(305 ILCS 5/12-4.47) Sec. 12-4.47. Continued eligibility for developmental disability services for dependents of military service members. (a) As used in this Section: "Dependent" means a spouse, birth child, adopted child, or
stepchild of a military service member. "Legal resident" means a person who maintains Illinois as his
or her principal establishment, home of record, or permanent home and
to where, whenever absent due to military obligation, he or she intends
to return. "Military service" means service in the armed forces or armed
forces reserves of the United States, or membership in the Illinois National Guard. "Military service member" means a person who is currently in military service or who
has separated from military service in the previous 18 months through
either retirement or military separation. (b) A dependent, who is a legal resident of the State, having
previously been determined to be eligible for developmental disability
services provided by the Department of Human Services, including waiver services provided under the home and community based services programs authorized under Section 1915(c) of the Social Security Act, shall retain eligibility for those developmental disability services as long as he
or she remains a legal resident of the State, regardless of having left the State due to the military service member's military assignment
outside the State, and as long as he or she is otherwise eligible for such services. (c) The Department of Human Services shall permit a dependent who resides out-of-state to be placed on the waiting list for developmental disabilities services if the dependent left the State due to the military service member's military assignment outside the State, is otherwise eligible for those services, and furnishes the following: (1) a copy of the military service member's DD-214 or |
| other equivalent discharge paperwork; and
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(2) proof of the military service member's legal
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| residence in the State, as prescribed by the Department.
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(d) For dependents who received developmental disability services
and who left the State due to the military service member's military
assignment outside the State, upon the dependent's return to the State and when a request for services is made, the Department shall:
(1) determine the dependent's eligibility for
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| services, which may include a request for waiver services provided under the home and community based services programs authorized under Section 1915(c) of the Social Security Act;
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(2) provide to the dependent notification of the
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| determination of eligibility for services, which includes notification of a denial of services if applicable;
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(3) provide the dependent an opportunity to contest
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| the Department's determination through the appeals processes established by the Department; and
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(4) resume services if the individual remains
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(e) As a condition of continued eligibility for services under subsection (b) of this Section,
a dependent must inform the Department of his or her
current address and provide updates as requested by the Department.
(f) No payment pursuant to this Section shall be made for developmental disability services authorized under the Illinois Title XIX State Plan and provided outside the State unless those services satisfy the conditions specified in 42 CFR 431.52. No payment pursuant to this Section shall be made for home and community based services provided outside the State of Illinois.
(g) The Department shall request a waiver from the appropriate
federal agency if a waiver is necessary to implement the provisions of this
Section.
(h) The Department may adopt rules necessary to implement the
provisions of this Section.
(Source: P.A. 98-1000, eff. 8-18-14; 99-78, eff. 7-20-15.)
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(305 ILCS 5/12-4.48) Sec. 12-4.48. Long-Term Services and Supports Disparities Workgroup. (a) The Department of Healthcare and Family Services shall establish a Long-Term Services and Supports Disparities Workgroup of the Medicaid Advisory Committee in accordance with the requirements of 42 CFR 431.12. (b) Members of the Workgroup shall be appointed by the Director of the Department of Healthcare and Family Services and may include representatives of the following agencies, organizations, or groups: (1) (Blank). (2) (Blank). (3) (Blank). (4) (Blank). (5) (Blank). (6) (Blank). (7) (Blank). (8) Managed Care Plans. (9) The for-profit urban nursing home or assisted |
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(10) The for-profit rural nursing home or assisted
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(11) The not-for-profit nursing home or assisted
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(12) The home care association or home care industry.
(13) The adult day care association or adult day care
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(14) An association representing workers who provide
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| long-term services and supports.
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(15) A representative of providers that serve the
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| predominantly ethnic minority populations.
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(16) Case Management Organizations.
(17) Three consumer representatives which may include
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| a consumer of long-term services and supports or an individual who advocates for such consumers. For purposes of this provision, "consumer representative" means a person who is not an elected official and who has no financial interest in a health or long-term care delivery system.
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(b-5) In addition, one representative from each of the following may serve ex officio: the Governor's Office; the Department of Healthcare and Family Services; the Department of Human Services; the Department on Aging; the Department of Public Health; and the Department of Human Rights.
(c) The Workgroup shall reflect diversity in race, ethnicity, and gender.
(d) The Chair of the Workgroup shall be appointed by the Director of the Department of Healthcare and Family Services.
