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Public Act 92-0597
HB4580 Enrolled LRB9213371REmb
AN ACT in relation to budget implementation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. Short title. This Act may be cited as the
FY2003 Budget Implementation Act.
Section 5. Purpose. It is the purpose of this Act to
make certain changes in State programs that are necessary to
implement the State's FY2003 budget.
Section 10. The Illinois Administrative Procedure Act is
amended by changing Section 5-45 as follows:
(5 ILCS 100/5-45) (from Ch. 127, par. 1005-45)
Sec. 5-45. Emergency rulemaking.
(a) "Emergency" means the existence of any situation
that any agency finds reasonably constitutes a threat to the
public interest, safety, or welfare.
(b) If any agency finds that an emergency exists that
requires adoption of a rule upon fewer days than is required
by Section 5-40 and states in writing its reasons for that
finding, the agency may adopt an emergency rule without prior
notice or hearing upon filing a notice of emergency
rulemaking with the Secretary of State under Section 5-70.
The notice shall include the text of the emergency rule and
shall be published in the Illinois Register. Consent orders
or other court orders adopting settlements negotiated by an
agency may be adopted under this Section. Subject to
applicable constitutional or statutory provisions, an
emergency rule becomes effective immediately upon filing
under Section 5-65 or at a stated date less than 10 days
thereafter. The agency's finding and a statement of the
specific reasons for the finding shall be filed with the
rule. The agency shall take reasonable and appropriate
measures to make emergency rules known to the persons who may
be affected by them.
(c) An emergency rule may be effective for a period of
not longer than 150 days, but the agency's authority to adopt
an identical rule under Section 5-40 is not precluded. No
emergency rule may be adopted more than once in any 24 month
period, except that this limitation on the number of
emergency rules that may be adopted in a 24 month period does
not apply to (i) emergency rules that make additions to and
deletions from the Drug Manual under Section 5-5.16 of the
Illinois Public Aid Code or the generic drug formulary under
Section 3.14 of the Illinois Food, Drug and Cosmetic Act or
(ii) emergency rules adopted by the Pollution Control Board
before July 1, 1997 to implement portions of the Livestock
Management Facilities Act. Two or more emergency rules
having substantially the same purpose and effect shall be
deemed to be a single rule for purposes of this Section.
(d) In order to provide for the expeditious and timely
implementation of the State's fiscal year 1999 budget,
emergency rules to implement any provision of Public Act
90-587 or 90-588 or any other budget initiative for fiscal
year 1999 may be adopted in accordance with this Section by
the agency charged with administering that provision or
initiative, except that the 24-month limitation on the
adoption of emergency rules and the provisions of Sections
5-115 and 5-125 do not apply to rules adopted under this
subsection (d). The adoption of emergency rules authorized
by this subsection (d) shall be deemed to be necessary for
the public interest, safety, and welfare.
(e) In order to provide for the expeditious and timely
implementation of the State's fiscal year 2000 budget,
emergency rules to implement any provision of this amendatory
Act of the 91st General Assembly or any other budget
initiative for fiscal year 2000 may be adopted in accordance
with this Section by the agency charged with administering
that provision or initiative, except that the 24-month
limitation on the adoption of emergency rules and the
provisions of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (e). The adoption of emergency
rules authorized by this subsection (e) shall be deemed to be
necessary for the public interest, safety, and welfare.
(f) In order to provide for the expeditious and timely
implementation of the State's fiscal year 2001 budget,
emergency rules to implement any provision of this amendatory
Act of the 91st General Assembly or any other budget
initiative for fiscal year 2001 may be adopted in accordance
with this Section by the agency charged with administering
that provision or initiative, except that the 24-month
limitation on the adoption of emergency rules and the
provisions of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (f). The adoption of emergency
rules authorized by this subsection (f) shall be deemed to be
necessary for the public interest, safety, and welfare.
(g) In order to provide for the expeditious and timely
implementation of the State's fiscal year 2002 budget,
emergency rules to implement any provision of this amendatory
Act of the 92nd General Assembly or any other budget
initiative for fiscal year 2002 may be adopted in accordance
with this Section by the agency charged with administering
that provision or initiative, except that the 24-month
limitation on the adoption of emergency rules and the
provisions of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (g). The adoption of emergency
rules authorized by this subsection (g) shall be deemed to be
necessary for the public interest, safety, and welfare.
(h) In order to provide for the expeditious and timely
implementation of the State's fiscal year 2003 budget,
emergency rules to implement any provision of this amendatory
Act of the 92nd General Assembly or any other budget
initiative for fiscal year 2003 may be adopted in accordance
with this Section by the agency charged with administering
that provision or initiative, except that the 24-month
limitation on the adoption of emergency rules and the
provisions of Sections 5-115 and 5-125 do not apply to rules
adopted under this subsection (h). The adoption of emergency
rules authorized by this subsection (h) shall be deemed to be
necessary for the public interest, safety, and welfare.
(Source: P.A. 91-24, eff. 7-1-99; 91-357, eff. 7-29-99;
91-712, eff. 7-1-00; 92-10, eff. 6-11-01.)
Section 15. The Illinois Act on the Aging is amended by
changing Section 4.02 as follows:
(20 ILCS 105/4.02) (from Ch. 23, par. 6104.02)
Sec. 4.02. The Department shall establish a program of
services to prevent unnecessary institutionalization of
persons age 60 and older in need of long term care or who are
established as persons who suffer from Alzheimer's disease or
a related disorder under the Alzheimer's Disease Assistance
Act, thereby enabling them to remain in their own homes or in
other living arrangements. Such preventive services, which
may be coordinated with other programs for the aged and
monitored by area agencies on aging in cooperation with the
Department, may include, but are not limited to, any or all
of the following:
(a) home health services;
(b) home nursing services;
(c) homemaker services;
(d) chore and housekeeping services;
(e) day care services;
(f) home-delivered meals;
(g) education in self-care;
(h) personal care services;
(i) adult day health services;
(j) habilitation services;
(k) respite care;
(l) other nonmedical social services that may
enable the person to become self-supporting; or
(m) clearinghouse for information provided by
senior citizen home owners who want to rent rooms to or
share living space with other senior citizens.
