.

11 (a) As used in this Section, "health care professional"

12 means a person licensed or registered by the Department of

13 Financial and Professional Regulation under the following

14 Acts: Medical Practice Act of 1987, Nurse Practice Act,

15 Clinical Psychologist Licensing Act, Illinois Dental Practice

16 Act, Illinois Optometric Practice Act of 1987, Pharmacy

17 Practice Act, Illinois Physical Therapy Act, Physician

18 Assistant Practice Act of 1987, Acupuncture Practice Act,

19 Illinois Athletic Trainers Practice Act, Clinical Social Work

20 and Social Work Practice Act, Dietitian Nutritionist Practice

21 Act, Home Medical Equipment and Services Provider License Act,

22 Naprapathic Practice Act, Nursing Home Administrators

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1 Licensing and Disciplinary Act, Illinois Occupational Therapy

2 Practice Act, Illinois Optometric Practice Act of 1987,

3 Podiatric Medical Practice Act of 1987, Respiratory Care

4 Practice Act, Professional Counselor and Clinical Professional

5 Counselor Licensing and Practice Act, Sex Offender Evaluation

6 and Treatment Provider Act, Illinois Speech-Language Pathology

7 and Audiology Practice Act, Perfusionist Practice Act,

8 Registered Surgical Assistant and Registered Surgical

9 Technologist Title Protection Act, and Genetic Counselor

10 Licensing Act.

11 (b) For license or registration renewals occurring on or

12 after January 1, 2022, a health care professional who has

13 continuing education requirements must complete at least a

14 one-hour course in training on implicit bias awareness per

15 renewal period. A health care professional may count this one

16 hour for completion of this course toward meeting the minimum

17 credit hours required for continuing education. Any training

18 on implicit bias awareness applied to meet any other State

19 licensure requirement, professional accreditation or

20 certification requirement, or health care institutional

21 practice agreement may count toward the one-hour requirement

22 under this Section.

23 (c) The Department may adopt rules for the implementation

24 of this Section.

25 Title V. Substance Abuse and Mental Health Treatment

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1 Article 50.

2 Section 50-5. The Illinois Controlled Substances Act is

3 amended by changing Section 414 as follows:

4 (720 ILCS 570/414)

5 Sec. 414. Overdose; limited immunity ~~from prosecution~~.

6 (a) For the purposes of this Section, "overdose" means a

7 controlled substance-induced physiological event that results

8 in a life-threatening emergency to the individual who

9 ingested, inhaled, injected or otherwise bodily absorbed a

10 controlled, counterfeit, or look-alike substance or a

11 controlled substance analog.

12 (b) A person who, in good faith, seeks or obtains

13 emergency medical assistance for someone experiencing an

14 overdose shall not be arrested, charged, or prosecuted for a

15 violation of Section 401 or 402 of the Illinois Controlled

16 Substances Act, Section 3.5 of the Drug Paraphernalia Control

17 Act, Section 55 or 60 of the Methamphetamine Control and

18 Community Protection Act, Section 9-3.3 of the Criminal Code

19 of 2012, or paragraph (1) of subsection (g) of Section 12-3.05

20 of the Criminal Code of 2012 ~~Class 4 felony possession of a~~

21 ~~controlled, counterfeit, or look-alike substance or a~~

22 ~~controlled substance analog~~ if evidence for the violation

23 ~~Class 4 felony possession charge~~ was acquired as a result of

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1 the person seeking or obtaining emergency medical assistance

2 and providing the amount of substance recovered is within the

3 amount identified in subsection (d) of this Section. The

4 violations listed in this subsection (b) must not serve as the

5 sole basis of a violation of parole, mandatory supervised

6 release, probation, or conditional discharge, or any seizure

7 of property under any State law authorizing civil forfeiture

8 so long as the evidence for the violation was acquired as a

9 result of the person seeking or obtaining emergency medical

10 assistance in the event of an overdose.

11 (c) A person who is experiencing an overdose shall not be

12 arrested, charged, or prosecuted for a violation of Section

13 401 or 402 of the Illinois Controlled Substances Act, Section

14 3.5 of the Drug Paraphernalia Control Act, Section 9-3.3 of

15 the Criminal Code of 2012, or paragraph (1) of subsection (g)

16 of Section 12-3.05 of the Criminal Code of 2012 ~~Class 4 felony~~

17 ~~possession of a controlled, counterfeit, or look-alike~~

18 ~~substance or a controlled substance analog~~ if evidence for the

19 violation ~~Class 4 felony possession charge~~ was acquired as a

20 result of the person seeking or obtaining emergency medical

21 assistance and providing the amount of substance recovered is

22 within the amount identified in subsection (d) of this

23 Section. The violations listed in this subsection (c) must not

24 serve as the sole basis of a violation of parole, mandatory

25 supervised release, probation, or conditional discharge, or

26 any seizure of property under any State law authorizing civil

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1 forfeiture so long as the evidence for the violation was

2 acquired as a result of the person seeking or obtaining

3 emergency medical assistance 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

8 heroin;

9 (2) less than 3 grams of a substance containing

10 cocaine;

11 (3) less than 3 grams of a substance containing

12 morphine;

13 (4) less than 40 grams of a substance containing

14 peyote;

15 (5) less than 40 grams of a substance containing a

16 derivative of barbituric acid or any of the salts of a

17 derivative of barbituric acid;

18 (6) less than 40 grams of a substance containing

19 amphetamine or any salt of an optical isomer of

20 amphetamine;

21 (7) less than 3 grams of a substance containing

22 lysergic acid diethylamide (LSD), or an analog thereof;

23 (8) less than 6 grams of a substance containing

24 pentazocine or any of the salts, isomers and salts of

25 isomers of pentazocine, or an analog thereof;

26 (9) less than 6 grams of a substance containing

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1 methaqualone or any of the salts, isomers and salts of

2 isomers of methaqualone;

3 (10) less than 6 grams of a substance containing

4 phencyclidine or any of the salts, isomers and salts of

5 isomers of phencyclidine (PCP);

6 (11) less than 6 grams of a substance containing

7 ketamine or any of the salts, isomers and salts of isomers

8 of ketamine;

9 (12) less than 40 grams of a substance containing a

10 substance classified as a narcotic drug in Schedules I or

11 II, or an analog thereof, which is not otherwise included

12 in this subsection.

13 (e) The limited immunity described in subsections (b) and

14 (c) of this Section shall not be extended if law enforcement

15 has reasonable suspicion or probable cause to detain, arrest,

16 or search the person described in subsection (b) or (c) of this

17 Section for criminal activity and the reasonable suspicion or

18 probable cause is based on information obtained prior to or

19 independent of the individual described in subsection (b) or

20 (c) taking action to seek or obtain emergency medical

21 assistance and not obtained as a direct result of the action of

22 seeking or obtaining emergency medical assistance. Nothing in

23 this Section is intended to interfere with or prevent the

24 investigation, arrest, or prosecution of any person for the

25 delivery or distribution of cannabis, methamphetamine or other

26 controlled substances, drug-induced homicide, or any other

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1 crime if the evidence of the violation is not acquired as a

2 result of the person seeking or obtaining emergency medical

3 assistance in the event of an overdose.

4 (Source: P.A. 97-678, eff. 6-1-12.)

5 Section 50-10. The Methamphetamine Control and Community

6 Protection Act is amended by changing Section 115 as follows:

7 (720 ILCS 646/115)

8 Sec. 115. Overdose; limited immunity ~~from prosecution~~.

9 (a) For the purposes of this Section, "overdose" means a

10 methamphetamine-induced physiological event that results in a

11 life-threatening emergency to the individual who ingested,

12 inhaled, injected, or otherwise bodily absorbed

13 methamphetamine.

14 (b) A person who, in good faith, seeks emergency medical

15 assistance for someone experiencing an overdose shall not be

16 arrested, charged or prosecuted for a violation of Section 55

17 or 60 of this Act or Section 3.5 of the Drug Paraphernalia

18 Control Act, Section 9-3.3 of the Criminal Code of 2012, or

19 paragraph (1) of subsection (g) of Section 12-3.05 of the

20 Criminal Code of 2012 ~~Class 3 felony possession of~~

21 ~~methamphetamine~~ if evidence for the violation ~~Class 3 felony~~

22 ~~possession charge~~ was acquired as a result of the person

23 seeking or obtaining emergency medical assistance and

24 providing the amount of substance recovered is less than 3

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1 grams ~~one gram~~ of methamphetamine or a substance containing

2 methamphetamine. The violations listed in this subsection (b)

3 must not serve as the sole basis of a violation of parole,

4 mandatory supervised release, probation, or conditional

5 discharge, 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, or any seizure

24 of property under any State law authorizing civil forfeiture

25 so long as the evidence for the violation was acquired as a

26 result of the person seeking or obtaining emergency medical

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1 assistance in the event of an overdose.

2 (d) The limited immunity described in subsections (b) and

3 (c) of this Section shall not be extended if law enforcement

4 has reasonable suspicion or probable cause to detain, arrest,

5 or search the person described in subsection (b) or (c) of this

6 Section for criminal activity and the reasonable suspicion or

7 probable cause is based on information obtained prior to or

8 independent of the individual described in subsection (b) or

9 (c) taking action to seek or obtain emergency medical

10 assistance and not obtained as a direct result of the action of

11 seeking or obtaining emergency medical assistance. Nothing in

12 this Section is intended to interfere with or prevent the

13 investigation, arrest, or prosecution of any person for the

14 delivery or distribution of cannabis, methamphetamine or other

15 controlled substances, drug-induced homicide, or any other

16 crime if the evidence of the violation is not acquired as a

17 result of the person seeking or obtaining emergency medical

18 assistance in the event of an overdose.

19 (Source: P.A. 97-678, eff. 6-1-12.)

20 Article 55.

21 Section 55-5. Findings. The General Assembly finds that:

22 (1) Prior to August of 2020, the federal Substance

23 Abuse and Mental Health Services Administration (SAMHSA)

24 and the federal Confidentiality of Substance Use Disorder

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1 Patient Records, set forth at 42 CFR 2, prohibited the

2 sharing of substance use disorder treatment information by

3 opioid treatment programs with prescription monitoring

4 programs.

5 (2) In August 2020, SAMHSA amended 42 CFR 2 to permit

6 the sharing of substance use disorder treatment

7 information by opioid treatment programs with prescription

8 monitoring programs if required by State law and if

9 patient consent is obtained. In light of the federal

10 modification to 42 CFR 2, the protections available under

11 federal and State law, and the express requirement of

12 patient consent, the reporting by opioid treatment

13 programs to the prescription monitoring program is

14 permitted and will allow for better coordination of care

15 among treating providers.

16 Section 55-10. The Illinois Controlled Substances Act is

17 amended by changing Section 316 as follows:

18 (720 ILCS 570/316)

19 Sec. 316. Prescription Monitoring Program.

20 (a) The Department must provide for a Prescription

21 Monitoring Program for Schedule II, III, IV, and V controlled

22 substances that includes the following components and

23 requirements:

24 (1) The dispenser must transmit to the central

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1 repository, in a form and manner specified by the

2 Department, the following information:

3 (A) The recipient's name and address.

4 (B) The recipient's date of birth and gender.

5 (C) The national drug code number of the

6 controlled substance dispensed.

7 (D) The date the controlled substance is

8 dispensed.

9 (E) The quantity of the controlled substance

10 dispensed and days supply.

11 (F) The dispenser's United States Drug Enforcement

12 Administration registration number.

13 (G) The prescriber's United States Drug

14 Enforcement Administration registration number.

15 (H) The dates the controlled substance

16 prescription is filled.

17 (I) The payment type used to purchase the

18 controlled substance (i.e. Medicaid, cash, third party

19 insurance).

20 (J) The patient location code (i.e. home, nursing

21 home, outpatient, etc.) for the controlled substances

22 other than those filled at a retail pharmacy.

23 (K) Any additional information that may be

24 required by the department by administrative rule,

25 including but not limited to information required for

26 compliance with the criteria for electronic reporting

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1 of the American Society for Automation and Pharmacy or

2 its successor.

3 (2) The information required to be transmitted under

4 this Section must be transmitted not later than the end of

5 the next business day after the date on which a controlled

6 substance is dispensed, or at such other time as may be

7 required by the Department by administrative rule.

8 (3) A dispenser must transmit the information required

9 under this Section by:

10 (A) an electronic device compatible with the

11 receiving device of the central repository;

12 (B) a computer diskette;

13 (C) a magnetic tape; or

14 (D) a pharmacy universal claim form or Pharmacy

15 Inventory Control form.

16 (3.5) The requirements of paragraphs (1), (2), and (3)

17 of this subsection (a) also apply to opioid treatment

18 programs licensed or certified by the Department of Human

19 Services' Division of Substance Use Prevention and

20 Recovery and that are authorized by the federal Drug

21 Enforcement Administration to prescribe Schedule II, III,

22 IV, or V controlled substances for the treatment of opioid

23 use disorder. Opioid treatment programs may not transmit

24 information without patient consent, and reports made may

25 not be utilized for law enforcement purposes, each as

26 proscribed by 42 CFR 2, as amended by 42 U.S.C. 290dd-2.

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1 Treatment of a patient may not be conditioned upon his or

2 her consent to reporting.

3 (4) The Department may impose a civil fine of up to

4 $100 per day for willful failure to report controlled

5 substance dispensing to the Prescription Monitoring

6 Program. The fine shall be calculated on no more than the

7 number of days from the time the report was required to be

8 made until the time the problem was resolved, and shall be

9 payable to the Prescription Monitoring Program.

10 (a-5) Notwithstanding subsection (a), a licensed

11 veterinarian is exempt from the reporting requirements of this

12 Section. If a person who is presenting an animal for treatment

13 is suspected of fraudulently obtaining any controlled

14 substance or prescription for a controlled substance, the

15 licensed veterinarian shall report that information to the

16 local law enforcement agency.

17 (b) The Department, by rule, may include in the

18 Prescription Monitoring Program certain other select drugs

19 that are not included in Schedule II, III, IV, or V. The

20 Prescription Monitoring Program does not apply to controlled

21 substance prescriptions as exempted under Section 313.

22 (c) The collection of data on select drugs and scheduled

23 substances by the Prescription Monitoring Program may be used

24 as a tool for addressing oversight requirements of long-term

25 care institutions as set forth by Public Act 96-1372.

26 Long-term care pharmacies shall transmit patient medication

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1 profiles to the Prescription Monitoring Program monthly or

2 more frequently as established by administrative rule.

3 (d) The Department of Human Services shall appoint a

4 full-time Clinical Director of the Prescription Monitoring

5 Program.

6 (e) (Blank).

7 (f) Within one year of January 1, 2018 (the effective date

8 of Public Act 100-564), the Department shall adopt rules

9 requiring all Electronic Health Records Systems to interface

10 with the Prescription Monitoring Program application program

11 on or before January 1, 2021 to ensure that all providers have

12 access to specific patient records during the treatment of

13 their patients. These rules shall also address the electronic

14 integration of pharmacy records with the Prescription

15 Monitoring Program to allow for faster transmission of the

16 information required under this Section. The Department shall

17 establish actions to be taken if a prescriber's Electronic

18 Health Records System does not effectively interface with the

19 Prescription Monitoring Program within the required timeline.

20 (g) The Department, in consultation with the Advisory

21 Committee, shall adopt rules allowing licensed prescribers or

22 pharmacists who have registered to access the Prescription

23 Monitoring Program to authorize a licensed or non-licensed

24 designee employed in that licensed prescriber's office or a

25 licensed designee in a licensed pharmacist's pharmacy who has

26 received training in the federal Health Insurance Portability

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1 and Accountability Act and 42 CFR Part 2 to consult the

2 Prescription Monitoring Program on their behalf. The rules

3 shall include reasonable parameters concerning a

4 practitioner's authority to authorize a designee, and the

5 eligibility of a person to be selected as a designee. In this

6 subsection (g), "pharmacist" shall include a clinical

7 pharmacist employed by and designated by a Medicaid Managed

8 Care Organization providing services under Article V of the

9 Illinois Public Aid Code under a contract with the Department

10 of Healthcare and Family Services for the sole purpose of

11 clinical review of services provided to persons covered by the

12 entity under the contract to determine compliance with

13 subsections (a) and (b) of Section 314.5 of this Act. A managed

14 care entity pharmacist shall notify prescribers of review

15 activities.

16 (Source: P.A. 100-564, eff. 1-1-18; 100-861, eff. 8-14-18;

17 100-1005, eff. 8-21-18; 100-1093, eff. 8-26-18; 101-81, eff.

18 7-12-19; 101-414, eff. 8-16-19.)

19 Article 60.

20 Section 60-5. The Adult Protective Services Act is amended

21 by adding Section 3.1 as follows:

22 (320 ILCS 20/3.1 new)

23 Sec. 3.1. Adult protective services dementia training.

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1 (a) This Section shall apply to any person who is employed

2 by the Department in the Adult Protective Services division

3 who works on the development and implementation of social

4 services to respond to and prevent adult abuse, neglect, or

5 exploitation, subject to appropriation.

6 (b) The Department shall develop and implement a dementia

7 training program that must include instruction on the

8 identification of people with dementia, risks such as

9 wandering, communication impairments, elder abuse, and the

10 best practices for interacting with people with dementia.

11 (c) Initial training of 4 hours shall be completed at the

12 start of employment with the Adult Protective Services

13 division and shall cover the following:

14 (1) Dementia, psychiatric, and behavioral symptoms.

15 (2) Communication issues, including how to communicate

16 respectfully and effectively.

17 (3) Techniques for understanding and approaching

18 behavioral symptoms.

19 (4) Information on how to address specific aspects of

20 safety, for example tips to prevent wandering.

21 (5) When it is necessary to alert law enforcement

22 agencies of potential criminal behavior involving a family

23 member, caretaker, or institutional abuse; neglect or

24 exploitation of a person with dementia; and what types of

25 abuse that are most common to people with dementia.

26 (6) Identifying incidents of self-neglect for people

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1 with dementia who live alone as well as neglect by a

2 caregiver.

3 (7) Protocols for connecting people living with

4 dementia to local care resources and professionals who are

5 skilled in dementia care to encourage cross-referral and

6 reporting regarding incidents of abuse.

7 (d) Annual continuing education shall include 2 hours of

8 dementia training covering the subjects described in

9 subsection (c).

10 (e) This Section is designed to address gaps in current

11 dementia training requirements for Adult Protective Services

12 officials and improve the quality of training. If currently

13 existing law or rules contain more rigorous training

14 requirements for Adult Protective Service officials, those

15 laws or rules shall apply. Where there is overlap between this

16 Section and other laws and rules, the Department shall

17 interpret this Section to avoid duplication of requirements

18 while ensuring that the minimum requirements set in this

19 Section are met.

20 (f) The Department may adopt rules for the administration

21 of this Section.

22 Article 65.

23 Section 65-1. Short title. This Article may be cited as

24 the Behavioral Health Workforce Education Center of Illinois

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1 Act. References in this Article to "this Act" mean this

2 Article.

3 Section 65-5. Findings. The General Assembly finds as

4 follows:

5 (1) There are insufficient behavioral health

6 professionals in this State's behavioral health workforce

7 and further that there are insufficient behavioral health

8 professionals trained in evidence-based practices.

9 (2) The Illinois behavioral health workforce situation

10 is at a crisis state and the lack of a behavioral health

11 strategy is exacerbating the problem.

12 (3) In 2019, the Journal of Community Health found

13 that suicide rates are disproportionately higher among

14 African American adolescents. From 2001 to 2017, the rate

15 for African American teen boys rose 60%, according to the

16 study. Among African American teen girls, rates nearly

17 tripled, rising by an astounding 182%. Illinois was among

18 the 10 states with the greatest number of African American

19 adolescent suicides (2015-2017).

20 (4) Workforce shortages are evident in all behavioral

21 health professions, including, but not limited to,

22 psychiatry, psychiatric nursing, psychiatric physician

23 assistant, social work (licensed social work, licensed

24 clinical social work), counseling (licensed professional

25 counseling, licensed clinical professional counseling),

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1 marriage and family therapy, licensed clinical psychology,

2 occupational therapy, prevention, substance use disorder

3 counseling, and peer support.

4 (5) The shortage of behavioral health practitioners

5 affects every Illinois county, every group of people with

6 behavioral health needs, including children and

7 adolescents, justice-involved populations, working

8 adults, people experiencing homelessness, veterans, and

9 older adults, and every health care and social service

10 setting, from residential facilities and hospitals to

11 community-based organizations and primary care clinics.

12 (6) Estimates of unmet needs consistently highlight

13 the dire situation in Illinois. Mental Health America

14 ranks Illinois 29th in the country in mental health

15 workforce availability based on its 480-to-1 ratio of

16 population to mental health professionals, and the Kaiser

17 Family Foundation estimates that only 23.3% of

18 Illinoisans' mental health needs can be met with its

19 current workforce.

20 (7) Shortages are especially acute in rural areas and

21 among low-income and under-insured individuals and

22 families. 30.3% of Illinois' rural hospitals are in

23 designated primary care shortage areas and 93.7% are in

24 designated mental health shortage areas. Nationally, 40%

25 of psychiatrists work in cash-only practices, limiting

26 access for those who cannot afford high out-of-pocket

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1 costs, especially Medicaid eligible individuals and

2 families.

3 (8) Spanish-speaking therapists in suburban Cook

4 County, as well as in immigrant new growth communities

5 throughout the State, for example, and master's-prepared

6 social workers in rural communities are especially

7 difficult to recruit and retain.

8 (9) Illinois' shortage of psychiatrists specializing

9 in serving children and adolescents is also severe.

10 Eighty-one out of 102 Illinois counties have no child and

11 adolescent psychiatrists, and the remaining 21 counties

12 have only 310 child and adolescent psychiatrists for a

13 population of 2,450,000 children.

14 (10) Only 38.9% of the 121,000 Illinois youth aged 12

15 through 17 who experienced a major depressive episode

16 received care.

17 (11) An annual average of 799,000 people in Illinois

18 aged 12 and older need but do not receive substance use

19 disorder treatment at specialty facilities.

20 (12) According to the Statewide Semiannual Opioid

21 Report, Illinois Department of Public Health, September

22 2020, the number of opioid deaths in Illinois has

23 increased 3% from 2,167 deaths in 2018 to 2,233 deaths in

24 2019.

25 (13) Behavioral health workforce shortages have led to

26 well-documented problems of long wait times for

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1 appointments with psychiatrists (4 to 6 months in some

2 cases), high turnover, and unfilled vacancies for social

3 workers and other behavioral health professionals that

4 have eroded the gains in insurance coverage for mental

5 illness and substance use disorder under the federal

6 Affordable Care Act and parity laws.

7 (14) As a result, individuals with mental illness or

8 substance use disorders end up in hospital emergency

9 rooms, which are the most expensive level of care, or are

10 incarcerated and do not receive adequate care, if any.

11 (15) There are many organizations and institutions

12 that are affected by behavioral health workforce

13 shortages, but no one entity is responsible for monitoring

14 the workforce supply and intervening to ensure it can

15 effectively meet behavioral health needs throughout the

16 State.

17 (16) Workforce shortages are more complex than simple

18 numerical shortfalls. Identifying the optimal number,

19 type, and location of behavioral health professionals to

20 meet the differing needs of Illinois' diverse regions and

21 populations across the lifespan is a difficult logistical

22 problem at the system and practice level that requires

23 coordinated efforts in research, education, service

24 delivery, and policy.

25 (17) This State has a compelling and substantial

26 interest in building a pipeline for behavioral health

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1 professionals and to anchor research and education for

2 behavioral health workforce development. Beginning with

3 the proposed Behavioral Health Workforce Education Center

4 of Illinois, Illinois has the chance to develop a

5 blueprint to be a national leader in behavioral health

6 workforce development.

7 (18) The State must act now to improve the ability of

8 its residents to achieve their human potential and to live

9 healthy, productive lives by reducing the misery and

10 suffering with unmet behavioral health needs.

11 Section 65-10. Behavioral Health Workforce Education

12 Center of Illinois.

13 (a) The Behavioral Health Workforce Education Center of

14 Illinois is created and shall be administered by a teaching,

15 research, or both teaching and research public institution of

16 higher education in this State. Subject to appropriation, the

17 Center shall be operational on or before July 1, 2022.

18 (b) The Behavioral Health Workforce Education Center of

19 Illinois shall leverage workforce and behavioral health

20 resources, including, but not limited to, State, federal, and

21 foundation grant funding, federal Workforce Investment Act of

22 1998 programs, the National Health Service Corps and other

23 nongraduate medical education physician workforce training

24 programs, and existing behavioral health partnerships, and

25 align with reforms in Illinois.