(e) The Director of the Department of Healthcare and Family Services shall assign appropriate staff and resources to support the efforts of the Workgroup. The Workgroup shall meet as often as necessary but not less than 4 times per calendar year.
(f) The Workgroup shall promote and facilitate communication, coordination, and collaboration among relevant State agencies and communities of color, limited English-speaking communities, and the private and public entities providing services to those communities.
(g) The Workgroup shall do all of the following:
(1) Document the number and types of Long-Term
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| Services and Supports (LTSS) providers in the State and the number of clients served in each setting.
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(2) Document the number and racial profiles of
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| residents using LTSS, including, but not limited to, residential nursing facilities, assisted living facilities, adult day care, home health services, and other home and community based long-term care services.
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(3) Document the number and profiles of family or
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| informal caregivers who provide care for minority elders.
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(4) Compare data over multiple years to identify
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| trends in the delivery of LTSS for each racial or ethnic category including: Alaskan Native or American Indian, Asian or Pacific Islander, black or African American, Hispanic, or white.
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(5) Identify any racial disparities in the provision
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| of care in various LTSS settings and determine factors that might influence the disparities found.
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(6) Identify any disparities uniquely experienced in
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| metropolitan or rural areas and make recommendations to address these areas.
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(7) Assess whether the LTSS industry, including
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| managed care plans and independent providers, is equipped to offer culturally sensitive, competent, and linguistically appropriate care to meet the needs of a diverse aging population and their informal and formal caregivers.
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(8) Consider whether to recommend that the State
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| require all home and community based services as a condition of licensure to report data similar to that gathered under the Minimum Data Set and required when a new resident is admitted to a nursing home.
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(9) Identify and prioritize recommendations for
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| actions to be taken by the State to address disparity issues identified in the course of these studies.
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(10) Monitor the progress of the State in eliminating
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| racial disparities in the delivery of LTSS.
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(h) The Workgroup may conduct public hearings, inquiries, studies, and other forms of information gathering to identify how the actions of State government contribute to or reduce racial disparities in long-term care settings.
(i) The Workgroup shall report its findings and recommendations to the Governor and the General Assembly with annual reports and shall include documentation of progress made to eliminate disparities in long-term care service settings.
(Source: P.A. 103-508, eff. 8-4-23.)
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(305 ILCS 5/12-4.50) Sec. 12-4.50. Healthy Local Food Incentives Program. (a) Legislative findings. Diet and other lifestyle choices contribute to more than half of all deaths in Illinois. Health risk factors include smoking, obesity, stress, nutrition, high blood pressure, and alcohol and drug use. Illinois residents should be encouraged to adopt diets and lifestyles that lead to wellness. The State can help provide that encouragement by funding wellness programs that enhance the health of Illinois residents. Healthy local food incentives encourage wellness among some of the most vulnerable residents of Illinois (those whose incomes are below the poverty line and who often have limited access to fresh, healthy, and affordable foods) by doubling the purchasing power of LINK cardholders at farmers markets across the State. The benefits of such a program include: an increase in population health, Medicaid health care cost savings, decreased incidence of preventable diseases, increased revenue for Illinois small farmers, and economic stimulus for the region. (b) Definitions. As used in this Section: "FINI eligible fruits and vegetables" means any variety of fresh, canned, dried, or frozen whole or cut fruits and vegetables without added sugars, fats, or oils, and salt (i.e. sodium), as defined by the Food Insecurity Nutrition Incentive Grant Program administered by the United States Department of Agriculture. "LINK card" means an electronic benefits transfer card issued by the Department of Human Services for the purpose of enabling a user of the card to obtain SNAP benefits or cash. "SNAP" means the federal Supplemental Nutrition Assistance Program. (c) The Department of Human Services shall establish a Healthy Local Food Incentives Program to double the purchasing power of Illinois residents with limited access to fresh fruits and vegetables. The Healthy Local Food Incentives Fund is created as a special fund in the State treasury for the purpose of implementing the Healthy Local Food Incentives Program. All moneys received pursuant to this Section shall be deposited into the Healthy Local Food Incentives Fund. (d) Subject to appropriation, the Department of Human Services shall make an annual grant of $500,000 from the Fund to a qualified Illinois non-profit organization or agency, which shall be distributed to participating Illinois farmers markets for the purpose of providing matching dollar incentives (up to a specified amount) for the dollar value of SNAP benefits spent on FINI eligible fruits and vegetables at participating Illinois farmers markets and direct producer-to-consumer venues. (e) The designated qualified non-profit organization or agency shall have a demonstrated track record of: (1) building a statewide network; (2) designing and implementing successful healthy |
| food incentive programs that connect SNAP recipients with local producers;
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(3) implementing funds distribution and reporting
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(4) providing training and technical assistance to
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(5) conducting community outreach and data
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(6) providing full accounting and administration of
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| funds distributed to farmers markets.