The Department shall establish eligibility standards for
such services taking into consideration the unique economic
and social needs of the target population for whom they are
to be provided. Such eligibility standards shall be based on
the recipient's ability to pay for services; provided,
however, that in determining the amount and nature of
services for which a person may qualify, consideration shall
not be given to the value of cash, property or other assets
held in the name of the person's spouse pursuant to a written
agreement dividing marital property into equal but separate
shares or pursuant to a transfer of the person's interest in
a home to his spouse, provided that the spouse's share of the
marital property is not made available to the person seeking
such services.
Beginning July 1, 2002, the Department shall require as a
condition of eligibility that all applicants and recipients
apply for medical assistance under Article V of the Illinois
Public Aid Code in accordance with rules promulgated by the
Department.
The Department shall, in conjunction with the Department
of Public Aid, seek appropriate amendments under Sections
1915 and 1924 of the Social Security Act. The purpose of the
amendments shall be to extend eligibility for home and
community based services under Sections 1915 and 1924 of the
Social Security Act to persons who transfer to or for the
benefit of a spouse those amounts of income and resources
allowed under Section 1924 of the Social Security Act.
Subject to the approval of such amendments, the Department
shall extend the provisions of Section 5-4 of the Illinois
Public Aid Code to persons who, but for the provision of home
or community-based services, would require the level of care
provided in an institution, as is provided for in federal
law. Those persons no longer found to be eligible for
receiving noninstitutional services due to changes in the
eligibility criteria shall be given 60 days notice prior to
actual termination. Those persons receiving notice of
termination may contact the Department and request the
determination be appealed at any time during the 60 day
notice period. With the exception of the lengthened notice
and time frame for the appeal request, the appeal process
shall follow the normal procedure. In addition, each person
affected regardless of the circumstances for discontinued
eligibility shall be given notice and the opportunity to
purchase the necessary services through the Community Care
Program. If the individual does not elect to purchase
services, the Department shall advise the individual of
alternative services. The target population identified for
the purposes of this Section are persons age 60 and older
with an identified service need. Priority shall be given to
those who are at imminent risk of institutionalization. The
services shall be provided to eligible persons age 60 and
older to the extent that the cost of the services together
with the other personal maintenance expenses of the persons
are reasonably related to the standards established for care
in a group facility appropriate to the person's condition.
These non-institutional services, pilot projects or
experimental facilities may be provided as part of or in
addition to those authorized by federal law or those funded
and administered by the Department of Human Services. The
Departments of Human Services, Public Aid, Public Health,
Veterans' Affairs, and Commerce and Community Affairs and
other appropriate agencies of State, federal and local
governments shall cooperate with the Department on Aging in
the establishment and development of the non-institutional
services. The Department shall require an annual audit from
all chore/housekeeping and homemaker vendors contracting with
the Department under this Section. The annual audit shall
assure that each audited vendor's procedures are in
compliance with Department's financial reporting guidelines
requiring a 27% administrative cost split and a 73% employee
wages and benefits cost split. The audit is a public record
under the Freedom of Information Act. The Department shall
execute, relative to the nursing home prescreening project,
written inter-agency agreements with the Department of Human
Services and the Department of Public Aid, to effect the
following: (1) intake procedures and common eligibility
criteria for those persons who are receiving
non-institutional services; and (2) the establishment and
development of non-institutional services in areas of the
State where they are not currently available or are
undeveloped. On and after July 1, 1996, all nursing home
prescreenings for individuals 60 years of age or older shall
be conducted by the Department.
The Department is authorized to establish a system of
recipient copayment for services provided under this Section,
such copayment to be based upon the recipient's ability to
pay but in no case to exceed the actual cost of the services
provided. Additionally, any portion of a person's income
which is equal to or less than the federal poverty standard
shall not be considered by the Department in determining the
copayment. The level of such copayment shall be adjusted
whenever necessary to reflect any change in the officially
designated federal poverty standard.
The Department, or the Department's authorized
representative, shall recover the amount of moneys expended
for services provided to or in behalf of a person under this
Section by a claim against the person's estate or against the
estate of the person's surviving spouse, but no recovery may
be had until after the death of the surviving spouse, if any,
and then only at such time when there is no surviving child
who is under age 21, blind, or permanently and totally
disabled. This paragraph, however, shall not bar recovery,
at the death of the person, of moneys for services provided
to the person or in behalf of the person under this Section
to which the person was not entitled; provided that such
recovery shall not be enforced against any real estate while
it is occupied as a homestead by the surviving spouse or
other dependent, if no claims by other creditors have been
filed against the estate, or, if such claims have been filed,
they remain dormant for failure of prosecution or failure of
the claimant to compel administration of the estate for the
purpose of payment. This paragraph shall not bar recovery
from the estate of a spouse, under Sections 1915 and 1924 of
the Social Security Act and Section 5-4 of the Illinois
Public Aid Code, who precedes a person receiving services
under this Section in death. All moneys for services paid to
or in behalf of the person under this Section shall be
claimed for recovery from the deceased spouse's estate.
"Homestead", as used in this paragraph, means the dwelling
house and contiguous real estate occupied by a surviving
spouse or relative, as defined by the rules and regulations
of the Illinois Department of Public Aid, regardless of the
value of the property.
The Department shall develop procedures to enhance
availability of services on evenings, weekends, and on an
emergency basis to meet the respite needs of caregivers.
Procedures shall be developed to permit the utilization of
services in successive blocks of 24 hours up to the monthly
maximum established by the Department. Workers providing
these services shall be appropriately trained.
Beginning on the effective date of this Amendatory Act of
1991, no person may perform chore/housekeeping and homemaker
services under a program authorized by this Section unless
that person has been issued a certificate of pre-service to
do so by his or her employing agency. Information gathered
to effect such certification shall include (i) the person's
name, (ii) the date the person was hired by his or her
current employer, and (iii) the training, including dates and
levels. Persons engaged in the program authorized by this
Section before the effective date of this amendatory Act of
1991 shall be issued a certificate of all pre- and in-service
training from his or her employer upon submitting the
necessary information. The employing agency shall be
required to retain records of all staff pre- and in-service
training, and shall provide such records to the Department
upon request and upon termination of the employer's contract
with the Department. In addition, the employing agency is
responsible for the issuance of certifications of in-service
training completed to their employees.
The Department is required to develop a system to ensure
that persons working as homemakers and chore housekeepers
receive increases in their wages when the federal minimum
wage is increased by requiring vendors to certify that they
are meeting the federal minimum wage statute for homemakers
and chore housekeepers. An employer that cannot ensure that
the minimum wage increase is being given to homemakers and
chore housekeepers shall be denied any increase in
reimbursement costs.
