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92_HB4580enr
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1 AN ACT in relation to budget implementation.
2 Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
4 Section 1. Short title. This Act may be cited as the
5 FY2003 Budget Implementation Act.
6 Section 5. Purpose. It is the purpose of this Act to
7 make certain changes in State programs that are necessary to
8 implement the State's FY2003 budget.
9 Section 10. The Illinois Administrative Procedure Act is
10 amended by changing Section 5-45 as follows:
11 (5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
12 Sec. 5-45. Emergency rulemaking.
13 (a) "Emergency" means the existence of any situation
14 that any agency finds reasonably constitutes a threat to the
15 public interest, safety, or welfare.
16 (b) If any agency finds that an emergency exists that
17 requires adoption of a rule upon fewer days than is required
18 by Section 5-40 and states in writing its reasons for that
19 finding, the agency may adopt an emergency rule without prior
20 notice or hearing upon filing a notice of emergency
21 rulemaking with the Secretary of State under Section 5-70.
22 The notice shall include the text of the emergency rule and
23 shall be published in the Illinois Register. Consent orders
24 or other court orders adopting settlements negotiated by an
25 agency may be adopted under this Section. Subject to
26 applicable constitutional or statutory provisions, an
27 emergency rule becomes effective immediately upon filing
28 under Section 5-65 or at a stated date less than 10 days
29 thereafter. The agency's finding and a statement of the
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1 specific reasons for the finding shall be filed with the
2 rule. The agency shall take reasonable and appropriate
3 measures to make emergency rules known to the persons who may
4 be affected by them.
5 (c) An emergency rule may be effective for a period of
6 not longer than 150 days, but the agency's authority to adopt
7 an identical rule under Section 5-40 is not precluded. No
8 emergency rule may be adopted more than once in any 24 month
9 period, except that this limitation on the number of
10 emergency rules that may be adopted in a 24 month period does
11 not apply to (i) emergency rules that make additions to and
12 deletions from the Drug Manual under Section 5-5.16 of the
13 Illinois Public Aid Code or the generic drug formulary under
14 Section 3.14 of the Illinois Food, Drug and Cosmetic Act or
15 (ii) emergency rules adopted by the Pollution Control Board
16 before July 1, 1997 to implement portions of the Livestock
17 Management Facilities Act. Two or more emergency rules
18 having substantially the same purpose and effect shall be
19 deemed to be a single rule for purposes of this Section.
20 (d) In order to provide for the expeditious and timely
21 implementation of the State's fiscal year 1999 budget,
22 emergency rules to implement any provision of Public Act
23 90-587 or 90-588 or any other budget initiative for fiscal
24 year 1999 may be adopted in accordance with this Section by
25 the agency charged with administering that provision or
26 initiative, except that the 24-month limitation on the
27 adoption of emergency rules and the provisions of Sections
28 5-115 and 5-125 do not apply to rules adopted under this
29 subsection (d). The adoption of emergency rules authorized
30 by this subsection (d) shall be deemed to be necessary for
31 the public interest, safety, and welfare.
32 (e) In order to provide for the expeditious and timely
33 implementation of the State's fiscal year 2000 budget,
34 emergency rules to implement any provision of this amendatory
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1 Act of the 91st General Assembly or any other budget
2 initiative for fiscal year 2000 may be adopted in accordance
3 with this Section by the agency charged with administering
4 that provision or initiative, except that the 24-month
5 limitation on the adoption of emergency rules and the
6 provisions of Sections 5-115 and 5-125 do not apply to rules
7 adopted under this subsection (e). The adoption of emergency
8 rules authorized by this subsection (e) shall be deemed to be
9 necessary for the public interest, safety, and welfare.
10 (f) In order to provide for the expeditious and timely
11 implementation of the State's fiscal year 2001 budget,
12 emergency rules to implement any provision of this amendatory
13 Act of the 91st General Assembly or any other budget
14 initiative for fiscal year 2001 may be adopted in accordance
15 with this Section by the agency charged with administering
16 that provision or initiative, except that the 24-month
17 limitation on the adoption of emergency rules and the
18 provisions of Sections 5-115 and 5-125 do not apply to rules
19 adopted under this subsection (f). The adoption of emergency
20 rules authorized by this subsection (f) shall be deemed to be
21 necessary for the public interest, safety, and welfare.
22 (g) In order to provide for the expeditious and timely
23 implementation of the State's fiscal year 2002 budget,
24 emergency rules to implement any provision of this amendatory
25 Act of the 92nd General Assembly or any other budget
26 initiative for fiscal year 2002 may be adopted in accordance
27 with this Section by the agency charged with administering
28 that provision or initiative, except that the 24-month
29 limitation on the adoption of emergency rules and the
30 provisions of Sections 5-115 and 5-125 do not apply to rules
31 adopted under this subsection (g). The adoption of emergency
32 rules authorized by this subsection (g) shall be deemed to be
33 necessary for the public interest, safety, and welfare.
34 (h) In order to provide for the expeditious and timely
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1 implementation of the State's fiscal year 2003 budget,
2 emergency rules to implement any provision of this amendatory
3 Act of the 92nd General Assembly or any other budget
4 initiative for fiscal year 2003 may be adopted in accordance
5 with this Section by the agency charged with administering
6 that provision or initiative, except that the 24-month
7 limitation on the adoption of emergency rules and the
8 provisions of Sections 5-115 and 5-125 do not apply to rules
9 adopted under this subsection (h). The adoption of emergency
10 rules authorized by this subsection (h) shall be deemed to be
11 necessary for the public interest, safety, and welfare.
12 (Source: P.A. 91-24, eff. 7-1-99; 91-357, eff. 7-29-99;
13 91-712, eff. 7-1-00; 92-10, eff. 6-11-01.)
14 Section 15. The Illinois Act on the Aging is amended by
15 changing Section 4.02 as follows:
16 (20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
17 Sec. 4.02. The Department shall establish a program of
18 services to prevent unnecessary institutionalization of
19 persons age 60 and older in need of long term care or who are
20 established as persons who suffer from Alzheimer's disease or
21 a related disorder under the Alzheimer's Disease Assistance
22 Act, thereby enabling them to remain in their own homes or in
23 other living arrangements. Such preventive services, which
24 may be coordinated with other programs for the aged and
25 monitored by area agencies on aging in cooperation with the
26 Department, may include, but are not limited to, any or all
27 of the following:
28 (a) home health services;
29 (b) home nursing services;
30 (c) homemaker services;
31 (d) chore and housekeeping services;
32 (e) day care services;
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1 (f) home-delivered meals;
2 (g) education in self-care;
3 (h) personal care services;
4 (i) adult day health services;
5 (j) habilitation services;
6 (k) respite care;
7 (l) other nonmedical social services that may
8 enable the person to become self-supporting; or
9 (m) clearinghouse for information provided by
10 senior citizen home owners who want to rent rooms to or
11 share living space with other senior citizens.
12 The Department shall establish eligibility standards for
13 such services taking into consideration the unique economic
14 and social needs of the target population for whom they are
15 to be provided. Such eligibility standards shall be based on
16 the recipient's ability to pay for services; provided,
17 however, that in determining the amount and nature of
18 services for which a person may qualify, consideration shall
19 not be given to the value of cash, property or other assets
20 held in the name of the person's spouse pursuant to a written
21 agreement dividing marital property into equal but separate
22 shares or pursuant to a transfer of the person's interest in
23 a home to his spouse, provided that the spouse's share of the
24 marital property is not made available to the person seeking
25 such services.
26 Beginning July 1, 2002, the Department shall require as a
27 condition of eligibility that all applicants and recipients
28 apply for medical assistance under Article V of the Illinois
29 Public Aid Code in accordance with rules promulgated by the
30 Department.
31 The Department shall, in conjunction with the Department
32 of Public Aid, seek appropriate amendments under Sections
33 1915 and 1924 of the Social Security Act. The purpose of the
34 amendments shall be to extend eligibility for home and
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1 community based services under Sections 1915 and 1924 of the
2 Social Security Act to persons who transfer to or for the
3 benefit of a spouse those amounts of income and resources
4 allowed under Section 1924 of the Social Security Act.
5 Subject to the approval of such amendments, the Department
6 shall extend the provisions of Section 5-4 of the Illinois
7 Public Aid Code to persons who, but for the provision of home
8 or community-based services, would require the level of care
9 provided in an institution, as is provided for in federal
10 law. Those persons no longer found to be eligible for
11 receiving noninstitutional services due to changes in the
12 eligibility criteria shall be given 60 days notice prior to
13 actual termination. Those persons receiving notice of
14 termination may contact the Department and request the
15 determination be appealed at any time during the 60 day
16 notice period. With the exception of the lengthened notice
17 and time frame for the appeal request, the appeal process
18 shall follow the normal procedure. In addition, each person
19 affected regardless of the circumstances for discontinued
20 eligibility shall be given notice and the opportunity to
21 purchase the necessary services through the Community Care
22 Program. If the individual does not elect to purchase
23 services, the Department shall advise the individual of
24 alternative services. The target population identified for
25 the purposes of this Section are persons age 60 and older
26 with an identified service need. Priority shall be given to
27 those who are at imminent risk of institutionalization. The
28 services shall be provided to eligible persons age 60 and
29 older to the extent that the cost of the services together
30 with the other personal maintenance expenses of the persons
31 are reasonably related to the standards established for care
32 in a group facility appropriate to the person's condition.
33 These non-institutional services, pilot projects or
34 experimental facilities may be provided as part of or in
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1 addition to those authorized by federal law or those funded
2 and administered by the Department of Human Services. The
3 Departments of Human Services, Public Aid, Public Health,
4 Veterans' Affairs, and Commerce and Community Affairs and
5 other appropriate agencies of State, federal and local
6 governments shall cooperate with the Department on Aging in
7 the establishment and development of the non-institutional
8 services. The Department shall require an annual audit from
9 all chore/housekeeping and homemaker vendors contracting with
10 the Department under this Section. The annual audit shall
11 assure that each audited vendor's procedures are in
12 compliance with Department's financial reporting guidelines
13 requiring a 27% administrative cost split and a 73% employee
14 wages and benefits cost split. The audit is a public record
15 under the Freedom of Information Act. The Department shall
16 execute, relative to the nursing home prescreening project,
17 written inter-agency agreements with the Department of Human
18 Services and the Department of Public Aid, to effect the
19 following: (1) intake procedures and common eligibility
20 criteria for those persons who are receiving
21 non-institutional services; and (2) the establishment and
22 development of non-institutional services in areas of the
23 State where they are not currently available or are
24 undeveloped. On and after July 1, 1996, all nursing home
25 prescreenings for individuals 60 years of age or older shall
26 be conducted by the Department.
27 The Department is authorized to establish a system of
28 recipient copayment for services provided under this Section,
29 such copayment to be based upon the recipient's ability to
30 pay but in no case to exceed the actual cost of the services
31 provided. Additionally, any portion of a person's income
32 which is equal to or less than the federal poverty standard
33 shall not be considered by the Department in determining the
34 copayment. The level of such copayment shall be adjusted
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1 whenever necessary to reflect any change in the officially
2 designated federal poverty standard.
3 The Department, or the Department's authorized
4 representative, shall recover the amount of moneys expended
5 for services provided to or in behalf of a person under this
6 Section by a claim against the person's estate or against the
7 estate of the person's surviving spouse, but no recovery may
8 be had until after the death of the surviving spouse, if any,
9 and then only at such time when there is no surviving child
10 who is under age 21, blind, or permanently and totally
11 disabled. This paragraph, however, shall not bar recovery,
12 at the death of the person, of moneys for services provided
13 to the person or in behalf of the person under this Section
14 to which the person was not entitled; provided that such
15 recovery shall not be enforced against any real estate while
16 it is occupied as a homestead by the surviving spouse or
17 other dependent, if no claims by other creditors have been
18 filed against the estate, or, if such claims have been filed,
19 they remain dormant for failure of prosecution or failure of
20 the claimant to compel administration of the estate for the
21 purpose of payment. This paragraph shall not bar recovery
22 from the estate of a spouse, under Sections 1915 and 1924 of
23 the Social Security Act and Section 5-4 of the Illinois
24 Public Aid Code, who precedes a person receiving services
25 under this Section in death. All moneys for services paid to
26 or in behalf of the person under this Section shall be
27 claimed for recovery from the deceased spouse's estate.
28 "Homestead", as used in this paragraph, means the dwelling
29 house and contiguous real estate occupied by a surviving
30 spouse or relative, as defined by the rules and regulations
31 of the Illinois Department of Public Aid, regardless of the
32 value of the property.
33 The Department shall develop procedures to enhance
34 availability of services on evenings, weekends, and on an
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1 emergency basis to meet the respite needs of caregivers.
2 Procedures shall be developed to permit the utilization of
3 services in successive blocks of 24 hours up to the monthly
4 maximum established by the Department. Workers providing
5 these services shall be appropriately trained.
6 Beginning on the effective date of this Amendatory Act of
7 1991, no person may perform chore/housekeeping and homemaker
8 services under a program authorized by this Section unless
9 that person has been issued a certificate of pre-service to
10 do so by his or her employing agency. Information gathered
11 to effect such certification shall include (i) the person's
12 name, (ii) the date the person was hired by his or her
13 current employer, and (iii) the training, including dates and
14 levels. Persons engaged in the program authorized by this
15 Section before the effective date of this amendatory Act of
16 1991 shall be issued a certificate of all pre- and in-service
17 training from his or her employer upon submitting the
18 necessary information. The employing agency shall be
19 required to retain records of all staff pre- and in-service
20 training, and shall provide such records to the Department
21 upon request and upon termination of the employer's contract
22 with the Department. In addition, the employing agency is
23 responsible for the issuance of certifications of in-service
24 training completed to their employees.