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(f) 100% of the moneys deposited into the Fund shall be distributed to participating Illinois farmers markets for healthy local food incentives.
(g) Within 90 days after the end of a grant cycle, the designated qualified non-profit organization or agency shall submit a progress report to the Department of Human Services. The progress report shall include the following information:
(1) the names and locations of Illinois farmers
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| markets and direct producer-to-consumer venues that received funds distributed under the Program;
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(2) the dollar amount of funds awarded to each
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| participating Illinois farmers market and direct producer-to-consumer venue;
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(3) the dollar amount of SNAP benefits, and funds
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| provided under the Program, that were spent at Illinois farmers markets participating in the Program, as well as the dollar amount of any unspent funds available under the Program;
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(4) the number of SNAP transactions carried out
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| annually at participating Illinois farmers markets;
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(5) the impact of the Program on increasing the
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| quantity of fresh fruits and vegetables consumed by SNAP families, as determined by customer surveys.
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(h) No later than December 31, 2017, the Department of Human Services shall adopt rules to implement the provisions of this Section.
(i) (Blank).
(Source: P.A. 99-928, eff. 1-20-17; 100-636, eff. 1-1-19 .)
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(305 ILCS 5/12-4.52) Sec. 12-4.52. Prescriber education. (a) The Department of Healthcare and Family Services shall develop, in collaboration with a public university that has a Doctor of Pharmacy Professional Program and is located in a county with a population of more than 3,000,000, a program designed to provide
prescribing physicians under the medical assistance program with an evidence-based, non-commercial source of the latest
objective information about pharmaceuticals. Information shall be
presented to prescribing physicians by specially trained pharmacists, nurses, or
other health professionals to assist prescribing physicians in making
appropriate therapeutic recommendations. (b) The prescriber education program shall consist of 2 components: a web-based curriculum and an academic educator outreach. The program shall contract with clinical pharmacists to provide scheduled visits with prescribing physicians to update them on the latest research concerning medication usage and new updates on disease states in an unbiased manner. (c) Education provided under the prescriber education program shall include, but not be limited to, disease-based educational modules on the treatment of chronic non-cancer pain, diabetes, hypertension, hyperlipidemia, respiratory syncytial virus, and nicotine dependence. New modules may be created periodically as needed and existing module content shall be reviewed and updated on an annual or as-needed basis. Educational modules provided under the program shall provide prescribing physicians with continuing medical education credit. (d) Additional resources provided under the prescriber education program shall include, but not be limited to, the following: (1) a drug information response center available to |
| prescribing physicians that provides thorough and timely in-depth answers to any questions a prescribing physician may have within 48 hours after a question is received; and
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(2) information on drug utilization trends within
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| individual and group practices.
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(Source: P.A. 101-278, eff. 1-1-20 .)
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(305 ILCS 5/12-4.56) Sec. 12-4.56. Managed Primary Care Demonstration Project. The Department shall establish and implement a Managed Primary Care Demonstration Project to provide primary care services that are focused on preventive rather than curative care to persons who reside in underserved communities that lack accessible health and medical services. The demonstration project shall operate for a 5-year period and provide supplemental services to medical assistance recipients. The Department shall contract with a health care organization through a competitive process that is capable of providing patient-centered, prevention-focused services, that may include, but are not limited to, the following: (1) Patient navigators to manage patient care. (2) Patient-tailored preventive health care plans. (3) Administrative personal health care consultants |
| for home health maintenance between medical office visits.
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(4) Clinical personal health care consultants for
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| telehealth (health information and advice) and wellness initiatives.
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(5) A patient portal.
(6) An online virtual health hub that provides
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| patients with access to wellness, self-guided education, health seminars, a video library, and additional health and wellness resources.
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(7) Community health and human services centers to
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| engage, educate, and empower patients to get involved in their own self-care.
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(8) Mobile preventive health stations and kiosks to
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| bring services to underserved communities that are health or medical deserts.
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(9) Call centers to interact with medical homes and
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| facilitate service offerings.
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A request for proposals for the demonstration project shall be issued by December 31, 2022.
(Source: P.A. 102-699, eff. 4-19-22.)
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