The Department on Aging and the Department of Human
Services shall cooperate in the development and submission of
an annual report on programs and services provided under this
Section. Such joint report shall be filed with the Governor
and the General Assembly on or before September 30 each year.
The requirement for reporting to the General Assembly
shall be satisfied by filing copies of the report with the
Speaker, the Minority Leader and the Clerk of the House of
Representatives and the President, the Minority Leader and
the Secretary of the Senate and the Legislative Research
Unit, as required by Section 3.1 of the General Assembly
Organization Act and filing such additional copies with the
State Government Report Distribution Center for the General
Assembly as is required under paragraph (t) of Section 7 of
the State Library Act.
Those persons previously found eligible for receiving
non-institutional services whose services were discontinued
under the Emergency Budget Act of Fiscal Year 1992, and who
do not meet the eligibility standards in effect on or after
July 1, 1992, shall remain ineligible on and after July 1,
1992. Those persons previously not required to cost-share
and who were required to cost-share effective March 1, 1992,
shall continue to meet cost-share requirements on and after
July 1, 1992. Beginning July 1, 1992, all clients will be
required to meet eligibility, cost-share, and other
requirements and will have services discontinued or altered
when they fail to meet these requirements.
(Source: P.A. 91-303, eff. 1-1-00; 91-798, eff. 7-9-00.)
Section 20. The Mental Health and Developmental
Disabilities Administrative Act is amended by adding Section
18.4 as follows:
(20 ILCS 1705/18.4 new)
Sec. 18.4. Community Mental Health Medicaid Trust Fund;
reimbursement.
(a) The Community Mental Health Medicaid Trust Fund is
hereby created in the State Treasury.
(b) Any funds paid to the State by the federal
government under Title XIX or Title XXI of the Social
Security Act for services delivered by community mental
health services providers, and any interest earned thereon,
shall be deposited directly into the Community Mental Health
Medicaid Trust Fund.
(c) The Department shall reimburse community mental
health services providers for Medicaid-reimbursed mental
health services provided to eligible individuals. Moneys in
the Community Mental Health Medicaid Trust Fund may be used
for that purpose.
(d) As used in this Section:
"Medicaid-reimbursed mental health services" means
services provided by a community mental health provider under
an agreement with the Department that is eligible for
reimbursement under the federal Title XIX program or Title
XXI program.
"Provider" means a community agency that is funded by the
Department to provide a Medicaid-reimbursed service.
"Services" means mental health services provided under
one of the following programs:
(1) Medicaid Clinic Option;
(2) Medicaid Rehabilitation Option;
(3) Targeted Case Management.
Section 25. The Illinois Health Finance Reform Act is
amended by changing Sections 2-1, 4-1, 4-2, and 4-4 as
follows:
(20 ILCS 2215/2-1) (from Ch. 111 1/2, par. 6502-1)
Sec. 2-1. Council abolished. Authorized. There is
hereby created The Illinois Health Care Cost Containment
Council is abolished at the close of business on June 30,
2002. Its successor agency, for purposes of the Successor
Agency Act and Section 9b of the State Finance Act, is the
Illinois Department of Public Health. It shall consist of 13
members appointed by the Governor with the advice and consent
of the Senate as follows: 5 members to represent providers as
follows: 2 members to represent Illinois hospitals at least
one of which must represent a small rural hospital, 2 members
to represent physicians licensed to practice medicine in all
its branches, and 1 member to represent ambulatory surgical
treatment centers; 3 members to represent consumers; 2
members to represent insurance companies; and 3 members to
represent businesses.
The members of the Council shall be appointed for 3-year
terms.
No more than 7 members may be from the same political
party.
Members shall be appointed within 30 days after the
effective date of this Act. The additional members appointed
under the amendatory Act of the 91st General Assembly must be
appointed within 30 days after the effective date of this
amendatory Act of the 91st General Assembly. The members of
the Council shall receive reimbursement of their actual
expenses incurred in connection with their service; in
addition, each member shall receive compensation of $150 a
day for each day served at regular or special meetings of the
Council, except that such compensation shall not exceed
$20,000 in any one year for any member. The Council shall
elect a Chairman from among its members, and shall have the
power to organize and appoint such other officers as it may
deem necessary.
All appointments shall be made in writing and filed with
the Secretary of State as a public record.
(Source: P.A. 91-756, eff. 6-2-00.)
(20 ILCS 2215/4-1) (from Ch. 111 1/2, par. 6504-1)
Sec. 4-1. Illinois Health Finance Data Collection. The
General Assembly finds that public sector and private sector
purchasers of health care need health care cost and
utilization data to enable them to make informed choices
among health care providers in the market place. The General
Assembly finds it necessary to create a mandated uniform
system in Illinois for the collection, analysis, and
distribution of health care cost and utilization data.
The purpose of this Article is to insure that data are
available to make valid comparisons among health care
providers of prices and utilization of services provided and
to support ongoing analysis of the health care delivery
system so that the Council can fulfill its mandate.
(Source: P.A. 91-756, eff. 6-2-00.)
(20 ILCS 2215/4-2) (from Ch. 111 1/2, par. 6504-2)
Sec. 4-2. Powers and duties.
(a) (Blank). The Illinois Health Care Cost Containment
Council may enter into any agreement with any corporation,
association or other entity it deems appropriate to undertake
the process described in this Article for the compilation and
analysis of data collected by the Council and to conduct or
contract for studies on health-related questions carried out
in pursuance of the purposes of this Article. The agreement
may provide for the corporation, association or entity to
prepare and distribute or make available data to health care
providers, health care subscribers, third-party payors,
government and the general public, in accordance with the
rules of confidentiality and review to be developed under
this Act.
(b) (Blank). The input data collected by and furnished
to the Council or designated corporation, association or
entity pursuant to this Section shall not be a public record
under the Illinois Freedom of Information Act. It is the
intent of this Act and of the regulations written pursuant to
it to protect the confidentiality of individual patient
information and the proprietary information of commercial
insurance carriers and health care providers. Data specified
in subsections (e) and (e-5) shall be released on a hospital
specific and licensed ambulatory surgical treatment center
specific basis to facilitate comparisons among hospitals and
licensed ambulatory surgical treatment centers by purchasers.