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1 Section 65-15. Structure.

2 (a) The Behavioral Health Workforce Education Center of

3 Illinois shall be structured as a multisite model, and the

4 administering public institution of higher education shall

5 serve as the hub institution, complemented by secondary

6 regional hubs, namely academic institutions, that serve rural

7 and small urban areas and at least one academic institution

8 serving a densely urban municipality with more than 1,000,000

9 inhabitants.

10 (b) The Behavioral Health Workforce Education Center of

11 Illinois shall be located within one academic institution and

12 shall be tasked with a convening and coordinating role for

13 workforce research and planning, including monitoring progress

14 toward Center goals.

15 (c) The Behavioral Health Workforce Education Center of

16 Illinois shall also coordinate with key State agencies

17 involved in behavioral health, workforce development, and

18 higher education in order to leverage disparate resources from

19 health care, workforce, and economic development programs in

20 Illinois government.

21 Section 65-20. Duties. The Behavioral Health Workforce

22 Education Center of Illinois shall perform the following

23 duties:

24 (1) Organize a consortium of universities in

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1 partnerships with providers, school districts, law

2 enforcement, consumers and their families, State agencies,

3 and other stakeholders to implement workforce development

4 concepts and strategies in every region of this State.

5 (2) Be responsible for developing and implementing a

6 strategic plan for the recruitment, education, and

7 retention of a qualified, diverse, and evolving behavioral

8 health workforce in this State. Its planning and

9 activities shall include:

10 (A) convening and organizing vested stakeholders

11 spanning government agencies, clinics, behavioral

12 health facilities, prevention programs, hospitals,

13 schools, jails, prisons and juvenile justice, police

14 and emergency medical services, consumers and their

15 families, and other stakeholders;

16 (B) collecting and analyzing data on the

17 behavioral health workforce in Illinois, with detailed

18 information on specialties, credentials, additional

19 qualifications (such as training or experience in

20 particular models of care), location of practice, and

21 demographic characteristics, including age, gender,

22 race and ethnicity, and languages spoken;

23 (C) building partnerships with school districts,

24 public institutions of higher education, and workforce

25 investment agencies to create pipelines to behavioral

26 health careers from high schools and colleges,

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1 pathways to behavioral health specialization among

2 health professional students, and expanded behavioral

3 health residency and internship opportunities for

4 graduates;

5 (D) evaluating and disseminating information about

6 evidence-based practices emerging from research

7 regarding promising modalities of treatment, care

8 coordination models, and medications;

9 (E) developing systems for tracking the

10 utilization of evidence-based practices that most

11 effectively meet behavioral health needs; and

12 (F) providing technical assistance to support

13 professional training and continuing education

14 programs that provide effective training in

15 evidence-based behavioral health practices.

16 (3) Coordinate data collection and analysis, including

17 systematic tracking of the behavioral health workforce and

18 datasets that support workforce planning for an

19 accessible, high-quality behavioral health system. In the

20 medium to long-term, the Center shall develop Illinois

21 behavioral workforce data capacity by:

22 (A) filling gaps in workforce data by collecting

23 information on specialty, training, and qualifications

24 for specific models of care, demographic

25 characteristics, including gender, race, ethnicity,

26 and languages spoken, and participation in public and

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1 private insurance networks;

2 (B) identifying the highest priority geographies,

3 populations, and occupations for recruitment and

4 training;

5 (C) monitoring the incidence of behavioral health

6 conditions to improve estimates of unmet need; and

7 (D) compiling up-to-date, evidence-based

8 practices, monitoring utilization, and aligning

9 training resources to improve the uptake of the most

10 effective practices.

11 (4) Work to grow and advance peer and parent-peer

12 workforce development by:

13 (A) assessing the credentialing and reimbursement

14 processes and recommending reforms;

15 (B) evaluating available peer-parent training

16 models, choosing a model that meets Illinois' needs,

17 and working with partners to implement it universally

18 in child-serving programs throughout this State; and

19 (C) including peer recovery specialists and

20 parent-peer support professionals in interdisciplinary

21 training programs.

22 (5) Focus on the training of behavioral health

23 professionals in telehealth techniques, including taking

24 advantage of a telehealth network that exists, and other

25 innovative means of care delivery in order to increase

26 access to behavioral health services for all persons

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1 within this State.

2 (6) No later than December 1 of every odd-numbered

3 year, prepare a report of its activities under this Act.

4 The report shall be filed electronically with the General

5 Assembly, as provided under Section 3.1 of the General

6 Assembly Organization Act, and shall be provided

7 electronically to any member of the General Assembly upon

8 request.

9 Section 65-25. Selection process.

10 (a) No later than 90 days after the effective date of this

11 Act, the Board of Higher Education shall select a public

12 institution of higher education, with input and assistance

13 from the Division of Mental Health of the Department of Human

14 Services, to administer the Behavioral Health Workforce

15 Education Center of Illinois.

16 (b) The selection process shall articulate the principles

17 of the Behavioral Health Workforce Education Center of

18 Illinois, not inconsistent with this Act.

19 (c) The Board of Higher Education, with input and

20 assistance from the Division of Mental Health of the

21 Department of Human Services, shall make its selection of a

22 public institution of higher education based on its ability

23 and willingness to execute the following tasks:

24 (1) Convening academic institutions providing

25 behavioral health education to:

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1 (A) develop curricula to train future behavioral

2 health professionals in evidence-based practices that

3 meet the most urgent needs of Illinois' residents;

4 (B) build capacity to provide clinical training

5 and supervision; and

6 (C) facilitate telehealth services to every region

7 of the State.

8 (2) Functioning as a clearinghouse for research,

9 education, and training efforts to identify and

10 disseminate evidence-based practices across the State.

11 (3) Leveraging financial support from grants and

12 social impact loan funds.

13 (4) Providing infrastructure to organize regional

14 behavioral health education and outreach. As budgets

15 allow, this shall include conference and training space,

16 research and faculty staff time, telehealth, and distance

17 learning equipment.

18 (5) Working with regional hubs that assess and serve

19 the workforce needs of specific, well-defined regions and

20 specialize in specific research and training areas, such

21 as telehealth or mental health-criminal justice

22 partnerships, for which the regional hub can serve as a

23 statewide leader.

24 (d) The Board of Higher Education may adopt such rules as

25 may be necessary to implement and administer this Section.

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1 Title VI. Access to Health Care

2 Article 70.

3 Section 70-5. The Use Tax Act is amended by changing

4 Section 3-10 as follows:

5 (35 ILCS 105/3-10)

6 Sec. 3-10. Rate of tax. Unless otherwise provided in this

7 Section, the tax imposed by this Act is at the rate of 6.25% of

8 either the selling price or the fair market value, if any, of

9 the tangible personal property. In all cases where property

10 functionally used or consumed is the same as the property that

11 was purchased at retail, then the tax is imposed on the selling

12 price of the property. In all cases where property

13 functionally used or consumed is a by-product or waste product

14 that has been refined, manufactured, or produced from property

15 purchased at retail, then the tax is imposed on the lower of

16 the fair market value, if any, of the specific property so used

17 in this State or on the selling price of the property purchased

18 at retail. For purposes of this Section "fair market value"

19 means the price at which property would change hands between a

20 willing buyer and a willing seller, neither being under any

21 compulsion to buy or sell and both having reasonable knowledge

22 of the relevant facts. The fair market value shall be

23 established by Illinois sales by the taxpayer of the same

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1 property as that functionally used or consumed, or if there

2 are no such sales by the taxpayer, then comparable sales or

3 purchases of property of like kind and character in Illinois.

4 Beginning on July 1, 2000 and through December 31, 2000,

5 with respect to motor fuel, as defined in Section 1.1 of the

6 Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of

7 the Use Tax Act, the tax is imposed at the rate of 1.25%.

8 Beginning on August 6, 2010 through August 15, 2010, with

9 respect to sales tax holiday items as defined in Section 3-6 of

10 this Act, the tax is imposed at the rate of 1.25%.

11 With respect to gasohol, the tax imposed by this Act

12 applies to (i) 70% of the proceeds of sales made on or after

13 January 1, 1990, and before July 1, 2003, (ii) 80% of the

14 proceeds of sales made on or after July 1, 2003 and on or

15 before July 1, 2017, and (iii) 100% of the proceeds of sales

16 made thereafter. If, at any time, however, the tax under this

17 Act on sales of gasohol is imposed at the rate of 1.25%, then

18 the tax imposed by this Act applies to 100% of the proceeds of

19 sales of gasohol made during that time.

20 With respect to majority blended ethanol fuel, the tax

21 imposed by this Act does not apply to the proceeds of sales

22 made on or after July 1, 2003 and on or before December 31,

23 2023 but applies to 100% of the proceeds of sales made

24 thereafter.

25 With respect to biodiesel blends with no less than 1% and

26 no more than 10% biodiesel, the tax imposed by this Act applies

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1 to (i) 80% of the proceeds of sales made on or after July 1,

2 2003 and on or before December 31, 2018 and (ii) 100% of the

3 proceeds of sales made thereafter. If, at any time, however,

4 the tax under this Act on sales of biodiesel blends with no

5 less than 1% and no more than 10% biodiesel is imposed at the

6 rate of 1.25%, then the tax imposed by this Act applies to 100%

7 of the proceeds of sales of biodiesel blends with no less than

8 1% and no more than 10% biodiesel made during that time.

9 With respect to 100% biodiesel and biodiesel blends with

10 more than 10% but no more than 99% biodiesel, the tax imposed

11 by this Act does not apply to the proceeds of sales made on or

12 after July 1, 2003 and on or before December 31, 2023 but

13 applies to 100% of the proceeds of sales made thereafter.

14 With respect to food for human consumption that is to be

15 consumed off the premises where it is sold (other than

16 alcoholic beverages, food consisting of or infused with adult

17 use cannabis, soft drinks, and food that has been prepared for

18 immediate consumption) and prescription and nonprescription

19 medicines, drugs, medical appliances, products classified as

20 Class III medical devices by the United States Food and Drug

21 Administration that are used for cancer treatment pursuant to

22 a prescription, as well as any accessories and components

23 related to those devices, modifications to a motor vehicle for

24 the purpose of rendering it usable by a person with a

25 disability, and insulin,blood sugar ~~urine~~ testing materials,

26 syringes, and needles used by human diabetics, ~~for human use,~~

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1 the tax is imposed at the rate of 1%. For the purposes of this

2 Section, until September 1, 2009: the term "soft drinks" means

3 any complete, finished, ready-to-use, non-alcoholic drink,

4 whether carbonated or not, including but not limited to soda

5 water, cola, fruit juice, vegetable juice, carbonated water,

6 and all other preparations commonly known as soft drinks of

7 whatever kind or description that are contained in any closed

8 or sealed bottle, can, carton, or container, regardless of

9 size; but "soft drinks" does not include coffee, tea,

10 non-carbonated water, infant formula, milk or milk products as

11 defined in the Grade A Pasteurized Milk and Milk Products Act,

12 or drinks containing 50% or more natural fruit or vegetable

13 juice.

14 Notwithstanding any other provisions of this Act,

15 beginning September 1, 2009, "soft drinks" means non-alcoholic

16 beverages that contain natural or artificial sweeteners. "Soft

17 drinks" do not include beverages that contain milk or milk

18 products, soy, rice or similar milk substitutes, or greater

19 than 50% of vegetable or fruit juice by volume.

20 Until August 1, 2009, and notwithstanding any other

21 provisions of this Act, "food for human consumption that is to

22 be consumed off the premises where it is sold" includes all

23 food sold through a vending machine, except soft drinks and

24 food products that are dispensed hot from a vending machine,

25 regardless of the location of the vending machine. Beginning

26 August 1, 2009, and notwithstanding any other provisions of

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1 this Act, "food for human consumption that is to be consumed

2 off the premises where it is sold" includes all food sold

3 through a vending machine, except soft drinks, candy, and food

4 products that are dispensed hot from a vending machine,

5 regardless of the location of the vending machine.

6 Notwithstanding any other provisions of this Act,

7 beginning September 1, 2009, "food for human consumption that

8 is to be consumed off the premises where it is sold" does not

9 include candy. For purposes of this Section, "candy" means a

10 preparation of sugar, honey, or other natural or artificial

11 sweeteners in combination with chocolate, fruits, nuts or

12 other ingredients or flavorings in the form of bars, drops, or

13 pieces. "Candy" does not include any preparation that contains

14 flour or requires refrigeration.

15 Notwithstanding any other provisions of this Act,

16 beginning September 1, 2009, "nonprescription medicines and

17 drugs" does not include grooming and hygiene products. For

18 purposes of this Section, "grooming and hygiene products"

19 includes, but is not limited to, soaps and cleaning solutions,

20 shampoo, toothpaste, mouthwash, antiperspirants, and sun tan

21 lotions and screens, unless those products are available by

22 prescription only, regardless of whether the products meet the

23 definition of "over-the-counter-drugs". For the purposes of

24 this paragraph, "over-the-counter-drug" means a drug for human

25 use that contains a label that identifies the product as a drug

26 as required by 21 C.F.R. � 201.66. The "over-the-counter-drug"

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1 label includes:

2 (A) A "Drug Facts" panel; or

3 (B) A statement of the "active ingredient(s)" with a

4 list of those ingredients contained in the compound,

5 substance or preparation.

6 Beginning on the effective date of this amendatory Act of

7 the 98th General Assembly, "prescription and nonprescription

8 medicines and drugs" includes medical cannabis purchased from

9 a registered dispensing organization under the Compassionate

10 Use of Medical Cannabis Program Act.

11 As used in this Section, "adult use cannabis" means

12 cannabis subject to tax under the Cannabis Cultivation

13 Privilege Tax Law and the Cannabis Purchaser Excise Tax Law

14 and does not include cannabis subject to tax under the

15 Compassionate Use of Medical Cannabis Program Act.

16 If the property that is purchased at retail from a

17 retailer is acquired outside Illinois and used outside

18 Illinois before being brought to Illinois for use here and is

19 taxable under this Act, the "selling price" on which the tax is

20 computed shall be reduced by an amount that represents a

21 reasonable allowance for depreciation for the period of prior

22 out-of-state use.

23 (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;

24 101-593, eff. 12-4-19.)

25 Section 70-10. The Service Use Tax Act is amended by

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1 changing Section 3-10 as follows:

2 (35 ILCS 110/3-10) (from Ch. 120, par. 439.33-10)

3 Sec. 3-10. Rate of tax. Unless otherwise provided in this

4 Section, the tax imposed by this Act is at the rate of 6.25% of

5 the selling price of tangible personal property transferred as

6 an incident to the sale of service, but, for the purpose of

7 computing this tax, in no event shall the selling price be less

8 than the cost price of the property to the serviceman.

9 Beginning on July 1, 2000 and through December 31, 2000,

10 with respect to motor fuel, as defined in Section 1.1 of the

11 Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of

12 the Use Tax Act, the tax is imposed at the rate of 1.25%.

13 With respect to gasohol, as defined in the Use Tax Act, the

14 tax imposed by this Act applies to (i) 70% of the selling price

15 of property transferred as an incident to the sale of service

16 on or after January 1, 1990, and before July 1, 2003, (ii) 80%

17 of the selling price of property transferred as an incident to

18 the sale of service on or after July 1, 2003 and on or before

19 July 1, 2017, and (iii) 100% of the selling price thereafter.

20 If, at any time, however, the tax under this Act on sales of

21 gasohol, as defined in the Use Tax Act, is imposed at the rate

22 of 1.25%, then the tax imposed by this Act applies to 100% of

23 the proceeds of sales of gasohol made during that time.

24 With respect to majority blended ethanol fuel, as defined

25 in the Use Tax Act, the tax imposed by this Act does not apply

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1 to the selling price of property transferred as an incident to

2 the 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 With respect to biodiesel blends, as defined in the Use

6 Tax Act, with no less than 1% and no more than 10% biodiesel,

7 the tax imposed by this Act applies to (i) 80% of the selling

8 price of property transferred as an incident to the sale of

9 service on or after July 1, 2003 and on or before December 31,

10 2018 and (ii) 100% of the proceeds of the selling price

11 thereafter. If, at any time, however, the tax under this Act on

12 sales of biodiesel blends, as defined in the Use Tax Act, with

13 no less than 1% and no more than 10% biodiesel is imposed at

14 the rate of 1.25%, then the tax imposed by this Act applies to

15 100% of the proceeds of sales of biodiesel blends with no less

16 than 1% and no more than 10% biodiesel made during that time.

17 With respect to 100% biodiesel, as defined in the Use Tax

18 Act, and biodiesel blends, as defined in the Use Tax Act, with

19 more than 10% but no more than 99% biodiesel, the tax imposed

20 by this Act does not apply to the proceeds of the selling price

21 of property transferred as an incident to the sale of service

22 on or after July 1, 2003 and on or before December 31, 2023 but

23 applies to 100% of the selling price thereafter.

24 At the election of any registered serviceman made for each

25 fiscal year, sales of service in which the aggregate annual

26 cost price of tangible personal property transferred as an

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1 incident to the sales of service is less than 35%, or 75% in

2 the case of servicemen transferring prescription drugs or

3 servicemen engaged in graphic arts production, of the

4 aggregate annual total gross receipts from all sales of

5 service, the tax imposed by this Act shall be based on the

6 serviceman's cost price of the tangible personal property

7 transferred as an incident to the sale of those services.

8 The tax shall be imposed at the rate of 1% on food prepared

9 for immediate consumption and transferred incident to a sale

10 of service subject to this Act or the Service Occupation Tax

11 Act by an entity licensed under the Hospital Licensing Act,

12 the Nursing Home Care Act, the ID/DD Community Care Act, the

13 MC/DD Act, the Specialized Mental Health Rehabilitation Act of

14 2013, or the Child Care Act of 1969. The tax shall also be

15 imposed at the rate of 1% on food for human consumption that is

16 to be consumed off the premises where it is sold (other than

17 alcoholic beverages, food consisting of or infused with adult

18 use cannabis, soft drinks, and food that has been prepared for

19 immediate consumption and is not otherwise included in this

20 paragraph) and prescription and nonprescription medicines,

21 drugs, medical appliances, products classified as Class III

22 medical devices by the United States Food and Drug

23 Administration that are used for cancer treatment pursuant to

24 a prescription, as well as any accessories and components

25 related to those devices, modifications to a motor vehicle for

26 the purpose of rendering it usable by a person with a

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1 disability, and insulin, blood sugar ~~urine~~testing materials,

2 syringes, and needles used by human diabetics~~, for human use~~.

3 For the purposes of this Section, until September 1, 2009: the

4 term "soft drinks" means any complete, finished, ready-to-use,

5 non-alcoholic drink, whether carbonated or not, including but

6 not limited to soda water, cola, fruit juice, vegetable juice,

7 carbonated water, and all other preparations commonly known as

8 soft drinks of whatever kind or description that are contained

9 in any closed or sealed bottle, can, carton, or container,

10 regardless of size; but "soft drinks" does not include coffee,

11 tea, non-carbonated water, infant formula, milk or milk

12 products as defined in the Grade A Pasteurized Milk and Milk

13 Products Act, or drinks containing 50% or more natural fruit

14 or vegetable juice.

15 Notwithstanding any other provisions of this Act,

16 beginning September 1, 2009, "soft drinks" means non-alcoholic

17 beverages that contain natural or artificial sweeteners. "Soft

18 drinks" do not include beverages that contain milk or milk

19 products, soy, rice or similar milk substitutes, or greater

20 than 50% of vegetable or fruit juice by volume.

21 Until August 1, 2009, and notwithstanding any other

22 provisions of this Act, "food for human consumption that is to

23 be consumed off the premises where it is sold" includes all

24 food sold through a vending machine, except soft drinks and

25 food products that are dispensed hot from a vending machine,

26 regardless of the location of the vending machine. Beginning

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1 August 1, 2009, and notwithstanding any other provisions of

2 this Act, "food for human consumption that is to be consumed

3 off the premises where it is sold" includes all food sold

4 through a vending machine, except soft drinks, candy, and food

5 products that are dispensed hot from a vending machine,

6 regardless of the location of the vending machine.

7 Notwithstanding any other provisions of this Act,

8 beginning September 1, 2009, "food for human consumption that

9 is to be consumed off the premises where it is sold" does not

10 include candy. For purposes of this Section, "candy" means a

11 preparation of sugar, honey, or other natural or artificial

12 sweeteners in combination with chocolate, fruits, nuts or

13 other ingredients or flavorings in the form of bars, drops, or

14 pieces. "Candy" does not include any preparation that contains

15 flour or requires refrigeration.

16 Notwithstanding any other provisions of this Act,

17 beginning September 1, 2009, "nonprescription medicines and

18 drugs" does not include grooming and hygiene products. For

19 purposes of this Section, "grooming and hygiene products"

20 includes, but is not limited to, soaps and cleaning solutions,

21 shampoo, toothpaste, mouthwash, antiperspirants, and sun tan

22 lotions and screens, unless those products are available by

23 prescription only, regardless of whether the products meet the

24 definition of "over-the-counter-drugs". For the purposes of

25 this paragraph, "over-the-counter-drug" means a drug for human

26 use that contains a label that identifies the product as a drug

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1 as required by 21 C.F.R. � 201.66. The "over-the-counter-drug"

2 label includes:

3 (A) A "Drug Facts" panel; or

4 (B) A statement of the "active ingredient(s)" with a

5 list of those ingredients contained in the compound,

6 substance or preparation.

7 Beginning on January 1, 2014 (the effective date of Public

8 Act 98-122), "prescription and nonprescription medicines and

9 drugs" includes medical cannabis purchased from a registered

10 dispensing organization under the Compassionate Use of Medical

11 Cannabis Program Act.

12 As used in this Section, "adult use cannabis" means

13 cannabis subject to tax under the Cannabis Cultivation

14 Privilege Tax Law and the Cannabis Purchaser Excise Tax Law

15 and does not include cannabis subject to tax under the

16 Compassionate Use of Medical Cannabis Program Act.

17 If the property that is acquired from a serviceman is

18 acquired outside Illinois and used outside Illinois before

19 being brought to Illinois for use here and is taxable under

20 this Act, the "selling price" on which the tax is computed

21 shall be reduced by an amount that represents a reasonable

22 allowance for depreciation for the period of prior

23 out-of-state use.

24 (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;

25 101-593, eff. 12-4-19.)

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1 Section 70-15. The Service Occupation Tax Act is amended

2 by changing Section 3-10 as follows:

3 (35 ILCS 115/3-10) (from Ch. 120, par. 439.103-10)

4 Sec. 3-10. 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 the "selling price", as defined in Section 2 of the Service Use

7 Tax Act, of the tangible personal property. For the purpose of

8 computing this tax, in no event shall the "selling price" be

9 less than the cost price to the serviceman of the tangible

10 personal property transferred. The selling price of each item

11 of tangible personal property transferred as an incident of a

12 sale of service may be shown as a distinct and separate item on

13 the serviceman's billing to the service customer. If the

14 selling price is not so shown, the selling price of the

15 tangible personal property is deemed to be 50% of the

16 serviceman's entire billing to the service customer. When,

17 however, a serviceman contracts to design, develop, and

18 produce special order machinery or equipment, the tax imposed

19 by this Act shall be based on the serviceman's cost price of

20 the tangible personal property transferred incident to the

21 completion of the contract.

22 Beginning on July 1, 2000 and through December 31, 2000,

23 with respect to motor fuel, as defined in Section 1.1 of the

24 Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of

25 the Use Tax Act, the tax is imposed at the rate of 1.25%.

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1 With respect to gasohol, as defined in the Use Tax Act, the

2 tax imposed by this Act shall apply to (i) 70% of the cost

3 price of property transferred as an incident to the sale of

4 service on or after January 1, 1990, and before July 1, 2003,

5 (ii) 80% of the selling price of property transferred as an

6 incident to the sale of service on or after July 1, 2003 and on

7 or before July 1, 2017, and (iii) 100% of the cost price

8 thereafter. If, at any time, however, the tax under this Act on

9 sales of gasohol, as defined in the Use Tax Act, is imposed at

10 the rate of 1.25%, then the tax imposed by this Act applies to

11 100% of the proceeds of sales of gasohol made during that time.

12 With respect to majority blended ethanol fuel, as defined

13 in the Use Tax Act, the tax imposed by this Act does not apply

14 to the selling price of property transferred as an incident to

15 the sale of service on or after July 1, 2003 and on or before

16 December 31, 2023 but applies to 100% of the selling price

17 thereafter.