25 The Department is required to develop a system to ensure
26 that persons working as homemakers and chore housekeepers
27 receive increases in their wages when the federal minimum
28 wage is increased by requiring vendors to certify that they
29 are meeting the federal minimum wage statute for homemakers
30 and chore housekeepers. An employer that cannot ensure that
31 the minimum wage increase is being given to homemakers and
32 chore housekeepers shall be denied any increase in
33 reimbursement costs.
34 The Department on Aging and the Department of Human
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1 Services shall cooperate in the development and submission of
2 an annual report on programs and services provided under this
3 Section. Such joint report shall be filed with the Governor
4 and the General Assembly on or before September 30 each year.
5 The requirement for reporting to the General Assembly
6 shall be satisfied by filing copies of the report with the
7 Speaker, the Minority Leader and the Clerk of the House of
8 Representatives and the President, the Minority Leader and
9 the Secretary of the Senate and the Legislative Research
10 Unit, as required by Section 3.1 of the General Assembly
11 Organization Act and filing such additional copies with the
12 State Government Report Distribution Center for the General
13 Assembly as is required under paragraph (t) of Section 7 of
14 the State Library Act.
15 Those persons previously found eligible for receiving
16 non-institutional services whose services were discontinued
17 under the Emergency Budget Act of Fiscal Year 1992, and who
18 do not meet the eligibility standards in effect on or after
19 July 1, 1992, shall remain ineligible on and after July 1,
20 1992. Those persons previously not required to cost-share
21 and who were required to cost-share effective March 1, 1992,
22 shall continue to meet cost-share requirements on and after
23 July 1, 1992. Beginning July 1, 1992, all clients will be
24 required to meet eligibility, cost-share, and other
25 requirements and will have services discontinued or altered
26 when they fail to meet these requirements.
27 (Source: P.A. 91-303, eff. 1-1-00; 91-798, eff. 7-9-00.)
28 Section 20. The Mental Health and Developmental
29 Disabilities Administrative Act is amended by adding Section
30 18.4 as follows:
31 (20 ILCS 1705/18.4 new)
32 Sec. 18.4. Community Mental Health Medicaid Trust Fund;
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1 reimbursement.
2 (a) The Community Mental Health Medicaid Trust Fund is
3 hereby created in the State Treasury.
4 (b) Any funds paid to the State by the federal
5 government under Title XIX or Title XXI of the Social
6 Security Act for services delivered by community mental
7 health services providers, and any interest earned thereon,
8 shall be deposited directly into the Community Mental Health
9 Medicaid Trust Fund.
10 (c) The Department shall reimburse community mental
11 health services providers for Medicaid-reimbursed mental
12 health services provided to eligible individuals. Moneys in
13 the Community Mental Health Medicaid Trust Fund may be used
14 for that purpose.
15 (d) As used in this Section:
16 "Medicaid-reimbursed mental health services" means
17 services provided by a community mental health provider under
18 an agreement with the Department that is eligible for
19 reimbursement under the federal Title XIX program or Title
20 XXI program.
21 "Provider" means a community agency that is funded by the
22 Department to provide a Medicaid-reimbursed service.
23 "Services" means mental health services provided under
24 one of the following programs:
25 (1) Medicaid Clinic Option;
26 (2) Medicaid Rehabilitation Option;
27 (3) Targeted Case Management.
28 Section 25. The Illinois Health Finance Reform Act is
29 amended by changing Sections 2-1, 4-1, 4-2, and 4-4 as
30 follows:
31 (20 ILCS 2215/2-1) (from Ch. 111 1/2, par. 6502-1)
32 Sec. 2-1. Council abolished. Authorized. There is
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1 hereby created The Illinois Health Care Cost Containment
2 Council is abolished at the close of business on June 30,
3 2002. Its successor agency, for purposes of the Successor
4 Agency Act and Section 9b of the State Finance Act, is the
5 Illinois Department of Public Health. It shall consist of 13
6 members appointed by the Governor with the advice and consent
7 of the Senate as follows: 5 members to represent providers as
8 follows: 2 members to represent Illinois hospitals at least
9 one of which must represent a small rural hospital, 2 members
10 to represent physicians licensed to practice medicine in all
11 its branches, and 1 member to represent ambulatory surgical
12 treatment centers; 3 members to represent consumers; 2
13 members to represent insurance companies; and 3 members to
14 represent businesses.
15 The members of the Council shall be appointed for 3-year
16 terms.
17 No more than 7 members may be from the same political
18 party.
19 Members shall be appointed within 30 days after the
20 effective date of this Act. The additional members appointed
21 under the amendatory Act of the 91st General Assembly must be
22 appointed within 30 days after the effective date of this
23 amendatory Act of the 91st General Assembly. The members of
24 the Council shall receive reimbursement of their actual
25 expenses incurred in connection with their service; in
26 addition, each member shall receive compensation of $150 a
27 day for each day served at regular or special meetings of the
28 Council, except that such compensation shall not exceed
29 $20,000 in any one year for any member. The Council shall
30 elect a Chairman from among its members, and shall have the
31 power to organize and appoint such other officers as it may
32 deem necessary.
33 All appointments shall be made in writing and filed with
34 the Secretary of State as a public record.
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1 (Source: P.A. 91-756, eff. 6-2-00.)
2 (20 ILCS 2215/4-1) (from Ch. 111 1/2, par. 6504-1)
3 Sec. 4-1. Illinois Health Finance Data Collection. The
4 General Assembly finds that public sector and private sector
5 purchasers of health care need health care cost and
6 utilization data to enable them to make informed choices
7 among health care providers in the market place. The General
8 Assembly finds it necessary to create a mandated uniform
9 system in Illinois for the collection, analysis, and
10 distribution of health care cost and utilization data.
11 The purpose of this Article is to insure that data are
12 available to make valid comparisons among health care
13 providers of prices and utilization of services provided and
14 to support ongoing analysis of the health care delivery
15 system so that the Council can fulfill its mandate.
16 (Source: P.A. 91-756, eff. 6-2-00.)
17 (20 ILCS 2215/4-2) (from Ch. 111 1/2, par. 6504-2)
18 Sec. 4-2. Powers and duties.
19 (a) (Blank). The Illinois Health Care Cost Containment
20 Council may enter into any agreement with any corporation,
21 association or other entity it deems appropriate to undertake
22 the process described in this Article for the compilation and
23 analysis of data collected by the Council and to conduct or
24 contract for studies on health-related questions carried out
25 in pursuance of the purposes of this Article. The agreement
26 may provide for the corporation, association or entity to
27 prepare and distribute or make available data to health care
28 providers, health care subscribers, third-party payors,
29 government and the general public, in accordance with the
30 rules of confidentiality and review to be developed under
31 this Act.
32 (b) (Blank). The input data collected by and furnished
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1 to the Council or designated corporation, association or
2 entity pursuant to this Section shall not be a public record
3 under the Illinois Freedom of Information Act. It is the
4 intent of this Act and of the regulations written pursuant to
5 it to protect the confidentiality of individual patient
6 information and the proprietary information of commercial
7 insurance carriers and health care providers. Data specified
8 in subsections (e) and (e-5) shall be released on a hospital
9 specific and licensed ambulatory surgical treatment center
10 specific basis to facilitate comparisons among hospitals and
11 licensed ambulatory surgical treatment centers by purchasers.
12 (c) (Blank). The Council shall require the Departments
13 of Public Health and Public Aid and hospitals located in the
14 State to assist the Council in gathering and submitting the
15 following hospital-specific financial information, and the
16 Council is authorized to share this data with both
17 Departments to reduce the burden on hospitals by avoiding
18 duplicate data collection:
19 OPERATING REVENUES
20 (1) Net patient service revenue
21 (2) Other revenue
22 (3) Total operating revenue
23 OPERATING EXPENSES
24 (4) Bad debt expense
25 (5) Total operating expenses
26 NON-OPERATING GAINS/LOSSES
27 (6) Total non-operating gains
28 (7) Total non-operating losses
29 PATIENT CARE REVENUES
30 (8) Gross inpatient revenue
31 (9) Gross outpatient revenue
32 (10) Other Patient care revenue
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1 (11) Total patient revenue
2 (12) Total gross patient care revenue
3 (13) Medicare gross revenue
4 (14) Medicaid gross revenue
5 (15) Total other gross revenue
6 DEDUCTIONS FROM REVENUE
7 (16) Charity care
8 (17) Medicare allowance
9 (18) Medicaid allowance
10 (19) Other contractual allowances
11 (20) Other allowances
12 (21) Total Deductions
13 ASSETS
14 (22) Operating cash and short-term investments
15 (23) Estimated patient accounts receivable
16 (24) Other current assets
17 (25) Total current assets
18 (26) Total other assets
19 (27) Total Assets
20 LIABILITIES AND FUND BALANCES
21 (28) Total current liabilities
22 (29) Long Term Debt
23 (30) Other liabilities
24 (31) Total liabilities
25 (32) Total liabilities and fund balances
26 All financial data collected by the Council from publicly
27 available sources such as the HCFA is releasable by the
28 Council on a hospital specific basis when appropriate.
29 (d) Uniform Provider Utilization and Charge Information.
30 The Council shall require that:
31 (1) The Department of Public Health shall require
32 that hospitals licensed to operate in the State of
33 Illinois adopt a uniform system for submitting patient
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1 charges for payment from public and private payors
2 effective January 1, 1985. This system shall be based
3 upon adoption of the uniform hospital billing form
4 (UB-92) or its successor form developed by the National
5 Uniform Billing Committee.
6 (2) (Blank).
7 (3) The Department of Insurance shall require all
8 third-party payors, including but not limited to,
9 licensed insurers, medical and hospital service
10 corporations, health maintenance organizations, and
11 self-funded employee health plans, to accept the uniform
12 billing form, without attachment as submitted by
13 hospitals pursuant to paragraph (1) of subsection (d)
14 above, effective January 1, 1985; provided, however,
15 nothing shall prevent all such third party payors from
16 requesting additional information necessary to determine
17 eligibility for benefits or liability for reimbursement
18 for services provided.
19 (e) (Blank). The Council, in cooperation with the State
20 Departments of Public Aid, Insurance, and Public Health,
21 shall establish a system for the collection of the following
22 information from hospitals utilizing the raw data available
23 on the uniform billing forms. Such data shall include the
24 following elements and other elements contained on the
25 uniform billing form or its successor form determined as
26 necessary by the Council:
27 (1) Patient date of birth
28 (2) Patient sex
29 (3) Patient zip code
30 (4) Third-party coverage
31 (5) Date of admission
32 (6) Source of admission
33 (7) Type of admission
34 (8) Discharge date
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1 (9) Principal and up to 8 other diagnoses
2 (10) Principal procedure and date
3 (11) Patient status
4 (12) Other procedures and dates
5 (13) Total charges and components of those charges
6 (14) Attending and consulting physician identification
7 numbers
8 (15) Hospital identification number
9 (16) An alphanumeric number based on the information to
10 identify the payor
11 (17) Principal source of payment.
12 (e-5) The Council, in cooperation with the Department of
13 Public Aid, the Department of Insurance, and the Department
14 of Public Health, shall establish a system for the collection
15 of the following information for each outpatient surgery
16 performed at hospitals and licensed ambulatory surgical
17 treatment centers using the raw data available on outpatient
18 billing forms submitted by hospitals and licensed ambulatory
19 surgical treatment centers to payors. The data must include
20 the following elements, if available on the billing forms,
21 and other elements contained on the billing forms that the
22 Council determines are necessary:
23 (1) patient date of birth;
24 (2) patient sex;
25 (3) patient zip code;
26 (4) third-party coverage;
27 (5) date of admission;
28 (6) source of admission;
29 (7) type of admission;
30 (8) discharge date;
31 (9) principal diagnosis and up to 8 other
32 diagnoses;
33 (10) principal procedure and the date of the
34 procedure;
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1 (11) patient status;
2 (12) other procedures and the dates of those
3 procedures;
4 (13) attending and consulting physician
5 identification numbers;
6 (14) hospital or licensed ambulatory surgical
7 treatment center identification number;
8 (15) an alphanumeric number based on the
9 information needed to identify the payor; and
10 (16) principal source of payment.
11 (f) Extracts of the UB-92 transactions shall be prepared
12 by hospitals according to regulations promulgated by the
13 Council and submitted in electronic format to the Council or
14 the corporation, association or entity designated by the
15 Council.
16 For hospitals unable to submit extracts in electronic
17 format, the Council shall determine an alternate method for
18 submission of data. Such extract reporting systems shall be
19 in operation before January 1, 1987; however, the Council may
20 grant time extensions to individual hospital.
21 (f-5) Extracts of the billing forms shall be prepared by
22 licensed ambulatory surgical treatment centers according to
23 rules adopted by the Council and submitted to the Council or
24 a corporation, association, or entity designated by the
25 Council. Electronic submissions shall be encouraged. For
26 licensed ambulatory surgical treatment centers unable to
27 submit extracts in an electronic format the Council must
28 determine an alternate method for submission of data.
29 (g) Under no circumstances shall patient name and social
30 security number appear on the extracts.
31 (h) Hospitals and licensed ambulatory surgical treatment
32 centers shall be assigned a standard identification number by
33 the Council to be used in the submission of all data.