(c) (Blank). The Council shall require the Departments
of Public Health and Public Aid and hospitals located in the
State to assist the Council in gathering and submitting the
following hospital-specific financial information, and the
Council is authorized to share this data with both
Departments to reduce the burden on hospitals by avoiding
duplicate data collection:
OPERATING REVENUES
(1) Net patient service revenue
(2) Other revenue
(3) Total operating revenue
OPERATING EXPENSES
(4) Bad debt expense
(5) Total operating expenses
NON-OPERATING GAINS/LOSSES
(6) Total non-operating gains
(7) Total non-operating losses
PATIENT CARE REVENUES
(8) Gross inpatient revenue
(9) Gross outpatient revenue
(10) Other Patient care revenue
(11) Total patient revenue
(12) Total gross patient care revenue
(13) Medicare gross revenue
(14) Medicaid gross revenue
(15) Total other gross revenue
DEDUCTIONS FROM REVENUE
(16) Charity care
(17) Medicare allowance
(18) Medicaid allowance
(19) Other contractual allowances
(20) Other allowances
(21) Total Deductions
ASSETS
(22) Operating cash and short-term investments
(23) Estimated patient accounts receivable
(24) Other current assets
(25) Total current assets
(26) Total other assets
(27) Total Assets
LIABILITIES AND FUND BALANCES
(28) Total current liabilities
(29) Long Term Debt
(30) Other liabilities
(31) Total liabilities
(32) Total liabilities and fund balances
All financial data collected by the Council from publicly
available sources such as the HCFA is releasable by the
Council on a hospital specific basis when appropriate.
(d) Uniform Provider Utilization and Charge Information.
The Council shall require that:
(1) The Department of Public Health shall require
that hospitals licensed to operate in the State of
Illinois adopt a uniform system for submitting patient
charges for payment from public and private payors
effective January 1, 1985. This system shall be based
upon adoption of the uniform hospital billing form
(UB-92) or its successor form developed by the National
Uniform Billing Committee.
(2) (Blank).
(3) The Department of Insurance shall require all
third-party payors, including but not limited to,
licensed insurers, medical and hospital service
corporations, health maintenance organizations, and
self-funded employee health plans, to accept the uniform
billing form, without attachment as submitted by
hospitals pursuant to paragraph (1) of subsection (d)
above, effective January 1, 1985; provided, however,
nothing shall prevent all such third party payors from
requesting additional information necessary to determine
eligibility for benefits or liability for reimbursement
for services provided.
(e) (Blank). The Council, in cooperation with the State
Departments of Public Aid, Insurance, and Public Health,
shall establish a system for the collection of the following
information from hospitals utilizing the raw data available
on the uniform billing forms. Such data shall include the
following elements and other elements contained on the
uniform billing form or its successor form determined as
necessary by the Council:
(1) Patient date of birth
(2) Patient sex
(3) Patient zip code
(4) Third-party coverage
(5) Date of admission
(6) Source of admission
(7) Type of admission
(8) Discharge date
(9) Principal and up to 8 other diagnoses
(10) Principal procedure and date
(11) Patient status
(12) Other procedures and dates
(13) Total charges and components of those charges
(14) Attending and consulting physician identification
numbers
(15) Hospital identification number
(16) An alphanumeric number based on the information to
identify the payor
(17) Principal source of payment.
(e-5) The Council, in cooperation with the Department of
Public Aid, the Department of Insurance, and the Department
of Public Health, shall establish a system for the collection
of the following information for each outpatient surgery
performed at hospitals and licensed ambulatory surgical
treatment centers using the raw data available on outpatient
billing forms submitted by hospitals and licensed ambulatory
surgical treatment centers to payors. The data must include
the following elements, if available on the billing forms,
and other elements contained on the billing forms that the
Council determines are necessary:
(1) patient date of birth;
(2) patient sex;
(3) patient zip code;
(4) third-party coverage;
(5) date of admission;
(6) source of admission;
(7) type of admission;
(8) discharge date;
(9) principal diagnosis and up to 8 other
diagnoses;
(10) principal procedure and the date of the
procedure;
(11) patient status;
(12) other procedures and the dates of those
procedures;
(13) attending and consulting physician
identification numbers;
(14) hospital or licensed ambulatory surgical
treatment center identification number;
(15) an alphanumeric number based on the
information needed to identify the payor; and
(16) principal source of payment.
(f) Extracts of the UB-92 transactions shall be prepared
by hospitals according to regulations promulgated by the
Council and submitted in electronic format to the Council or
the corporation, association or entity designated by the
Council.
For hospitals unable to submit extracts in electronic
format, the Council shall determine an alternate method for
submission of data. Such extract reporting systems shall be
in operation before January 1, 1987; however, the Council may
grant time extensions to individual hospital.
(f-5) Extracts of the billing forms shall be prepared by
licensed ambulatory surgical treatment centers according to
rules adopted by the Council and submitted to the Council or
a corporation, association, or entity designated by the
Council. Electronic submissions shall be encouraged. For
licensed ambulatory surgical treatment centers unable to
submit extracts in an electronic format the Council must
determine an alternate method for submission of data.
(g) Under no circumstances shall patient name and social
security number appear on the extracts.
(h) Hospitals and licensed ambulatory surgical treatment
centers shall be assigned a standard identification number by
the Council to be used in the submission of all data.
(i) The Council shall collect a 100% inpatient sample
from hospitals annually. The Council shall require each
hospital in the State to submit the UB-92 data extracts
required in subsection (e) to the Council, except that
hospitals with fewer than 50 beds may be exempted by the
Council from the filing requirements if they prove to the
Council's satisfaction that the requirements would impose
undue economic hardship and if the Council determines that
the data submitted from these hospitals are not essential to
its data base and its concomitant health care cost comparison
efforts.
(i-5) The Council shall collect up to a 100% outpatient
sample annually from hospitals and licensed ambulatory
surgical treatment centers. The Council shall require each
hospital and licensed ambulatory surgical treatment center in
the State to submit the data extracts required under
subsection (e-5) to the Council, except that hospitals and
licensed ambulatory surgical treatment centers may be
exempted by the Council from the filing requirements if the
hospitals or licensed ambulatory surgical treatment centers
prove to the Council's satisfaction that the requirements
would impose undue economic hardship and if the Council
determines that the data submitted from those hospitals and
licensed ambulatory surgical treatment centers are not
essential to the Council's database and its concomitant
health care comparison efforts.