18 With respect to biodiesel blends, as defined in the Use

19 Tax Act, with no less than 1% and no more than 10% biodiesel,

20 the tax imposed by this Act applies to (i) 80% of the selling

21 price of property transferred as an incident to the sale of

22 service on or after July 1, 2003 and on or before December 31,

23 2018 and (ii) 100% of the proceeds of the selling price

24 thereafter. If, at any time, however, the tax under this Act on

25 sales of biodiesel blends, as defined in the Use Tax Act, with

26 no less than 1% and no more than 10% biodiesel is imposed at

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1 the rate of 1.25%, then the tax imposed by this Act applies to

2 100% of the proceeds of sales of biodiesel blends with no less

3 than 1% and no more than 10% biodiesel made during that time.

4 With respect to 100% biodiesel, as defined in the Use Tax

5 Act, and biodiesel blends, as defined in the Use Tax Act, with

6 more than 10% but no more than 99% biodiesel material, the tax

7 imposed by this Act does not apply to the proceeds of the

8 selling price of property transferred as an incident to the

9 sale of service on or after July 1, 2003 and on or before

10 December 31, 2023 but applies to 100% of the selling price

11 thereafter.

12 At the election of any registered serviceman made for each

13 fiscal year, sales of service in which the aggregate annual

14 cost price of tangible personal property transferred as an

15 incident to the sales of service is less than 35%, or 75% in

16 the case of servicemen transferring prescription drugs or

17 servicemen engaged in graphic arts production, of the

18 aggregate annual total gross receipts from all sales of

19 service, the tax imposed by this Act shall be based on the

20 serviceman's cost price of the tangible personal property

21 transferred incident to the sale of those services.

22 The tax shall be imposed at the rate of 1% on food prepared

23 for immediate consumption and transferred incident to a sale

24 of service subject to this Act or the Service Occupation Tax

25 Act by an entity licensed under the Hospital Licensing Act,

26 the Nursing Home Care Act, the ID/DD Community Care Act, the

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1 MC/DD Act, the Specialized Mental Health Rehabilitation Act of

2 2013, or the Child Care Act of 1969. The tax shall also be

3 imposed at the rate of 1% on food for human consumption that is

4 to be consumed off the premises where it is sold (other than

5 alcoholic beverages, food consisting of or infused with adult

6 use cannabis, soft drinks, and food that has been prepared for

7 immediate consumption and is not otherwise included in this

8 paragraph) and prescription and nonprescription medicines,

9 drugs, medical appliances, products classified as Class III

10 medical devices by the United States Food and Drug

11 Administration that are used for cancer treatment pursuant to

12 a prescription, as well as any accessories and components

13 related to those devices, modifications to a motor vehicle for

14 the purpose of rendering it usable by a person with a

15 disability, and insulin,blood sugar ~~urine~~ testing materials,

16 syringes, and needles used by human diabetics~~, for human use~~.

17 For the purposes of this Section, until September 1, 2009: the

18 term "soft drinks" means any complete, finished, ready-to-use,

19 non-alcoholic drink, whether carbonated or not, including but

20 not limited to soda water, cola, fruit juice, vegetable juice,

21 carbonated water, and all other preparations commonly known as

22 soft drinks of whatever kind or description that are contained

23 in any closed or sealed can, carton, or container, regardless

24 of size; but "soft drinks" does not include coffee, tea,

25 non-carbonated water, infant formula, milk or milk products as

26 defined in the Grade A Pasteurized Milk and Milk Products Act,

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1 or drinks containing 50% or more natural fruit or vegetable

2 juice.

3 Notwithstanding any other provisions of this Act,

4 beginning September 1, 2009, "soft drinks" means non-alcoholic

5 beverages that contain natural or artificial sweeteners. "Soft

6 drinks" do not include beverages that contain milk or milk

7 products, soy, rice or similar milk substitutes, or greater

8 than 50% of vegetable or fruit juice by volume.

9 Until August 1, 2009, and notwithstanding any other

10 provisions of this Act, "food for human consumption that is to

11 be consumed off the premises where it is sold" includes all

12 food sold through a vending machine, except soft drinks and

13 food products that are dispensed hot from a vending machine,

14 regardless of the location of the vending machine. Beginning

15 August 1, 2009, and notwithstanding any other provisions of

16 this Act, "food for human consumption that is to be consumed

17 off the premises where it is sold" includes all food sold

18 through a vending machine, except soft drinks, candy, and food

19 products that are dispensed hot from a vending machine,

20 regardless of the location of the vending machine.

21 Notwithstanding any other provisions of this Act,

22 beginning September 1, 2009, "food for human consumption that

23 is to be consumed off the premises where it is sold" does not

24 include candy. For purposes of this Section, "candy" means a

25 preparation of sugar, honey, or other natural or artificial

26 sweeteners in combination with chocolate, fruits, nuts or

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1 other ingredients or flavorings in the form of bars, drops, or

2 pieces. "Candy" does not include any preparation that contains

3 flour or requires refrigeration.

4 Notwithstanding any other provisions of this Act,

5 beginning September 1, 2009, "nonprescription medicines and

6 drugs" does not include grooming and hygiene products. For

7 purposes of this Section, "grooming and hygiene products"

8 includes, but is not limited to, soaps and cleaning solutions,

9 shampoo, toothpaste, mouthwash, antiperspirants, and sun tan

10 lotions and screens, unless those products are available by

11 prescription only, regardless of whether the products meet the

12 definition of "over-the-counter-drugs". For the purposes of

13 this paragraph, "over-the-counter-drug" means a drug for human

14 use that contains a label that identifies the product as a drug

15 as required by 21 C.F.R. � 201.66. The "over-the-counter-drug"

16 label includes:

17 (A) A "Drug Facts" panel; or

18 (B) A statement of the "active ingredient(s)" with a

19 list of those ingredients contained in the compound,

20 substance or preparation.

21 Beginning on January 1, 2014 (the effective date of Public

22 Act 98-122), "prescription and nonprescription medicines and

23 drugs" includes medical cannabis purchased from a registered

24 dispensing organization under the Compassionate Use of Medical

25 Cannabis Program Act.

26 As used in this Section, "adult use cannabis" means

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1 cannabis subject to tax under the Cannabis Cultivation

2 Privilege Tax Law and the Cannabis Purchaser Excise Tax Law

3 and does not include cannabis subject to tax under the

4 Compassionate Use of Medical Cannabis Program Act.

5 (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;

6 101-593, eff. 12-4-19.)

7 Section 70-20. The Retailers' Occupation Tax Act is

8 amended by changing Section 2-10 as follows:

9 (35 ILCS 120/2-10)

10 Sec. 2-10. Rate of tax. Unless otherwise provided in this

11 Section, the tax imposed by this Act is at the rate of 6.25% of

12 gross receipts from sales of tangible personal property made

13 in the course of business.

14 Beginning on July 1, 2000 and through December 31, 2000,

15 with respect to motor fuel, as defined in Section 1.1 of the

16 Motor Fuel Tax Law, and gasohol, as defined in Section 3-40 of

17 the Use Tax Act, the tax is imposed at the rate of 1.25%.

18 Beginning on August 6, 2010 through August 15, 2010, with

19 respect to sales tax holiday items as defined in Section 2-8 of

20 this Act, the tax is imposed at the rate of 1.25%.

21 Within 14 days after the effective date of this amendatory

22 Act of the 91st General Assembly, each retailer of motor fuel

23 and gasohol shall cause the following notice to be posted in a

24 prominently visible place on each retail dispensing device

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1 that is used to dispense motor fuel or gasohol in the State of

2 Illinois: "As of July 1, 2000, the State of Illinois has

3 eliminated the State's share of sales tax on motor fuel and

4 gasohol through December 31, 2000. The price on this pump

5 should reflect the elimination of the tax." The notice shall

6 be printed in bold print on a sign that is no smaller than 4

7 inches by 8 inches. The sign shall be clearly visible to

8 customers. Any retailer who fails to post or maintain a

9 required sign through December 31, 2000 is guilty of a petty

10 offense for which the fine shall be $500 per day per each

11 retail premises where a violation occurs.

12 With respect to gasohol, as defined in the Use Tax Act, the

13 tax imposed by this Act applies to (i) 70% of the proceeds of

14 sales made on or after January 1, 1990, and before July 1,

15 2003, (ii) 80% of the proceeds of sales made on or after July

16 1, 2003 and on or before July 1, 2017, and (iii) 100% of the

17 proceeds of sales made thereafter. If, at any time, however,

18 the tax under this Act on sales of gasohol, as defined in the

19 Use Tax Act, is imposed at the rate of 1.25%, then the tax

20 imposed by this Act applies to 100% of the proceeds of sales of

21 gasohol made during that time.

22 With respect to majority blended ethanol fuel, as defined

23 in the Use Tax Act, the tax imposed by this Act does not apply

24 to the proceeds of sales made on or after July 1, 2003 and on

25 or before December 31, 2023 but applies to 100% of the proceeds

26 of sales made thereafter.

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1 With respect to biodiesel blends, as defined in the Use

2 Tax Act, with no less than 1% and no more than 10% biodiesel,

3 the tax imposed by this Act applies to (i) 80% of the proceeds

4 of sales made on or after July 1, 2003 and on or before

5 December 31, 2018 and (ii) 100% of the proceeds of sales made

6 thereafter. If, at any time, however, the tax under this Act on

7 sales of biodiesel blends, as defined in the Use Tax Act, with

8 no less than 1% and no more than 10% biodiesel is imposed at

9 the rate of 1.25%, then the tax imposed by this Act applies to

10 100% of the proceeds of sales of biodiesel blends with no less

11 than 1% and no more than 10% biodiesel made during that time.

12 With respect to 100% biodiesel, as defined in the Use Tax

13 Act, and biodiesel blends, as defined in the Use Tax Act, with

14 more than 10% but no more than 99% biodiesel, the tax imposed

15 by this Act does not apply to the proceeds of sales made on or

16 after July 1, 2003 and on or before December 31, 2023 but

17 applies to 100% of the proceeds of sales made thereafter.

18 With respect to food for human consumption that is to be

19 consumed off the premises where it is sold (other than

20 alcoholic beverages, food consisting of or infused with adult

21 use cannabis, soft drinks, and food that has been prepared for

22 immediate consumption) and prescription and nonprescription

23 medicines, drugs, medical appliances, products classified as

24 Class III medical devices by the United States Food and Drug

25 Administration that are used for cancer treatment pursuant to

26 a prescription, as well as any accessories and components

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1 related to those devices, modifications to a motor vehicle for

2 the purpose of rendering it usable by a person with a

3 disability, and insulin,blood sugar ~~urine~~ testing materials,

4 syringes, and needles used by human diabetics, ~~for human use,~~

5 the tax is imposed at the rate of 1%. For the purposes of this

6 Section, until September 1, 2009: the term "soft drinks" means

7 any complete, finished, ready-to-use, non-alcoholic drink,

8 whether carbonated or not, including but not limited to soda

9 water, cola, fruit juice, vegetable juice, carbonated water,

10 and all other preparations commonly known as soft drinks of

11 whatever kind or description that are contained in any closed

12 or sealed bottle, can, carton, or container, regardless of

13 size; but "soft drinks" does not include coffee, tea,

14 non-carbonated water, infant formula, milk or milk products as

15 defined in the Grade A Pasteurized Milk and Milk Products Act,

16 or drinks containing 50% or more natural fruit or vegetable

17 juice.

18 Notwithstanding any other provisions of this Act,

19 beginning September 1, 2009, "soft drinks" means non-alcoholic

20 beverages that contain natural or artificial sweeteners. "Soft

21 drinks" do not include beverages that contain milk or milk

22 products, soy, rice or similar milk substitutes, or greater

23 than 50% of vegetable or fruit juice by volume.

24 Until August 1, 2009, and notwithstanding any other

25 provisions of this Act, "food for human consumption that is to

26 be consumed off the premises where it is sold" includes all

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1 food sold through a vending machine, except soft drinks and

2 food products that are dispensed hot from a vending machine,

3 regardless of the location of the vending machine. Beginning

4 August 1, 2009, and notwithstanding any other provisions of

5 this Act, "food for human consumption that is to be consumed

6 off the premises where it is sold" includes all food sold

7 through a vending machine, except soft drinks, candy, and food

8 products that are dispensed hot from a vending machine,

9 regardless of the location of the vending machine.

10 Notwithstanding any other provisions of this Act,

11 beginning September 1, 2009, "food for human consumption that

12 is to be consumed off the premises where it is sold" does not

13 include candy. For purposes of this Section, "candy" means a

14 preparation of sugar, honey, or other natural or artificial

15 sweeteners in combination with chocolate, fruits, nuts or

16 other ingredients or flavorings in the form of bars, drops, or

17 pieces. "Candy" does not include any preparation that contains

18 flour or requires refrigeration.

19 Notwithstanding any other provisions of this Act,

20 beginning September 1, 2009, "nonprescription medicines and

21 drugs" does not include grooming and hygiene products. For

22 purposes of this Section, "grooming and hygiene products"

23 includes, but is not limited to, soaps and cleaning solutions,

24 shampoo, toothpaste, mouthwash, antiperspirants, and sun tan

25 lotions and screens, unless those products are available by

26 prescription only, regardless of whether the products meet the

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1 definition of "over-the-counter-drugs". For the purposes of

2 this paragraph, "over-the-counter-drug" means a drug for human

3 use that contains a label that identifies the product as a drug

4 as required by 21 C.F.R. � 201.66. The "over-the-counter-drug"

5 label includes:

6 (A) A "Drug Facts" panel; or

7 (B) A statement of the "active ingredient(s)" with a

8 list of those ingredients contained in the compound,

9 substance or preparation.

10 Beginning on the effective date of this amendatory Act of

11 the 98th General Assembly, "prescription and nonprescription

12 medicines and drugs" includes medical cannabis purchased from

13 a registered dispensing organization under the Compassionate

14 Use of Medical Cannabis Program Act.

15 As used in this Section, "adult use cannabis" means

16 cannabis subject to tax under the Cannabis Cultivation

17 Privilege Tax Law and the Cannabis Purchaser Excise Tax Law

18 and does not include cannabis subject to tax under the

19 Compassionate Use of Medical Cannabis Program Act.

20 (Source: P.A. 100-22, eff. 7-6-17; 101-363, eff. 8-9-19;

21 101-593, eff. 12-4-19.)

22 Article 72.

23 Section 72-1. Short title. This Article may be cited as

24 the Underlying Causes of Crime and Violence Study Act.

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1 Section 72-5. Legislative findings. In the State of

2 Illinois, two-thirds of gun violence is related to suicide,

3 and one-third is related to homicide, claiming approximately

4 12,000 lives a year. Violence has plagued communities,

5 predominantly poor and distressed communities in urban

6 settings, which have always treated violence as a criminal

7 justice issue, instead of a public health issue. On February

8 21, 2018, Pastor Anthony Williams was informed that his son,

9 Nehemiah William, had been shot to death. Due to this

10 disheartening event, Pastor Anthony Williams reached out to

11 State Representative Elizabeth "Lisa" Hernandez, urging that

12 the issue of violence be treated as a public health crisis. In

13 2018, elected officials from all levels of government started

14 a coalition to address violence as a public health crisis,

15 with the assistance of faith-based organizations, advocates,

16 and community members and held a statewide listening tour from

17 August 2018 to April 2019. The listening tour consisted of

18 stops on the South Side and West Side of Chicago, Maywood,

19 Springfield, and East St. Louis, with a future scheduled visit

20 in Danville. During the statewide listening sessions,

21 community members actively discussed neighborhood safety,

22 defining violence and how and why violence occurs in their

23 communities. The listening sessions provided different

24 solutions to address violence, however, all sessions confirmed

25 a disconnect from the priorities of government and the needs

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1 of these communities.

2 Section 72-10. Study. The Department of Public Health and

3 the Department of Human Services shall study how to create a

4 process to identify high violence communities, also known as

5 R3 (Restore, Reinvest, and Renew) areas, and prioritize State

6 dollars to go to these communities to fund programs as well as

7 community and economic development projects that would address

8 the underlying causes of crime and violence.

9 Due to a variety of reasons, including in particular the

10 State's budget impasse, funds from multiple sources to

11 establish such a comprehensive policy are subject to

12 appropriation. Private philanthropic efforts will also be

13 considered. Policies like R3 are needed in order to provide

14 communities that have historically suffered from divestment,

15 poverty, and incarceration with smart solutions that can solve

16 the plague of structural violence that includes collective,

17 interpersonal, and self-directed violence. Understanding

18 structural violence helps explain the multiple and often

19 intersecting forces that create and perpetuate these

20 conditions on multiple levels. It is clear that violence is a

21 public health problem that needs to be treated as such.

22 Research has shown that when violence is treated in such a way

23 that educates, fosters collaboration, and redirects the

24 funding on a governmental level, its effects can be slowed or

25 even halted, resulting in civility being brought to our

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1 communities in the State of Illinois. Research has shown that

2 when violence is treated in such a way, then its effects can be

3 slowed or even halted.

4 Section 72-15. Report. The Department of Public Health

5 and the Department of Human Services are required to report

6 their findings to the General Assembly by December 31, 2021.

7 Article 80.

8 Section 80-5. The Employee Sick Leave Act is amended by

9 changing Sections 5 and 10 as follows:

10 (820 ILCS 191/5)

11 Sec. 5. Definitions. In this Act:

12 "Covered family member" means an employee's child,

13 stepchild, spouse, domestic partner, sibling, parent,

14 mother-in-law, father-in-law, grandchild, grandparent, or

15 stepparent.

16 "Department" means the Department of Labor.

17 "Personal care" means activities to ensure that a covered

18 family member's basic medical, hygiene, nutritional, or safety

19 needs are met, or to provide transportation to medical

20 appointments, for a covered family member who is unable to

21 meet those needs himself or herself. "Personal care" also

22 means being physically present to provide emotional support to

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1 a covered family member with a serious health condition who is

2 receiving inpatient or home care.

3 "Personal sick leave benefits" means any paid or unpaid

4 time available to an employee as provided through an

5 employment benefit plan or paid time off policy to be used as a

6 result of absence from work due to personal illness, injury,

7 ~~or~~ medical appointment, or for personal care of a covered

8 family member. An employment benefit plan or paid time off

9 policy does not include long term disability, short term

10 disability, an insurance policy, or other comparable benefit

11 plan or policy.

12 (Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)

13 (820 ILCS 191/10)

14 Sec. 10. Use of leave; limitations.

15 (a) An employee may use personal sick leave benefits

16 provided by the employer for absences due to an illness,

17 injury, or medical appointment of the employee's child,

18 stepchild, spouse, domestic partner, sibling, parent,

19 mother-in-law, father-in-law, grandchild, grandparent, or

20 stepparent, or for personal care of a covered family member on

21 the same terms upon which the employee is able to use personal

22 sick leave benefits for the employee's own illness or injury.

23 An employer may request written verification of the employee's

24 absence from a health care professional if such verification

25 is required under the employer's employment benefit plan or

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1 paid time off policy.

2 (b) An employer may limit the use of personal sick leave

3 benefits provided by the employer for absences due to an

4 illness, injury, ~~or~~ medical appointment, or personal care of

5 the employee's covered family member ~~of the employee's child,~~

6 ~~stepchild, spouse, domestic partner, sibling, parent,~~

7 ~~mother-in-law, father-in-law, grandchild, grandparent, or~~

8 ~~stepparent~~ to an amount not less than the personal sick leave

9 that would be earned or accrued during 6 months at the

10 employee's then current rate of entitlement. For employers who

11 base personal sick leave benefits on an employee's years of

12 service instead of annual or monthly accrual, such employer

13 may limit the amount of sick leave to be used under this Act to

14 half of the employee's maximum annual grant.

15 (c) An employer who provides personal sick leave benefits

16 or a paid time off policy that would otherwise provide

17 benefits as required under subsections (a) and (b) shall not

18 be required to modify such benefits.

19 (Source: P.A. 99-841, eff. 1-1-17; 99-921, eff. 1-13-17.)

20 Article 90.

21 Section 90-5. The Nursing Home Care Act is amended by

22 adding Section 3-206.06 as follows:

23 (210 ILCS 45/3-206.06 new)

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1 Sec. 3-206.06. Testing for Legionella bacteria. A facility

2 shall develop a policy for testing its water supply for

3 Legionella bacteria. The policy shall include the frequency

4 with which testing is conducted. The policy and the results of

5 any tests shall be made available to the Department upon

6 request.

7 Section 90-10. The Hospital Licensing Act is amended by

8 adding Section 6.29 as follows:

9 (210 ILCS 85/6.29 new)

10 Sec. 6.29. Testing for Legionella bacteria. A hospital

11 shall develop a policy for testing its water supply for

12 Legionella bacteria. The policy shall include the frequency

13 with which testing is conducted. The policy and the results of

14 any tests shall be made available to the Department upon

15 request.

16 Article 95.

17 Section 95-5. The Child Care Act of 1969 is amended by

18 changing Section 7 as follows:

19 (225 ILCS 10/7) (from Ch. 23, par. 2217)

20 Sec. 7. (a) The Department must prescribe and publish

21 minimum standards for licensing that apply to the various

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1 types of facilities for child care defined in this Act and that

2 are equally applicable to like institutions under the control

3 of the Department and to foster family homes used by and under

4 the direct supervision of the Department. The Department shall

5 seek the advice and assistance of persons representative of

6 the various types of child care facilities in establishing

7 such standards. The standards prescribed and published under

8 this Act take effect as provided in the Illinois

9 Administrative Procedure Act, and are restricted to

10 regulations pertaining to the following matters and to any

11 rules and regulations required or permitted by any other

12 Section of this Act:

13 (1) The operation and conduct of the facility and

14 responsibility it assumes for child care;

15 (2) The character, suitability and qualifications of

16 the applicant and other persons directly responsible for

17 the care and welfare of children served. All child day

18 care center licensees and employees who are required to

19 report child abuse or neglect under the Abused and

20 Neglected Child Reporting Act shall be required to attend

21 training on recognizing child abuse and neglect, as

22 prescribed by Department rules;

23 (3) The general financial ability and competence of

24 the applicant to provide necessary care for children and

25 to maintain prescribed standards;

26 (4) The number of individuals or staff required to

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1 insure adequate supervision and care of the children

2 received. The standards shall provide that each child care

3 institution, maternity center, day care center, group

4 home, day care home, and group day care home shall have on

5 its premises during its hours of operation at least one

6 staff member certified in first aid, in the Heimlich

7 maneuver and in cardiopulmonary resuscitation by the

8 American Red Cross or other organization approved by rule

9 of the Department. Child welfare agencies shall not be

10 subject to such a staffing requirement. The Department may

11 offer, or arrange for the offering, on a periodic basis in

12 each community in this State in cooperation with the

13 American Red Cross, the American Heart Association or

14 other appropriate organization, voluntary programs to

15 train operators of foster family homes and day care homes

16 in first aid and cardiopulmonary resuscitation;

17 (5) The appropriateness, safety, cleanliness, and

18 general adequacy of the premises, including maintenance of

19 adequate fire prevention and health standards conforming

20 to State laws and municipal codes to provide for the

21 physical comfort, care, and well-being of children

22 received;

23 (6) Provisions for food, clothing, educational

24 opportunities, program, equipment and individual supplies

25 to assure the healthy physical, mental, and spiritual

26 development of children served;

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1 (7) Provisions to safeguard the legal rights of

2 children served;

3 (8) Maintenance of records pertaining to the

4 admission, progress, health, and discharge of children,

5 including, for day care centers and day care homes,

6 records indicating each child has been immunized as

7 required by State regulations. The Department shall

8 require proof that children enrolled in a facility have

9 been immunized against Haemophilus Influenzae B (HIB);

10 (9) Filing of reports with the Department;

11 (10) Discipline of children;

12 (11) Protection and fostering of the particular

13 religious faith of the children served;

14 (12) Provisions prohibiting firearms on day care

15 center premises except in the possession of peace

16 officers;

17 (13) Provisions prohibiting handguns on day care home

18 premises except in the possession of peace officers or

19 other adults who must possess a handgun as a condition of

20 employment and who reside on the premises of a day care

21 home;

22 (14) Provisions requiring that any firearm permitted

23 on day care home premises, except handguns in the

24 possession of peace officers, shall be kept in a

25 disassembled state, without ammunition, in locked storage,

26 inaccessible to children and that ammunition permitted on

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1 day care home premises shall be kept in locked storage

2 separate from that of disassembled firearms, inaccessible

3 to children;

4 (15) Provisions requiring notification of parents or

5 guardians enrolling children at a day care home of the

6 presence in the day care home of any firearms and

7 ammunition and of the arrangements for the separate,

8 locked storage of such firearms and ammunition;

9 (16) Provisions requiring all licensed child care

10 facility employees who care for newborns and infants to

11 complete training every 3 years on the nature of sudden

12 unexpected infant death (SUID), sudden infant death

13 syndrome (SIDS), and the safe sleep recommendations of the

14 American Academy of Pediatrics; and

15 (17) With respect to foster family homes, provisions

16 requiring the Department to review quality of care

17 concerns and to consider those concerns in determining

18 whether a foster family home is qualified to care for

19 children.