34 (i) The Council shall collect a 100% inpatient sample
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1 from hospitals annually. The Council shall require each
2 hospital in the State to submit the UB-92 data extracts
3 required in subsection (e) to the Council, except that
4 hospitals with fewer than 50 beds may be exempted by the
5 Council from the filing requirements if they prove to the
6 Council's satisfaction that the requirements would impose
7 undue economic hardship and if the Council determines that
8 the data submitted from these hospitals are not essential to
9 its data base and its concomitant health care cost comparison
10 efforts.
11 (i-5) The Council shall collect up to a 100% outpatient
12 sample annually from hospitals and licensed ambulatory
13 surgical treatment centers. The Council shall require each
14 hospital and licensed ambulatory surgical treatment center in
15 the State to submit the data extracts required under
16 subsection (e-5) to the Council, except that hospitals and
17 licensed ambulatory surgical treatment centers may be
18 exempted by the Council from the filing requirements if the
19 hospitals or licensed ambulatory surgical treatment centers
20 prove to the Council's satisfaction that the requirements
21 would impose undue economic hardship and if the Council
22 determines that the data submitted from those hospitals and
23 licensed ambulatory surgical treatment centers are not
24 essential to the Council's database and its concomitant
25 health care comparison efforts.
26 (i-10) The outpatient data shall be collected by the
27 Council on a phase-in and trial basis for a one-year period
28 beginning on January 1, 2001. The Council shall implement
29 outpatient data collection for reporting purposes beginning
30 on January 1, 2002.
31 (j) The information submitted to the Council pursuant to
32 subsections (e) and (e-5) shall be reported for each primary
33 payor category, including Medicare, Medicaid, other
34 government programs, private insurance, health maintenance
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1 organizations, self-insured, private pay patients, and
2 others. Preferred provider organization reimbursement shall
3 also be reported for each primary third party payor category.
4 (k) The Council shall require and the designated
5 corporation, association or entity, if applicable, shall
6 prepare quarterly basic reports in the aggregate on health
7 care cost and utilization trends in Illinois. The Council
8 shall provide these reports to the public, if requested.
9 These shall include, but not be limited to, comparative
10 information on average charges, total and ancillary charge
11 components, length of stay on diagnosis-specific and
12 procedure specific cases, and number of discharges, compiled
13 in aggregate by hospital and licensed ambulatory surgical
14 treatment center, by diagnosis, and by primary payor
15 category.
16 (l) The Council shall, from information submitted
17 pursuant to subsection (e), prepare an annual report in the
18 aggregate by hospital containing the following:
19 (1) the ratio of caesarean section deliveries to
20 total deliveries;
21 (2) the average length of stay for patients who
22 undergo caesarean sections;
23 (3) the average total charges for patients who have
24 normal deliveries without any significant complications;
25 (4) the average total charges for patients who
26 deliver by caesarean section.
27 The Council shall provide this report to the public, if
28 requested.
29 (l-5) (Blank).
30 (m) Prior to the release or dissemination of these
31 reports, the Council or the designated corporation shall
32 permit providers the opportunity to verify the accuracy of
33 any information pertaining to the provider. The providers
34 may submit to the Council any corrections or errors in the
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1 compilation of the data with any supporting evidence and
2 documents the providers may submit. The Council or
3 corporation shall correct data found to be in error and
4 include additional commentary as requested by the provider
5 for major deviations in the charges from the average charges.
6 For purposes of this subsection (m), "providers" includes
7 physicians licensed to practice medicine in all of its
8 branches.
9 (n) In addition to the reports indicated above, the
10 Council shall respond to requests by agencies of government
11 and organizations in the private sector for data products,
12 special studies and analysis of data collected pursuant to
13 this Section. Such reports shall be undertaken only by the
14 agreement of a majority of the members of the Council who
15 shall designate the form in which the information shall be
16 made available. The Council or the corporation, association
17 or entity in consultation with the Council shall also
18 determine a fee to be charged to the requesting agency or
19 private sector organization to cover the direct and indirect
20 costs for producing such a report, and shall permit affected
21 providers the rights to review the accuracy of the report
22 before it is released. Such reports shall not be subject to
23 The Freedom of Information Act.
24 (Source: P.A. 91-756, eff. 6-2-00.)
25 (20 ILCS 2215/4-4) (from Ch. 111 1/2, par. 6504-4)
26 Sec. 4-4. (a) Hospitals shall make available to
27 prospective patients information on the normal charge
28 incurred for any procedure or operation the prospective
29 patient is considering.
30 (b) The Department of Public Health Council shall
31 require hospitals to post in letters no more than one inch in
32 height the established charges for services, where
33 applicable, including but not limited to the hospital's
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1 private room charge, semi-private room charge, charge for a
2 room with 3 or more beds, intensive care room charges,
3 emergency room charge, operating room charge,
4 electrocardiogram charge, anesthesia charge, chest x-ray
5 charge, blood sugar charge, blood chemistry charge, tissue
6 exam charge, blood typing charge and Rh factor charge. The
7 definitions of each charge to be posted shall be determined
8 by the Department Council.
9 (Source: P.A. 90-655, eff. 7-30-98.)
10 (20 ILCS 2215/1-2 rep.)
11 (20 ILCS 2215/2-2 rep.)
12 (20 ILCS 2215/2-3 rep.)
13 (20 ILCS 2215/2-4 rep.)
14 (20 ILCS 2215/2-5 rep.)
15 (20 ILCS 2215/2-6 rep.)
16 (20 ILCS 2215/4-3 rep.)
17 (20 ILCS 2215/4-5 rep.)
18 (20 ILCS 2215/5-2 rep.)
19 Section 26. The Illinois Health Finance Reform Act is
20 amended by repealing Sections 1-2, 2-2, 2-3, 2-4, 2-5, 2-6,
21 4-3, 4-5, and 5-2.
22 Section 30. The Department of Public Health Powers and
23 Duties Law of the Civil Administrative Code of Illinois is
24 amended by adding Section 2310-57 as follows:
25 (20 ILCS 2310/2310-57 new)
26 Sec. 2310-57. Collecting information regarding hospital
27 discharges and surgery. The Department of Public Health
28 shall establish a system for the collection of data regarding
29 hospital discharges and inpatient and outpatient surgery
30 performed at hospitals and licensed ambulatory surgical
31 treatment centers.
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1 The Department may establish a system to provide data to
2 hospitals required for accreditation, including data required
3 by the Joint Commission on Accreditation of Healthcare
4 Organizations.
5 The Department may adopt any rules necessary to carry out
6 this function, including reasonable fees for providing
7 accreditation data. The Department may contract with a
8 vendor to collect any data required to be submitted to the
9 Department under this Section.
10 Section 35. The Illinois Emergency Management Agency Act
11 is amended by changing Section 5 as follows:
12 (20 ILCS 3305/5) (from Ch. 127, par. 1055)
13 Sec. 5. Illinois Emergency Management Agency.
14 (a) There is created within the executive branch of the
15 State Government an Illinois Emergency Management Agency and
16 a Director of the Illinois Emergency Management Agency,
17 herein called the "Director" who shall be the head thereof.
18 The Director shall be appointed by the Governor, with the
19 advice and consent of the Senate, and shall serve for a term
20 of 2 years beginning on the third Monday in January of the
21 odd-numbered year, and until a successor is appointed and has
22 qualified; except that the term of the first Director
23 appointed under this Act shall expire on the third Monday in
24 January, 1989. The Director shall not hold any other
25 remunerative public office. The Director shall receive an
26 annual salary as set by the Governor from time to time or the
27 amount set by the Compensation Review Board, whichever is
28 higher. If set by the Governor, the Director's annual salary
29 may not exceed 85% of the Governor's annual salary.
30 (b) The Illinois Emergency Management Agency shall
31 obtain, under the provisions of the Personnel Code,
32 technical, clerical, stenographic and other administrative
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1 personnel, and may make expenditures within the appropriation
2 therefor as may be necessary to carry out the purpose of this
3 Act. The agency created by this Act is intended to be a
4 successor to the agency created under the Illinois Emergency
5 Services and Disaster Agency Act of 1975 and the personnel,
6 equipment, records, and appropriations of that agency are
7 transferred to the successor agency as of the effective date
8 of this Act.
9 (c) The Director, subject to the direction and control
10 of the Governor, shall be the executive head of the Illinois
11 Emergency Management Agency and the State Emergency Response
12 Commission and shall be responsible under the direction of
13 the Governor, for carrying out the program for emergency
14 management of this State. The Director shall also maintain
15 liaison and cooperate with the emergency management
16 organizations of this State and other states and of the
17 federal government.
18 (d) The Illinois Emergency Management Agency shall take
19 an integral part in the development and revision of political
20 subdivision emergency operations plans prepared under
21 paragraph (f) of Section 10. To this end it shall employ or
22 otherwise secure the services of professional and technical
23 personnel capable of providing expert assistance to the
24 emergency services and disaster agencies. These personnel
25 shall consult with emergency services and disaster agencies
26 on a regular basis and shall make field examinations of the
27 areas, circumstances, and conditions that particular
28 political subdivision emergency operations plans are intended
29 to apply.
30 (e) The Illinois Emergency Management Agency and
31 political subdivisions shall be encouraged to form an
32 emergency management advisory committee composed of private
33 and public personnel representing the emergency management
34 phases of mitigation, preparedness, response, and recovery.
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1 The Local Emergency Planning Committee, as created under the
2 Illinois Emergency Planning and Community Right to Know Act,
3 shall serve as an advisory committee to the emergency
4 services and disaster agency or agencies serving within the
5 boundaries of that Local Emergency Planning Committee
6 planning district for:
7 (1) the development of emergency operations plan
8 provisions for hazardous chemical emergencies; and
9 (2) the assessment of emergency response
10 capabilities related to hazardous chemical emergencies.
11 (f) The Illinois Emergency Management Agency shall:
12 (1) Coordinate the overall emergency management
13 program of the State.
14 (2) Cooperate with local governments, the federal
15 government and any public or private agency or entity in
16 achieving any purpose of this Act and in implementing
17 emergency management programs for mitigation,
18 preparedness, response, and recovery.
19 (2.5) Cooperate with the Department of Nuclear
20 Safety in development of the comprehensive emergency
21 preparedness and response plan for any nuclear accident
22 in accordance with Section 2005-65 of the Department of
23 Nuclear Safety Law of the Civil Administrative Code of
24 Illinois and in development of the Illinois Nuclear
25 Safety Preparedness program in accordance with Section 8
26 of the Illinois Nuclear Safety Preparedness Act.
27 (3) Prepare, for issuance by the Governor,
28 executive orders, proclamations, and regulations as
29 necessary or appropriate in coping with disasters.
30 (4) Promulgate rules and requirements for political
31 subdivision emergency operations plans that are not
32 inconsistent with and are at least as stringent as
33 applicable federal laws and regulations.
34 (5) Review and approve, in accordance with Illinois
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1 Emergency Management Agency rules, emergency operations
2 plans for those political subdivisions required to have
3 an emergency services and disaster agency pursuant to
4 this Act.
5 (5.5) Promulgate rules and requirements for the
6 political subdivision emergency management exercises,
7 including, but not limited to, exercises of the emergency
8 operations plans.
9 (5.10) Review, evaluate, and approve, in accordance
10 with Illinois Emergency Management Agency rules,
11 political subdivision emergency management exercises for
12 those political subdivisions required to have an
13 emergency services and disaster agency pursuant to this
14 Act.
15 (6) Determine requirements of the State and its
16 political subdivisions for food, clothing, and other
17 necessities in event of a disaster.
18 (7) Establish a register of persons with types of
19 emergency management training and skills in mitigation,
20 preparedness, response, and recovery.
21 (8) Establish a register of government and private
22 response resources available for use in a disaster.
23 (9) Expand the Earthquake Awareness Program and its
24 efforts to distribute earthquake preparedness materials
25 to schools, political subdivisions, community groups,
26 civic organizations, and the media. Emphasis will be
27 placed on those areas of the State most at risk from an
28 earthquake. Maintain the list of all school districts,
29 hospitals, airports, power plants, including nuclear
30 power plants, lakes, dams, emergency response facilities
31 of all types, and all other major public or private
32 structures which are at the greatest risk of damage from
33 earthquakes under circumstances where the damage would
34 cause subsequent harm to the surrounding communities and
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1 residents.
2 (10) Disseminate all information, completely and
3 without delay, on water levels for rivers and streams and
4 any other data pertaining to potential flooding supplied
5 by the Division of Water Resources within the Department
6 of Natural Resources to all political subdivisions to the
7 maximum extent possible.
8 (11) Develop agreements, if feasible, with medical
9 supply and equipment firms to supply resources as are
10 necessary to respond to an earthquake or any other
11 disaster as defined in this Act. These resources will be
12 made available upon notifying the vendor of the disaster.
13 Payment for the resources will be in accordance with
14 Section 7 of this Act. The Illinois Department of Public
15 Health shall determine which resources will be required
16 and requested.
17 (12) Out of funds appropriated for these purposes,
18 award capital and non-capital grants to Illinois
19 hospitals or health care facilities located outside of a
20 city with a population in excess of 1,000,000 to be used
21 for purposes that include, but are not limited to,
22 preparing to respond to mass casualties and disasters,
23 maintaining and improving patient safety and quality of
24 care, and protecting the confidentiality of patient
25 information. No single grant for a capital expenditure
26 shall exceed $300,000. No single grant for a non-capital
27 expenditure shall exceed $100,000. In awarding such
28 grants, preference shall be given to hospitals that serve
29 a significant number of Medicaid recipients, but do not
30 qualify for disproportionate share hospital adjustment
31 payments under the Illinois Public Aid Code. To receive
32 such a grant, a hospital or health care facility must
33 provide funding of at least 50% of the cost of the
34 project for which the grant is being requested. In
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1 awarding such grants the Illinois Emergency Management
2 Agency shall consider the recommendations of the Illinois
3 Hospital Association.
4 (13) (12) Do all other things necessary, incidental
5 or appropriate for the implementation of this Act.