(i-10) The outpatient data shall be collected by the
Council on a phase-in and trial basis for a one-year period
beginning on January 1, 2001. The Council shall implement
outpatient data collection for reporting purposes beginning
on January 1, 2002.
(j) The information submitted to the Council pursuant to
subsections (e) and (e-5) shall be reported for each primary
payor category, including Medicare, Medicaid, other
government programs, private insurance, health maintenance
organizations, self-insured, private pay patients, and
others. Preferred provider organization reimbursement shall
also be reported for each primary third party payor category.
(k) The Council shall require and the designated
corporation, association or entity, if applicable, shall
prepare quarterly basic reports in the aggregate on health
care cost and utilization trends in Illinois. The Council
shall provide these reports to the public, if requested.
These shall include, but not be limited to, comparative
information on average charges, total and ancillary charge
components, length of stay on diagnosis-specific and
procedure specific cases, and number of discharges, compiled
in aggregate by hospital and licensed ambulatory surgical
treatment center, by diagnosis, and by primary payor
category.
(l) The Council shall, from information submitted
pursuant to subsection (e), prepare an annual report in the
aggregate by hospital containing the following:
(1) the ratio of caesarean section deliveries to
total deliveries;
(2) the average length of stay for patients who
undergo caesarean sections;
(3) the average total charges for patients who have
normal deliveries without any significant complications;
(4) the average total charges for patients who
deliver by caesarean section.
The Council shall provide this report to the public, if
requested.
(l-5) (Blank).
(m) Prior to the release or dissemination of these
reports, the Council or the designated corporation shall
permit providers the opportunity to verify the accuracy of
any information pertaining to the provider. The providers
may submit to the Council any corrections or errors in the
compilation of the data with any supporting evidence and
documents the providers may submit. The Council or
corporation shall correct data found to be in error and
include additional commentary as requested by the provider
for major deviations in the charges from the average charges.
For purposes of this subsection (m), "providers" includes
physicians licensed to practice medicine in all of its
branches.
(n) In addition to the reports indicated above, the
Council shall respond to requests by agencies of government
and organizations in the private sector for data products,
special studies and analysis of data collected pursuant to
this Section. Such reports shall be undertaken only by the
agreement of a majority of the members of the Council who
shall designate the form in which the information shall be
made available. The Council or the corporation, association
or entity in consultation with the Council shall also
determine a fee to be charged to the requesting agency or
private sector organization to cover the direct and indirect
costs for producing such a report, and shall permit affected
providers the rights to review the accuracy of the report
before it is released. Such reports shall not be subject to
The Freedom of Information Act.
(Source: P.A. 91-756, eff. 6-2-00.)
(20 ILCS 2215/4-4) (from Ch. 111 1/2, par. 6504-4)
Sec. 4-4. (a) Hospitals shall make available to
prospective patients information on the normal charge
incurred for any procedure or operation the prospective
patient is considering.
(b) The Department of Public Health Council shall
require hospitals to post in letters no more than one inch in
height the established charges for services, where
applicable, including but not limited to the hospital's
private room charge, semi-private room charge, charge for a
room with 3 or more beds, intensive care room charges,
emergency room charge, operating room charge,
electrocardiogram charge, anesthesia charge, chest x-ray
charge, blood sugar charge, blood chemistry charge, tissue
exam charge, blood typing charge and Rh factor charge. The
definitions of each charge to be posted shall be determined
by the Department Council.
(Source: P.A. 90-655, eff. 7-30-98.)
(20 ILCS 2215/1-2 rep.)
(20 ILCS 2215/2-2 rep.)
(20 ILCS 2215/2-3 rep.)
(20 ILCS 2215/2-4 rep.)
(20 ILCS 2215/2-5 rep.)
(20 ILCS 2215/2-6 rep.)
(20 ILCS 2215/4-3 rep.)
(20 ILCS 2215/4-5 rep.)
(20 ILCS 2215/5-2 rep.)
Section 26. The Illinois Health Finance Reform Act is
amended by repealing Sections 1-2, 2-2, 2-3, 2-4, 2-5, 2-6,
4-3, 4-5, and 5-2.
Section 30. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by adding Section 2310-57 as follows:
(20 ILCS 2310/2310-57 new)
Sec. 2310-57. Collecting information regarding hospital
discharges and surgery. The Department of Public Health
shall establish a system for the collection of data regarding
hospital discharges and inpatient and outpatient surgery
performed at hospitals and licensed ambulatory surgical
treatment centers.
The Department may establish a system to provide data to
hospitals required for accreditation, including data required
by the Joint Commission on Accreditation of Healthcare
Organizations.
The Department may adopt any rules necessary to carry out
this function, including reasonable fees for providing
accreditation data. The Department may contract with a
vendor to collect any data required to be submitted to the
Department under this Section.
Section 35. The Illinois Emergency Management Agency Act
is amended by changing Section 5 as follows:
(20 ILCS 3305/5) (from Ch. 127, par. 1055)
Sec. 5. Illinois Emergency Management Agency.
(a) There is created within the executive branch of the
State Government an Illinois Emergency Management Agency and
a Director of the Illinois Emergency Management Agency,
herein called the "Director" who shall be the head thereof.
The Director shall be appointed by the Governor, with the
advice and consent of the Senate, and shall serve for a term
of 2 years beginning on the third Monday in January of the
odd-numbered year, and until a successor is appointed and has
qualified; except that the term of the first Director
appointed under this Act shall expire on the third Monday in
January, 1989. The Director shall not hold any other
remunerative public office. The Director shall receive an
annual salary as set by the Governor from time to time or the
amount set by the Compensation Review Board, whichever is
higher. If set by the Governor, the Director's annual salary
may not exceed 85% of the Governor's annual salary.
(b) The Illinois Emergency Management Agency shall
obtain, under the provisions of the Personnel Code,
technical, clerical, stenographic and other administrative
personnel, and may make expenditures within the appropriation
therefor as may be necessary to carry out the purpose of this
Act. The agency created by this Act is intended to be a
successor to the agency created under the Illinois Emergency
Services and Disaster Agency Act of 1975 and the personnel,
equipment, records, and appropriations of that agency are
transferred to the successor agency as of the effective date
of this Act.
(c) The Director, subject to the direction and control
of the Governor, shall be the executive head of the Illinois
Emergency Management Agency and the State Emergency Response
Commission and shall be responsible under the direction of
the Governor, for carrying out the program for emergency
management of this State. The Director shall also maintain
liaison and cooperate with the emergency management
organizations of this State and other states and of the
federal government.