20 By July 1, 2022, all licensed day care home providers,

21 licensed group day care home providers, and licensed day care

22 center directors and classroom staff shall participate in at

23 least one training that includes the topics of early childhood

24 social emotional learning, infant and early childhood mental

25 health, early childhood trauma, or adverse childhood

26 experiences. Current licensed providers, directors, and

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1 classroom staff shall complete training by July 1, 2022 and

2 shall participate in training that includes the above topics

3 at least once every 3 years.

4 (b) If, in a facility for general child care, there are

5 children diagnosed as mentally ill or children diagnosed as

6 having an intellectual or physical disability, who are

7 determined to be in need of special mental treatment or of

8 nursing care, or both mental treatment and nursing care, the

9 Department shall seek the advice and recommendation of the

10 Department of Human Services, the Department of Public Health,

11 or both Departments regarding the residential treatment and

12 nursing care provided by the institution.

13 (c) The Department shall investigate any person applying

14 to be licensed as a foster parent to determine whether there is

15 any evidence of current drug or alcohol abuse in the

16 prospective foster family. The Department shall not license a

17 person as a foster parent if drug or alcohol abuse has been

18 identified in the foster family or if a reasonable suspicion

19 of such abuse exists, except that the Department may grant a

20 foster parent license to an applicant identified with an

21 alcohol or drug problem if the applicant has successfully

22 participated in an alcohol or drug treatment program,

23 self-help group, or other suitable activities and if the

24 Department determines that the foster family home can provide

25 a safe, appropriate environment and meet the physical and

26 emotional needs of children.

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1 (d) The Department, in applying standards prescribed and

2 published, as herein provided, shall offer consultation

3 through employed staff or other qualified persons to assist

4 applicants and licensees in meeting and maintaining minimum

5 requirements for a license and to help them otherwise to

6 achieve programs of excellence related to the care of children

7 served. Such consultation shall include providing information

8 concerning education and training in early childhood

9 development to providers of day care home services. The

10 Department may provide or arrange for such education and

11 training for those providers who request such assistance.

12 (e) The Department shall distribute copies of licensing

13 standards to all licensees and applicants for a license. Each

14 licensee or holder of a permit shall distribute copies of the

15 appropriate licensing standards and any other information

16 required by the Department to child care facilities under its

17 supervision. Each licensee or holder of a permit shall

18 maintain appropriate documentation of the distribution of the

19 standards. Such documentation shall be part of the records of

20 the facility and subject to inspection by authorized

21 representatives of the Department.

22 (f) The Department shall prepare summaries of day care

23 licensing standards. Each licensee or holder of a permit for a

24 day care facility shall distribute a copy of the appropriate

25 summary and any other information required by the Department,

26 to the legal guardian of each child cared for in that facility

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1 at the time when the child is enrolled or initially placed in

2 the facility. The licensee or holder of a permit for a day care

3 facility shall secure appropriate documentation of the

4 distribution of the summary and brochure. Such documentation

5 shall be a part of the records of the facility and subject to

6 inspection by an authorized representative of the Department.

7 (g) The Department shall distribute to each licensee and

8 holder of a permit copies of the licensing or permit standards

9 applicable to such person's facility. Each licensee or holder

10 of a permit shall make available by posting at all times in a

11 common or otherwise accessible area a complete and current set

12 of licensing standards in order that all employees of the

13 facility may have unrestricted access to such standards. All

14 employees of the facility shall have reviewed the standards

15 and any subsequent changes. Each licensee or holder of a

16 permit shall maintain appropriate documentation of the current

17 review of licensing standards by all employees. Such records

18 shall be part of the records of the facility and subject to

19 inspection by authorized representatives of the Department.

20 (h) Any standards involving physical examinations,

21 immunization, or medical treatment shall include appropriate

22 exemptions for children whose parents object thereto on the

23 grounds that they conflict with the tenets and practices of a

24 recognized church or religious organization, of which the

25 parent is an adherent or member, and for children who should

26 not be subjected to immunization for clinical reasons.

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1 (i) The Department, in cooperation with the Department of

2 Public Health, shall work to increase immunization awareness

3 and participation among parents of children enrolled in day

4 care centers and day care homes by publishing on the

5 Department's website information about the benefits of

6 immunization against vaccine preventable diseases, including

7 influenza and pertussis. The information for vaccine

8 preventable diseases shall include the incidence and severity

9 of the diseases, the availability of vaccines, and the

10 importance of immunizing children and persons who frequently

11 have close contact with children. The website content shall be

12 reviewed annually in collaboration with the Department of

13 Public Health to reflect the most current recommendations of

14 the Advisory Committee on Immunization Practices (ACIP). The

15 Department shall work with day care centers and day care homes

16 licensed under this Act to ensure that the information is

17 annually distributed to parents in August or September.

18 (j) Any standard adopted by the Department that requires

19 an applicant for a license to operate a day care home to

20 include a copy of a high school diploma or equivalent

21 certificate with his or her application shall be deemed to be

22 satisfied if the applicant includes a copy of a high school

23 diploma or equivalent certificate or a copy of a degree from an

24 accredited institution of higher education or vocational

25 institution or equivalent certificate.

26 (Source: P.A. 99-143, eff. 7-27-15; 99-779, eff. 1-1-17;

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1 100-201, eff. 8-18-17.)

2 Article 100.

3 Section 100-1. Short title. This Article may be cited as

4 the Special Commission on Gynecologic Cancers Act.

5 Section 100-5. Creation; members; duties; report.

6 (a) The Special Commission on Gynecologic Cancers is

7 created. Membership of the Commission shall be as follows:

8 (1) A representative of the Illinois Comprehensive

9 Cancer Control Program, appointed by the Director of

10 Public Health;

11 (2) The Director of Insurance, or his or her designee;

12 and

13 (3) 20 members who shall be appointed as follows:

14 (A) three members appointed by the Speaker of

15 the House of Representatives, one of whom shall be a

16 survivor of ovarian cancer, one of whom shall be a

17 survivor of cervical, vaginal, vulvar, or uterine

18 cancer, and one of whom shall be a medical specialist

19 in gynecologic cancers;

20 (B) three members appointed by the Senate

21 President, one of whom shall be a survivor of ovarian

22 cancer, one of whom shall be a survivor of cervical,

23 vaginal, vulvar, or uterine cancer, and one of whom

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1 shall be a medical specialist in gynecologic cancers;

2 (C) three members appointed by the House

3 Minority Leader, one of whom shall be a survivor of

4 ovarian cancer, one of whom shall be a survivor of

5 cervical, vaginal, vulvar, or uterine cancer, and one

6 of whom shall be a medical specialist in gynecologic

7 cancers;

8 (D) three members appointed by the Senate

9 Minority Leader, one of whom shall be a survivor of

10 ovarian cancer, one of whom shall be a survivor of

11 cervical, vaginal, vulvar, or uterine cancer, and one

12 of whom shall be a medical specialist in gynecologic

13 cancers; and

14 (E) eight members appointed by the Governor,

15 one of whom shall be a caregiver of a woman diagnosed

16 with a gynecologic cancer, one of whom shall be a

17 medical specialist in gynecologic cancers, one of whom

18 shall be an individual with expertise in community

19 based health care and issues affecting underserved and

20 vulnerable populations, 2 of whom shall be individuals

21 representing gynecologic cancer awareness and support

22 groups in the State, one of whom shall be a researcher

23 specializing in gynecologic cancers, and 2 of whom

24 shall be members of the public with demonstrated

25 expertise in issues relating to the work of the

26 Commission.

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1 (b) Members of the Commission shall serve without

2 compensation or reimbursement from the Commission. Members

3 shall select a Chair from among themselves and the Chair shall

4 set the meeting schedule.

5 (c) The Illinois Department of Public Health shall provide

6 administrative support to the Commission.

7 (d) The Commission is charged with the study of the

8 following:

9 (1) establishing a mechanism to ascertain the

10 prevalence of gynecologic cancers in the State and, to the

11 extent possible, to collect statistics relative to the

12 timing of diagnosis and risk factors associated with

13 gynecologic cancers;

14 (2) determining how to best effectuate early diagnosis

15 and treatment for gynecologic cancer patients;

16 (3) determining best practices for closing disparities

17 in outcomes for gynecologic cancer patients and innovative

18 approaches to reaching underserved and vulnerable

19 populations;

20 (4) determining any unmet needs of persons with

21 gynecologic cancers and those of their families; and

22 (5) providing recommendations for additional

23 legislation, support programs, and resources to meet the

24 unmet needs of persons with gynecologic cancers and their

25 families.

26 (e) The Commission shall file its final report with the

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1 General Assembly no later than December 31, 2021 and, upon the

2 filing of its report, is dissolved.

3 Section 100-90. Repeal. This Article is repealed on

4 January 1, 2023.

5 Article 105.

6 Section 105-5. The Illinois Public Aid Code is amended by

7 changing Section 5A-12.7 as follows:

8 (305 ILCS 5/5A-12.7)

9 (Section scheduled to be repealed on December 31, 2022)

10 Sec. 5A-12.7. Continuation of hospital access payments on

11 and after July 1, 2020.

12 (a) To preserve and improve access to hospital services,

13 for hospital services rendered on and after July 1, 2020, the

14 Department shall, except for hospitals described in subsection

15 (b) of Section 5A-3, make payments to hospitals or require

16 capitated managed care organizations to make payments as set

17 forth in this Section. Payments under this Section are not due

18 and payable, however, until: (i) the methodologies described

19 in this Section are approved by the federal government in an

20 appropriate State Plan amendment or directed payment preprint;

21 and (ii) the assessment imposed under this Article is

22 determined to be a permissible tax under Title XIX of the

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1 Social Security Act. In determining the hospital access

2 payments authorized under subsection (g) of this Section, if a

3 hospital ceases to qualify for payments from the pool, the

4 payments for all hospitals continuing to qualify for payments

5 from such pool shall be uniformly adjusted to fully expend the

6 aggregate net amount of the pool, with such adjustment being

7 effective on the first day of the second month following the

8 date the hospital ceases to receive payments from such pool.

9 (b) Amounts moved into claims-based rates and distributed

10 in accordance with Section 14-12 shall remain in those

11 claims-based rates.

12 (c) Graduate medical education.

13 (1) The calculation of graduate medical education

14 payments shall be based on the hospital's Medicare cost

15 report ending in Calendar Year 2018, as reported in the

16 Healthcare Cost Report Information System file, release

17 date September 30, 2019. An Illinois hospital reporting

18 intern and resident cost on its Medicare cost report shall

19 be eligible for graduate medical education payments.

20 (2) Each hospital's annualized Medicaid Intern

21 Resident Cost is calculated using annualized intern and

22 resident total costs obtained from Worksheet B Part I,

23 Columns 21 and 22 the sum of Lines 30-43, 50-76, 90-93,

24 96-98, and 105-112 multiplied by the percentage that the

25 hospital's Medicaid days (Worksheet S3 Part I, Column 7,

26 Lines 2, 3, 4, 14, 16-18, and 32) comprise of the

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1 hospital's total days (Worksheet S3 Part I, Column 8,

2 Lines 14, 16-18, and 32).

3 (3) An annualized Medicaid indirect medical education

4 (IME) payment is calculated for each hospital using its

5 IME payments (Worksheet E Part A, Line 29, Column 1)

6 multiplied by the percentage that its Medicaid days

7 (Worksheet S3 Part I, Column 7, Lines 2, 3, 4, 14, 16-18,

8 and 32) comprise of its Medicare days (Worksheet S3 Part

9 I, Column 6, Lines 2, 3, 4, 14, and 16-18).

10 (4) For each hospital, its annualized Medicaid Intern

11 Resident Cost and its annualized Medicaid IME payment are

12 summed, and, except as capped at 120% of the average cost

13 per intern and resident for all qualifying hospitals as

14 calculated under this paragraph, is multiplied by 22.6% to

15 determine the hospital's final graduate medical education

16 payment. Each hospital's average cost per intern and

17 resident shall be calculated by summing its total

18 annualized Medicaid Intern Resident Cost plus its

19 annualized Medicaid IME payment and dividing that amount

20 by the hospital's total Full Time Equivalent Residents and

21 Interns. If the hospital's average per intern and resident

22 cost is greater than 120% of the same calculation for all

23 qualifying hospitals, the hospital's per intern and

24 resident cost shall be capped at 120% of the average cost

25 for all qualifying hospitals.

26 (d) Fee-for-service supplemental payments. Each Illinois

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1 hospital shall receive an annual payment equal to the amounts

2 below, to be paid in 12 equal installments on or before the

3 seventh State business day of each month, except that no

4 payment shall be due within 30 days after the later of the date

5 of notification of federal approval of the payment

6 methodologies required under this Section or any waiver

7 required under 42 CFR 433.68, at which time the sum of amounts

8 required under this Section prior to the date of notification

9 is due and payable.

10 (1) For critical access hospitals, $385 per covered

11 inpatient day contained in paid fee-for-service claims and

12 $530 per paid fee-for-service outpatient claim for dates

13 of service in Calendar Year 2019 in the Department's

14 Enterprise Data Warehouse as of May 11, 2020.

15 (2) For safety-net hospitals, $960 per covered

16 inpatient day contained in paid fee-for-service claims and

17 $625 per paid fee-for-service outpatient claim for dates

18 of service in Calendar Year 2019 in the Department's

19 Enterprise Data Warehouse as of May 11, 2020.

20 (3) For long term acute care hospitals, $295 per

21 covered inpatient day contained in paid fee-for-service

22 claims for dates of service in Calendar Year 2019 in the

23 Department's Enterprise Data Warehouse as of May 11, 2020.

24 (4) For freestanding psychiatric hospitals, $125 per

25 covered inpatient day contained in paid fee-for-service

26 claims and $130 per paid fee-for-service outpatient claim

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1 for dates of service in Calendar Year 2019 in the

2 Department's Enterprise Data Warehouse as of May 11, 2020.

3 (5) For freestanding rehabilitation hospitals, $355

4 per covered inpatient day contained in paid

5 fee-for-service claims for dates of service in Calendar

6 Year 2019 in the Department's Enterprise Data Warehouse as

7 of May 11, 2020.

8 (6) For all general acute care hospitals and high

9 Medicaid hospitals as defined in subsection (f), $350 per

10 covered inpatient day for dates of service in Calendar

11 Year 2019 contained in paid fee-for-service claims and

12 $620 per paid fee-for-service outpatient claim in the

13 Department's Enterprise Data Warehouse as of May 11, 2020.

14 (7) Alzheimer's treatment access payment. Each

15 Illinois academic medical center or teaching hospital, as

16 defined in Section 5-5e.2 of this Code, that is identified

17 as the primary hospital affiliate of one of the Regional

18 Alzheimer's Disease Assistance Centers, as designated by

19 the Alzheimer's Disease Assistance Act and identified in

20 the Department of Public Health's Alzheimer's Disease

21 State Plan dated December 2016, shall be paid an

22 Alzheimer's treatment access payment equal to the product

23 of the qualifying hospital's State Fiscal Year 2018 total

24 inpatient fee-for-service days multiplied by the

25 applicable Alzheimer's treatment rate of $226.30 for

26 hospitals located in Cook County and $116.21 for hospitals

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1 located outside Cook County.

2 (e) The Department shall require managed care

3 organizations (MCOs) to make directed payments and

4 pass-through payments according to this Section. Each calendar

5 year, the Department shall require MCOs to pay the maximum

6 amount out of these funds as allowed as pass-through payments

7 under federal regulations. The Department shall require MCOs

8 to make such pass-through payments as specified in this

9 Section. The Department shall require the MCOs to pay the

10 remaining amounts as directed Payments as specified in this

11 Section. The Department shall issue payments to the

12 Comptroller by the seventh business day of each month for all

13 MCOs that are sufficient for MCOs to make the directed

14 payments and pass-through payments according to this Section.

15 The Department shall require the MCOs to make pass-through

16 payments and directed payments using electronic funds

17 transfers (EFT), if the hospital provides the information

18 necessary to process such EFTs, in accordance with directions

19 provided monthly by the Department, within 7 business days of

20 the date the funds are paid to the MCOs, as indicated by the

21 "Paid Date" on the website of the Office of the Comptroller if

22 the funds are paid by EFT and the MCOs have received directed

23 payment instructions. If funds are not paid through the

24 Comptroller by EFT, payment must be made within 7 business

25 days of the date actually received by the MCO. The MCO will be

26 considered to have paid the pass-through payments when the

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1 payment remittance number is generated or the date the MCO

2 sends the check to the hospital, if EFT information is not

3 supplied. If an MCO is late in paying a pass-through payment or

4 directed payment as required under this Section (including any

5 extensions granted by the Department), it shall pay a penalty,

6 unless waived by the Department for reasonable cause, to the

7 Department equal to 5% of the amount of the pass-through

8 payment or directed payment not paid on or before the due date

9 plus 5% of the portion thereof remaining unpaid on the last day

10 of each 30-day period thereafter. Payments to MCOs that would

11 be paid consistent with actuarial certification and enrollment

12 in the absence of the increased capitation payments under this

13 Section shall not be reduced as a consequence of payments made

14 under this subsection. The Department shall publish and

15 maintain on its website for a period of no less than 8 calendar

16 quarters, the quarterly calculation of directed payments and

17 pass-through payments owed to each hospital from each MCO. All

18 calculations and reports shall be posted no later than the

19 first day of the quarter for which the payments are to be

20 issued.

21 (f)(1) For purposes of allocating the funds included in

22 capitation payments to MCOs, Illinois hospitals shall be

23 divided into the following classes as defined in

24 administrative rules:

25 (A) Critical access hospitals.

26 (B) Safety-net hospitals, except that stand-alone

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1 children's hospitals that are not specialty children's

2 hospitals will not be included.

3 (C) Long term acute care hospitals.

4 (D) Freestanding psychiatric hospitals.

5 (E) Freestanding rehabilitation hospitals.

6 (F) High Medicaid hospitals. As used in this Section,

7 "high Medicaid hospital" means a general acute care

8 hospital that is not a safety-net hospital or critical

9 access hospital and that has a Medicaid Inpatient

10 Utilization Rate above 30% or a hospital that had over

11 35,000 inpatient Medicaid days during the applicable

12 period. For the period July 1, 2020 through December 31,

13 2020, the applicable period for the Medicaid Inpatient

14 Utilization Rate (MIUR) is the rate year 2020 MIUR and for

15 the number of inpatient days it is State fiscal year 2018.

16 Beginning in calendar year 2021, the Department shall use

17 the most recently determined MIUR, as defined in

18 subsection (h) of Section 5-5.02, and for the inpatient

19 day threshold, the State fiscal year ending 18 months

20 prior to the beginning of the calendar year. For purposes

21 of calculating MIUR under this Section, children's

22 hospitals and affiliated general acute care hospitals

23 shall be considered a single hospital.

24 (G) General acute care hospitals. As used under this

25 Section, "general acute care hospitals" means all other

26 Illinois hospitals not identified in subparagraphs (A)

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1 through (F).

2 (2) Hospitals' qualification for each class shall be

3 assessed prior to the beginning of each calendar year and the

4 new class designation shall be effective January 1 of the next

5 year. The Department shall publish by rule the process for

6 establishing class determination.

7 (g) Fixed pool directed payments. Beginning July 1, 2020,

8 the Department shall issue payments to MCOs which shall be

9 used to issue directed payments to qualified Illinois

10 safety-net hospitals and critical access hospitals on a

11 monthly basis in accordance with this subsection. Prior to the

12 beginning of each Payout Quarter beginning July 1, 2020, the

13 Department shall use encounter claims data from the

14 Determination Quarter, accepted by the Department's Medicaid

15 Management Information System for inpatient and outpatient

16 services rendered by safety-net hospitals and critical access

17 hospitals to determine a quarterly uniform per unit add-on for

18 each hospital class.

19 (1) Inpatient per unit add-on. A quarterly uniform per

20 diem add-on shall be derived by dividing the quarterly

21 Inpatient Directed Payments Pool amount allocated to the

22 applicable hospital class by the total inpatient days

23 contained on all encounter claims received during the

24 Determination Quarter, for all hospitals in the class.

25 (A) Each hospital in the class shall have a

26 quarterly inpatient directed payment calculated that

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1 is equal to the product of the number of inpatient days

2 attributable to the hospital used in the calculation

3 of the quarterly uniform class per diem add-on,

4 multiplied by the calculated applicable quarterly

5 uniform class per diem add-on of the hospital class.

6 (B) Each hospital shall be paid 1/3 of its

7 quarterly inpatient directed payment in each of the 3

8 months of the Payout Quarter, in accordance with

9 directions provided to each MCO by the Department.

10 (2) Outpatient per unit add-on. A quarterly uniform

11 per claim add-on shall be derived by dividing the

12 quarterly Outpatient Directed Payments Pool amount

13 allocated to the applicable hospital class by the total

14 outpatient encounter claims received during the

15 Determination Quarter, for all hospitals in the class.

16 (A) Each hospital in the class shall have a

17 quarterly outpatient directed payment calculated that

18 is equal to the product of the number of outpatient

19 encounter claims attributable to the hospital used in

20 the calculation of the quarterly uniform class per

21 claim add-on, multiplied by the calculated applicable

22 quarterly uniform class per claim add-on of the

23 hospital class.

24 (B) Each hospital shall be paid 1/3 of its

25 quarterly outpatient directed payment in each of the 3

26 months of the Payout Quarter, in accordance with

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1 directions provided to each MCO by the Department.

2 (3) Each MCO shall pay each hospital the Monthly

3 Directed Payment as identified by the Department on its

4 quarterly determination report.

5 (4) Definitions. As used in this subsection:

6 (A) "Payout Quarter" means each 3 month calendar

7 quarter, beginning July 1, 2020.

8 (B) "Determination Quarter" means each 3 month

9 calendar quarter, which ends 3 months prior to the

10 first day of each Payout Quarter.

11 (5) For the period July 1, 2020 through December 2020,

12 the following amounts shall be allocated to the following

13 hospital class directed payment pools for the quarterly

14 development of a uniform per unit add-on:

15 (A) $2,894,500 for hospital inpatient services for

16 critical access hospitals.

17 (B) $4,294,374 for hospital outpatient services

18 for critical access hospitals.

19 (C) $29,109,330 for hospital inpatient services

20 for safety-net hospitals.

21 (D) $35,041,218 for hospital outpatient services

22 for safety-net hospitals.

23 (h) Fixed rate directed payments. Effective July 1, 2020,

24 the Department shall issue payments to MCOs which shall be

25 used to issue directed payments to Illinois hospitals not

26 identified in paragraph (g) on a monthly basis. Prior to the

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1 beginning of each Payout Quarter beginning July 1, 2020, the

2 Department shall use encounter claims data from the

3 Determination Quarter, accepted by the Department's Medicaid

4 Management Information System for inpatient and outpatient

5 services rendered by hospitals in each hospital class

6 identified in paragraph (f) and not identified in paragraph

7 (g). For the period July 1, 2020 through December 2020, the

8 Department shall direct MCOs to make payments as follows:

9 (1) For general acute care hospitals an amount equal

10 to $1,750 multiplied by the hospital's category of service

11 20 case mix index for the determination quarter multiplied

12 by the hospital's total number of inpatient admissions for

13 category of service 20 for the determination quarter.

14 (2) For general acute care hospitals an amount equal

15 to $160 multiplied by the hospital's category of service

16 21 case mix index for the determination quarter multiplied

17 by the hospital's total number of inpatient admissions for

18 category of service 21 for the determination quarter.

19 (3) For general acute care hospitals an amount equal

20 to $80 multiplied by the hospital's category of service 22

21 case mix index for the determination quarter multiplied by

22 the hospital's total number of inpatient admissions for

23 category of service 22 for the determination quarter.

24 (4) For general acute care hospitals an amount equal

25 to $375 multiplied by the hospital's category of service

26 24 case mix index for the determination quarter multiplied

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1 by the hospital's total number of category of service 24

2 paid EAPG (EAPGs) for the determination quarter.

3 (5) For general acute care hospitals an amount equal

4 to $240 multiplied by the hospital's category of service

5 27 and 28 case mix index for the determination quarter

6 multiplied by the hospital's total number of category of

7 service 27 and 28 paid EAPGs for the determination

8 quarter.