6 (Source: P.A. 91-25, eff. 6-9-99; 92-73, eff. 1-1-02.)
7 Section 40. The State Finance Act is amended by changing
8 Sections 5.198, 6z-12, and 6z-43, changing and renumbering
9 Section 6z-51 (as added by Public Act 92-208), and adding
10 Sections 5.570 and 5.571 as follows:
11 (30 ILCS 105/5.198) (from Ch. 127, par. 141.198)
12 (Section scheduled to be repealed on October 15, 2002.)
13 Sec. 5.198. The Illinois Health Care Cost Containment
14 Council Special Studies Fund. This Section is repealed on
15 October 15, 2002.
16 (Source: P.A. 84-1240; 84-1438.)
17 (30 ILCS 105/5.570 new)
18 Sec. 5.570. The Illinois Student Assistance Commission
19 Contracts and Grants Fund.
20 (30 ILCS 105/5.571 new)
21 Sec. 5.571. The Career and Technical Education Fund.
22 (30 ILCS 105/6z-12) (from Ch. 127, par. 142z-12)
23 (Section scheduled to be repealed on October 15, 2002.)
24 Sec. 6z-12. Funds received by the Illinois Health Care
25 Cost Containment Council for special studies pursuant to the
26 Illinois Health Finance Reform Act shall be deposited in the
27 Illinois Health Care Cost Containment Council Special Studies
28 Fund. The General Assembly shall from time to time make
29 appropriations from the Illinois Health Care Cost Containment
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1 Council Special Studies Fund for the payment of the direct
2 and indirect costs of special studies. The Illinois Health
3 Care Cost Containment Council shall by rule, adopted pursuant
4 to the Illinois Administrative Procedure Act, provide for the
5 allocation of the direct and indirect costs of producing
6 special studies pursuant to the Illinois Health Finance
7 Reform Act.
8 In addition to any other permitted use of moneys in the
9 Fund, moneys in the Illinois Health Care Cost Containment
10 Council Special Studies Fund may be used by the Council,
11 subject to appropriation, to provide services to the Illinois
12 Health Care Reform Task Force created under Section 6-4 of
13 the Medicaid Revenue Act and to support Council operations.
14 The Illinois Health Care Cost Containment Council Special
15 Studies Fund is abolished on October 15, 2002. Any balance
16 remaining in the Fund on that date shall be transferred to
17 the Public Health Special State Projects Fund.
18 This Section is repealed on October 15, 2002.
19 (Source: P.A. 87-838; 87-1248.)
20 (30 ILCS 105/6z-43)
21 Sec. 6z-43. Tobacco Settlement Recovery Fund.
22 (a) There is created in the State Treasury a special
23 fund to be known as the Tobacco Settlement Recovery Fund,
24 into which shall be deposited all monies paid to the State
25 pursuant to (1) the Master Settlement Agreement entered in
26 the case of People of the State of Illinois v. Philip Morris,
27 et al. (Circuit Court of Cook County, No. 96-L13146) and (2)
28 any settlement with or judgment against any tobacco product
29 manufacturer other than one participating in the Master
30 Settlement Agreement in satisfaction of any released claim as
31 defined in the Master Settlement Agreement, as well as any
32 other monies as provided by law. All earnings on Fund
33 investments shall be deposited into the Fund. Upon the
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1 creation of the Fund, the State Comptroller shall order the
2 State Treasurer to transfer into the Fund any monies paid to
3 the State as described in item (1) or (2) of this Section
4 before the creation of the Fund plus any interest earned on
5 the investment of those monies. The Treasurer may invest the
6 moneys in the Fund in the same manner, in the same types of
7 investments, and subject to the same limitations provided in
8 the Illinois Pension Code for the investment of pension funds
9 other than those established under Article 3 or 4 of the
10 Code.
11 (b) As soon as may be practical after June 30, 2001,
12 upon notification from and at the direction of the Governor,
13 the State Comptroller shall direct and the State Treasurer
14 shall transfer the unencumbered balance in the Tobacco
15 Settlement Recovery Fund as of June 30, 2001, as determined
16 by the Governor, into the Budget Stabilization Fund. The
17 Treasurer may invest the moneys in the Budget Stabilization
18 Fund in the same manner, in the same types of investments,
19 and subject to the same limitations provided in the Illinois
20 Pension Code for the investment of pension funds other than
21 those established under Article 3 or 4 of the Code.
22 (c) All federal financial participation moneys received
23 pursuant to expenditures from the Fund shall be deposited
24 into the Fund.
25 (Source: P.A. 91-646, eff. 11-19-99; 91-704, eff. 7-1-00;
26 91-797, eff. 6-9-00; 92-11, eff. 6-11-01; 92-16, eff.
27 6-28-01.)
28 (30 ILCS 105/6z-55)
29 Sec. 6z-55. 6z-51. Statewide Economic Development Fund.
30 (a) The Statewide Economic Development Fund is created as a
31 special fund in the State treasury. Moneys in the Fund shall
32 be used, subject to appropriation, for the purpose of
33 statewide economic development activities or by the Illinois
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1 Emergency Management Agency for awarding grants to Illinois
2 hospitals and health care facilities to provide for the
3 health and security of Illinois residents.
4 (Source: P.A. 92-208, eff. 8-2-01; revised 10-17-01.)
5 Section 45. The School Code is amended by changing
6 Sections 14-7.03 and 18-3 as follows:
7 (105 ILCS 5/14-7.03) (from Ch. 122, par. 14-7.03)
8 Sec. 14-7.03. Special Education Classes for Children from
9 Orphanages, Foster Family Homes, Children's Homes, or in
10 State Housing Units. If a school district maintains special
11 education classes on the site of orphanages and children's
12 homes, or if children from the orphanages, children's homes,
13 foster family homes, other State agencies, or State
14 residential units for children attend classes for children
15 with disabilities in which the school district is a
16 participating member of a joint agreement, or if the children
17 from the orphanages, children's homes, foster family homes,
18 other State agencies, or State residential units attend
19 classes for the children with disabilities maintained by the
20 school district, then reimbursement shall be paid to eligible
21 districts in accordance with the provisions of this Section
22 by the Comptroller as directed by the State Superintendent of
23 Education.
24 The amount of tuition for such children shall be
25 determined by the actual cost of maintaining such classes,
26 using the per capita cost formula set forth in Section
27 14-7.01, such program and cost to be pre-approved by the
28 State Superintendent of Education.
29 On forms prepared by the State Superintendent of
30 Education, the district shall certify to the regional
31 superintendent the following:
32 (1) The name of the home or State residential unit
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1 with the name of the owner or proprietor and address of
2 those maintaining it;
3 (2) That no service charges or other payments
4 authorized by law were collected in lieu of taxes
5 therefrom or on account thereof during either of the
6 calendar years included in the school year for which
7 claim is being made;
8 (3) The number of children qualifying under this
9 Act in special education classes for instruction on the
10 site of the orphanages and children's homes;
11 (4) The number of children attending special
12 education classes for children with disabilities in which
13 the district is a participating member of a special
14 education joint agreement;
15 (5) The number of children attending special
16 education classes for children with disabilities
17 maintained by the district;
18 (6) The computed amount of tuition payment claimed
19 as due, as approved by the State Superintendent of
20 Education, for maintaining these classes.
21 If a school district makes a claim for reimbursement
22 under Section 18-3 or 18-4 of this Act it shall not include
23 in any claim filed under this Section a claim for such
24 children. Payments authorized by law, including State or
25 federal grants for education of children included in this
26 Section, shall be deducted in determining the tuition amount.
27 Nothing in this Act shall be construed so as to prohibit
28 reimbursement for the tuition of children placed in for
29 profit facilities. Private facilities shall provide adequate
30 space at the facility for special education classes provided
31 by a school district or joint agreement for children with
32 disabilities who are residents of the facility at no cost to
33 the school district or joint agreement upon request of the
34 school district or joint agreement. If such a private
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1 facility provides space at no cost to the district or joint
2 agreement for special education classes provided to children
3 with disabilities who are residents of the facility, the
4 district or joint agreement shall not include any costs for
5 the use of those facilities in its claim for reimbursement.
6 Reimbursement for tuition may include the cost of
7 providing summer school programs for children with severe and
8 profound disabilities served under this Section. Claims for
9 that reimbursement shall be filed by November 1 and shall be
10 paid on or before December 15 from appropriations made for
11 the purposes of this Section.
12 The State Board of Education shall establish such rules
13 and regulations as may be necessary to implement the
14 provisions of this Section.
15 Claims filed on behalf of programs operated under this
16 Section housed in a jail or detention center shall be on an
17 individual student basis only for eligible students with
18 disabilities. These claims shall be in accordance with
19 applicable rules.
20 Each district claiming reimbursement for a program
21 operated as a group program shall have an approved budget on
22 file with the State Board of Education prior to the
23 initiation of the program's operation. On September 30,
24 December 31, and March 31, the State Board of Education shall
25 voucher payments to group programs based upon the approved
26 budget during the year of operation. Final claims for group
27 payments shall be filed on or before July 15. Final claims
28 for group programs received at the State Board of Education
29 on or before June 15 shall be vouchered by June 30. Final
30 claims received at the State Board of Education between June
31 16 and July 15 shall be vouchered by August 30. Claims for
32 group programs received after July 15 shall not be honored.
33 Each district claiming reimbursement for individual
34 students shall have the eligibility of those students
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1 verified by the State Board of Education. On September 30,
2 December 31, and March 31, the State Board of Education shall
3 voucher payments for individual students based upon an
4 estimated cost calculated from the prior year's claim. Final
5 claims for individual students for the regular school term
6 must be received at the State Board of Education by July 15.
7 Claims for individual students received after July 15 shall
8 not be honored. Final claims for individual students shall be
9 vouchered by August 30.
10 Reimbursement shall be made based upon approved group
11 programs or individual students. The State Superintendent of
12 Education shall direct the Comptroller to pay a specified
13 amount to the district by the 30th day of September,
14 December, March, June, or August, respectively. However,
15 notwithstanding any other provisions of this Section or the
16 School Code, beginning with fiscal year 1994 and each fiscal
17 year thereafter through fiscal year 2002, if the amount
18 appropriated for any fiscal year is less than the amount
19 required for purposes of this Section, the amount required to
20 eliminate any insufficient reimbursement for each district
21 claim under this Section shall be reimbursed on August 30 of
22 the next fiscal year, and the. payments required to eliminate
23 any insufficiency for prior fiscal year claims shall be made
24 before any claims are paid for the current fiscal year.
25 Notwithstanding any other provision of this Section or this
26 Code, beginning with fiscal year 2003, total reimbursement
27 under this Section in any fiscal year is limited to the
28 amount appropriated for that purpose for that fiscal year,
29 and if the amount appropriated for any fiscal year is less
30 than the amount required for purposes of this Section, the
31 insufficiency shall be apportioned pro rata among the school
32 districts seeking reimbursement.
33 The claim of a school district otherwise eligible to be
34 reimbursed in accordance with Section 14-12.01 for the
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1 1976-77 school year but for this amendatory Act of 1977 shall
2 not be paid unless the district ceases to maintain such
3 classes for one entire school year.
4 If a school district's current reimbursement payment for
5 the 1977-78 school year only is less than the prior year's
6 reimbursement payment owed, the district shall be paid the
7 amount of the difference between the payments in addition to
8 the current reimbursement payment, and the amount so paid
9 shall be subtracted from the amount of prior year's
10 reimbursement payment owed to the district.
11 Regional superintendents may operate special education
12 classes for children from orphanages, foster family homes,
13 children's homes or State housing units located within the
14 educational services region upon consent of the school board
15 otherwise so obligated. In electing to assume the powers and
16 duties of a school district in providing and maintaining such
17 a special education program, the regional superintendent may
18 enter into joint agreements with other districts and may
19 contract with public or private schools or the orphanage,
20 foster family home, children's home or State housing unit for
21 provision of the special education program. The regional
22 superintendent exercising the powers granted under this
23 Section shall claim the reimbursement authorized by this
24 Section directly from the State Board of Education.
25 Any child who is not a resident of Illinois who is placed
26 in a child welfare institution, private facility, foster
27 family home, State operated program, orphanage or children's
28 home shall have the payment for his educational tuition and
29 any related services assured by the placing agent.
30 Commencing July 1, 1992, for each disabled student who is
31 placed residentially by a State agency or the courts for care
32 or custody or both care and custody, welfare, medical or
33 mental health treatment or both medical and mental health
34 treatment, rehabilitation, and protection, whether placed
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1 there on, before, or after July 1, 1992, the costs for
2 educating the student are eligible for reimbursement under
3 this Section providing the placing agency or court has
4 notified the appropriate school district authorities of the
5 status of student residency where applicable prior to or upon
6 placement.
7 The district of residence of the parent, guardian, or
8 disabled student as defined in Sections 14-1.11 and 14-1.11a
9 is responsible for the actual costs of the student's special
10 education program and is eligible for reimbursement under
11 this Section when placement is made by a State agency or the
12 courts. Payments shall be made by the resident district to
13 the district wherein the facility is located no less than
14 once per quarter unless otherwise agreed to in writing by the
15 parties.