(d) The Illinois Emergency Management Agency shall take
an integral part in the development and revision of political
subdivision emergency operations plans prepared under
paragraph (f) of Section 10. To this end it shall employ or
otherwise secure the services of professional and technical
personnel capable of providing expert assistance to the
emergency services and disaster agencies. These personnel
shall consult with emergency services and disaster agencies
on a regular basis and shall make field examinations of the
areas, circumstances, and conditions that particular
political subdivision emergency operations plans are intended
to apply.
(e) The Illinois Emergency Management Agency and
political subdivisions shall be encouraged to form an
emergency management advisory committee composed of private
and public personnel representing the emergency management
phases of mitigation, preparedness, response, and recovery.
The Local Emergency Planning Committee, as created under the
Illinois Emergency Planning and Community Right to Know Act,
shall serve as an advisory committee to the emergency
services and disaster agency or agencies serving within the
boundaries of that Local Emergency Planning Committee
planning district for:
(1) the development of emergency operations plan
provisions for hazardous chemical emergencies; and
(2) the assessment of emergency response
capabilities related to hazardous chemical emergencies.
(f) The Illinois Emergency Management Agency shall:
(1) Coordinate the overall emergency management
program of the State.
(2) Cooperate with local governments, the federal
government and any public or private agency or entity in
achieving any purpose of this Act and in implementing
emergency management programs for mitigation,
preparedness, response, and recovery.
(2.5) Cooperate with the Department of Nuclear
Safety in development of the comprehensive emergency
preparedness and response plan for any nuclear accident
in accordance with Section 2005-65 of the Department of
Nuclear Safety Law of the Civil Administrative Code of
Illinois and in development of the Illinois Nuclear
Safety Preparedness program in accordance with Section 8
of the Illinois Nuclear Safety Preparedness Act.
(3) Prepare, for issuance by the Governor,
executive orders, proclamations, and regulations as
necessary or appropriate in coping with disasters.
(4) Promulgate rules and requirements for political
subdivision emergency operations plans that are not
inconsistent with and are at least as stringent as
applicable federal laws and regulations.
(5) Review and approve, in accordance with Illinois
Emergency Management Agency rules, emergency operations
plans for those political subdivisions required to have
an emergency services and disaster agency pursuant to
this Act.
(5.5) Promulgate rules and requirements for the
political subdivision emergency management exercises,
including, but not limited to, exercises of the emergency
operations plans.
(5.10) Review, evaluate, and approve, in accordance
with Illinois Emergency Management Agency rules,
political subdivision emergency management exercises for
those political subdivisions required to have an
emergency services and disaster agency pursuant to this
Act.
(6) Determine requirements of the State and its
political subdivisions for food, clothing, and other
necessities in event of a disaster.
(7) Establish a register of persons with types of
emergency management training and skills in mitigation,
preparedness, response, and recovery.
(8) Establish a register of government and private
response resources available for use in a disaster.
(9) Expand the Earthquake Awareness Program and its
efforts to distribute earthquake preparedness materials
to schools, political subdivisions, community groups,
civic organizations, and the media. Emphasis will be
placed on those areas of the State most at risk from an
earthquake. Maintain the list of all school districts,
hospitals, airports, power plants, including nuclear
power plants, lakes, dams, emergency response facilities
of all types, and all other major public or private
structures which are at the greatest risk of damage from
earthquakes under circumstances where the damage would
cause subsequent harm to the surrounding communities and
residents.
(10) Disseminate all information, completely and
without delay, on water levels for rivers and streams and
any other data pertaining to potential flooding supplied
by the Division of Water Resources within the Department
of Natural Resources to all political subdivisions to the
maximum extent possible.
(11) Develop agreements, if feasible, with medical
supply and equipment firms to supply resources as are
necessary to respond to an earthquake or any other
disaster as defined in this Act. These resources will be
made available upon notifying the vendor of the disaster.
Payment for the resources will be in accordance with
Section 7 of this Act. The Illinois Department of Public
Health shall determine which resources will be required
and requested.
(12) Out of funds appropriated for these purposes,
award capital and non-capital grants to Illinois
hospitals or health care facilities located outside of a
city with a population in excess of 1,000,000 to be used
for purposes that include, but are not limited to,
preparing to respond to mass casualties and disasters,
maintaining and improving patient safety and quality of
care, and protecting the confidentiality of patient
information. No single grant for a capital expenditure
shall exceed $300,000. No single grant for a non-capital
expenditure shall exceed $100,000. In awarding such
grants, preference shall be given to hospitals that serve
a significant number of Medicaid recipients, but do not
qualify for disproportionate share hospital adjustment
payments under the Illinois Public Aid Code. To receive
such a grant, a hospital or health care facility must
provide funding of at least 50% of the cost of the
project for which the grant is being requested. In
awarding such grants the Illinois Emergency Management
Agency shall consider the recommendations of the Illinois
Hospital Association.
(13) (12) Do all other things necessary, incidental
or appropriate for the implementation of this Act.
(Source: P.A. 91-25, eff. 6-9-99; 92-73, eff. 1-1-02.)
Section 40. The State Finance Act is amended by changing
Sections 5.198, 6z-12, and 6z-43, changing and renumbering
Section 6z-51 (as added by Public Act 92-208), and adding
Sections 5.570 and 5.571 as follows:
(30 ILCS 105/5.198) (from Ch. 127, par. 141.198)
(Section scheduled to be repealed on October 15, 2002.)
Sec. 5.198. The Illinois Health Care Cost Containment
Council Special Studies Fund. This Section is repealed on
October 15, 2002.
(Source: P.A. 84-1240; 84-1438.)
(30 ILCS 105/5.570 new)
Sec. 5.570. The Illinois Student Assistance Commission
Contracts and Grants Fund.
(30 ILCS 105/5.571 new)
Sec. 5.571. The Career and Technical Education Fund.
(30 ILCS 105/6z-12) (from Ch. 127, par. 142z-12)
(Section scheduled to be repealed on October 15, 2002.)
Sec. 6z-12. Funds received by the Illinois Health Care
Cost Containment Council for special studies pursuant to the
Illinois Health Finance Reform Act shall be deposited in the
Illinois Health Care Cost Containment Council Special Studies
Fund. The General Assembly shall from time to time make
appropriations from the Illinois Health Care Cost Containment
Council Special Studies Fund for the payment of the direct
and indirect costs of special studies. The Illinois Health
Care Cost Containment Council shall by rule, adopted pursuant
to the Illinois Administrative Procedure Act, provide for the
allocation of the direct and indirect costs of producing
special studies pursuant to the Illinois Health Finance
Reform Act.