9 (6) For general acute care hospitals an amount equal

10 to $290 multiplied by the hospital's category of service

11 29 case mix index for the determination quarter multiplied

12 by the hospital's total number of category of service 29

13 paid EAPGs for the determination quarter.

14 (7) For high Medicaid hospitals an amount equal to

15 $1,800 multiplied by the hospital's category of service 20

16 case mix index for the determination quarter multiplied by

17 the hospital's total number of inpatient admissions for

18 category of service 20 for the determination quarter.

19 (8) For high Medicaid hospitals an amount equal to

20 $160 multiplied by the hospital's category of service 21

21 case mix index for the determination quarter multiplied by

22 the hospital's total number of inpatient admissions for

23 category of service 21 for the determination quarter.

24 (9) For high Medicaid hospitals an amount equal to $80

25 multiplied by the hospital's category of service 22 case

26 mix index for the determination quarter multiplied by the

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1 hospital's total number of inpatient admissions for

2 category of service 22 for the determination quarter.

3 (10) For high Medicaid hospitals an amount equal to

4 $400 multiplied by the hospital's category of service 24

5 case mix index for the determination quarter multiplied by

6 the hospital's total number of category of service 24 paid

7 EAPG outpatient claims for the determination quarter.

8 (11) For high Medicaid hospitals an amount equal to

9 $240 multiplied by the hospital's category of service 27

10 and 28 case mix index for the determination quarter

11 multiplied by the hospital's total number of category of

12 service 27 and 28 paid EAPGs for the determination

13 quarter.

14 (12) For high Medicaid hospitals an amount equal to

15 $290 multiplied by the hospital's category of service 29

16 case mix index for the determination quarter multiplied by

17 the hospital's total number of category of service 29 paid

18 EAPGs for the determination quarter.

19 (13) For long term acute care hospitals the amount of

20 $495 multiplied by the hospital's total number of

21 inpatient days for the determination quarter.

22 (14) For psychiatric hospitals the amount of $210

23 multiplied by the hospital's total number of inpatient

24 days for category of service 21 for the determination

25 quarter.

26 (15) For psychiatric hospitals the amount of $250

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1 multiplied by the hospital's total number of outpatient

2 claims for category of service 27 and 28 for the

3 determination quarter.

4 (16) For rehabilitation hospitals the amount of $410

5 multiplied by the hospital's total number of inpatient

6 days for category of service 22 for the determination

7 quarter.

8 (17) For rehabilitation hospitals the amount of $100

9 multiplied by the hospital's total number of outpatient

10 claims for category of service 29 for the determination

11 quarter.

12 (18) Each hospital shall be paid 1/3 of their

13 quarterly inpatient and outpatient directed payment in

14 each of the 3 months of the Payout Quarter, in accordance

15 with directions provided to each MCO by the Department.

16 (19) Each MCO shall pay each hospital the Monthly

17 Directed Payment amount as identified by the Department on

18 its quarterly determination report.

19 Notwithstanding any other provision of this subsection, if

20 the Department determines that the actual total hospital

21 utilization data that is used to calculate the fixed rate

22 directed payments is substantially different than anticipated

23 when the rates in this subsection were initially determined

24 (for unforeseeable circumstances such as the COVID-19

25 pandemic), the Department may adjust the rates specified in

26 this subsection so that the total directed payments

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1 approximate the total spending amount anticipated when the

2 rates were initially established.

3 Definitions. As used in this subsection:

4 (A) "Payout Quarter" means each calendar quarter,

5 beginning July 1, 2020.

6 (B) "Determination Quarter" means each calendar

7 quarter which ends 3 months prior to the first day of

8 each Payout Quarter.

9 (C) "Case mix index" means a hospital specific

10 calculation. For inpatient claims the case mix index

11 is calculated each quarter by summing the relative

12 weight of all inpatient Diagnosis-Related Group (DRG)

13 claims for a category of service in the applicable

14 Determination Quarter and dividing the sum by the

15 number of sum total of all inpatient DRG admissions

16 for the category of service for the associated claims.

17 The case mix index for outpatient claims is calculated

18 each quarter by summing the relative weight of all

19 paid EAPGs in the applicable Determination Quarter and

20 dividing the sum by the sum total of paid EAPGs for the

21 associated claims.

22 (i) Beginning January 1, 2021, the rates for directed

23 payments shall be recalculated in order to spend the

24 additional funds for directed payments that result from

25 reduction in the amount of pass-through payments allowed under

26 federal regulations. The additional funds for directed

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1 payments shall be allocated proportionally to each class of

2 hospitals based on that class' proportion of services.

3 (j) Pass-through payments.

4 (1) For the period July 1, 2020 through December 31,

5 2020, the Department shall assign quarterly pass-through

6 payments to each class of hospitals equal to one-fourth of

7 the following annual allocations:

8 (A) $390,487,095 to safety-net hospitals.

9 (B) $62,553,886 to critical access hospitals.

10 (C) $345,021,438 to high Medicaid hospitals.

11 (D) $551,429,071 to general acute care hospitals.

12 (E) $27,283,870 to long term acute care hospitals.

13 (F) $40,825,444 to freestanding psychiatric

14 hospitals.

15 (G) $9,652,108 to freestanding rehabilitation

16 hospitals.

17 (2) The pass-through payments shall at a minimum

18 ensure hospitals receive a total amount of monthly

19 payments under this Section as received in calendar year

20 2019 in accordance with this Article and paragraph (1) of

21 subsection (d-5) of Section 14-12, exclusive of amounts

22 received through payments referenced in subsection (b).

23 (3) For the calendar year beginning January 1, 2021,

24 and each calendar year thereafter, each hospital's

25 pass-through payment amount shall be reduced

26 proportionally to the reduction of all pass-through

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1 payments required by federal regulations.

2 (k) At least 30 days prior to each calendar year, the

3 Department shall notify each hospital of changes to the

4 payment methodologies in this Section, including, but not

5 limited to, changes in the fixed rate directed payment rates,

6 the aggregate pass-through payment amount for all hospitals,

7 and the hospital's pass-through payment amount for the

8 upcoming calendar year.

9 (l) Notwithstanding any other provisions of this Section,

10 the Department may adopt rules to change the methodology for

11 directed and pass-through payments as set forth in this

12 Section, but only to the extent necessary to obtain federal

13 approval of a necessary State Plan amendment or Directed

14 Payment Preprint or to otherwise conform to federal law or

15 federal regulation.

16 (m) As used in this subsection, "managed care

17 organization" or "MCO" means an entity which contracts with

18 the Department to provide services where payment for medical

19 services is made on a capitated basis, excluding contracted

20 entities for dual eligible or Department of Children and

21 Family Services youth populations.

22 (n) In order to address the escalating infant mortality

23 rates among minority communities in Illinois, the State shall,

24 subject to appropriation, create a pool of funding of at least

25 $50,000,000 annually to be disbursed among safety-net

26 hospitals that maintain perinatal designation from the

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1 Department of Public Health. The funding shall be used to

2 preserve or enhance OB/GYN services or other specialty

3 services at the receiving hospital, with the distribution of

4 funding to be established by rule and with consideration to

5 perinatal hospitals with safe birthing levels and quality

6 metrics for healthy mothers and babies.

7 (Source: P.A. 101-650, eff. 7-7-20.)

8 Article 110.

9 Section 110-1. Short title. This Article may be cited as

10 the Racial Impact Note Act.

11 Section 110-5. Racial impact note.

12 (a) Every bill which has or could have a disparate impact

13 on racial and ethnic minorities, upon the request of any

14 member, shall have prepared for it, before second reading in

15 the house of introduction, a brief explanatory statement or

16 note that shall include a reliable estimate of the anticipated

17 impact on those racial and ethnic minorities likely to be

18 impacted by the bill. Each racial impact note must include,

19 for racial and ethnic minorities for which data are available:

20 (i) an estimate of how the proposed legislation would impact

21 racial and ethnic minorities; (ii) a statement of the

22 methodologies and assumptions used in preparing the estimate;

23 (iii) an estimate of the racial and ethnic composition of the

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1 population who may be impacted by the proposed legislation,

2 including those persons who may be negatively impacted and

3 those persons who may benefit from the proposed legislation;

4 and (iv) any other matter that a responding agency considers

5 appropriate in relation to the racial and ethnic minorities

6 likely to be affected by the bill.

7 Section 110-10. Preparation.

8 (a) The sponsor of each bill for which a request under

9 Section 110-5 has been made shall present a copy of the bill

10 with the request for a racial impact note to the appropriate

11 responding agency or agencies under subsection (b). The

12 responding agency or agencies shall prepare and submit the

13 note to the sponsor of the bill within 5 calendar days, except

14 that whenever, because of the complexity of the measure,

15 additional time is required for the preparation of the racial

16 impact note, the responding agency or agencies may inform the

17 sponsor of the bill, and the sponsor may approve an extension

18 of the time within which the note is to be submitted, not to

19 extend, however, beyond June 15, following the date of the

20 request. If, in the opinion of the responding agency or

21 agencies, there is insufficient information to prepare a

22 reliable estimate of the anticipated impact, a statement to

23 that effect can be filed and shall meet the requirements of

24 this Act.

25 (b) If a bill concerns arrests, convictions, or law

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1 enforcement, a statement shall be prepared by the Illinois

2 Criminal Justice Information Authority specifying the impact

3 on racial and ethnic minorities. If a bill concerns

4 corrections, sentencing, or the placement of individuals

5 within the Department of Corrections, a statement shall be

6 prepared by the Department of Corrections specifying the

7 impact on racial and ethnic minorities. If a bill concerns

8 local government, a statement shall be prepared by the

9 Department of Commerce and Economic Opportunity specifying the

10 impact on racial and ethnic minorities. If a bill concerns

11 education, one of the following agencies shall prepare a

12 statement specifying the impact on racial and ethnic

13 minorities: (i) the Illinois Community College Board, if the

14 bill affects community colleges; (ii) the Illinois State Board

15 of Education, if the bill affects primary and secondary

16 education; or (iii) the Illinois Board of Higher Education, if

17 the bill affects State universities. Any other State agency

18 impacted or responsible for implementing all or part of this

19 bill shall prepare a statement of the racial and ethnic impact

20 of the bill as it relates to that agency.

21 Section 110-15. Requisites and contents. The note shall be

22 factual in nature, as brief and concise as may be, and, in

23 addition, it shall include both the immediate effect and, if

24 determinable or reasonably foreseeable, the long range effect

25 of the measure on racial and ethnic minorities. If, after

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1 careful investigation, it is determined that such an effect is

2 not ascertainable, the note shall contain a statement to that

3 effect, setting forth the reasons why no ascertainable effect

4 can be given.

5 Section 110-20. Comment or opinion; technical or

6 mechanical defects. No comment or opinion shall be included

7 in the racial impact note with regard to the merits of the

8 measure for which the racial impact note is prepared; however,

9 technical or mechanical defects may be noted.

10 Section 110-25. Appearance of State officials and

11 employees in support or opposition of measure. The fact that a

12 racial impact note is prepared for any bill shall not preclude

13 or restrict the appearance before any committee of the General

14 Assembly of any official or authorized employee of the

15 responding agency or agencies, or any other impacted State

16 agency, who desires to be heard in support of or in opposition

17 to the measure.

18 Article 115.

19 Section 115-5. The Illinois Public Aid Code is amended by

20 adding Section 14-14 as follows:

21 (305 ILCS 5/14-14 new)

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1 Sec. 14-14. Increasing access to primary care in

2 hospitals. The Department of Healthcare and Family Services

3 shall develop a program to facilitate coordination between

4 Federally Qualified Health Centers (FQHCs) and safety net

5 hospitals, encourage coordination between Federally Qualified

6 Health Centers (FQHCs) and hospitals, including, but not

7 limited to, safety-net hospitals, with the goal of increasing

8 care coordination, managing chronic diseases, and addressing

9 the social determinants of health on or before December 31,

10 2021. Coordination between FQHCs and safety hospitals may

11 include, but is not limited to, embedding FQHC staff in

12 hospitals, utilizing health information technology for care

13 coordination and enabling FQHCs to connect hospital patients

14 to community-based resources when needed to provide

15 whole-person care. In addition, the Department shall develop a

16 payment methodology to allow FQHCs to provide care

17 coordination services, including, but not limited to, chronic

18 disease management and behavioral health services. The

19 Department of Healthcare and Family Services shall develop a

20 payment methodology to allow for FQHC care coordination

21 services by no later than December 31, 2021.

22 Article 120.

23 Section 120-5. The Civil Administrative Code of Illinois

24 is amended by changing Section 5-565 as follows:

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1 (20 ILCS 5/5-565) (was 20 ILCS 5/6.06)

2 Sec. 5-565. In the Department of Public Health.

3 (a) The General Assembly declares it to be the public

4 policy of this State that allresidents ~~citizens~~ of Illinois

5 are entitled to lead healthy lives. Governmental public health

6 has a specific responsibility to ensure that a public health

7 system is in place to allow the public health mission to be

8 achieved. The public health system is the collection of

9 public, private, and voluntary entities as well as individuals

10 and informal associations that contribute to the public's

11 health within the State. To develop a public health system

12 requires certain core functions to be performed by government.

13 The State Board of Health is to assume the leadership role in

14 advising the Director in meeting the following functions:

15 (1) Needs assessment.

16 (2) Statewide health objectives.

17 (3) Policy development.

18 (4) Assurance of access to necessary services.

19 There shall be a State Board of Health composed of 20

20 persons, all of whom shall be appointed by the Governor, with

21 the advice and consent of the Senate for those appointed by the

22 Governor on and after June 30, 1998, and one of whom shall be a

23 senior citizen age 60 or over. Five members shall be

24 physicians licensed to practice medicine in all its branches,

25 one representing a medical school faculty, one who is board

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1 certified in preventive medicine, and one who is engaged in

2 private practice. One member shall be a chiropractic

3 physician. One member shall be a dentist; one an environmental

4 health practitioner; one a local public health administrator;

5 one a local board of health member; one a registered nurse; one

6 a physical therapist; one an optometrist; one a veterinarian;

7 one a public health academician; one a health care industry

8 representative; one a representative of the business

9 community; one a representative of the non-profit public

10 interest community; and 2 shall be citizens at large.

11 The terms of Board of Health members shall be 3 years,

12 except that members shall continue to serve on the Board of

13 Health until a replacement is appointed. Upon the effective

14 date of Public Act 93-975 (January 1, 2005) ~~this amendatory~~

15 ~~Act of the 93rd General Assembly~~, in the appointment of the

16 Board of Health members appointed to vacancies or positions

17 with terms expiring on or before December 31, 2004, the

18 Governor shall appoint up to 6 members to serve for terms of 3

19 years; up to 6 members to serve for terms of 2 years; and up to

20 5 members to serve for a term of one year, so that the term of

21 no more than 6 members expire in the same year. All members

22 shall be legal residents of the State of Illinois. The duties

23 of the Board shall include, but not be limited to, the

24 following:

25 (1) To advise the Department of ways to encourage

26 public understanding and support of the Department's

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1 programs.

2 (2) To evaluate all boards, councils, committees,

3 authorities, and bodies advisory to, or an adjunct of, the

4 Department of Public Health or its Director for the

5 purpose of recommending to the Director one or more of the

6 following:

7 (i) The elimination of bodies whose activities are

8 not consistent with goals and objectives of the

9 Department.

10 (ii) The consolidation of bodies whose activities

11 encompass compatible programmatic subjects.

12 (iii) The restructuring of the relationship

13 between the various bodies and their integration

14 within the organizational structure of the Department.

15 (iv) The establishment of new bodies deemed

16 essential to the functioning of the Department.

17 (3) To serve as an advisory group to the Director for

18 public health emergencies and control of health hazards.

19 (4) To advise the Director regarding public health

20 policy, and to make health policy recommendations

21 regarding priorities to the Governor through the Director.

22 (5) To present public health issues to the Director

23 and to make recommendations for the resolution of those

24 issues.

25 (6) To recommend studies to delineate public health

26 problems.

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1 (7) To make recommendations to the Governor through

2 the Director regarding the coordination of State public

3 health activities with other State and local public health

4 agencies and organizations.

5 (8) To report on or before February 1 of each year on

6 the health of the residents of Illinois to the Governor,

7 the General Assembly, and the public.

8 (9) To review the final draft of all proposed

9 administrative rules, other than emergency orperemptory

10 ~~preemptory~~rules and those rules that another advisory

11 body must approve or review within a statutorily defined

12 time period, of the Department after September 19, 1991

13 (the effective date of Public Act 87-633). The Board shall

14 review the proposed rules within 90 days of submission by

15 the Department. The Department shall take into

16 consideration any comments and recommendations of the

17 Board regarding the proposed rules prior to submission to

18 the Secretary of State for initial publication. If the

19 Department disagrees with the recommendations of the

20 Board, it shall submit a written response outlining the

21 reasons for not accepting the recommendations.

22 In the case of proposed administrative rules or

23 amendments to administrative rules regarding immunization

24 of children against preventable communicable diseases

25 designated by the Director under the Communicable Disease

26 Prevention Act, after the Immunization Advisory Committee

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1 has made its recommendations, the Board shall conduct 3

2 public hearings, geographically distributed throughout the

3 State. At the conclusion of the hearings, the State Board

4 of Health shall issue a report, including its

5 recommendations, to the Director. The Director shall take

6 into consideration any comments or recommendations made by

7 the Board based on these hearings.

8 (10) To deliver to the Governor for presentation to

9 the General Assembly a State Health Assessment (SHA) and a

10 State Health Improvement Plan (SHIP). The first 5 ~~3~~ such

11 plans shall be delivered to the Governor on January 1,

12 2006, January 1, 2009, ~~and~~ January 1, 2016, January 1,

13 2021, and June 30, 2022, and then every 5 years

14 thereafter.

15 The State Health Assessment and State Health

16 Improvement Plan ~~Plan~~ shall assess and recommend

17 priorities and strategies to improve the public health

18 system, ~~and~~ the health status of Illinois residents,

19 reduce health disparities and inequities, and promote

20 health equity. The State Health Assessment and State

21 Health Improvement Plan development and implementation

22 shall conform to national Public Health Accreditation

23 Board Standards. The State Health Assessment and State

24 Health Improvement Plan development and implementation

25 process shall be carried out with the administrative and

26 operational support of the Department of Public Health

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1 ~~taking into consideration national health objectives and~~

2 ~~system standards as frameworks for assessment~~.

3 The State Health Assessment shall include

4 comprehensive, broad-based data and information from a

5 variety of sources on health status and the public health

6 system including:

7 (i) quantitative data, if it is available, on the

8 demographics and health status of the population,

9 including data over time on health by gender identity,

10 sexual orientation, race, ethnicity, age,

11 socio-economic factors, geographic region, disability

12 status, and other indicators of disparity;

13 (ii) quantitative data on social and structural

14 issues affecting health (social and structural

15 determinants of health), including, but not limited

16 to, housing, transportation, educational attainment,

17 employment, and income inequality;

18 (iii) priorities and strategies developed at the

19 community level through the Illinois Project for Local

20 Assessment of Needs (IPLAN) and other local and

21 regional community health needs assessments;

22 (iv) qualitative data representing the

23 population's input on health concerns and well-being,

24 including the perceptions of people experiencing

25 disparities and health inequities;

26 (v) information on health disparities and health

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1 inequities; and

2 (vi) information on public health system strengths

3 and areas for improvement.

4 ~~The Plan shall also take into consideration priorities~~

5 ~~and strategies developed at the community level through~~

6 ~~the Illinois Project for Local Assessment of Needs (IPLAN)~~

7 ~~and any regional health improvement plans that may be~~

8 ~~developed.~~

9 The State Health Improvement Plan ~~Plan~~ shall focus on

10 prevention, social determinants of health, and promoting

11 health equity as key strategies ~~as a key strategy~~ for

12 long-term health improvement in Illinois.

13 The State Health Improvement Plan ~~Plan~~ shall identify

14 priority State health issues and social issues affecting

15 health, and shall examine and make recommendations on the

16 contributions and strategies of the public and private

17 sectors for improving health status and the public health

18 system in the State. In addition to recommendations on

19 health status improvement priorities and strategies for

20 the population of the State as a whole, the State Health

21 Improvement Plan ~~Plan~~ shall make recommendations, provided

22 that data exists to support such recommendations,

23 regarding priorities and strategies for reducing and

24 eliminating health disparities and health inequities in

25 Illinois; including racial, ethnic, gender identification,

26 sexual orientation, age, disability, socio-economic, and

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1 geographic disparities. The State Health Improvement Plan

2 shall make recommendations regarding social determinants

3 of health, such as housing, transportation, educational

4 attainment, employment, and income inequality.

5 The development and implementation of the State Health

6 Assessment and State Health Improvement Plan shall be a

7 collaborative public-private cross-agency effort overseen

8 by the SHA and SHIP Partnership. The Director of Public

9 Health shall consult with the Governor to ensure

10 participation by the head of State agencies with public

11 health responsibilities (or their designees) in the SHA

12 and SHIP Partnership, including, but not limited to, the

13 Department of Public Health, the Department of Human

14 Services, the Department of Healthcare and Family

15 Services, the Department of Children and Family Services,

16 the Environmental Protection Agency, the Illinois State

17 Board of Education, the Department on Aging, the Illinois

18 Housing Development Authority, the Illinois Criminal

19 Justice Information Authority, the Department of

20 Agriculture, the Department of Transportation, the

21 Department of Corrections, the Department of Commerce and

22 Economic Opportunity, and the Chair of the State Board of

23 Health to also serve on the Partnership. A member of the

24 Governors' staff shall participate in the Partnership and

25 serve as a liaison to the Governors' office.

26 The Director of ~~the Illinois Department of~~ Public

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1 Health shall appoint a minimum of 15 other members of the

2 SHA and SHIP Partnership representing ~~a Planning Team that~~

3 ~~includes~~ a range of public, private, and voluntary sector

4 stakeholders and participants in the public health system.

5 For the first SHA and SHIP Partnership after the effective

6 date of this amendatory Act of the 102nd General Assembly,

7 one-half of the members shall be appointed for a 3-year

8 term, and one-half of the members shall be appointed for a

9 5-year term. Subsequently, members shall be appointed to

10 5-year terms. Should any member not be able to fulfill his

11 or her term, the Director may appoint a replacement to

12 complete that term. The Director, in consultation with the

13 SHA and SHIP Partnership, may engage additional

14 individuals and organizations to serve on subcommittees

15 and ad hoc efforts to conduct the State Health Assessment

16 and develop and implement the State Health Improvement

17 Plan. Members of the SHA and SHIP Partnership shall

18 receive no compensation for serving as members, but may be

19 reimbursed for their necessary expenses if departmental

20 resources allow.

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~~

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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

14 chaired by the Director of Public Health or his or her

15 designee.