16 When a dispute arises over the determination of the
17 district of residence, the district or districts may appeal
18 the decision in writing to the State Superintendent of
19 Education. The decision of the State Superintendent of
20 Education shall be final.
21 In the event a district does not make a tuition payment
22 to another district that is providing the special education
23 program and services, the State Board of Education shall
24 immediately withhold 125% of the then remaining annual
25 tuition cost from the State aid or categorical aid payment
26 due to the school district that is determined to be the
27 resident school district. All funds withheld by the State
28 Board of Education shall immediately be forwarded to the
29 school district where the student is being served.
30 When a child eligible for services under this Section
31 14-7.03 must be placed in a nonpublic facility, that facility
32 shall meet the programmatic requirements of Section 14-7.02
33 and its regulations, and the educational services shall be
34 funded only in accordance with this Section 14-7.03.
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1 (Source: P.A. 89-235, eff. 8-4-95; 89-397, eff. 8-20-95;
2 89-698, eff. 1-14-97; 90-463, eff. 8-17-97; 90-644, eff.
3 7-24-98.)
4 (105 ILCS 5/18-3) (from Ch. 122, par. 18-3)
5 Sec. 18-3. Tuition of children from orphanages and
6 children's homes.
7 When the children from any home for orphans, dependent,
8 abandoned or maladjusted children maintained by any
9 organization or association admitting to such home children
10 from the State in general or when children residing in a
11 school district wherein the State of Illinois maintains and
12 operates any welfare or penal institution on property owned
13 by the State of Illinois, which contains houses, housing
14 units or housing accommodations within a school district,
15 attend grades kindergarten through 12 of the public schools
16 maintained by that school district, the State Superintendent
17 of Education shall direct the State Comptroller to pay a
18 specified amount sufficient to pay the annual tuition cost of
19 such children who attended such public schools during the
20 regular school year ending on June 30 or the summer term for
21 that school year, and the Comptroller shall pay the amount
22 after receipt of a voucher submitted by the State
23 Superintendent of Education.
24 The amount of the tuition for such children attending the
25 public schools of the district shall be determined by the
26 State Superintendent of Education by multiplying the number
27 of such children in average daily attendance in such schools
28 by 1.2 times the total annual per capita cost of
29 administering the schools of the district. Such total annual
30 per capita cost shall be determined by totaling all expenses
31 of the school district in the educational, operations and
32 maintenance, bond and interest, transportation, Illinois
33 municipal retirement, and rent funds for the school year
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1 preceding the filing of such tuition claims less expenditures
2 not applicable to the regular K-12 program, less offsetting
3 revenues from State sources except those from the common
4 school fund, less offsetting revenues from federal sources
5 except those from federal impaction aid, less student and
6 community service revenues, plus a depreciation allowance;
7 and dividing such total by the average daily attendance for
8 the year.
9 Annually on or before June 30 the superintendent of the
10 district upon forms prepared by the State Superintendent of
11 Education shall certify to the regional superintendent the
12 following:
13 1. The name of the home and of the organization or
14 association maintaining it; or the legal description of
15 the real estate upon which the house, housing units, or
16 housing accommodations are located and that no taxes or
17 service charges or other payments authorized by law to be
18 made in lieu of taxes were collected therefrom or on
19 account thereof during either of the calendar years
20 included in the school year for which claim is being
21 made;
22 2. The number of children from the home or living
23 in such houses, housing units or housing accommodations
24 and attending the schools of the district;
25 3. The total number of children attending the
26 schools of the district;
27 4. The per capita tuition charge of the district;
28 and
29 5. The computed amount of the tuition payment
30 claimed as due.
31 Whenever the persons in charge of such home for orphans,
32 dependent, abandoned or maladjusted children have received
33 from the parent or guardian of any such child or by virtue of
34 an order of court a specific allowance for educating such
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1 child, such persons shall pay to the school board in the
2 district where the child attends school such amount of the
3 allowance as is necessary to pay the tuition required by such
4 district for the education of the child. If the allowance is
5 insufficient to pay the tuition in full the State
6 Superintendent of Education shall direct the Comptroller to
7 pay to the district the difference between the total tuition
8 charged and the amount of the allowance.
9 Whenever the facilities of a school district in which
10 such house, housing units or housing accommodations are
11 located, are limited, pupils may be assigned by that district
12 to the schools of any adjacent district to the limit of the
13 facilities of the adjacent district to properly educate such
14 pupils as shall be determined by the school board of the
15 adjacent district, and the State Superintendent of Education
16 shall direct the Comptroller to pay a specified amount
17 sufficient to pay the annual tuition of the children so
18 assigned to and attending public schools in the adjacent
19 districts and the Comptroller shall draw his warrant upon the
20 State Treasurer for the payment of such amount for the
21 benefit of the adjacent school districts in the same manner
22 as for districts in which the houses, housing units or
23 housing accommodations are located.
24 The school district shall certify to the State
25 Superintendent of Education the report of claims due for such
26 tuition payments on or before July 31. Failure on the part of
27 the school board to certify its claim on July 31 shall
28 constitute a forfeiture by the district of its right to the
29 payment of any such tuition claim for the school year. The
30 State Superintendent of Education shall direct the
31 Comptroller to pay to the district, on or before August 15,
32 the amount due the district for the school year in accordance
33 with the calculation of the claim as set forth in this
34 Section.
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1 Claims for tuition for children from any home for orphans
2 or dependent, abandoned, or maladjusted children beginning
3 with the 1993-1994 school year shall be paid on a current
4 year basis. On September 30, December 31, and March 31, the
5 State Board of Education shall voucher payments for districts
6 with those students based on an estimated cost calculated
7 from the prior year's claim. Final claims for those students
8 for the regular school term and summer term must be received
9 at the State Board of Education by July 31 following the end
10 of the regular school year. Final claims for those students
11 shall be vouchered by August 15. During fiscal year 1994
12 both the 1992-1993 school year and the 1993-1994 school year
13 shall be paid in order to change the cycle of payment from a
14 reimbursement basis to a current year funding basis of
15 payment. However, notwithstanding any other provisions of
16 this Section or the School Code, beginning with fiscal year
17 1994 and each fiscal year thereafter through fiscal year
18 2002, if the amount appropriated for any fiscal year is less
19 than the amount required for purposes of this Section, the
20 amount required to eliminate any insufficient reimbursement
21 for each district claim under this Section shall be
22 reimbursed on August 30 of the next fiscal year, and the.
23 payments required to eliminate any insufficiency for prior
24 fiscal year claims shall be made before any claims are paid
25 for the current fiscal year. Notwithstanding any other
26 provision of this Section or this Code, beginning with fiscal
27 year 2003, total reimbursement under this Section in any
28 fiscal year is limited to the amount appropriated for that
29 purpose for that fiscal year, and if the amount appropriated
30 for any fiscal year is less than the amount required for
31 purposes of this Section, the insufficiency shall be
32 apportioned pro rata among the school districts seeking
33 reimbursement.
34 If a school district makes a claim for reimbursement
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1 under Section 18-4 or 14-7.03 it shall not include in any
2 claim filed under this Section children residing on the
3 property of State institutions included in its claim under
4 Section 18-4 or 14-7.03.
5 Any child who is not a resident of Illinois who is placed
6 in a child welfare institution, private facility, State
7 operated program, orphanage or children's home shall have the
8 payment for his educational tuition and any related services
9 assured by the placing agent.
10 In order to provide services appropriate to allow a
11 student under the legal guardianship or custodianship of the
12 State to participate in local school district educational
13 programs, costs may be incurred in appropriate cases by the
14 district that are in excess of 1.2 times the district per
15 capita tuition charge allowed under the provisions of this
16 Section. In the event such excess costs are incurred, they
17 must be documented in accordance with cost rules established
18 under the authority of this Section and may then be claimed
19 for reimbursement under this Section.
20 Planned services for students eligible for this funding
21 must be a collaborative effort between the appropriate State
22 agency or the student's group home or institution and the
23 local school district.
24 (Source: P.A. 91-764, eff. 6-9-00; 92-94, eff. 1-1-02.)
25 Section 50. The State Aid Continuing Appropriation Law
26 is amended by changing Sections 15-10, 15-15, and 15-25 as
27 follows:
28 (105 ILCS 235/15-10)
29 (Section scheduled to be repealed on June 30, 2002)
30 Sec. 15-10. Annual budget; recommendation. The Governor
31 shall include a Common School Fund recommendation to the
32 State Board of Education in the fiscal year 1999 through 2003
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1 2002 annual Budgets sufficient to fund (i) the General State
2 Aid Formula set forth in subsection (E) (Computation of
3 General State Aid) and subsection (H) (Supplemental General
4 State Aid) of Section 18-8.05 of the School Code and (ii) the
5 supplementary payments for school districts set forth in
6 subsection (J) (Supplementary Grants in Aid) of Section
7 18-8.05 of the School Code.
8 (Source: P.A. 92-7, eff. 6-29-01.)
9 (105 ILCS 235/15-15)
10 (Section scheduled to be repealed on June 30, 2002)
11 Sec. 15-15. State Aid Formula; Funding. The General
12 Assembly shall annually make Common School Fund
13 appropriations to the State Board of Education in fiscal
14 years 1999 through 2003 2002 sufficient to fund (i) the
15 General State Aid Formula set forth in subsection (E)
16 (Computation of General State Aid) and subsection (H)
17 (Supplemental General State Aid) of Section 18-8.05 of the
18 School Code and (ii) the supplementary payments for school
19 districts set forth in subsection (J) (Supplementary Grants
20 in Aid) of Section 18-8.05 of the School Code.
21 (Source: P.A. 92-7, eff. 6-29-01.)
22 (105 ILCS 235/15-25)
23 (Section scheduled to be repealed on June 30, 2002)
24 Sec. 15-25. Repeal. This Article is repealed June 30,
25 2003. Section 15-20 of this Article is repealed June 30,
26 2002.
27 (Source: P.A. 92-7, eff. 6-29-01.)
28 Section 55. The Public Community College Act is amended
29 by adding Section 2-16.07 as follows:
30 (110 ILCS 805/2-16.07 new)
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1 Sec. 2-16.07. Career and Technical Education Fund. The
2 Career and Technical Education Fund is created as a special
3 fund in the State treasury. The Comptroller shall order
4 transferred and the State Treasurer shall transfer from the
5 Federal Department of Education Fund into the Career and
6 Technical Education Fund such amounts as may be directed in
7 writing by the State Board of Education. All moneys so
8 deposited into the Career and Technical Education Fund may be
9 used, subject to appropriation, by the State Board for
10 operational expenses associated with the administration of
11 Career and Technical Education, for payment of Career and
12 Technical Education grants to colleges, and for payment of
13 costs relating to State leadership activities, as provided by
14 the United States Department of Education.
15 Section 60. The Higher Education Student Assistance
16 Act is amended by adding Sections 65.56 and 77 as
17 follows:
18 (110 ILCS 947/65.56 new)
19 Sec. 65.56. Illinois Teachers and Child Care Providers
20 Loan Repayment Program.
21 (a) In order to encourage academically talented Illinois
22 students to enter and continue teaching in Illinois schools
23 in low-income areas and to encourage students to enter the
24 early child care profession and serve low-income areas, the
25 Commission shall, each year, receive and consider
26 applications for loan repayment assistance under this
27 Section. This program shall be known as the Illinois Teachers
28 and Child Care Providers Loan Repayment Program. The
29 Commission shall administer the program and shall make all
30 necessary and proper rules not inconsistent with this Section
31 for the program's effective implementation. The Commission
32 may use up to 5% of the appropriation for this program for
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1 administration and promotion of teacher incentive programs.
2 (b) Beginning January 1, 2003, subject to a separate
3 appropriation made for such purposes, the Commission shall
4 award a grant to each qualified applicant in an amount equal
5 to the amount of educational loans forgiven on behalf of the
6 qualified applicant pursuant to Sections 424 and 425 of Title
7 IV of the Higher Education Amendments of 1998 (20 U.S.C.
8 1078-10 and 1078-11), up to a maximum of $5,000. The
9 Commission shall encourage the recipient of a grant under
10 this Section to use the grant amount awarded to pay off his
11 or her educational loans.
12 (c) A person is a qualified applicant under this Section
13 if he or she meets all of the following qualifications:
14 (1) The person is a United States citizen or
15 eligible noncitizen.
16 (2) The person is a resident of this State.
17 (3) The person is a borrower who has had an amount
18 of his or her educational loans forgiven pursuant to
19 Sections 424 and 425 of Title IV of the Higher Education
20 Amendments of 1998.
21 (4) The person has fulfilled the obligations set
22 forth by Sections 424 and 425 of Title IV of the Higher
23 Education Amendments of 1998 in this State.
24 (d) All applications for grant assistance under this
25 Section shall be made to the Commission. The form of
26 application and the information required to be set forth in
27 the application shall be determined by the Commission, and
28 the Commission shall require applicants to submit with their
29 applications such supporting documents as the Commission
30 deems necessary.
31 (e) A qualified applicant must apply for a grant under
32 this Section within 6 months after receiving notification of
33 loan forgiveness pursuant to Sections 424 and 425 of Title IV
34 of the Higher Education Amendments of 1998.
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1 (110 ILCS 947/77 new)
2 Sec. 77. Illinois Student Assistance Commission
3 Contracts and Grants Fund.
4 (a) The Illinois Student Assistance Commission Contracts
5 and Grants Fund is created as a special fund in the State
6 treasury. All gifts, grants, or donations of money received
7 by the Commission must be deposited into this Fund.
8 (b) Moneys in the Fund may be used by the Commission,
9 subject to appropriation, for support of the Commission's
10 student assistance outreach activities.
11 (110 ILCS 947/65.57 rep.)