In addition to any other permitted use of moneys in the
Fund, moneys in the Illinois Health Care Cost Containment
Council Special Studies Fund may be used by the Council,
subject to appropriation, to provide services to the Illinois
Health Care Reform Task Force created under Section 6-4 of
the Medicaid Revenue Act and to support Council operations.
The Illinois Health Care Cost Containment Council Special
Studies Fund is abolished on October 15, 2002. Any balance
remaining in the Fund on that date shall be transferred to
the Public Health Special State Projects Fund.
This Section is repealed on October 15, 2002.
(Source: P.A. 87-838; 87-1248.)
(30 ILCS 105/6z-43)
Sec. 6z-43. Tobacco Settlement Recovery Fund.
(a) There is created in the State Treasury a special
fund to be known as the Tobacco Settlement Recovery Fund,
into which shall be deposited all monies paid to the State
pursuant to (1) the Master Settlement Agreement entered in
the case of People of the State of Illinois v. Philip Morris,
et al. (Circuit Court of Cook County, No. 96-L13146) and (2)
any settlement with or judgment against any tobacco product
manufacturer other than one participating in the Master
Settlement Agreement in satisfaction of any released claim as
defined in the Master Settlement Agreement, as well as any
other monies as provided by law. All earnings on Fund
investments shall be deposited into the Fund. Upon the
creation of the Fund, the State Comptroller shall order the
State Treasurer to transfer into the Fund any monies paid to
the State as described in item (1) or (2) of this Section
before the creation of the Fund plus any interest earned on
the investment of those monies. The Treasurer may invest the
moneys in the Fund in the same manner, in the same types of
investments, and subject to the same limitations provided in
the Illinois Pension Code for the investment of pension funds
other than those established under Article 3 or 4 of the
Code.
(b) As soon as may be practical after June 30, 2001,
upon notification from and at the direction of the Governor,
the State Comptroller shall direct and the State Treasurer
shall transfer the unencumbered balance in the Tobacco
Settlement Recovery Fund as of June 30, 2001, as determined
by the Governor, into the Budget Stabilization Fund. The
Treasurer may invest the moneys in the Budget Stabilization
Fund in the same manner, in the same types of investments,
and subject to the same limitations provided in the Illinois
Pension Code for the investment of pension funds other than
those established under Article 3 or 4 of the Code.
(c) All federal financial participation moneys received
pursuant to expenditures from the Fund shall be deposited
into the Fund.
(Source: P.A. 91-646, eff. 11-19-99; 91-704, eff. 7-1-00;
91-797, eff. 6-9-00; 92-11, eff. 6-11-01; 92-16, eff.
6-28-01.)
(30 ILCS 105/6z-55)
Sec. 6z-55. 6z-51. Statewide Economic Development Fund.
(a) The Statewide Economic Development Fund is created as a
special fund in the State treasury. Moneys in the Fund shall
be used, subject to appropriation, for the purpose of
statewide economic development activities or by the Illinois
Emergency Management Agency for awarding grants to Illinois
hospitals and health care facilities to provide for the
health and security of Illinois residents.
(Source: P.A. 92-208, eff. 8-2-01; revised 10-17-01.)
Section 45. The School Code is amended by changing
Sections 14-7.03 and 18-3 as follows:
(105 ILCS 5/14-7.03) (from Ch. 122, par. 14-7.03)
Sec. 14-7.03. Special Education Classes for Children from
Orphanages, Foster Family Homes, Children's Homes, or in
State Housing Units. If a school district maintains special
education classes on the site of orphanages and children's
homes, or if children from the orphanages, children's homes,
foster family homes, other State agencies, or State
residential units for children attend classes for children
with disabilities in which the school district is a
participating member of a joint agreement, or if the children
from the orphanages, children's homes, foster family homes,
other State agencies, or State residential units attend
classes for the children with disabilities maintained by the
school district, then reimbursement shall be paid to eligible
districts in accordance with the provisions of this Section
by the Comptroller as directed by the State Superintendent of
Education.
The amount of tuition for such children shall be
determined by the actual cost of maintaining such classes,
using the per capita cost formula set forth in Section
14-7.01, such program and cost to be pre-approved by the
State Superintendent of Education.
On forms prepared by the State Superintendent of
Education, the district shall certify to the regional
superintendent the following:
(1) The name of the home or State residential unit
with the name of the owner or proprietor and address of
those maintaining it;
(2) That no service charges or other payments
authorized by law were collected in lieu of taxes
therefrom or on account thereof during either of the
calendar years included in the school year for which
claim is being made;
(3) The number of children qualifying under this
Act in special education classes for instruction on the
site of the orphanages and children's homes;
(4) The number of children attending special
education classes for children with disabilities in which
the district is a participating member of a special
education joint agreement;
(5) The number of children attending special
education classes for children with disabilities
maintained by the district;
(6) The computed amount of tuition payment claimed
as due, as approved by the State Superintendent of
Education, for maintaining these classes.
If a school district makes a claim for reimbursement
under Section 18-3 or 18-4 of this Act it shall not include
in any claim filed under this Section a claim for such
children. Payments authorized by law, including State or
federal grants for education of children included in this
Section, shall be deducted in determining the tuition amount.
Nothing in this Act shall be construed so as to prohibit
reimbursement for the tuition of children placed in for
profit facilities. Private facilities shall provide adequate
space at the facility for special education classes provided
by a school district or joint agreement for children with
disabilities who are residents of the facility at no cost to
the school district or joint agreement upon request of the
school district or joint agreement. If such a private
facility provides space at no cost to the district or joint
agreement for special education classes provided to children
with disabilities who are residents of the facility, the
district or joint agreement shall not include any costs for
the use of those facilities in its claim for reimbursement.
Reimbursement for tuition may include the cost of
providing summer school programs for children with severe and
profound disabilities served under this Section. Claims for
that reimbursement shall be filed by November 1 and shall be
paid on or before December 15 from appropriations made for
the purposes of this Section.
The State Board of Education shall establish such rules
and regulations as may be necessary to implement the
provisions of this Section.
