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90_HB3144
305 ILCS 5/5-19 from Ch. 23, par. 5-19
Amends the Illinois Public Aid Code by making a stylistic
change to the Section concerning the Healthy Kids Program.
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1 AN ACT to amend the Illinois Public Aid Code by changing
2 Section 5-19.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Public Aid Code is amended by
6 changing Section 5-19 as follows:
7 (305 ILCS 5/5-19) (from Ch. 23, par. 5-19)
8 Sec. 5-19. Healthy Kids Program.
9 (a) Any child under the age of 21 eligible to receive
10 Medical Assistance from the Illinois Department under Article
11 V of this Code shall be eligible for Early and Periodic
12 Screening, Diagnosis and Treatment services provided by the
13 Healthy Kids Program of the Illinois Department under the
14 Social Security Act, 42 U.S.C. 1396d(r).
15 (b) Enrollment of Children in Medicaid. The Illinois
16 Department shall provide for receipt and initial processing
17 of applications for Medical Assistance for all pregnant women
18 and children under the age of 21 at locations in addition to
19 those used for processing applications for cash assistance,
20 including disproportionate share hospitals, federally
21 qualified health centers and other sites as selected by the
22 Illinois Department.
23 (c) Healthy Kids Examinations. The Illinois Department
24 shall consider any examination of a child eligible for the
25 Healthy Kids services provided by a medical provider meeting
26 the requirements and complying with the rules and regulations
27 of the Illinois Department to be reimbursed as a Healthy Kids
28 examination.
29 (d) Medical Screening Examinations.
30 (1) The Illinois Department shall insure Medicaid
31 coverage for periodic health, vision, hearing, and dental
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1 screenings for children eligible for Healthy Kids
2 services scheduled from a child's birth up until the
3 child turns 21 years. The Illinois Department shall pay
4 for vision, hearing, dental and health screening
5 examinations for any child eligible for Healthy Kids
6 services by qualified providers at intervals established
7 by Department rules.
8 (2) The Illinois Department shall pay for an
9 interperiodic health, vision, hearing, or dental
10 screening examination for any child eligible for Healthy
11 Kids services whenever an examination is:
12 (A) requested by a child's parent, guardian,
13 or custodian, or is determined to be necessary or
14 appropriate by social services, developmental,
15 health, or educational personnel; or
16 (B) necessary for enrollment in school; or
17 (C) necessary for enrollment in a licensed day
18 care program, including Head Start; or
19 (D) necessary for placement in a licensed
20 child welfare facility, including a foster home,
21 group home or child care institution; or
22 (E) necessary for attendance at a camping
23 program; or
24 (F) necessary for participation in an
25 organized athletic program; or
26 (G) necessary for enrollment in an early
27 childhood education program recognized by the
28 Illinois State Board of Education; or
29 (H) necessary for participation in a Women,
30 Infant, and Children (WIC) program; or
31 (I) deemed appropriate by the Illinois
32 Department.
33 (e) Minimum Screening Protocols For Periodic Health
34 Screening Examinations. Health Screening Examinations must
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1 include the following services:
2 (1) Comprehensive Health and Development Assessment
3 including:
4 (A) Development/Mental Health/Psychosocial
5 Assessment; and
6 (B) Assessment of nutritional status including
7 tests for iron deficiency and anemia for children at
8 the following ages: 9 months, 2 years, 8 years, and
9 18 years;
10 (2) Comprehensive unclothed physical exam;
11 (3) Appropriate immunizations at a minimum, as
12 required by the Secretary of the United States U.S.
13 Department of Health and Human Services under 42 U.S.C.
14 1396d(r).
15 (4) Appropriate laboratory tests including blood
16 lead levels appropriate for age and risk factors.
17 (A) Anemia test.
18 (B) Sickle cell test.
19 (C) Tuberculin test at 12 months of age and
20 every 1-2 years thereafter unless the treating
21 health care professional determines that testing is
22 medically contraindicated.
23 (D) Other -- The Illinois Department shall
24 insure that testing for HIV, drug exposure, and
25 sexually transmitted diseases is provided for as
26 clinically indicated.
27 (5) Health Education. The Illinois Department
28 shall require providers to provide anticipatory guidance
29 as recommended by the American Academy of Pediatrics.
30 (6) Vision Screening. The Illinois Department
31 shall require providers to provide vision screenings
32 consistent with those set forth in the Department of
33 Public Health's Administrative Rules.
34 (7) Hearing Screening. The Illinois Department
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1 shall require providers to provide hearing screenings
2 consistent with those set forth in the Department of
3 Public Health's Administrative Rules.
4 (8) Dental Screening. The Illinois Department
5 shall require providers to provide dental screenings
6 consistent with those set forth in the Department of
7 Public Health's Administrative Rules.
8 (f) Covered Medical Services. The Illinois Department
9 shall provide coverage for all necessary health care,
10 diagnostic services, treatment and other measures to correct
11 or ameliorate defects, physical and mental illnesses, and
12 conditions whether discovered by the screening services or
13 not for all children eligible for Medical Assistance under
14 Article V of this Code.
15 (g) Notice of Healthy Kids Services.
16 (1) The Illinois Department shall inform any child
17 eligible for Healthy Kids services and the child's family
18 about the benefits provided under the Healthy Kids
19 Program, including, but not limited to, the following:
20 what services are available under Healthy Kids, including
21 discussion of the periodicity schedules and immunization
22 schedules, that services are provided at no cost to
23 eligible children, the benefits of preventive health
24 care, where the services are available, how to obtain
25 them, and that necessary transportation and scheduling
26 assistance is available.
27 (2) The Illinois Department shall widely
28 disseminate information regarding the availability of the
29 Healthy Kids Program throughout the State by outreach
30 activities which shall include, but not be limited to,
31 (i) the development of cooperation agreements with local
32 school districts, public health agencies, clinics,
33 hospitals and other health care providers, including
34 developmental disability and mental health providers, and
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1 with charities, to notify the constituents of each of the
2 Program and assist individuals, as feasible, with
3 applying for the Program, (ii) using the media for public
4 service announcements and advertisements of the Program,
5 and (iii) developing posters advertising the Program for
6 display in hospital and clinic waiting rooms.
7 (3) The Illinois Department shall utilize accepted
8 methods for informing persons who are illiterate, blind,
9 deaf, or cannot understand the English language,
10 including but not limited to public services
11 announcements and advertisements in the foreign language
12 media of radio, television and newspapers.
13 (4) The Illinois Department shall provide notice of
14 the Healthy Kids Program to every child eligible for
15 Healthy Kids services and his or her family at the
16 following times:
17 (A) orally by the intake worker and in writing
18 at the time of application for Medical Assistance;
19 (B) at the time the applicant is informed that
20 he or she is eligible for Medical Assistance
21 benefits; and
22 (C) at least 20 days before the date of any
23 periodic health, vision, hearing, and dental
24 examination for any child eligible for Healthy Kids
25 services. Notice given under this subparagraph (C)
26 must state that a screening examination is due under
27 the periodicity schedules and must advise the
28 eligible child and his or her family that the
29 Illinois Department will provide assistance in
30 scheduling an appointment and arranging medical
31 transportation.
32 (h) Data Collection. The Illinois Department shall
33 collect data in a usable form to track utilization of Healthy
34 Kids screening examinations by children eligible for Healthy
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1 Kids services, including but not limited to data showing
2 screening examinations and immunizations received, a summary
3 of follow-up treatment received by children eligible for
4 Healthy Kids services and the number of children receiving
5 dental, hearing and vision services.
6 (Source: P.A. 87-630; 87-895.)
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