12 Section 65. The Higher Education Student Assistance Act
13 is amended by repealing Section 65.57.
14 Section 70. The Comprehensive Health Insurance Plan Act
15 is amended by changing Section 3 as follows:
16 (215 ILCS 105/3) (from Ch. 73, par. 1303)
17 Sec. 3. Operation of the Plan.
18 a. There is hereby created an Illinois Comprehensive
19 Health Insurance Plan.
20 b. The Plan shall operate subject to the supervision and
21 control of the board. The board is created as a political
22 subdivision and body politic and corporate and, as such, is
23 not a State agency. The board shall consist of 10 public
24 members, appointed by the Governor with the advice and
25 consent of the Senate.
26 Initial members shall be appointed to the Board by the
27 Governor as follows: 2 members to serve until July 1, 1988,
28 and until their successors are appointed and qualified; 2
29 members to serve until July 1, 1989, and until their
30 successors are appointed and qualified; 3 members to serve
31 until July 1, 1990, and until their successors are appointed
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1 and qualified; and 3 members to serve until July 1, 1991, and
2 until their successors are appointed and qualified. As terms
3 of initial members expire, their successors shall be
4 appointed for terms to expire the first day in July 3 years
5 thereafter, and until their successors are appointed and
6 qualified.
7 Any vacancy in the Board occurring for any reason other
8 than the expiration of a term shall be filled for the
9 unexpired term in the same manner as the original
10 appointment.
11 Any member of the Board may be removed by the Governor
12 for neglect of duty, misfeasance, malfeasance, or nonfeasance
13 in office.
14 In addition, a representative of the Bureau of the Budget
15 Illinois Health Care Cost Containment Council, a
16 representative of the Office of the Attorney General and the
17 Director or the Director's designated representative shall be
18 members of the board. Four members of the General Assembly,
19 one each appointed by the President and Minority Leader of
20 the Senate and by the Speaker and Minority Leader of the
21 House of Representatives, shall serve as nonvoting members of
22 the board. At least 2 of the public members shall be
23 individuals reasonably expected to qualify for coverage under
24 the Plan, the parent or spouse of such an individual, or a
25 surviving family member of an individual who could have
26 qualified for the plan during his lifetime. The Director or
27 Director's representative shall be the chairperson of the
28 board. Members of the board shall receive no compensation,
29 but shall be reimbursed for reasonable expenses incurred in
30 the necessary performance of their duties.
31 c. The board shall make an annual report in September
32 and shall file the report with the Secretary of the Senate
33 and the Clerk of the House of Representatives. The report
34 shall summarize the activities of the Plan in the preceding
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1 calendar year, including net written and earned premiums, the
2 expense of administration, the paid and incurred losses for
3 the year and other information as may be requested by the
4 General Assembly. The report shall also include analysis and
5 recommendations regarding utilization review, quality
6 assurance and access to cost effective quality health care.
7 d. In its plan of operation the board shall:
8 (1) Establish procedures for selecting a plan
9 administrator in accordance with Section 5 of this Act.
10 (2) Establish procedures for the operation of the
11 board.
12 (3) Create a Plan fund, under management of the
13 board, to fund administrative, claim, and other expenses
14 of the Plan.
15 (4) Establish procedures for the handling and
16 accounting of assets and monies of the Plan.
17 (5) Develop and implement a program to publicize
18 the existence of the Plan, the eligibility requirements
19 and procedures for enrollment and to maintain public
20 awareness of the Plan.
21 (6) Establish procedures under which applicants and
22 participants may have grievances reviewed by a grievance
23 committee appointed by the board. The grievances shall
24 be reported to the board immediately after completion of
25 the review. The Department and the board shall retain
26 all written complaints regarding the Plan for at least 3
27 years. Oral complaints shall be reduced to written form
28 and maintained for at least 3 years.
29 (7) Provide for other matters as may be necessary
30 and proper for the execution of its powers, duties and
31 obligations under the Plan.
32 e. No later than 5 years after the Plan is operative the
33 board and the Department shall conduct cooperatively a study
34 of the Plan and the persons insured by the Plan to determine:
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1 (1) claims experience including a breakdown of medical
2 conditions for which claims were paid; (2) whether
3 availability of the Plan affected employment opportunities
4 for participants; (3) whether availability of the Plan
5 affected the receipt of medical assistance benefits by Plan
6 participants; (4) whether a change occurred in the number of
7 personal bankruptcies due to medical or other health related
8 costs; (5) data regarding all complaints received about the
9 Plan including its operation and services; (6) and any other
10 significant observations regarding utilization of the Plan.
11 The study shall culminate in a written report to be presented
12 to the Governor, the President of the Senate, the Speaker of
13 the House and the chairpersons of the House and Senate
14 Insurance Committees. The report shall be filed with the
15 Secretary of the Senate and the Clerk of the House of
16 Representatives. The report shall also be available to
17 members of the general public upon request.
18 f. The board may:
19 (1) Prepare and distribute certificate of
20 eligibility forms and enrollment instruction forms to
21 insurance producers and to the general public in this
22 State.
23 (2) Provide for reinsurance of risks incurred by
24 the Plan and enter into reinsurance agreements with
25 insurers to establish a reinsurance plan for risks of
26 coverage described in the Plan, or obtain commercial
27 reinsurance to reduce the risk of loss through the Plan.
28 (3) Issue additional types of health insurance
29 policies to provide optional coverages as are otherwise
30 permitted by this Act including a Medicare supplement
31 policy designed to supplement Medicare.
32 (4) Provide for and employ cost containment
33 measures and requirements including, but not limited to,
34 preadmission certification, second surgical opinion,
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1 concurrent utilization review programs, and individual
2 case management for the purpose of making the pool more
3 cost effective.
4 (5) Design, utilize, contract, or otherwise arrange
5 for the delivery of cost effective health care services,
6 including establishing or contracting with preferred
7 provider organizations, health maintenance organizations,
8 and other limited network provider arrangements.
9 (6) Adopt bylaws, rules, regulations, policies and
10 procedures as may be necessary or convenient for the
11 implementation of the Act and the operation of the Plan.
12 (7) Administer separate pools, separate accounts,
13 or other plans or arrangements as required by this Act to
14 separate federally eligible individuals or groups of
15 federally eligible individuals who qualify for plan
16 coverage under Section 15 of this Act from eligible
17 persons or groups of eligible persons who qualify for
18 plan coverage under Section 7 of this Act and apportion
19 the costs of the administration among such separate
20 pools, separate accounts, or other plans or arrangements.
21 g. The Director may, by rule, establish additional
22 powers and duties of the board and may adopt rules for any
23 other purposes, including the operation of the Plan, as are
24 necessary or proper to implement this Act.
25 h. The board is not liable for any obligation of the
26 Plan. There is no liability on the part of any member or
27 employee of the board or the Department, and no cause of
28 action of any nature may arise against them, for any action
29 taken or omission made by them in the performance of their
30 powers and duties under this Act, unless the action or
31 omission constitutes willful or wanton misconduct. The board
32 may provide in its bylaws or rules for indemnification of,
33 and legal representation for, its members and employees.
34 i. There is no liability on the part of any insurance
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1 producer for the failure of any applicant to be accepted by
2 the Plan unless the failure of the applicant to be accepted
3 by the Plan is due to an act or omission by the insurance
4 producer which constitutes willful or wanton misconduct.
5 (Source: P.A. 90-30, eff. 7-1-97.)
6 Section 75. The Children's Health Insurance Program Act
7 is amended by changing Sections 20, 40, and 97 as follows:
8 (215 ILCS 106/20)
9 (Section scheduled to be repealed on July 1, 2002)
10 Sec. 20. Eligibility.
11 (a) To be eligible for this Program, a person must be a
12 person who has a child eligible under this Act and who is
13 eligible under a waiver of federal requirements pursuant to
14 an application made pursuant to subdivision (a)(1) of Section
15 40 of this Act or who is a child who:
16 (1) is a child who is not eligible for medical
17 assistance;
18 (2) is a child whose annual household income, as
19 determined by the Department, is above 133% of the
20 federal poverty level and at or below 185% of the federal
21 poverty level;
22 (3) is a resident of the State of Illinois; and
23 (4) is a child who is either a United States
24 citizen or included in one of the following categories of
25 non-citizens:
26 (A) unmarried dependent children of either a
27 United States Veteran honorably discharged or a
28 person on active military duty;
29 (B) refugees under Section 207 of the
30 Immigration and Nationality Act;
31 (C) asylees under Section 208 of the
32 Immigration and Nationality Act;
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1 (D) persons for whom deportation has been
2 withheld under Section 243(h) of the Immigration
3 and Nationality Act;
4 (E) persons granted conditional entry under
5 Section 203(a)(7) of the Immigration and Nationality
6 Act as in effect prior to April 1, 1980;
7 (F) persons lawfully admitted for permanent
8 residence under the Immigration and Nationality Act;
9 and
10 (G) parolees, for at least one year, under
11 Section 212(d)(5) of the Immigration and Nationality
12 Act.
13 Those children who are in the categories set forth in
14 subdivisions (4)(F) and (4)(G) of this subsection, who enter
15 the United States on or after August 22, 1996, shall not be
16 eligible for 5 years beginning on the date the child entered
17 the United States.
18 (b) A child who is determined to be eligible for
19 assistance may shall remain eligible for 12 months, provided
20 the child maintains his or her residence in the State, has
21 not yet attained 19 years of age, and is not excluded
22 pursuant to subsection (c). A child who has been determined
23 to be eligible for assistance must reapply or otherwise
24 establish eligibility Eligibility shall be re-determined by
25 the Department at least annually. An eligible child shall be
26 required, as determined by the Department by rule, to report
27 promptly those changes in income and other circumstances that
28 affect eligibility. The eligibility of a child may be
29 redetermined based on the information reported or may be
30 terminated based on the failure to report or failure to
31 report accurately. A child's responsible relative or
32 caretaker may also be held liable to the Department for any
33 payments made by the Department on such child's behalf that
34 were inappropriate. An applicant shall be provided with
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1 notice of these obligations.
2 (c) A child shall not be eligible for coverage under
3 this Program if:
4 (1) the premium required pursuant to Section 30 of
5 this Act has not been paid. If the required premiums are
6 not paid the liability of the Program shall be limited to
7 benefits incurred under the Program for the time period
8 for which premiums had been paid. If the required
9 monthly premium is not paid, the child shall be
10 ineligible for re-enrollment for a minimum period of 3
11 months. Re-enrollment shall be completed prior to the
12 next covered medical visit and the first month's required
13 premium shall be paid in advance of the next covered
14 medical visit. The Department shall promulgate rules
15 regarding grace periods, notice requirements, and hearing
16 procedures pursuant to this subsection;
17 (2) the child is an inmate of a public institution
18 or a patient in an institution for mental diseases; or
19 (3) the child is a member of a family that is
20 eligible for health benefits covered under the State of
21 Illinois health benefits plan on the basis of a member's
22 employment with a public agency.
23 (Source: P.A. 90-736, eff. 8-12-98.)
24 (215 ILCS 106/40)
25 (Section scheduled to be repealed on July 1, 2002)
26 Sec. 40. Waivers.
27 (a) The Department shall request any necessary waivers
28 of federal requirements in order to allow receipt of federal
29 funding for:
30 (1) the coverage of families with eligible children
31 under this Act; and
32 (2) for the coverage of children who would
33 otherwise be eligible under this Act, but who have health
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1 insurance.
2 (b) The failure of the responsible federal agency to
3 approve a waiver for children who would otherwise be eligible
4 under this Act but who have health insurance shall not
5 prevent the implementation of any Section of this Act
6 provided that there are sufficient appropriated funds.
7 (c) Eligibility of a person under an approved waiver due
8 to the relationship with a child pursuant to Article V of the
9 Illinois Public Aid Code or this Act shall be limited to such
10 a person whose countable income is determined by the
11 Department to be at or below 65% of the federal poverty
12 level. Such persons who are determined to be eligible must
13 reapply, or otherwise establish eligibility, at least
14 annually. An eligible person shall be required, as
15 determined by the Department by rule, to report promptly
16 those changes in income and other circumstances that affect
17 eligibility. The eligibility of a person may be redetermined
18 based on the information reported or may be terminated based
19 on the failure to report or failure to report accurately. A
20 person may also be held liable to the Department for any
21 payments made by the Department on such person's behalf that
22 were inappropriate. An applicant shall be provided with
23 notice of these obligations.
24 (Source: P.A. 90-736, eff. 8-12-98.)
25 (215 ILCS 106/97)
26 (Section scheduled to be repealed on July 1, 2002)
27 Sec. 97. Repealer. This Act is repealed on July 1, 2003
28 2002.
29 (Source: P.A. 90-736, eff. 8-12-98; 91-712, eff. 7-1-00.)