16 The SHA and SHIP Partnership shall develop and

17 implement a community engagement process that facilitates

18 input into the development of the State Health Assessment

19 and State Health Improvement Plan. This engagement process

20 shall ensure that individuals with lived experience in the

21 issues addressed in the State Health Assessment and State

22 Health Improvement Plan are meaningfully engaged in the

23 development and implementation of the State Health

24 Assessment and State Health Improvement Plan.

25 The State Board of Health shall hold at least 3 public

26 hearings addressing a draft of the State Health

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1 Improvement Plan ~~drafts of the Plan~~ in representative

2 geographic areas of the State.~~Members of the Planning~~

3 ~~Team shall receive no compensation for their services, but~~

4 ~~may be reimbursed for their necessary expenses.~~

5 ~~Upon the delivery of each State Health Improvement~~

6 ~~Plan, the Governor shall appoint a SHIP Implementation~~

7 ~~Coordination Council that includes a range of public,~~

8 ~~private, and voluntary sector stakeholders and~~

9 ~~participants in the public health system. The Council~~

10 ~~shall include the directors of State agencies and entities~~

11 ~~with public health system responsibilities (or their~~

12 ~~designees), including but not limited to the Department of~~

13 ~~Public Health, Department of Human Services, Department of~~

14 ~~Healthcare and Family Services, Environmental Protection~~

15 ~~Agency, Illinois State Board of Education, Department on~~

16 ~~Aging, Illinois Violence Prevention Authority, Department~~

17 ~~of Agriculture, Department of Insurance, Department of~~

18 ~~Financial and Professional Regulation, Department of~~

19 ~~Transportation, and Department of Commerce and Economic~~

20 ~~Opportunity and the Chair of the State Board of Health.~~

21 ~~The Council shall include representatives of local health~~

22 ~~departments and individuals with expertise who represent~~

23 ~~an array of organizations and constituencies engaged in~~

24 ~~public health improvement and prevention, including~~

25 ~~non-profit public interest groups, health issue groups,~~

26 ~~faith community groups, health care providers, businesses~~

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1 ~~and employers, academic institutions, and community-based~~

2 ~~organizations. The Governor shall endeavor to make the~~

3 ~~membership of the Council representative of the racial,~~

4 ~~ethnic, gender, socio-economic, and geographic diversity~~

5 ~~of the State. The Governor shall designate one State~~

6 ~~agency representative and one other non-governmental~~

7 ~~member as co-chairs of the Council. The Governor shall~~

8 ~~designate a member of the Governor's office to serve as~~

9 ~~liaison to the Council and one or more State agencies to~~

10 ~~provide or arrange for support to the Council. The members~~

11 ~~of the SHIP Implementation Coordination Council for each~~

12 ~~State Health Improvement Plan shall serve until the~~

13 ~~delivery of the subsequent State Health Improvement Plan,~~

14 ~~whereupon a new Council shall be appointed. Members of the~~

15 ~~SHIP Planning Team may serve on the SHIP Implementation~~

16 ~~Coordination Council if so appointed by the Governor.~~

17 Upon the delivery of each State Health Assessment and

18 State Health Improvement Plan, the SHA and SHIP

19 Partnership ~~The SHIP Implementation Coordination Council~~

20 shall coordinate the efforts and engagement of the public,

21 private, and voluntary sector stakeholders and

22 participants in the public health system to implement each

23 SHIP. The Partnership ~~Council~~ shall serve as a forum for

24 collaborative action; coordinate existing and new

25 initiatives; develop detailed implementation steps, with

26 mechanisms for action; implement specific projects;

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1 identify public and private funding sources at the local,

2 State and federal level; promote public awareness of the

3 SHIP; and advocate for the implementation of the SHIP. The

4 SHA and SHIP Partnership shall implement strategies to

5 ensure that individuals and communities affected by health

6 disparities and health inequities are engaged in the

7 process throughout the 5-year cycle. The SHA and SHIP

8 Partnership shall regularly evaluate and update the State

9 Health Assessment and track implementation of the State

10 Health Improvement Plan with revisions as necessary. The

11 SHA and SHIP Partnership shall not have the authority to

12 direct any public or private entity to take specific

13 action to implement the SHIP. ~~; and develop an annual~~

14 ~~report to the Governor, General Assembly, and public~~

15 ~~regarding the status of implementation of the SHIP. The~~

16 ~~Council shall not, however, have the authority to direct~~

17 ~~any public or private entity to take specific action to~~

18 ~~implement the SHIP.~~

19 The State Board of Health shall submit a report by

20 January 31 of each year on the status of State Health

21 Improvement Plan implementation and community engagement

22 activities to the Governor, General Assembly, and public.

23 In the fifth year, the report may be consolidated into the

24 new State Health Assessment and State Health Improvement

25 Plan.

26 (11) Upon the request of the Governor, to recommend to

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1 the Governor candidates for Director of Public Health when

2 vacancies occur in the position.

3 (12) To adopt bylaws for the conduct of its own

4 business, including the authority to establish ad hoc

5 committees to address specific public health programs

6 requiring resolution.

7 (13) (Blank).

8 Upon appointment, the Board shall elect a chairperson from

9 among its members.

10 Members of the Board shall receive compensation for their

11 services at the rate of $150 per day, not to exceed $10,000 per

12 year, as designated by the Director for each day required for

13 transacting the business of the Board and shall be reimbursed

14 for necessary expenses incurred in the performance of their

15 duties. The Board shall meet from time to time at the call of

16 the Department, at the call of the chairperson, or upon the

17 request of 3 of its members, but shall not meet less than 4

18 times per year.

19 (b) (Blank).

20 (c) An Advisory Board on Necropsy Service to Coroners,

21 which shall counsel and advise with the Director on the

22 administration of the Autopsy Act. The Advisory Board shall

23 consist of 11 members, including a senior citizen age 60 or

24 over, appointed by the Governor, one of whom shall be

25 designated as chairman by a majority of the members of the

26 Board. In the appointment of the first Board the Governor

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1 shall appoint 3 members to serve for terms of 1 year, 3 for

2 terms of 2 years, and 3 for terms of 3 years. The members first

3 appointed under Public Act 83-1538 shall serve for a term of 3

4 years. All members appointed thereafter shall be appointed for

5 terms of 3 years, except that when an appointment is made to

6 fill a vacancy, the appointment shall be for the remaining

7 term of the position vacant. The members of the Board shall be

8 citizens of the State of Illinois. In the appointment of

9 members of the Advisory Board the Governor shall appoint 3

10 members who shall be persons licensed to practice medicine and

11 surgery in the State of Illinois, at least 2 of whom shall have

12 received post-graduate training in the field of pathology; 3

13 members who are duly elected coroners in this State; and 5

14 members who shall have interest and abilities in the field of

15 forensic medicine but who shall be neither persons licensed to

16 practice any branch of medicine in this State nor coroners. In

17 the appointment of medical and coroner members of the Board,

18 the Governor shall invite nominations from recognized medical

19 and coroners organizations in this State respectively. Board

20 members, while serving on business of the Board, shall receive

21 actual necessary travel and subsistence expenses while so

22 serving away from their places of residence.

23 (Source: P.A. 98-463, eff. 8-16-13; 99-527, eff. 1-1-17;

24 revised 7-17-19.)

25 Article 125.

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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

15 throughout the State, leading to poorer health outcomes

16 among those 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

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1 crime victims access justice, assistance, and the support

2 they need to heal.

3 (8) Research has shown that people who are repeatedly

4 victimized are more likely to face mental health problems

5 such as depression, anxiety, and symptoms related to

6 post-traumatic stress disorder and chronic trauma.

7 (9) Trauma-informed care has been promoted and

8 established in communities across the country on a

9 bipartisan basis, and numerous federal agencies have

10 integrated trauma-informed approaches into their programs

11 and grants, which should be leveraged by the State of

12 Illinois.

13 (10) Infants, children, and youth and their families

14 who have experienced or are at risk of experiencing

15 trauma, including those who are low-income, homeless,

16 involved with the child welfare system, involved in the

17 juvenile or adult justice system, unemployed, or not

18 enrolled in or at risk of dropping out of an educational

19 institution and live in a community that has faced acute

20 or long-term exposure to substantial discrimination,

21 historical oppression, intergenerational poverty, a high

22 rate of violence or drug overdose deaths, should have an

23 opportunity for improved outcomes; this means increasing

24 access to greater opportunities to meet educational,

25 employment, health, developmental, community reentry,

26 permanency from foster care, or other key goals.

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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

21 on ways the Medicaid program can partner and cooperate with

22 other 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

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1 Protection Agency, and the Department of Public Health, to

2 better address social determinants of public health,

3 including, but not limited to, food deserts, affordable

4 housing, environmental pollutions, employment, education, and

5 public support services. This shall include a review and

6 recommendations on ways Medicaid and the agencies can share

7 costs related to better health outcomes.

8 (3) The Task Force shall review the current partnership,

9 communication, and cooperation between Federally Qualified

10 Health Centers (FQHCs) and safety-net hospitals in Illinois

11 and make recommendations on public policies that will improve

12 interoperability and cooperations between these entities in

13 order to achieve improved coordinated care and better health

14 outcomes for vulnerable populations in the State.

15 (4) The Task Force shall review and examine public

16 policies affecting trauma and social determinants of health,

17 including trauma-informed care, and make recommendations on

18 ways to improve and integrate trauma-informed approaches into

19 programs and agencies in the State, including, but not limited

20 to, Medicaid and other health care programs administered by

21 the State, and increase awareness of trauma and its effects on

22 communities across Illinois.

23 (5) The Task Force shall review and examine the connection

24 between access to education and health outcomes particularly

25 in African American and minority communities and make

26 recommendations on public policies to address any gaps or

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1 deficiencies.

2 Section 125-20. Membership; appointments; meetings;

3 support.

4 (1) The Task Force shall include representation from both

5 public and private organizations, and its membership shall

6 reflect regional, racial, and cultural diversity to ensure

7 representation of the needs of all Illinois citizens. Task

8 Force members shall include one member appointed by the

9 President of the Senate, one member appointed by the Minority

10 Leader of the Senate, one member appointed by the Speaker of

11 the House of Representatives, one member appointed by the

12 Minority Leader of the House of Representatives, and other

13 members appointed by the Governor. The Governor's appointments

14 shall include, without limitation, the following:

15 (A) One member of the Senate, appointed by the Senate

16 President, who shall serve as Co-Chair;

17 (B) One member of the House of Representatives,

18 appointed by the Speaker of the House, who shall serve as

19 Co-Chair;

20 (C) Eight members of the General Assembly representing

21 each of the majority and minority caucuses of each

22 chamber.

23 (D) The Directors or Secretaries of the following

24 State agencies or their designees:

25 (i) Department of Human Services.

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1 (ii) Department of Children and Family Services.

2 (iii) Department of Healthcare and Family

3 Services.

4 (iv) State Board of Education.

5 (v) Department on Aging.

6 (vi) Department of Public Health.

7 (vii) Department of Veterans' Affairs.

8 (viii) Department of Insurance.

9 (E) Local government stakeholders and nongovernmental

10 stakeholders with an interest in human services, including

11 representation among the following private-sector fields

12 and constituencies:

13 (i) Early childhood education and development.

14 (ii) Child care.

15 (iii) Child welfare.

16 (iv) Youth services.

17 (v) Developmental disabilities.

18 (vi) Mental health.

19 (vii) Employment and training.

20 (viii) Sexual and domestic violence.

21 (ix) Alcohol and substance abuse.

22 (x) Local community collaborations among human

23 services programs.

24 (xi) Immigrant services.

25 (xii) Affordable housing.

26 (xiii) Food and nutrition.

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1 (xiv) Homelessness.

2 (xv) Older adults.

3 (xvi) Physical disabilities.

4 (xvii) Maternal and child health.

5 (xviii) Medicaid managed care organizations.

6 (xix) Healthcare delivery.

7 (xx) Health insurance.

8 (2) Members shall serve without compensation for the

9 duration of the Task Force.

10 (3) In the event of a vacancy, the appointment to fill the

11 vacancy shall be made in the same manner as the original

12 appointment.

13 (4) The Task Force shall convene within 60 days after the

14 effective date of this Act. The initial meeting of the Task

15 Force shall be convened by the co-chair selected by the

16 Governor. Subsequent meetings shall convene at the call of the

17 co-chairs. The Task Force shall meet on a quarterly basis, or

18 more often if necessary.

19 (5) The Department of Human Services shall provide

20 administrative support to the Task Force.

21 Section 125-25. Report. The Task Force shall report to the

22 Governor and the General Assembly on the Task Force's progress

23 toward its goals and objectives by June 30, 2021, and every

24 June 30 thereafter.

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1 Section 125-30. Transparency. In addition to whatever

2 policies or procedures it may adopt, all operations of the

3 Task Force shall be subject to the provisions of the Freedom of

4 Information Act and the Open Meetings Act. This Section shall

5 not be construed so as to preclude other State laws from

6 applying to the Task Force and its activities.

7 Section 125-40. Repeal. This Article is repealed June 30,

8 2023.

9 Article 130.

10 Section 130-1. Short title. This Article may be cited as

11 the Anti-Racism Commission Act. References in this Article to

12 "this Act" mean this Article.

13 Section 130-5. Findings. The General Assembly finds and

14 declares all of the following:

15 (1) Public health is the science and art of preventing

16 disease, of protecting and improving the health of people,

17 entire populations, and their communities; this work is

18 achieved by promoting healthy lifestyles and choices,

19 researching disease, and preventing injury.

20 (2) Public health professionals try to prevent

21 problems from happening or recurring through implementing

22 educational programs, recommending policies,

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1 administering services, and limiting health disparities

2 through the promotion of equitable and accessible

3 healthcare.

4 (3) According to the Centers for Disease Control and

5 Prevention, racism and segregation in the State of

6 Illinois have exacerbated a health divide, resulting in

7 Black residents having lower life expectancies than white

8 citizens of this State and being far more likely than

9 other races to die prematurely (before the age of 75) and

10 to die of heart disease or stroke; Black residents of

11 Illinois have a higher level of infant mortality, lower

12 birth weight babies, and are more likely to be overweight

13 or obese as adults, have adult diabetes, and have

14 long-term complications from diabetes that exacerbate

15 other conditions, including the susceptibility to

16 COVID-19.

17 (4) Black and Brown people are more likely to

18 experience poor health outcomes as a consequence of their

19 social determinants of health, health inequities stemming

20 from economic instability, education, physical

21 environment, food, and access to health care systems.

22 (5) Black residents in Illinois are more likely than

23 white residents to experience violence-related trauma as a

24 result of socioeconomic conditions resulting from systemic

25 racism.

26 (6) Racism is a social system with multiple dimensions

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1 in which individual racism is internalized or

2 interpersonal and systemic racism is institutional or

3 structural and is a system of structuring opportunity and

4 assigning value based on the social interpretation of how

5 one looks; this unfairly disadvantages specific

6 individuals and communities, while unfairly giving

7 advantages to other individuals and communities; it saps

8 the strength of the whole society through the waste of

9 human resources.

10 (7) Racism causes persistent racial discrimination

11 that influences many areas of life, including housing,

12 education, employment, and criminal justice; an emerging

13 body of research demonstrates that racism itself is a

14 social determinant of health.

15 (8) More than 100 studies have linked racism to worse

16 health outcomes.

17 (9) The American Public Health Association launched a

18 National Campaign against Racism.

19 (10) Public health's responsibilities to address

20 racism include reshaping our discourse and agenda so that

21 we all actively engage in racial justice work.

22 Section 130-10. Anti-Racism Commission.

23 (a) The Anti-Racism Commission is hereby created to

24 identify and propose statewide policies to eliminate systemic

25 racism and advance equitable solutions for Black and Brown

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1 people in Illinois.

2 (b) The Anti-Racism Commission shall consist of the

3 following members, who shall serve without compensation:

4 (1) one member of the House of Representatives,

5 appointed by the Speaker of the House of Representatives,

6 who shall serve as co-chair;

7 (2) one member of the Senate, appointed by the Senate

8 President, who shall serve as co-chair;

9 (3) one member of the House of Representatives,

10 appointed by the Minority Leader of the House of

11 Representatives;

12 (4) one member of the Senate, appointed by the

13 Minority Leader of the Senate;

14 (5) the Director of Public Health, or his or her

15 designee;

16 (6) the Chair of the House Black Caucus;

17 (7) the Chair of the Senate Black Caucus;

18 (8) the Chair of the Joint Legislative Black Caucus;

19 (9) the director of a statewide association

20 representing public health departments, appointed by the

21 Speaker of the House of Representatives;

22 (10) the Chair of the House Latino Caucus;

23 (11) the Chair of the Senate Latino Caucus;

24 (12) one community member appointed by the House Black

25 Caucus Chair;

26 (13) one community member appointed by the Senate

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1 Black Caucus Chair;

2 (14) one community member appointed by the House

3 Latino Caucus Chair; and

4 (15) one community member appointed by the Senate

5 Latino Caucus Chair.

6 (c) The Department of Public Health shall provide

7 administrative support for the Commission.

8 (d) The Commission is charged with, but not limited to,

9 the following tasks:

10 (1) Working to create an equity and justice-oriented

11 State government.

12 (2) Assessing the policy and procedures of all State

13 agencies to ensure racial equity is a core element of

14 State government.

15 (3) Developing and incorporating into the

16 organizational structure of State government a plan for

17 educational efforts to understand, address, and dismantle

18 systemic racism in government actions.

19 (4) Recommending and advocating for policies that

20 improve health in Black and Brown people and support

21 local, State, regional, and federal initiatives that

22 advance efforts to dismantle systemic racism.

23 (5) Working to build alliances and partnerships with

24 organizations that are confronting racism and encouraging

25 other local, State, regional, and national entities to

26 recognize racism as a public health crisis.

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1 (6) Promoting community engagement, actively engaging

2 citizens on issues of racism and assisting in providing

3 tools to engage actively and authentically with Black and

4 Brown people.

5 (7) Reviewing all portions of codified State laws

6 through the lens of racial equity.

7 (8) Working with the Department of Central Management

8 Services to update policies that encourage diversity in

9 human resources, including hiring, board appointments, and

10 vendor selection by agencies, and to review all grant

11 management activities with an eye toward equity and

12 workforce development.

13 (9) Recommending policies that promote racially

14 equitable economic and workforce development practices.

15 (10) Promoting and supporting all policies that

16 prioritize the health of all people, especially people of

17 color, by mitigating exposure to adverse childhood

18 experiences and trauma in childhood and ensuring

19 implementation of health and equity in all policies.

20 (11) Encouraging community partners and stakeholders

21 in the education, employment, housing, criminal justice,

22 and safety arenas to recognize racism as a public health

23 crisis and to implement policy recommendations.

24 (12) Identifying clear goals and objectives, including

25 specific benchmarks, to assess progress.

26 (13) Holding public hearings across Illinois to

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1 continue to explore and to recommend needed action by the

2 General Assembly.

3 (14) Working with the Governor and the General

4 Assembly to identify the necessary funds to support the

5 Anti-Racism Commission and its endeavors.

6 (15) Identifying resources to allocate to Black and

7 Brown communities on an annual basis.

8 (16) Encouraging corporate investment in anti-racism

9 policies in Black and Brown communities.

10 (e) The Commission shall submit its final report to the

11 Governor and the General Assembly no later than December 31,

12 2021. The Commission is dissolved upon the filing of its

13 report.

14 Section 130-15. Repeal. This Article is repealed on

15 January 1, 2023.

16 Article 131.

17 Section 131-1. Short title. This Article may be cited as

18 the Sickle Cell Prevention, Care, and Treatment Program Act.

19 References in this Article to "this Act" mean this Article.

20 Section 131-5. Definitions. As used in this Act:

21 "Department" means the Department of Public Health.

22 "Program" means the Sickle Cell Prevention, Care, and

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1 Treatment Program.

2 Section 131-10. Sickle Cell Prevention, Care, and

3 Treatment Program. The Department shall establish a grant

4 program for the purpose of providing for the prevention, care,

5 and treatment of sickle cell disease and for educational

6 programs concerning the disease.

7 Section 131-15. Grants; eligibility standards.

8 (a) The Department shall do the following:

9 (1)(A) Develop application criteria and standards of

10 eligibility for groups or organizations who apply for

11 funds under the program.

12 (B) Make available grants to groups and organizations

13 who meet the eligibility standards set by the Department.

14 However:

15 (i) the highest priority for grants shall be

16 accorded to established sickle cell disease

17 community-based organizations throughout Illinois; and

18 (ii) priority shall also be given to ensuring the

19 establishment of sickle cell disease centers in

20 underserved areas that have a higher population of

21 sickle cell disease patients.

22 (2) Determine the maximum amount available for each

23 grant provided under subparagraph (B) of paragraph (1).

24 (3) Determine policies for the expiration and renewal

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1 of grants provided under subparagraph (B) of paragraph

2 (1).

3 (4) Require that all grant funds be used for the

4 purpose of prevention, care, and treatment of sickle cell

5 disease or for educational programs concerning the

6 disease. Grant funds shall be used for one or more of the

7 following purposes:

8 (A) Assisting in the development and expansion of

9 care for the treatment of individuals with sickle cell

10 disease, particularly for adults, including the

11 following types of care:

12 (i) Self-administered care.

13 (ii) Preventive care.

14 (iii) Home care.

15 (iv) Other evidence-based medical procedures

16 and techniques designed to provide maximum control

17 over sickling episodes typical of occurring to an

18 individual with the disease.

19 (B) Increasing access to health care for

20 individuals with sickle cell disease.

21 (C) Establishing additional sickle cell disease

22 infusion centers.

23 (D) Increasing access to mental health resources

24 and pain management therapies for individuals with

25 sickle cell disease.

26 (E) Providing counseling to any individual, at no

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1 cost, concerning sickle cell disease and sickle cell

2 trait, and the characteristics, symptoms, and

3 treatment of the disease.

4 (i) The counseling described in this

5 subparagraph (E) may consist of any of the

6 following:

7 (I) Genetic counseling for an individual

8 who tests positive for the sickle cell trait.

9 (II) Psychosocial counseling for an

10 individual who tests positive for sickle cell

11 disease, including any of the following:

12 (aa) Social service counseling.

13 (bb) Psychological counseling.

14 (cc) Psychiatric counseling.

15 (5) Develop a sickle cell disease educational outreach

16 program that includes the dissemination of educational

17 materials to the following concerning sickle cell disease

18 and sickle cell trait:

19 (A) Medical residents.

20 (B) Immigrants.

21 (C) Schools and universities.

22 (6) Adopt any rules necessary to implement the

23 provisions of this Act.

24 (b) The Department may contract with an entity to

25 implement the sickle cell disease educational outreach program

26 described in paragraph (5) of subsection (a).

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1 Section 131-20. Sickle Cell Chronic Disease Fund.

2 (a) The Sickle Cell Chronic Disease Fund is created as a

3 special fund in the State treasury for the purpose of carrying

4 out the provisions of this Act and for no other purpose. The

5 Fund shall be administered by the Department.

6 (b) The Fund shall consist of:

7 (1) Any moneys appropriated to the Department for the

8 Sickle Cell Prevention, Care, and Treatment Program.

9 (2) Gifts, bequests, and other sources of funding.

10 (3) All interest earned on moneys in the Fund.

11 Section 131-25. Study.

12 (a) Before July 1, 2022, and on a biennial basis

13 thereafter, the Department, with the assistance of:

14 (1) the Center for Minority Health Services;

15 (2) health care providers that treat individuals with

16 sickle cell disease;

17 (3) individuals diagnosed with sickle cell disease;

18 (4) representatives of community-based organizations

19 that serve individuals with sickle cell disease; and

20 (5) data collected via newborn screening for sickle

21 cell disease;

22 shall perform a study to determine the prevalence, impact, and

23 needs of individuals with sickle cell disease and the sickle

24 cell trait in Illinois.

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1 (b) The study must include the following:

2 (1) The prevalence, by geographic location, of

3 individuals diagnosed with sickle cell disease in

4 Illinois.

5 (2) The prevalence, by geographic location, of

6 individuals diagnosed as sickle cell trait carriers in

7 Illinois.

8 (3) The availability and affordability of screening

9 services in Illinois for the sickle cell trait.

10 (4) The location and capacity of the following for the

11 treatment of sickle cell disease and sickle cell trait

12 carriers:

13 (A) Treatment centers.

14 (B) Clinics.

15 (C) Community-based social service organizations.

16 (D) Medical specialists.

17 (5) The unmet medical, psychological, and social needs

18 encountered by individuals in Illinois with sickle cell

19 disease.

20 (6) The underserved areas of Illinois for the

21 treatment of sickle cell disease.

22 (7) Recommendations for actions to address any

23 shortcomings in the State identified under this Section.

24 (c) The Department shall submit a report on the study

25 performed under this Section to the General Assembly.

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1 Section 131-30. Implementation subject to appropriation.

2 Implementation of this Act is subject to appropriation.

3 Section 131-90. The State Finance Act is amended by adding

4 Section 5.937 as follows:

5 (30 ILCS 105/5.937 new)

6 Sec. 5.937. The Sickle Cell Chronic Disease Fund.

7 Title VII. Hospital Closure

8 Article 135.

9 Section 135-5. The Illinois Health Facilities Planning Act

10 is amended by changing Sections 4, 5.4, and 8.7 as follows:

11 (20 ILCS 3960/4) (from Ch. 111 1/2, par. 1154)

12 (Section scheduled to be repealed on December 31, 2029)

13 Sec. 4. Health Facilities and Services Review Board;

14 membership; appointment; term; compensation; quorum.

15 (a) There is created the Health Facilities and Services

16 Review Board, which shall perform the functions described in

17 this Act. The Department shall provide operational support to

18 the Board as necessary, including the provision of office

19 space, supplies, and clerical, financial, and accounting

20 services. The Board may contract for functions or operational

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1 support as needed. The Board may also contract with experts

2 related to specific health services or facilities and create

3 technical advisory panels to assist in the development of

4 criteria, standards, and procedures used in the evaluation of

5 applications for permit and exemption.

6 (b) The State Board shall consist of 11 ~~9~~ voting members.

7 All members shall be residents of Illinois and at least 4 shall

8 reside outside the Chicago Metropolitan Statistical Area.

9 Consideration shall be given to potential appointees who

10 reflect the ethnic and cultural diversity of the State.

11 Neither Board members nor Board staff shall be convicted

12 felons or have pled guilty to a felony.