30 Section 80. The Illinois Public Aid Code is amended by
31 changing Sections 5-2, 5-4.1, 5-5.4, 5-5.12, 11-16, 12-3,
32 12-4.34, 12-10.5, and 12-13.05 as follows:
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1 (305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
2 Sec. 5-2. Classes of Persons Eligible. Medical
3 assistance under this Article shall be available to any of
4 the following classes of persons in respect to whom a plan
5 for coverage has been submitted to the Governor by the
6 Illinois Department and approved by him:
7 1. Recipients of basic maintenance grants under Articles
8 III and IV.
9 2. Persons otherwise eligible for basic maintenance
10 under Articles III and IV but who fail to qualify thereunder
11 on the basis of need, and who have insufficient income and
12 resources to meet the costs of necessary medical care,
13 including but not limited to the following:
14 (a) All persons otherwise eligible for basic
15 maintenance under Article III but who fail to qualify
16 under that Article on the basis of need and who meet
17 either of the following requirements:
18 (i) their income, as determined by the
19 Illinois Department in accordance with any federal
20 requirements, is equal to or less than 70% in fiscal
21 year 2001, equal to or less than 85% in fiscal year
22 2002 and until a date to be determined by the
23 Department by rule, and equal to or less than 100%
24 beginning on the date determined by the Department
25 by rule, in fiscal year 2003 and thereafter of the
26 nonfarm income official poverty line, as defined by
27 the federal Office of Management and Budget and
28 revised annually in accordance with Section 673(2)
29 of the Omnibus Budget Reconciliation Act of 1981,
30 applicable to families of the same size; or
31 (ii) their income, after the deduction of
32 costs incurred for medical care and for other types
33 of remedial care, is equal to or less than 70% in
34 fiscal year 2001, equal to or less than 85% in
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1 fiscal year 2002 and until a date to be determined
2 by the Department by rule, and equal to or less than
3 100% beginning on the date determined by the
4 Department by rule, in fiscal year 2003 and
5 thereafter of the nonfarm income official poverty
6 line, as defined in item (i) of this subparagraph
7 (a).
8 (b) All persons who would be determined eligible
9 for such basic maintenance under Article IV by
10 disregarding the maximum earned income permitted by
11 federal law.
12 3. Persons who would otherwise qualify for Aid to the
13 Medically Indigent under Article VII.
14 4. Persons not eligible under any of the preceding
15 paragraphs who fall sick, are injured, or die, not having
16 sufficient money, property or other resources to meet the
17 costs of necessary medical care or funeral and burial
18 expenses.
19 5. (a) Women during pregnancy, after the fact of
20 pregnancy has been determined by medical diagnosis, and
21 during the 60-day period beginning on the last day of the
22 pregnancy, together with their infants and children born
23 after September 30, 1983, whose income and resources are
24 insufficient to meet the costs of necessary medical care
25 to the maximum extent possible under Title XIX of the
26 Federal Social Security Act.
27 (b) The Illinois Department and the Governor shall
28 provide a plan for coverage of the persons eligible under
29 paragraph 5(a) by April 1, 1990. Such plan shall provide
30 ambulatory prenatal care to pregnant women during a
31 presumptive eligibility period and establish an income
32 eligibility standard that is equal to 133% of the nonfarm
33 income official poverty line, as defined by the federal
34 Office of Management and Budget and revised annually in
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1 accordance with Section 673(2) of the Omnibus Budget
2 Reconciliation Act of 1981, applicable to families of the
3 same size, provided that costs incurred for medical care
4 are not taken into account in determining such income
5 eligibility.
6 (c) The Illinois Department may conduct a
7 demonstration in at least one county that will provide
8 medical assistance to pregnant women, together with their
9 infants and children up to one year of age, where the
10 income eligibility standard is set up to 185% of the
11 nonfarm income official poverty line, as defined by the
12 federal Office of Management and Budget. The Illinois
13 Department shall seek and obtain necessary authorization
14 provided under federal law to implement such a
15 demonstration. Such demonstration may establish resource
16 standards that are not more restrictive than those
17 established under Article IV of this Code.
18 6. Persons under the age of 18 who fail to qualify as
19 dependent under Article IV and who have insufficient income
20 and resources to meet the costs of necessary medical care to
21 the maximum extent permitted under Title XIX of the Federal
22 Social Security Act.
23 7. Persons who are 18 years of age or younger and would
24 qualify as disabled as defined under the Federal Supplemental
25 Security Income Program, provided medical service for such
26 persons would be eligible for Federal Financial
27 Participation, and provided the Illinois Department
28 determines that:
29 (a) the person requires a level of care provided by
30 a hospital, skilled nursing facility, or intermediate
31 care facility, as determined by a physician licensed to
32 practice medicine in all its branches;
33 (b) it is appropriate to provide such care outside
34 of an institution, as determined by a physician licensed
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1 to practice medicine in all its branches;
2 (c) the estimated amount which would be expended
3 for care outside the institution is not greater than the
4 estimated amount which would be expended in an
5 institution.
6 8. Persons who become ineligible for basic maintenance
7 assistance under Article IV of this Code in programs
8 administered by the Illinois Department due to employment
9 earnings and persons in assistance units comprised of adults
10 and children who become ineligible for basic maintenance
11 assistance under Article VI of this Code due to employment
12 earnings. The plan for coverage for this class of persons
13 shall:
14 (a) extend the medical assistance coverage for up
15 to 12 months following termination of basic maintenance
16 assistance; and
17 (b) offer persons who have initially received 6
18 months of the coverage provided in paragraph (a) above,
19 the option of receiving an additional 6 months of
20 coverage, subject to the following:
21 (i) such coverage shall be pursuant to
22 provisions of the federal Social Security Act;
23 (ii) such coverage shall include all services
24 covered while the person was eligible for basic
25 maintenance assistance;
26 (iii) no premium shall be charged for such
27 coverage; and
28 (iv) such coverage shall be suspended in the
29 event of a person's failure without good cause to
30 file in a timely fashion reports required for this
31 coverage under the Social Security Act and coverage
32 shall be reinstated upon the filing of such reports
33 if the person remains otherwise eligible.
34 9. Persons with acquired immunodeficiency syndrome
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1 (AIDS) or with AIDS-related conditions with respect to whom
2 there has been a determination that but for home or
3 community-based services such individuals would require the
4 level of care provided in an inpatient hospital, skilled
5 nursing facility or intermediate care facility the cost of
6 which is reimbursed under this Article. Assistance shall be
7 provided to such persons to the maximum extent permitted
8 under Title XIX of the Federal Social Security Act.
9 10. Participants in the long-term care insurance
10 partnership program established under the Partnership for
11 Long-Term Care Act who meet the qualifications for protection
12 of resources described in Section 25 of that Act.
13 11. Persons with disabilities who are employed and
14 eligible for Medicaid, pursuant to Section
15 1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
16 provided by the Illinois Department by rule.
17 12. Subject to federal approval, persons who are
18 eligible for medical assistance coverage under applicable
19 provisions of the federal Social Security Act and the federal
20 Breast and Cervical Cancer Prevention and Treatment Act of
21 2000. Those eligible persons are defined to include, but not
22 be limited to, the following persons:
23 (1) persons who have been screened for breast or
24 cervical cancer under the U.S. Centers for Disease
25 Control and Prevention Breast and Cervical Cancer Program
26 established under Title XV of the federal Public Health
27 Services Act in accordance with the requirements of
28 Section 1504 of that Act as administered by the Illinois
29 Department of Public Health; and
30 (2) persons whose screenings under the above
31 program were funded in whole or in part by funds
32 appropriated to the Illinois Department of Public Health
33 for breast or cervical cancer screening.
34 "Medical assistance" under this paragraph 12 shall be
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1 identical to the benefits provided under the State's approved
2 plan under Title XIX of the Social Security Act. The
3 Department must request federal approval of the coverage
4 under this paragraph 12 within 30 days after the effective
5 date of this amendatory Act of the 92nd General Assembly.
6 The Illinois Department and the Governor shall provide a
7 plan for coverage of the persons eligible under paragraph 7
8 as soon as possible after July 1, 1984.
9 The eligibility of any such person for medical assistance
10 under this Article is not affected by the payment of any
11 grant under the Senior Citizens and Disabled Persons Property
12 Tax Relief and Pharmaceutical Assistance Act or any
13 distributions or items of income described under subparagraph
14 (X) of paragraph (2) of subsection (a) of Section 203 of the
15 Illinois Income Tax Act. The Department shall by rule
16 establish the amounts of assets to be disregarded in
17 determining eligibility for medical assistance, which shall
18 at a minimum equal the amounts to be disregarded under the
19 Federal Supplemental Security Income Program. The amount of
20 assets of a single person to be disregarded shall not be less
21 than $2,000, and the amount of assets of a married couple to
22 be disregarded shall not be less than $3,000.
23 To the extent permitted under federal law, any person
24 found guilty of a second violation of Article VIIIA shall be
25 ineligible for medical assistance under this Article, as
26 provided in Section 8A-8.
27 The eligibility of any person for medical assistance
28 under this Article shall not be affected by the receipt by
29 the person of donations or benefits from fundraisers held for
30 the person in cases of serious illness, as long as neither
31 the person nor members of the person's family have actual
32 control over the donations or benefits or the disbursement of
33 the donations or benefits.
34 (Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00;
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1 91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff.
2 7-3-01.)
3 (305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
4 Sec. 5-4.1. Co-payments. The Department may by rule
5 provide that recipients under any Article of this Code (other
6 than group care recipients) shall pay a fee as a co-payment
7 for services. Co-payments may not exceed $3 for brand name
8 drugs, $1 one dollar for other pharmacy services, and $2 for
9 physicians services, dental services, optical services and
10 supplies, chiropractic services, podiatry services, and
11 encounter rate clinic services. Co-payments may not exceed
12 $3 three dollars for hospital outpatient and clinic services.
13 Provided, however, that any such rule must provide that no
14 co-payment requirement can exist for renal dialysis,
15 radiation therapy, cancer chemotherapy, or insulin, and other
16 products necessary on a recurring basis, the absence of which
17 would be life threatening, or where co-payment expenditures
18 for required services and/or medications for chronic diseases
19 that the Illinois Department shall by rule designate shall
20 cause an extensive financial burden on the recipient, and
21 provided no co-payment shall exist for emergency room
22 encounters which are for medical emergencies.
23 (Source: P.A. 82-664.)
24 (305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
25 Sec. 5-5.4. Standards of Payment - Department of Public
26 Aid. The Department of Public Aid shall develop standards of
27 payment of skilled nursing and intermediate care services in
28 facilities providing such services under this Article which:
29 (1) Provide Provides for the determination of a
30 facility's payment for skilled nursing and intermediate care
31 services on a prospective basis. The amount of the payment
32 rate for all nursing facilities certified under the medical
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1 assistance program shall be prospectively established
2 annually on the basis of historical, financial, and
3 statistical data reflecting actual costs from prior years,
4 which shall be applied to the current rate year and updated
5 for inflation, except that the capital cost element for newly
6 constructed facilities shall be based upon projected budgets.
7 The annually established payment rate shall take effect on
8 July 1 in 1984 and subsequent years. Rate increases shall be
9 provided annually thereafter on July 1 in 1984 and on each
10 subsequent July 1 in the following years, except that no rate
11 increase and no update for inflation shall be provided on or
12 after July 1, 1994 and before July 1, 2003 2002, unless
13 specifically provided for in this Section.
14 For facilities licensed by the Department of Public
15 Health under the Nursing Home Care Act as Intermediate Care
16 for the Developmentally Disabled facilities or Long Term Care
17 for Under Age 22 facilities, the rates taking effect on July
18 1, 1998 shall include an increase of 3%. For facilities
19 licensed by the Department of Public Health under the Nursing
20 Home Care Act as Skilled Nursing facilities or Intermediate
21 Care facilities, the rates taking effect on July 1, 1998
22 shall include an increase of 3% plus $1.10 per resident-day,
23 as defined by the Department.
24 For facilities licensed by the Department of Public
25 Health under the Nursing Home Care Act as Intermediate Care
26 for the Developmentally Disabled facilities or Long Term Care
27 for Under Age 22 facilities, the rates taking effect on July
28 1, 1999 shall include an increase of 1.6% plus $3.00 per
29 resident-day, as defined by the Department. For facilities
30 licensed by the Department of Public Health under the Nursing
31 Home Care Act as Skilled Nursing facilities or Intermediate
32 Care facilities, the rates taking effect on July 1, 1999
33 shall include an increase of 1.6% and, for services provided
34 on or after October 1, 1999, shall be increased by $4.00 per
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1 resident-day, as defined by the Department.
2 For facilities licensed by the Department of Public
3 Health under the Nursing Home Care Act as Intermediate Care
4 for the Developmentally Disabled facilities or Long Term Care
5 for Under Age 22 facilities, the rates taking effect on July
6 1, 2000 shall include an increase of 2.5% per resident-day,
7 as defined by the Department. For facilities licensed by the
8 Department of Public Health under the Nursing Home Care Act
9 as Skilled Nursing facilities or Intermediate Care
10 facilities, the rates taking effect on July 1, 2000 shall
11 include an increase of 2.5% per resident-day, as defined by
12 the Department.
13 For facilities licensed by the Department of Public
14 Health under the Nursing Home Care Act as Intermediate Care
15 for the Developmentally Disabled facilities or Long Term Care
16 for Under Age 22 facilities, the rates taking effect on March
17 1, 2001 shall include a statewide increase of 7.85%, as
18 defined by the Department.
19 For facilities licensed by the Department of Public
20 Health under the Nursing Home Care Act as Intermediate Care
21 for the Developmentally Disabled facilities or Long Term Care
22 for Under Age 22 facilities, the rates taking effect on April
23 1, 2002 shall include a statewide increase of 2.0%, as
24 defined by the Department. This increase terminates on July
25 1, 2002; beginning July 1, 2002 these rates are reduced to
26 the level of the rates in effect on March 31, 2002, as
27 defined by the Department.