13 Each member shall have a reasonable knowledge of the

14 practice, procedures and principles of the health care

15 delivery system in Illinois, including at least 5 members who

16 shall be knowledgeable about health care delivery systems,

17 health systems planning, finance, or the management of health

18 care facilities currently regulated under the Act. One member

19 shall be a representative of a non-profit health care consumer

20 advocacy organization. One member shall be a representative

21 from the community with experience on the effects of

22 discontinuing health care services or the closure of health

23 care facilities on the surrounding community; provided,

24 however, that all other members of the Board shall be

25 appointed before this member shall be appointed. A spouse,

26 parent, sibling, or child of a Board member cannot be an

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1 employee, agent, or under contract with services or facilities

2 subject to the Act. Prior to appointment and in the course of

3 service on the Board, members of the Board shall disclose the

4 employment or other financial interest of any other relative

5 of the member, if known, in service or facilities subject to

6 the Act. Members of the Board shall declare any conflict of

7 interest that may exist with respect to the status of those

8 relatives and recuse themselves from voting on any issue for

9 which a conflict of interest is declared. No person shall be

10 appointed or continue to serve as a member of the State Board

11 who is, or whose spouse, parent, sibling, or child is, a member

12 of the Board of Directors of, has a financial interest in, or

13 has a business relationship with a health care facility.

14 Notwithstanding any provision of this Section to the

15 contrary, the term of office of each member of the State Board

16 serving on the day before the effective date of this

17 amendatory Act of the 96th General Assembly is abolished on

18 the date upon which members of the ~~9-member~~ Board, as

19 established by this amendatory Act of the 96th General

20 Assembly, have been appointed and can begin to take action as a

21 Board.

22 (c) The State Board shall be appointed by the Governor,

23 with the advice and consent of the Senate. Not more than6 ~~5~~ of

24 the appointments shall be of the same political party at the

25 time of the appointment.

26 The Secretary of Human Services, the Director of

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1 Healthcare and Family Services, and the Director of Public

2 Health, or their designated representatives, shall serve as

3 ex-officio, non-voting members of the State Board.

4 (d) Of those ~~9~~ members initially appointed by the Governor

5 following the effective date of this amendatory Act of the

6 96th General Assembly, 3 shall serve for terms expiring July

7 1, 2011, 3 shall serve for terms expiring July 1, 2012, and 3

8 shall serve for terms expiring July 1, 2013. Thereafter, each

9 appointed member shall hold office for a term of 3 years,

10 provided that any member appointed to fill a vacancy occurring

11 prior to the expiration of the term for which his or her

12 predecessor was appointed shall be appointed for the remainder

13 of such term and the term of office of each successor shall

14 commence on July 1 of the year in which his predecessor's term

15 expires. Each member shall hold office until his or her

16 successor is appointed and qualified. The Governor may

17 reappoint a member for additional terms, but no member shall

18 serve more than 3 terms, subject to review and re-approval

19 every 3 years.

20 (e) State Board members, while serving on business of the

21 State Board, shall receive actual and necessary travel and

22 subsistence expenses while so serving away from their places

23 of residence. Until March 1, 2010, a member of the State Board

24 who experiences a significant financial hardship due to the

25 loss of income on days of attendance at meetings or while

26 otherwise engaged in the business of the State Board may be

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1 paid a hardship allowance, as determined by and subject to the

2 approval of the Governor's Travel Control Board.

3 (f) The Governor shall designate one of the members to

4 serve as the Chairman of the Board, who shall be a person with

5 expertise in health care delivery system planning, finance or

6 management of health care facilities that are regulated under

7 the Act. The Chairman shall annually review Board member

8 performance and shall report the attendance record of each

9 Board member to the General Assembly.

10 (g) The State Board, through the Chairman, shall prepare a

11 separate and distinct budget approved by the General Assembly

12 and shall hire and supervise its own professional staff

13 responsible for carrying out the responsibilities of the

14 Board.

15 (h) The State Board shall meet at least every 45 days, or

16 as often as the Chairman of the State Board deems necessary, or

17 upon the request of a majority of the members.

18 (i) Six~~Five~~ members of the State Board shall constitute a

19 quorum. The affirmative vote of6 ~~5~~ of the members of the State

20 Board shall be necessary for any action requiring a vote to be

21 taken by the State Board. A vacancy in the membership of the

22 State Board shall not impair the right of a quorum to exercise

23 all the rights and perform all the duties of the State Board as

24 provided by this Act.

25 (j) A State Board member shall disqualify himself or

26 herself from the consideration of any application for a permit

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1 or exemption in which the State Board member or the State Board

2 member's spouse, parent, sibling, or child: (i) has an

3 economic interest in the matter; or (ii) is employed by,

4 serves as a consultant for, or is a member of the governing

5 board of the applicant or a party opposing the application.

6 (k) The Chairman, Board members, and Board staff must

7 comply with the Illinois Governmental Ethics Act.

8 (Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)

9 (20 ILCS 3960/5.4)

10 (Section scheduled to be repealed on December 31, 2029)

11 Sec. 5.4. Safety Net Impact Statement.

12 (a) General review criteria shall include a requirement

13 that all health care facilities, with the exception of skilled

14 and intermediate long-term care facilities licensed under the

15 Nursing Home Care Act, provide a Safety Net Impact Statement,

16 which shall be filed with an application for a substantive

17 project or when the application proposes to discontinue a

18 category of service.

19 (b) For the purposes of this Section, "safety net

20 services" are services provided by health care providers or

21 organizations that deliver health care services to persons

22 with barriers to mainstream health care due to lack of

23 insurance, inability to pay, special needs, ethnic or cultural

24 characteristics, or geographic isolation. Safety net service

25 providers include, but are not limited to, hospitals and

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1 private practice physicians that provide charity care,

2 school-based health centers, migrant health clinics, rural

3 health clinics, federally qualified health centers, community

4 health centers, public health departments, and community

5 mental health centers.

6 (c) As developed by the applicant, a Safety Net Impact

7 Statement shall describe all of the following:

8 (1) The project's material impact, if any, on

9 essential safety net services in the community, including

10 the impact on racial and health care disparities in the

11 community, to the extent that it is feasible for an

12 applicant to have such knowledge.

13 (2) The project's impact on the ability of another

14 provider or health care system to cross-subsidize safety

15 net services, if reasonably known to the applicant.

16 (3) How the discontinuation of a facility or service

17 might impact the remaining safety net providers in a given

18 community, if reasonably known by the applicant.

19 (d) Safety Net Impact Statements shall also include all of

20 the following:

21 (1) For the 3 fiscal years prior to the application, a

22 certification describing the amount of charity care

23 provided by the applicant. The amount calculated by

24 hospital applicants shall be in accordance with the

25 reporting requirements for charity care reporting in the

26 Illinois Community Benefits Act. Non-hospital applicants

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1 shall report charity care, at cost, in accordance with an

2 appropriate methodology specified by the Board.

3 (2) For the 3 fiscal years prior to the application, a

4 certification of the amount of care provided to Medicaid

5 patients. Hospital and non-hospital applicants shall

6 provide Medicaid information in a manner consistent with

7 the information reported each year to the State Board

8 regarding "Inpatients and Outpatients Served by Payor

9 Source" and "Inpatient and Outpatient Net Revenue by Payor

10 Source" as required by the Board under Section 13 of this

11 Act and published in the Annual Hospital Profile.

12 (3) Any information the applicant believes is directly

13 relevant to safety net services, including information

14 regarding teaching, research, and any other service.

15 (e) The Board staff shall publish a notice, that an

16 application accompanied by a Safety Net Impact Statement has

17 been filed, in a newspaper having general circulation within

18 the area affected by the application. If no newspaper has a

19 general circulation within the county, the Board shall post

20 the notice in 5 conspicuous places within the proposed area.

21 (f) Any person, community organization, provider, or

22 health system or other entity wishing to comment upon or

23 oppose the application may file a Safety Net Impact Statement

24 Response with the Board, which shall provide additional

25 information concerning a project's impact on safety net

26 services in the community.

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1 (g) Applicants shall be provided an opportunity to submit

2 a reply to any Safety Net Impact Statement Response.

3 (h) The State Board Staff Report shall include a statement

4 as to whether a Safety Net Impact Statement was filed by the

5 applicant and whether it included information on charity care,

6 the amount of care provided to Medicaid patients, and

7 information on teaching, research, or any other service

8 provided by the applicant directly relevant to safety net

9 services. The report shall also indicate the names of the

10 parties submitting responses and the number of responses and

11 replies, if any, that were filed.

12 (Source: P.A. 100-518, eff. 6-1-18.)

13 (20 ILCS 3960/8.7)

14 (Section scheduled to be repealed on December 31, 2029)

15 Sec. 8.7. Application for permit for discontinuation of a

16 health care facility or category of service; public notice and

17 public hearing.

18 (a) Upon a finding that an application to close a health

19 care facility or discontinue a category of service is

20 complete, the State Board shall publish a legal notice on 3

21 consecutive days in a newspaper of general circulation in the

22 area or community to be affected and afford the public an

23 opportunity to request a hearing. If the application is for a

24 facility located in a Metropolitan Statistical Area, an

25 additional legal notice shall be published in a newspaper of

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1 limited circulation, if one exists, in the area in which the

2 facility is located. If the newspaper of limited circulation

3 is published on a daily basis, the additional legal notice

4 shall be published on 3 consecutive days. The legal notice

5 shall also be posted on the Health Facilities and Services

6 Review Board's website and sent to the State Representative

7 and State Senator of the district in which the health care

8 facility is located. In addition, the health care facility

9 shall provide notice of closure to the local media that the

10 health care facility would routinely notify about facility

11 events.

12 An application to close a health care facility shall only

13 be deemed complete if it includes evidence that the health

14 care facility provided written notice at least 30 days prior

15 to filing the application of its intent to do so to the

16 municipality in which it is located, the State Representative

17 and State Senator of the district in which the health care

18 facility is located, the State Board, the Director of Public

19 Health, and the Director of Healthcare and Family Services.

20 The changes made to this subsection by this amendatory Act of

21 the 101st General Assembly shall apply to all applications

22 submitted after the effective date of this amendatory Act of

23 the 101st General Assembly.

24 (b) No later than 30 days after issuance of a permit to

25 close a health care facility or discontinue a category of

26 service, the permit holder shall give written notice of the

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1 closure or discontinuation to the State Senator and State

2 Representative serving the legislative district in which the

3 health care facility is located.

4 (c)(1) If there is a pending lawsuit that challenges an

5 application to discontinue a health care facility that either

6 names the Board as a party or alleges fraud in the filing of

7 the application, the Board may defer action on the application

8 for up to 6 months after the date of the initial deferral of

9 the application.

10 (2) The Board may defer action on an application to

11 discontinue a hospital that is pending before the Board as of

12 the effective date of this amendatory Act of the 102nd General

13 Assembly for up to 60 days after the effective date of this

14 amendatory Act of the 102nd General Assembly.

15 (3) The Board may defer taking final action on an

16 application to discontinue a hospital that is filed on or

17 after January 12, 2021, until the earlier to occur of: (i) the

18 expiration of the statewide disaster declaration proclaimed by

19 the Governor of the State of Illinois due to the COVID-19

20 pandemic that is in effect on January 12, 2021, or any

21 extension thereof, or July 1, 2021, whichever occurs later; or

22 (ii) the expiration of the declaration of a public health

23 emergency due to the COVID-19 pandemic as declared by the

24 Secretary of the U.S. Department of Health and Human Services

25 that is in effect on January 12, 2021, or any extension

26 thereof, or July 1, 2021, whichever occurs later. This

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1 paragraph (3) is repealed as of the date of the expiration of

2 the statewide disaster declaration proclaimed by the Governor

3 of the State of Illinois due to the COVID-19 pandemic that is

4 in effect on January 12, 2021, or any extension thereof, or

5 July 1, 2021, whichever occurs later.

6 (d) The changes made to this Section by this amendatory

7 Act of the 101st General Assembly shall apply to all

8 applications submitted after the effective date of this

9 amendatory Act of the 101st General Assembly.

10 (Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)

11 Title VIII. Managed Care Organization Reform

12 Article 150.

13 Section 150-5. The Illinois Public Aid Code is amended by

14 changing Section 5-30.1 as follows:

15 (305 ILCS 5/5-30.1)

16 Sec. 5-30.1. Managed care protections.

17 (a) As used in this Section:

18 "Managed care organization" or "MCO" means any entity

19 which contracts with the Department to provide services where

20 payment for medical services is made on a capitated basis.

21 "Emergency services" include:

22 (1) emergency services, as defined by Section 10 of

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1 the Managed Care Reform and Patient Rights Act;

2 (2) emergency medical screening examinations, as

3 defined by Section 10 of the Managed Care Reform and

4 Patient Rights Act;

5 (3) post-stabilization medical services, as defined by

6 Section 10 of the Managed Care Reform and Patient Rights

7 Act; and

8 (4) emergency medical conditions, as defined by

9 Section 10 of the Managed Care Reform and Patient Rights

10 Act.

11 (b) As provided by Section 5-16.12, managed care

12 organizations are subject to the provisions of the Managed

13 Care Reform and Patient Rights Act.

14 (c) An MCO shall pay any provider of emergency services

15 that does not have in effect a contract with the contracted

16 Medicaid MCO. The default rate of reimbursement shall be the

17 rate paid under Illinois Medicaid fee-for-service program

18 methodology, including all policy adjusters, including but not

19 limited to Medicaid High Volume Adjustments, Medicaid

20 Percentage Adjustments, Outpatient High Volume Adjustments,

21 and all outlier add-on adjustments to the extent such

22 adjustments are incorporated in the development of the

23 applicable MCO capitated rates.

24 (d) An MCO shall pay for all post-stabilization services

25 as a covered service in any of the following situations:

26 (1) the MCO authorized such services;

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1 (2) such services were administered to maintain the

2 enrollee's stabilized condition within one hour after a

3 request to the MCO for authorization of further

4 post-stabilization services;

5 (3) the MCO did not respond to a request to authorize

6 such services within one hour;

7 (4) the MCO could not be contacted; or

8 (5) the MCO and the treating provider, if the treating

9 provider is a non-affiliated provider, could not reach an

10 agreement concerning the enrollee's care and an affiliated

11 provider was unavailable for a consultation, in which case

12 the MCO must pay for such services rendered by the

13 treating non-affiliated provider until an affiliated

14 provider was reached and either concurred with the

15 treating non-affiliated provider's plan of care or assumed

16 responsibility for the enrollee's care. Such payment shall

17 be made at the default rate of reimbursement paid under

18 Illinois Medicaid fee-for-service program methodology,

19 including all policy adjusters, including but not limited

20 to Medicaid High Volume Adjustments, Medicaid Percentage

21 Adjustments, Outpatient High Volume Adjustments and all

22 outlier add-on adjustments to the extent that such

23 adjustments are incorporated in the development of the

24 applicable MCO capitated rates.

25 (e) The following requirements apply to MCOs in

26 determining payment for all emergency services:

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1 (1) MCOs shall not impose any requirements for prior

2 approval of emergency services.

3 (2) The MCO shall cover emergency services provided to

4 enrollees who are temporarily away from their residence

5 and outside the contracting area to the extent that the

6 enrollees would be entitled to the emergency services if

7 they still were within the contracting area.

8 (3) The MCO shall have no obligation to cover medical

9 services provided on an emergency basis that are not

10 covered services under the contract.

11 (4) The MCO shall not condition coverage for emergency

12 services on the treating provider notifying the MCO of the

13 enrollee's screening and treatment within 10 days after

14 presentation for emergency services.

15 (5) The determination of the attending emergency

16 physician, or the provider actually treating the enrollee,

17 of whether an enrollee is sufficiently stabilized for

18 discharge or transfer to another facility, shall be

19 binding on the MCO. The MCO shall cover emergency services

20 for all enrollees whether the emergency services are

21 provided by an affiliated or non-affiliated provider.

22 (6) The MCO's financial responsibility for

23 post-stabilization care services it has not pre-approved

24 ends when:

25 (A) a plan physician with privileges at the

26 treating hospital assumes responsibility for the

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1 enrollee's care;

2 (B) a plan physician assumes responsibility for

3 the enrollee's care through transfer;

4 (C) a contracting entity representative and the

5 treating physician reach an agreement concerning the

6 enrollee's care; or

7 (D) the enrollee is discharged.

8 (f) Network adequacy and transparency.

9 (1) The Department shall:

10 (A) ensure that an adequate provider network is in

11 place, taking into consideration health professional

12 shortage areas and medically underserved areas;

13 (B) publicly release an explanation of its process

14 for analyzing network adequacy;

15 (C) periodically ensure that an MCO continues to

16 have an adequate network in place; ~~and~~

17 (D) require MCOs, including Medicaid Managed Care

18 Entities as defined in Section 5-30.2, to meet

19 provider directory requirements under Section 5-30.3;

20 and ~~.~~

21 (E) require MCOs to ensure that any

22 Medicaid-certified provider under contract with an MCO

23 and previously submitted on a roster on the date of

24 service is paid for any medically necessary,

25 Medicaid-covered, and authorized service rendered to

26 any of the MCO's enrollees, regardless of inclusion on

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1 the MCO's published and publicly available directory

2 of available providers.

3 (2) Each MCO shall confirm its receipt of information

4 submitted specific to physician or dentist additions or

5 physician or dentist deletions from the MCO's provider

6 network within 3 days after receiving all required

7 information from contracted physicians or dentists, and

8 electronic physician and dental directories must be

9 updated consistent with current rules as published by the

10 Centers for Medicare and Medicaid Services or its

11 successor agency.

12 (g) Timely payment of claims.

13 (1) The MCO shall pay a claim within 30 days of

14 receiving a claim that contains all the essential

15 information needed to adjudicate the claim.

16 (2) The MCO shall notify the billing party of its

17 inability to adjudicate a claim within 30 days of

18 receiving that claim.

19 (3) The MCO shall pay a penalty that is at least equal

20 to the timely payment interest penalty imposed under

21 Section 368a of the Illinois Insurance Code for any claims

22 not timely paid.

23 (A) When an MCO is required to pay a timely payment

24 interest penalty to a provider, the MCO must calculate

25 and pay the timely payment interest penalty that is

26 due to the provider within 30 days after the payment of

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1 the claim. In no event shall a provider be required to

2 request or apply for payment of any owed timely

3 payment interest penalties.

4 (B) Such payments shall be reported separately

5 from the claim payment for services rendered to the

6 MCO's enrollee and clearly identified as interest

7 payments.

8 (4)(A) The Department shall require MCOs to expedite

9 payments to providers identified on the Department's

10 expedited provider list, determined in accordance with 89

11 Ill. Adm. Code 140.71(b), on a schedule at least as

12 frequently as the providers are paid under the

13 Department's fee-for-service expedited provider schedule.

14 (B) Compliance with the expedited provider

15 requirement may be satisfied by an MCO through the use

16 of a Periodic Interim Payment (PIP) program that has

17 been mutually agreed to and documented between the MCO

18 and the provider, if ~~and~~ the PIP program ensures that

19 any expedited provider receives regular and periodic

20 payments based on prior period payment experience from

21 that MCO. Total payments under the PIP program may be

22 reconciled against future PIP payments on a schedule

23 mutually agreed to between the MCO and the provider.

24 (C) The Department shall share at least monthly

25 its expedited provider list and the frequency with

26 which it pays providers on the expedited list.

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1 (g-5) Recognizing that the rapid transformation of the

2 Illinois Medicaid program may have unintended operational

3 challenges for both payers and providers:

4 (1) in no instance shall a medically necessary covered

5 service rendered in good faith, based upon eligibility

6 information documented by the provider, be denied coverage

7 or diminished in payment amount if the eligibility or

8 coverage information available at the time the service was

9 rendered is later found to be inaccurate in the assignment

10 of coverage responsibility between MCOs or the

11 fee-for-service system, except for instances when an

12 individual is deemed to have not been eligible for

13 coverage under the Illinois Medicaid program; and

14 (2) the Department shall, by December 31, 2016, adopt

15 rules establishing policies that shall be included in the

16 Medicaid managed care policy and procedures manual

17 addressing payment resolutions in situations in which a

18 provider renders services based upon information obtained

19 after verifying a patient's eligibility and coverage plan

20 through either the Department's current enrollment system

21 or a system operated by the coverage plan identified by

22 the patient presenting for services:

23 (A) such medically necessary covered services

24 shall be considered rendered in good faith;

25 (B) such policies and procedures shall be

26 developed in consultation with industry

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1 representatives of the Medicaid managed care health

2 plans and representatives of provider associations

3 representing the majority of providers within the

4 identified provider industry; and

5 (C) such rules shall be published for a review and

6 comment period of no less than 30 days on the

7 Department's website with final rules remaining

8 available on the Department's website.

9 The rules on payment resolutions shall include, but not be

10 limited to:

11 (A) the extension of the timely filing period;

12 (B) retroactive prior authorizations; and

13 (C) guaranteed minimum payment rate of no less than

14 the current, as of the date of service, fee-for-service

15 rate, plus all applicable add-ons, when the resulting

16 service relationship is out of network.

17 The rules shall be applicable for both MCO coverage and

18 fee-for-service coverage.

19 If the fee-for-service system is ultimately determined to

20 have been responsible for coverage on the date of service, the

21 Department shall provide for an extended period for claims

22 submission outside the standard timely filing requirements.

23 (g-6) MCO Performance Metrics Report.

24 (1) The Department shall publish, on at least a

25 quarterly basis, each MCO's operational performance,

26 including, but not limited to, the following categories of

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1 metrics:

2 (A) claims payment, including timeliness and

3 accuracy;

4 (B) prior authorizations;

5 (C) grievance and appeals;

6 (D) utilization statistics;

7 (E) provider disputes;

8 (F) provider credentialing; and

9 (G) member and provider customer service.

10 (2) The Department shall ensure that the metrics

11 report is accessible to providers online by January 1,

12 2017.

13 (3) The metrics shall be developed in consultation

14 with industry representatives of the Medicaid managed care

15 health plans and representatives of associations

16 representing the majority of providers within the

17 identified industry.

18 (4) Metrics shall be defined and incorporated into the

19 applicable Managed Care Policy Manual issued by the

20 Department.

21 (g-7) MCO claims processing and performance analysis. In

22 order to monitor MCO payments to hospital providers, pursuant

23 to this amendatory Act of the 100th General Assembly, the

24 Department shall post an analysis of MCO claims processing and

25 payment performance on its website every 6 months. Such

26 analysis shall include a review and evaluation of a

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1 representative sample of hospital claims that are rejected and

2 denied for clean and unclean claims and the top 5 reasons for

3 such actions and timeliness of claims adjudication, which

4 identifies the percentage of claims adjudicated within 30, 60,

5 90, and over 90 days, and the dollar amounts associated with

6 those claims. The Department shall post the contracted claims

7 report required by HealthChoice Illinois on its website every

8 3 months.

9 (g-8) Dispute resolution process. The Department shall

10 maintain a provider complaint portal through which a provider

11 can submit to the Department unresolved disputes with an MCO.

12 An unresolved dispute means an MCO's decision that denies in

13 whole or in part a claim for reimbursement to a provider for

14 health care services rendered by the provider to an enrollee

15 of the MCO with which the provider disagrees. Disputes shall

16 not be submitted to the portal until the provider has availed

17 itself of the MCO's internal dispute resolution process.

18 Disputes that are submitted to the MCO internal dispute

19 resolution process may be submitted to the Department of

20 Healthcare and Family Services' complaint portal no sooner

21 than 30 days after submitting to the MCO's internal process

22 and not later than 30 days after the unsatisfactory resolution

23 of the internal MCO process or 60 days after submitting the

24 dispute to the MCO internal process. Multiple claim disputes

25 involving the same MCO may be submitted in one complaint,

26 regardless of whether the claims are for different enrollees,

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1 when the specific reason for non-payment of the claims

2 involves a common question of fact or policy. Within 10

3 business days of receipt of a complaint, the Department shall

4 present such disputes to the appropriate MCO, which shall then

5 have 30 days to issue its written proposal to resolve the

6 dispute. The Department may grant one 30-day extension of this

7 time frame to one of the parties to resolve the dispute. If the

8 dispute remains unresolved at the end of this time frame or the

9 provider is not satisfied with the MCO's written proposal to

10 resolve the dispute, the provider may, within 30 days, request

11 the Department to review the dispute and make a final

12 determination. Within 30 days of the request for Department

13 review of the dispute, both the provider and the MCO shall

14 present all relevant information to the Department for

15 resolution and make individuals with knowledge of the issues

16 available to the Department for further inquiry if needed.