28 For facilities licensed by the Department of Public
29 Health under the Nursing Home Care Act as skilled nursing
30 facilities or intermediate care facilities, the rates taking
31 effect on July 1, 2001, and each subsequent year thereafter,
32 shall be computed using the most recent cost reports on file
33 with the Department of Public Aid no later than April 1,
34 2000, updated for inflation to January 1, 2001. For rates
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1 effective July 1, 2001 only, rates shall be the greater of
2 the rate computed for July 1, 2001 or the rate effective on
3 June 30, 2001.
4 Notwithstanding any other provision of this Section, for
5 facilities licensed by the Department of Public Health under
6 the Nursing Home Care Act as skilled nursing facilities or
7 intermediate care facilities, the Illinois Department shall
8 determine by rule the rates taking effect on July 1, 2002,
9 which shall be 5.9% less than the rates in effect on June 30,
10 2002.
11 Rates established effective each July 1 shall govern
12 payment for services rendered throughout that fiscal year,
13 except that rates established on July 1, 1996 shall be
14 increased by 6.8% for services provided on or after January
15 1, 1997. Such rates will be based upon the rates calculated
16 for the year beginning July 1, 1990, and for subsequent years
17 thereafter until June 30, 2001 shall be based on the facility
18 cost reports for the facility fiscal year ending at any point
19 in time during the previous calendar year, updated to the
20 midpoint of the rate year. The cost report shall be on file
21 with the Department no later than April 1 of the current rate
22 year. Should the cost report not be on file by April 1, the
23 Department shall base the rate on the latest cost report
24 filed by each skilled care facility and intermediate care
25 facility, updated to the midpoint of the current rate year.
26 In determining rates for services rendered on and after July
27 1, 1985, fixed time shall not be computed at less than zero.
28 The Department shall not make any alterations of regulations
29 which would reduce any component of the Medicaid rate to a
30 level below what that component would have been utilizing in
31 the rate effective on July 1, 1984.
32 (2) Shall take into account the actual costs incurred by
33 facilities in providing services for recipients of skilled
34 nursing and intermediate care services under the medical
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1 assistance program.
2 (3) Shall take into account the medical and
3 psycho-social characteristics and needs of the patients.
4 (4) Shall take into account the actual costs incurred by
5 facilities in meeting licensing and certification standards
6 imposed and prescribed by the State of Illinois, any of its
7 political subdivisions or municipalities and by the U.S.
8 Department of Health and Human Services pursuant to Title XIX
9 of the Social Security Act.
10 The Department of Public Aid shall develop precise
11 standards for payments to reimburse nursing facilities for
12 any utilization of appropriate rehabilitative personnel for
13 the provision of rehabilitative services which is authorized
14 by federal regulations, including reimbursement for services
15 provided by qualified therapists or qualified assistants, and
16 which is in accordance with accepted professional practices.
17 Reimbursement also may be made for utilization of other
18 supportive personnel under appropriate supervision.
19 (Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
20 eff. 6-11-01; 92-31, eff. 6-28-01; revised 12-13-01.)
21 (305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)
22 Sec. 5-5.12. Pharmacy payments.
23 (a) Every request submitted by a pharmacy for
24 reimbursement under this Article for prescription drugs
25 provided to a recipient of aid under this Article shall
26 include the name of the prescriber or an acceptable
27 identification number as established by the Department.
28 (b) Pharmacies providing prescription drugs under this
29 Article shall be reimbursed at a rate which shall include a
30 professional dispensing fee as determined by the Illinois
31 Department, plus the current acquisition cost of the
32 prescription drug dispensed. The Illinois Department shall
33 update its information on the acquisition costs of all
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1 prescription drugs no less frequently than every 30 days.
2 However, the Illinois Department may set the rate of
3 reimbursement for the acquisition cost, by rule, at a
4 percentage of the current average wholesale acquisition cost.
5 (c) Reimbursement under this Article for prescription
6 drugs shall be limited to reimbursement for 4 brand-name
7 prescription drugs per patient per month. This subsection
8 applies only if (i) the brand-name drug was not prescribed
9 for an acute or urgent condition, (ii) the brand-name drug
10 was not prescribed for Alzheimer's disease, arthritis,
11 diabetes, HIV/AIDS, a mental health condition, or respiratory
12 disease, and (iii) a therapeutically equivalent generic
13 medication has been approved by the federal Food and Drug
14 Administration.
15 (Source: P.A. 88-554, eff. 7-26-94; 89-673, eff. 8-14-96.)
16 (305 ILCS 5/11-16) (from Ch. 23, par. 11-16)
17 Sec. 11-16. Changes in grants; cancellations,
18 revocations, suspensions.
19 (a) All grants of financial aid under this Code shall be
20 considered as frequently as may be required by the rules of
21 the Illinois Department. The Department of Public Aid shall
22 consider grants of financial aid to children who are eligible
23 under Article V of this Code at least annually and shall take
24 into account those reports filed, or required to be filed,
25 pursuant to Sections 11-18 and 11-19. After such
26 investigation as may be necessary, the amount and manner of
27 giving aid may be changed or the aid may be entirely
28 withdrawn if the County Department, local governmental unit,
29 or Illinois Department finds that the recipient's
30 circumstances have altered sufficiently to warrant such
31 action. Financial aid may at any time be canceled or revoked
32 for cause or suspended for such period as may be proper.
33 (b) Whenever any such grant of financial aid is
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1 cancelled, revoked, reduced, or terminated because of the
2 failure of the recipient to cooperate with the Department,
3 including but not limited to the failure to keep an
4 appointment, attend a meeting, or produce proof or
5 verification of eligibility or need, the grant shall be
6 reinstated in full, retroactive to the date of the change in
7 or termination of the grant, provided that within 10 working
8 days after the first day the financial aid would have been
9 available, the recipient cooperates with the Department and
10 is not otherwise ineligible for benefits for the period in
11 question. This subsection (b) does not apply to sanctions
12 imposed for the failure of any recipient to participate as
13 required in the child support enforcement program or in any
14 educational, training, or employment program under this Code
15 or any other sanction under Section 4-21, nor does this
16 subsection (b) apply to any cancellation, revocation,
17 reduction, termination, or sanction imposed for the failure
18 of any recipient to cooperate in the monthly reporting
19 process or the quarterly reporting process.
20 (Source: P.A. 90-17, eff. 7-1-97; 91-357, eff. 7-29-99.)
21 (305 ILCS 5/12-3) (from Ch. 23, par. 12-3)
22 Sec. 12-3. Local governmental units. As provided in
23 Article VI, local governmental units shall provide funds for
24 and administer the programs provided in that Article subject,
25 where so provided, to the supervision of the Illinois
26 Department. Local governmental units shall also provide the
27 social services and utilize the rehabilitative facilities
28 authorized in Article IX for persons served through Article
29 VI, and shall discharge such other duties as may be required
30 by this Code or other laws of this State.
31 In counties not under township organization, the county
32 shall provide funds for and administer such programs.
33 In counties under township organization (including any
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1 such counties in which the governing authority is a board of
2 commissioners) the various towns other than those towns lying
3 entirely within the corporate limits of any city, village or
4 incorporated town having a population of more than 500,000
5 inhabitants shall provide funds for and administer such
6 programs.
7 Cities, villages, and incorporated towns having a
8 population of more than 500,000 inhabitants shall provide
9 funds for public aid purposes under Article VI but the
10 Department of Human Services shall administer the program for
11 such municipality. For the fiscal year beginning July 1,
12 2003, however, the municipality shall decrease by $5,000,000
13 the amount of funds it provides for public aid purposes under
14 Article VI. For each fiscal year thereafter, the
15 municipality shall decrease the amount of funds it provides
16 for public aid purposes under Article VI in that fiscal year
17 by an additional amount equal to (i) $5,000,000 or (ii) the
18 amount provided by the municipality in the preceding fiscal
19 year, whichever is less, until the municipality does not
20 provide any funds for public aid purposes under Article VI.
21 Incorporated towns which have superseded civil townships
22 shall provide funds for and administer the public aid program
23 provided by Article VI.
24 In counties of less than 3 million population having a
25 County Veterans Assistance Commission in which there has been
26 levied a tax as authorized by Section 5-2006 of the Counties
27 Code for the purpose of providing assistance to military
28 veterans and their families, the County Veterans Assistance
29 Commission shall administer the programs provided by Article
30 VI for such military veterans and their families as seek aid
31 through the County Veterans Assistance Commission.
32 (Source: P.A. 92-111, eff. 1-1-02.)
33 (305 ILCS 5/12-4.34)
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1 (Section scheduled to be repealed on August 31, 2002)
2 Sec. 12-4.34. Services to noncitizens.
3 (a) Subject to specific appropriation for this purpose
4 and notwithstanding Sections 1-11 and 3-1 of this Code, the
5 Department of Human Services is authorized to provide
6 services to legal immigrants, including but not limited to
7 naturalization and nutrition services and financial
8 assistance. The nature of these services, payment levels,
9 and eligibility conditions shall be determined by rule.
10 (b) The Illinois Department is authorized to lower the
11 payment levels established under this subsection or take such
12 other actions during the fiscal year as are necessary to
13 ensure that payments under this subsection do not exceed the
14 amounts appropriated for this purpose. These changes may be
15 accomplished by emergency rule under Section 5-45 of the
16 Illinois Administrative Procedure Act, except that the
17 limitation on the number of emergency rules that may be
18 adopted in a 24-month period shall not apply.
19 (c) This Section is repealed on August 31, 2002.
20 (Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
21 eff. 6-11-01.)
22 (305 ILCS 5/12-10.5)
23 Sec. 12-10.5. Medical Special Purposes Trust Fund.
24 (a) The Medical Special Purposes Trust Fund ("the Fund")
25 is created. Any grant, gift, donation, or legacy of money or
26 securities that the Department of Public Aid is authorized to
27 receive under Section 12-4.18 or Section 12-4.19, and that is
28 dedicated for functions connected with the administration of
29 any medical program administered by the Department, shall be
30 deposited into the Fund. All federal moneys received by the
31 Department as reimbursement for disbursements authorized to
32 be made from the Fund shall also be deposited into the Fund.
33 In addition, federal moneys received on account of State
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1 expenditures made in connection with obtaining compliance
2 with the federal Health Insurance Portability and
3 Accountability Act (HIPAA) shall be deposited into the Fund.
4 (b) No moneys received from a service provider or a
5 governmental or private entity that is enrolled with the
6 Department as a provider of medical services shall be
7 deposited into the Fund.
8 (c) Disbursements may be made from the Fund for the
9 purposes connected with the grants, gifts, donations, or
10 legacies deposited into the Fund, including, but not limited
11 to, medical quality assessment projects, eligibility
12 population studies, medical information systems evaluations,
13 and other administrative functions that assist the Department
14 in fulfilling its health care mission under the Illinois
15 Public Aid Code and the Children's Health Insurance Program
16 Act.
17 (Source: P.A. 92-37, eff. 7-1-01.)
18 (305 ILCS 5/12-13.05)
19 Sec. 12-13.05. Rules for Temporary Assistance for Needy
20 Families. All rules regulating the Temporary Assistance for
21 Needy Families program and all other rules regulating the
22 amendatory changes to this Code made by this amendatory Act
23 of 1997 shall be promulgated pursuant to this Section. All
24 rules regulating the Temporary Assistance for Needy Families
25 program and all other rules regulating the amendatory changes
26 to this Code made by this amendatory Act of 1997 are repealed
27 on July 1 2006 January 1, 2003. On and after July 1, 2006
28 January 1, 2003, the Illinois Department may not promulgate
29 any rules regulating the Temporary Assistance for Needy
30 Families program or regulating the amendatory changes to this
31 Code made by this amendatory Act of 1997.
32 (Source: P.A. 91-5, eff. 5-27-99; 92-111, eff. 1-1-02.)
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1 Section 85. The Senior Citizens and Disabled Persons
2 Property Tax Relief and Pharmaceutical Assistance Act is
3 amended by changing Section 3.16 as follows:
4 (320 ILCS 25/3.16) (from Ch. 67 1/2, par. 403.16)
5 Sec. 3.16. "Reasonable cost" means Average Wholesale
6 Price (AWP) minus 10% for products provided by authorized
7 pharmacies plus a professional dispensing fee determined by
8 the Department in accordance with its findings in a survey of
9 professional pharmacy dispensing fees conducted at least
10 every 12 months. For the purpose of this Act, AWP shall be
11 determined from the latest publication of the Blue Book, a
12 universally subscribed pharmacist reference guide annually
13 published by the Hearst Corporation. AWP may also be derived
14 electronically from the drug pricing database synonymous with
15 the latest publication of the Blue Book and furnished in the
16 National Drug Data File (NDDF) by First Data Bank (FDB), a
17 service of the Hearst Corporation. The elements of such fees
18 and methodology of such survey shall be promulgated as an
19 administrative rule. Effective July 1, 1986, the
20 professional dispensing fee shall be $3.60 per prescription
21 and such amount shall be adjusted on July 1st of each year
22 thereafter in accordance with a survey of professional
23 pharmacy dispensing fees. The Department may establish
24 maximum acquisition costs from time to time based upon
25 information as to the cost at which covered products may be
26 readily acquired by authorized pharmacies. In no case shall
27 the reasonable cost of any given pharmacy exceed the price
28 normally charged to the general public by that pharmacy. In
29 the event that generic equivalents for covered prescription
30 drugs are available at lower cost, the Department shall
31 establish the maximum acquisition costs for such covered
32 prescription drugs at the lower generic cost unless, pursuant
33 to the conditions described in subsection (f) of Section 4, a
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1 non-generic drug may be substituted.
2 Effective July 1, 2002, the rates paid for products
3 provided by authorized pharmacies and a professional
4 dispensing fee shall be determined by the Department by rule.
5 (Source: P.A. 91-699, eff. 1-1-01.)
6 Section 99. Effective date. This Act takes effect upon
7 becoming law, except that Sections 25, 26, 45, 60, and 65
8 take effect on July 1, 2002.
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