17 Within 30 days of receiving the relevant information on the

18 dispute, or the lapse of the period for submitting such

19 information, the Department shall issue a written decision on

20 the dispute based on contractual terms between the provider

21 and the MCO, contractual terms between the MCO and the

22 Department of Healthcare and Family Services and applicable

23 Medicaid policy. The decision of the Department shall be

24 final. By January 1, 2020, the Department shall establish by

25 rule further details of this dispute resolution process.

26 Disputes between MCOs and providers presented to the

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1 Department for resolution are not contested cases, as defined

2 in Section 1-30 of the Illinois Administrative Procedure Act,

3 conferring any right to an administrative hearing.

4 (g-9)(1) The Department shall publish annually on its

5 website a report on the calculation of each managed care

6 organization's medical loss ratio showing the following:

7 (A) Premium revenue, with appropriate adjustments.

8 (B) Benefit expense, setting forth the aggregate

9 amount spent for the following:

10 (i) Direct paid claims.

11 (ii) Subcapitation payments.

12 (iii) Other claim payments.

13 (iv) Direct reserves.

14 (v) Gross recoveries.

15 (vi) Expenses for activities that improve health

16 care quality as allowed by the Department.

17 (2) The medical loss ratio shall be calculated consistent

18 with federal law and regulation following a claims runout

19 period determined by the Department.

20 (g-10)(1) "Liability effective date" means the date on

21 which an MCO becomes responsible for payment for medically

22 necessary and covered services rendered by a provider to one

23 of its enrollees in accordance with the contract terms between

24 the MCO and the provider. The liability effective date shall

25 be the later of:

26 (A) The execution date of a network participation

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1 contract agreement.

2 (B) The date the provider or its representative

3 submits to the MCO the complete and accurate standardized

4 roster form for the provider in the format approved by the

5 Department.

6 (C) The provider effective date contained within the

7 Department's provider enrollment subsystem within the

8 Illinois Medicaid Program Advanced Cloud Technology

9 (IMPACT) System.

10 (2) The standardized roster form may be submitted to the

11 MCO at the same time that the provider submits an enrollment

12 application to the Department through IMPACT.

13 (3) By October 1, 2019, the Department shall require all

14 MCOs to update their provider directory with information for

15 new practitioners of existing contracted providers within 30

16 days of receipt of a complete and accurate standardized roster

17 template in the format approved by the Department provided

18 that the provider is effective in the Department's provider

19 enrollment subsystem within the IMPACT system. Such provider

20 directory shall be readily accessible for purposes of

21 selecting an approved health care provider and comply with all

22 other federal and State requirements.

23 (g-11) The Department shall work with relevant

24 stakeholders on the development of operational guidelines to

25 enhance and improve operational performance of Illinois'

26 Medicaid managed care program, including, but not limited to,

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1 improving provider billing practices, reducing claim

2 rejections and inappropriate payment denials, and

3 standardizing processes, procedures, definitions, and response

4 timelines, with the goal of reducing provider and MCO

5 administrative burdens and conflict. The Department shall

6 include a report on the progress of these program improvements

7 and other topics in its Fiscal Year 2020 annual report to the

8 General Assembly.

9 (g-12) Notwithstanding any other provision of law, if the

10 Department or an MCO requires submission of a claim for

11 payment in a non-electronic format, a provider shall always be

12 afforded a period of no less than 90 business days, as a

13 correction period, following any notification of rejection by

14 either the Department or the MCO to correct errors or

15 omissions in the original submission.

16 Under no circumstances, either by an MCO or under the

17 State's fee-for-service system, shall a provider be denied

18 payment for failure to comply with any timely submission

19 requirements under this Code or under any existing contract,

20 unless the non-electronic format claim submission occurs after

21 the initial 180 days following the latest date of service on

22 the claim, or after the 90 business days correction period

23 following notification to the provider of rejection or denial

24 of payment.

25 (h) The Department shall not expand mandatory MCO

26 enrollment into new counties beyond those counties already

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1 designated by the Department as of June 1, 2014 for the

2 individuals whose eligibility for medical assistance is not

3 the seniors or people with disabilities population until the

4 Department provides an opportunity for accountable care

5 entities and MCOs to participate in such newly designated

6 counties.

7 (i) The requirements of this Section apply to contracts

8 with accountable care entities and MCOs entered into, amended,

9 or renewed after June 16, 2014 (the effective date of Public

10 Act 98-651).

11 (j) Health care information released to managed care

12 organizations. A health care provider shall release to a

13 Medicaid managed care organization, upon request, and subject

14 to the Health Insurance Portability and Accountability Act of

15 1996 and any other law applicable to the release of health

16 information, the health care information of the MCO's

17 enrollee, if the enrollee has completed and signed a general

18 release form that grants to the health care provider

19 permission to release the recipient's health care information

20 to the recipient's insurance carrier.

21 (k) The Department of Healthcare and Family Services,

22 managed care organizations, a statewide organization

23 representing hospitals, and a statewide organization

24 representing safety-net hospitals shall explore ways to

25 support billing departments in safety-net hospitals.

26 (l) The requirements of this Section added by this

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1 amendatory Act of the 102nd General Assembly shall apply to

2 services provided on or after the first day of the month that

3 begins 60 days after the effective date of this amendatory Act

4 of the 102nd General Assembly.

5 (Source: P.A. 100-201, eff. 8-18-17; 100-580, eff. 3-12-18;

6 100-587, eff. 6-4-18; 101-209, eff. 8-5-19.)

7 Article 155.

8 Section 155-5. The Illinois Public Aid Code is amended by

9 adding Section 5-30.17 as follows:

10 (305 ILCS 5/5-30.17 new)

11 Sec. 5-30.17. Medicaid Managed Care Oversight Commission.

12 (a) The Medicaid Managed Care Oversight Commission is

13 created within the Department of Healthcare and Family

14 Services to evaluate the effectiveness of Illinois' managed

15 care program.

16 (b) The Commission shall consist of the following members:

17 (1) One member of the Senate, appointed by the Senate

18 President, who shall serve as co-chair.

19 (2) One member of the House of Representatives,

20 appointed by the Speaker of the House of Representatives,

21 who shall serve as co-chair.

22 (3) One member of the House of Representatives,

23 appointed by the Minority Leader of the House of

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1 Representatives.

2 (4) One member of the Senate, appointed by the Senate

3 Minority Leader.

4 (5) One member representing the Department of

5 Healthcare and Family Services, appointed by the Governor.

6 (6) One member representing the Department of Public

7 Health, appointed by the Governor.

8 (7) One member representing the Department of Human

9 Services, appointed by the Governor.

10 (8) One member representing the Department of Children

11 and Family Services, appointed by the Governor.

12 (9) One member of a statewide association representing

13 Medicaid managed care plans, appointed by the Governor.

14 (10) One member of a statewide association

15 representing a majority of hospitals, appointed by the

16 Governor.

17 (11) Two academic experts on Medicaid managed care

18 programs, appointed by the Governor.

19 (12) One member of a statewide association

20 representing primary care providers, appointed by the

21 Governor.

22 (13) One member of a statewide association

23 representing behavioral health providers, appointed by the

24 Governor.

25 (14) Members representing Federally Qualified Health

26 Centers, a long-term care association, a dental

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1 association, pharmacies, pharmacists, a developmental

2 disability association, a Medicaid consumer advocate, a

3 Medicaid consumer, an association representing physicians,

4 a behavioral health association, and an association

5 representing pediatricians, appointed by the Governor.

6 (15) A member of a statewide association representing

7 only safety-net hospitals, appointed by the Governor.

8 (c) The Director of Healthcare and Family Services and

9 chief of staff, or their designees, shall serve as the

10 Commission's executive administrators in providing

11 administrative support, research support, and other

12 administrative tasks requested by the Commission's co-chairs.

13 Any expenses, including, but not limited to, travel and

14 housing, shall be paid for by the Department's existing

15 budget.

16 (d) The members of the Commission shall receive no

17 compensation for their services as members of the Commission.

18 (e) The Commission shall meet quarterly beginning as soon

19 as is practicable after the effective date of this amendatory

20 Act of the 102nd General Assembly.

21 (f) The Commission shall:

22 (1) review data on health outcomes of Medicaid managed

23 care members;

24 (2) review current care coordination and case

25 management efforts and make recommendations on expanding

26 care coordination to additional populations with a focus

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1 on the social determinants of health;

2 (3) review and assess the appropriateness of metrics

3 used in the Pay-for-Performance programs;

4 (4) review the Department's prior authorization and

5 utilization management requirements and recommend

6 adaptations for the Medicaid population;

7 (5) review managed care performance in meeting

8 diversity contracting goals and the use of funds dedicated

9 to meeting such goals, including, but not limited to,

10 contracting requirements set forth in the Business

11 Enterprise for Minorities, Women, and Persons with

12 Disabilities Act; recommend strategies to increase

13 compliance with diversity contracting goals in

14 collaboration with the Chief Procurement Officer for

15 General Services and the Business Enterprise Council for

16 Minorities, Women, and Persons with Disabilities; and

17 recoup any misappropriated funds for diversity

18 contracting;

19 (6) review data on the effectiveness of processing to

20 medical providers;

21 (7) review member access to health care services in

22 the Medicaid Program, including specialty care services;

23 (8) review value-based and other alternative payment

24 methodologies to make recommendations to enhance program

25 efficiency and improve health outcomes;

26 (9) review the compliance of all managed care entities

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1 in State contracts and recommend reasonable financial

2 penalties for any noncompliance;

3 (10) produce an annual report detailing the

4 Commission's findings based upon its review of research

5 conducted under this Section, including specific

6 recommendations, if any, and any other information the

7 Commission may deem proper in furtherance of its duties

8 under this Section;

9 (11) review provider availability and make

10 recommendations to increase providers where needed,

11 including reviewing the regulatory environment and making

12 recommendations for reforms;

13 (12) review capacity for culturally competent

14 services, including translation services among providers;

15 and

16 (13) review and recommend changes to the safety-net

17 hospital definition to create different classifications of

18 safety-net hospitals.

19 (f-5) The Department shall make available upon request the

20 analytics of Medicaid managed care clearinghouse data

21 regarding processing.

22 (g) Beginning January 1, 2022, and for each year

23 thereafter, the Commission shall submit a report of its

24 findings and recommendations to the General Assembly. The

25 report to the General Assembly shall be filed with the Clerk of

26 the House of Representatives and the Secretary of the Senate

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1 in electronic form only, in the manner that the Clerk and the

2 Secretary shall direct.

3 Article 160.

4 Section 160-5. The State Finance Act is amended by adding

5 Sections 5.935 and 6z-124 as follows:

6 (30 ILCS 105/5.935 new)

7 Sec. 5.935. The Managed Care Oversight Fund.

8 (30 ILCS 105/6z-124 new)

9 Sec. 6z-124. Managed Care Oversight Fund. The Managed Care

10 Oversight Fund is created as a special fund in the State

11 treasury. Subject to appropriation, available annual moneys in

12 the Fund shall be used by the Department of Healthcare and

13 Family Services to support contracting with women and

14 minority-owned businesses as part of the Department's Business

15 Enterprise Program requirements. The Department shall

16 prioritize contracts for care coordination services, workforce

17 development, and other services that support the Department's

18 mission to promote health equity. Funds may not be used for any

19 administrative costs of the Department.

20 Article 170.

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1 Section 170-5. The Illinois Public Aid Code is amended by

2 adding Section 5-30.16 as follows:

3 (305 ILCS 5/5-30.16 new)

4 Sec. 5-30.16. Medicaid Business Opportunity Commission.

5 (a) The Medicaid Business Opportunity Commission is

6 created within the Department of Healthcare and Family

7 Services to develop a program to support and grow minority,

8 women, and persons with disability owned businesses.

9 (b) The Commission shall consist of the following members:

10 (1) Two members appointed by the Illinois Legislative

11 Black Caucus.

12 (2) Two members appointed by the Illinois Legislative

13 Latino Caucus.

14 (3) Two members appointed by the Conference of Women

15 Legislators of the Illinois General Assembly.

16 (4) Two members representing a statewide Medicaid

17 health plan association, appointed by the Governor.

18 (5) One member representing the Department of

19 Healthcare and Family Services, appointed by the Governor.

20 (6) Three members representing businesses currently

21 registered with the Business Enterprise Program, appointed

22 by the Governor.

23 (7) One member representing the disability community,

24 appointed by the Governor.

25 (8) One member representing the Business Enterprise

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1 Council, appointed by the Governor.

2 (c) The Director of Healthcare and Family Services and

3 chief of staff, or their designees, shall serve as the

4 Commission's executive administrators in providing

5 administrative support, research support, and other

6 administrative tasks requested by the Commission's co-chairs.

7 Any expenses, including, but not limited to, travel and

8 housing, shall be paid for by the Department's existing

9 budget.

10 (d) The members of the Commission shall receive no

11 compensation for their services as members of the Commission.

12 (e) The members of the Commission shall designate

13 co-chairs of the Commission to lead their efforts at the first

14 meeting of the Commission.

15 (f) The Commission shall meet at least monthly beginning

16 as soon as is practicable after the effective date of this

17 amendatory Act of the 102nd General Assembly.

18 (g) The Commission shall:

19 (1) Develop a recommendation on a Medicaid Business

20 Opportunity Program for Minority, Women, and Persons with

21 Disability Owned business contracting requirements to be

22 included in the contracts between the Department of

23 Healthcare and Family Services and the Managed Care

24 entities for the provision of Medicaid Services.

25 (2) Make recommendations on the process by which

26 vendors or providers would be certified as eligible to be

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1 included in the program and appropriate eligibility

2 standards relative to the healthcare industry.

3 (3) Make a recommendation on whether to include not

4 for profit organizations, diversity councils, or diversity

5 chambers as eligible for certification.

6 (4) Make a recommendation on whether diverse staff

7 shall be considered within the goals set for managed care

8 entities.

9 (5) Make a recommendation on whether a new platform

10 for certification is necessary to administer this program

11 or if the existing platform for the Business Enterprise

12 Program is capable of including recommended changes coming

13 from this Commission.

14 (6) Make a recommendation on the ongoing activity of

15 the Commission including structure, frequency of meetings,

16 and agendas to ensure ongoing oversight of the program by

17 the Commission.

18 (h) The Commission shall provide recommendations to the

19 Department and the General assembly by April 15, 2021 in order

20 to ensure prompt implementation of the Medicaid Business

21 Opportunity Program.

22 (i) Beginning January 1, 2022, and for each year

23 thereafter, the Commission shall submit a report of its

24 findings and recommendations to the General Assembly. The

25 report to the General Assembly shall be filed with the Clerk of

26 the House of Representatives and the Secretary of the Senate

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1 in electronic form only, in the manner that the Clerk and the

2 Secretary shall direct.

3 Article 172.

4 Section 172-5. The Illinois Public Aid Code is amended by

5 changing Section 14-13 as follows:

6 (305 ILCS 5/14-13)

7 Sec. 14-13. Reimbursement for inpatient stays extended

8 beyond medical necessity.

9 (a) By October 1, 2019, the Department shall by rule

10 implement a methodology effective for dates of service July 1,

11 2019 and later to reimburse hospitals for inpatient stays

12 extended beyond medical necessity due to the inability of the

13 Department or the managed care organization in which a

14 recipient is enrolled or the hospital discharge planner to

15 find an appropriate placement after discharge from the

16 hospital. The Department shall evaluate the effectiveness of

17 the current reimbursement rate for inpatient hospital stays

18 beyond medical necessity.

19 (b) The methodology shall provide reasonable compensation

20 for the services provided attributable to the days of the

21 extended stay for which the prevailing rate methodology

22 provides no reimbursement. The Department may use a day

23 outlier program to satisfy this requirement. The reimbursement

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1 rate shall be set at a level so as not to act as an incentive

2 to avoid transfer to the appropriate level of care needed or

3 placement, after discharge.

4 (c) The Department shall require managed care

5 organizations to adopt this methodology or an alternative

6 methodology that pays at least as much as the Department's

7 adopted methodology unless otherwise mutually agreed upon

8 contractual language is developed by the provider and the

9 managed care organization for a risk-based or innovative

10 payment methodology.

11 (d) Days beyond medical necessity shall not be eligible

12 for per diem add-on payments under the Medicaid High Volume

13 Adjustment (MHVA) or the Medicaid Percentage Adjustment (MPA)

14 programs.

15 (e) For services covered by the fee-for-service program,

16 reimbursement under this Section shall only be made for days

17 beyond medical necessity that occur after the hospital has

18 notified the Department of the need for post-discharge

19 placement. For services covered by a managed care

20 organization, hospitals shall notify the appropriate managed

21 care organization of an admission within 24 hours of

22 admission. For every 24-hour period beyond the initial 24

23 hours after admission that the hospital fails to notify the

24 managed care organization of the admission, reimbursement

25 under this subsection shall be reduced by one day.

26 (Source: P.A. 101-209, eff. 8-5-19.)

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1 Title IX. Maternal and Infant Mortality

2 Article 175.

3 Section 175-5. The Illinois Public Aid Code is amended by

4 adding Section 5-18.5 as follows:

5 (305 ILCS 5/5-18.5 new)

6 Sec. 5-18.5. Perinatal doula and evidence-based home

7 visiting services.

8 (a) As used in this Section:

9 "Home visiting" means a voluntary, evidence-based strategy

10 used to support pregnant people, infants, and young children

11 and their caregivers to promote infant, child, and maternal

12 health, to foster educational development and school

13 readiness, and to help prevent child abuse and neglect. Home

14 visitors are trained professionals whose visits and activities

15 focus on promoting strong parent-child attachment to foster

16 healthy child development.

17 "Perinatal doula" means a trained provider who provides

18 regular, voluntary physical, emotional, and educational

19 support, but not medical or midwife care, to pregnant and

20 birthing persons before, during, and after childbirth,

21 otherwise known as the perinatal period.

22 "Perinatal doula training" means any doula training that

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1 focuses on providing support throughout the prenatal, labor

2 and delivery, or postpartum period, and reflects the type of

3 doula care that the doula seeks to provide.

4 (b) Notwithstanding any other provision of this Article,

5 perinatal doula services and evidence-based home visiting

6 services shall be covered under the medical assistance

7 program, subject to appropriation, for persons who are

8 otherwise eligible for medical assistance under this Article.

9 Perinatal doula services include regular visits beginning in

10 the prenatal period and continuing into the postnatal period,

11 inclusive of continuous support during labor and delivery,

12 that support healthy pregnancies and positive birth outcomes.

13 Perinatal doula services may be embedded in an existing

14 program, such as evidence-based home visiting. Perinatal doula

15 services provided during the prenatal period may be provided

16 weekly, services provided during the labor and delivery period

17 may be provided for the entire duration of labor and the time

18 immediately following birth, and services provided during the

19 postpartum period may be provided up to 12 months postpartum.

20 (c) The Department of Healthcare and Family Services shall

21 adopt rules to administer this Section. In this rulemaking,

22 the Department shall consider the expertise of and consult

23 with doula program experts, doula training providers,

24 practicing doulas, and home visiting experts, along with State

25 agencies implementing perinatal doula services and relevant

26 bodies under the Illinois Early Learning Council. This body of

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1 experts shall inform the Department on the credentials

2 necessary for perinatal doula and home visiting services to be

3 eligible for Medicaid reimbursement and the rate of

4 reimbursement for home visiting and perinatal doula services

5 in the prenatal, labor and delivery, and postpartum periods.

6 Every 2 years, the Department shall assess the rates of

7 reimbursement for perinatal doula and home visiting services

8 and adjust rates accordingly.

9 (d) The Department shall seek such State plan amendments

10 or waivers as may be necessary to implement this Section and

11 shall secure federal financial participation for expenditures

12 made by the Department in accordance with this Section.

13 Title X. Medicaid Managed Care Reform

14 Article 185.

15 Section 185-1. Short title. This Article may be cited as

16 the Medicaid Technical Assistance Act. References in this

17 Article to "this Act" mean this Article.

18 Section 185-5. Definitions. As used in this Act:

19 "Behavioral health providers" means mental health and

20 substance use disorder providers.

21 "Department" means the Department of Healthcare and Family

22 Services.

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1 "Health care providers" means organizations who provide

2 physical, mental, substance use disorder, or social

3 determinant of health services.

4 "Network adequacy" means a Medicaid beneficiaries' ability

5 to access all necessary provider types within time and

6 distance standards as defined in the Managed Care Organization

7 model contract.

8 "Service deserts" means geographic areas of the State with

9 no or limited Medicaid providers that accept Medicaid.

10 "Social determinants of health" means any conditions that

11 impact an individual's health, including, but not limited to,

12 access to healthy food, safety, education, and housing

13 stability.

14 "Stakeholders" means, but are not limited to, health care

15 providers, advocacy organizations, managed care organizations,

16 Medicaid beneficiaries, and State and city partners.

17 Section 185-10. Medicaid Technical Assistance Center. The

18 Department of Healthcare and Family Services shall establish a

19 Medicaid Technical Assistance Center. The Medicaid Technical

20 Assistance Center shall operate as a cross-system educational

21 resource to strengthen the business infrastructure of health

22 care provider organizations in Illinois to ultimately increase

23 the capacity, access, and quality of Illinois' Medicaid

24 managed care program, HealthChoice Illinois. The Medicaid

25 Technical Assistance Center shall be established within the

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1 Department's Office of Medicaid Innovation.

2 Section 185-15. Collaboration. The Medicaid Technical

3 Assistance Center shall collaborate with public and private

4 partners throughout the State to identify, establish, and

5 maintain best practices necessary for health providers to

6 ensure their capacity to participate in HealthChoice Illinois.

7 The Medicaid Technical Assistance Center shall administer the

8 following:

9 (1) Trainings: The Medicaid Technical Assistance

10 Center shall create and administer ongoing trainings for

11 health care providers. Trainings may be subcontracted. The

12 Medicaid Technical Assistance Center shall provide

13 in-person and web-based trainings. In-person training

14 shall be conducted throughout the State. All trainings

15 must be free of charge. The Medicaid Technical Assistance

16 Center shall administer post-training surveys and

17 incorporate feedback. Training content and delivery must

18 be reflective of Illinois providers' varying levels of

19 readiness, resources, and client populations.

20 (2) Web-based resources: The Medicaid Technical

21 Assistance Center shall maintain an independent, easy to

22 navigate, and up-to-date website that includes, but is not

23 limited to: recorded training archives, a training

24 calendar, provider resources and tools, up-to-date

25 explanations of Department and managed care organization

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1 guidance, a running database of frequently asked questions

2 and contact information for key staff members of the

3 Department, managed care organizations, and the Medicaid

4 Technical Assistance Center.

5 (3) Learning collaboratives: The Medicaid Technical

6 Assistance Center shall host regional learning

7 collaboratives that will supplement the Medicaid Technical

8 Assistance Center training curriculum to bring together

9 groups of stakeholders to share issues, best practices,

10 and escalate issues. Leadership of the Department and

11 managed care organizations shall attend learning

12 collaboratives on a quarterly basis.

13 (4) Network adequacy reports: The Medicaid Technical

14 Assistance Center shall publicly release a report on

15 Medicaid provider network adequacy within the first 3

16 years of implementation and annually thereafter. The

17 reports shall identify provider service deserts and health

18 care disparities by race and ethnicity.

19 Section 185-20. Federal financial participation. The

20 Department of Healthcare and Family Services, to the extent

21 allowable under federal law, shall maximize federal financial

22 participation for any moneys appropriated to the Department

23 for the Medicaid Technical Assistance Center. Any federal

24 financial participation funds obtained in accordance with this

25 Section shall be used for the further development and

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1 expansion of the Medicaid Technical Assistance Center. All

2 federal financial participation funds obtained under this

3 subsection shall be deposited into the Medicaid Technical

4 Assistance Center Fund created under Section 185-25.

5 Section 185-25. Medicaid Technical Assistance Center Fund.

6 The Medicaid Technical Assistance Center Fund is created as a

7 special fund in the State treasury. The Fund shall consist of

8 any moneys appropriated to the Department of Healthcare and

9 Family Services for the purposes of this Act and any federal

10 financial participation funds obtained as provided under

11 Section 20. Moneys in the Fund shall be used for carrying out

12 the purposes of this Act and for no other purpose. All interest

13 earned on the moneys in the Fund shall be deposited into the

14 Fund.

15 Section 185-90. The State Finance Act is amended by adding

16 Section 5.936 as follows:

17 (30 ILCS 105/5.936 new)

18 Sec. 5.936. The Medicaid Technical Assistance Center Fund.

19 Title XI. Miscellaneous

20 Article 999.

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1 Section 999-99. Effective date. This Act takes effect upon

2 becoming law.".