Claims filed on behalf of programs operated under this
Section housed in a jail or detention center shall be on an
individual student basis only for eligible students with
disabilities. These claims shall be in accordance with
applicable rules.
Each district claiming reimbursement for a program
operated as a group program shall have an approved budget on
file with the State Board of Education prior to the
initiation of the program's operation. On September 30,
December 31, and March 31, the State Board of Education shall
voucher payments to group programs based upon the approved
budget during the year of operation. Final claims for group
payments shall be filed on or before July 15. Final claims
for group programs received at the State Board of Education
on or before June 15 shall be vouchered by June 30. Final
claims received at the State Board of Education between June
16 and July 15 shall be vouchered by August 30. Claims for
group programs received after July 15 shall not be honored.
Each district claiming reimbursement for individual
students shall have the eligibility of those students
verified by the State Board of Education. On September 30,
December 31, and March 31, the State Board of Education shall
voucher payments for individual students based upon an
estimated cost calculated from the prior year's claim. Final
claims for individual students for the regular school term
must be received at the State Board of Education by July 15.
Claims for individual students received after July 15 shall
not be honored. Final claims for individual students shall be
vouchered by August 30.
Reimbursement shall be made based upon approved group
programs or individual students. The State Superintendent of
Education shall direct the Comptroller to pay a specified
amount to the district by the 30th day of September,
December, March, June, or August, respectively. However,
notwithstanding any other provisions of this Section or the
School Code, beginning with fiscal year 1994 and each fiscal
year thereafter through fiscal year 2002, if the amount
appropriated for any fiscal year is less than the amount
required for purposes of this Section, the amount required to
eliminate any insufficient reimbursement for each district
claim under this Section shall be reimbursed on August 30 of
the next fiscal year, and the. payments required to eliminate
any insufficiency for prior fiscal year claims shall be made
before any claims are paid for the current fiscal year.
Notwithstanding any other provision of this Section or this
Code, beginning with fiscal year 2003, total reimbursement
under this Section in any fiscal year is limited to the
amount appropriated for that purpose for that fiscal year,
and if the amount appropriated for any fiscal year is less
than the amount required for purposes of this Section, the
insufficiency shall be apportioned pro rata among the school
districts seeking reimbursement.
The claim of a school district otherwise eligible to be
reimbursed in accordance with Section 14-12.01 for the
1976-77 school year but for this amendatory Act of 1977 shall
not be paid unless the district ceases to maintain such
classes for one entire school year.
If a school district's current reimbursement payment for
the 1977-78 school year only is less than the prior year's
reimbursement payment owed, the district shall be paid the
amount of the difference between the payments in addition to
the current reimbursement payment, and the amount so paid
shall be subtracted from the amount of prior year's
reimbursement payment owed to the district.
Regional superintendents may operate special education
classes for children from orphanages, foster family homes,
children's homes or State housing units located within the
educational services region upon consent of the school board
otherwise so obligated. In electing to assume the powers and
duties of a school district in providing and maintaining such
a special education program, the regional superintendent may
enter into joint agreements with other districts and may
contract with public or private schools or the orphanage,
foster family home, children's home or State housing unit for
provision of the special education program. The regional
superintendent exercising the powers granted under this
Section shall claim the reimbursement authorized by this
Section directly from the State Board of Education.
Any child who is not a resident of Illinois who is placed
in a child welfare institution, private facility, foster
family home, State operated program, orphanage or children's
home shall have the payment for his educational tuition and
any related services assured by the placing agent.
Commencing July 1, 1992, for each disabled student who is
placed residentially by a State agency or the courts for care
or custody or both care and custody, welfare, medical or
mental health treatment or both medical and mental health
treatment, rehabilitation, and protection, whether placed
there on, before, or after July 1, 1992, the costs for
educating the student are eligible for reimbursement under
this Section providing the placing agency or court has
notified the appropriate school district authorities of the
status of student residency where applicable prior to or upon
placement.
The district of residence of the parent, guardian, or
disabled student as defined in Sections 14-1.11 and 14-1.11a
is responsible for the actual costs of the student's special
education program and is eligible for reimbursement under
this Section when placement is made by a State agency or the
courts. Payments shall be made by the resident district to
the district wherein the facility is located no less than
once per quarter unless otherwise agreed to in writing by the
parties.
When a dispute arises over the determination of the
district of residence, the district or districts may appeal
the decision in writing to the State Superintendent of
Education. The decision of the State Superintendent of
Education shall be final.
In the event a district does not make a tuition payment
to another district that is providing the special education
program and services, the State Board of Education shall
immediately withhold 125% of the then remaining annual
tuition cost from the State aid or categorical aid payment
due to the school district that is determined to be the
resident school district. All funds withheld by the State
Board of Education shall immediately be forwarded to the
school district where the student is being served.
When a child eligible for services under this Section
14-7.03 must be placed in a nonpublic facility, that facility
shall meet the programmatic requirements of Section 14-7.02
and its regulations, and the educational services shall be
funded only in accordance with this Section 14-7.03.
(Source: P.A. 89-235, eff. 8-4-95; 89-397, eff. 8-20-95;
89-698, eff. 1-14-97; 90-463, eff. 8-17-97; 90-644, eff.
7-24-98.)
(105 ILCS 5/18-3) (from Ch. 122, par. 18-3)
Sec. 18-3. Tuition of children from orphanages and
children's homes.
When the children from any home for orphans, dependent,
abandoned or maladjusted children maintained by any
organization or association admitting to such home children
from the State in general or when children residing in a
school district wherein the State of Illinois maintains and
operates any welfare or penal institution on property owned
by the State of Illinois, which contains houses, housing
units or housing accommodations within a school district,
attend grades kindergarten through 12 of the public schools
maintained by that school district, the State Superintendent
of Education shall direct the State Comptroller to pay a
specified amount sufficient to pay the annual tuition cost of
such children who attended such public schools during the
regular school year ending on June 30 or the summer term for
that school year, and the Comptroller shall pay the amount
after receipt of a voucher submitted by the State
Superintendent of Education.
The amount of the tuition for such children attending the
public schools of the district shall be determined by the
State Superintendent of Education by multiplying the number
of such children in average daily attendance in such schools
by 1.2 times the total annual per capita cost of
administering the schools of the district. Such total annual
per capita cost shall be determined by totaling all expenses
of the school district in the educational, operations and
maintenance, bond and interest, transportation, Illinois
municipal retirement, and rent funds for the school year
preceding the filing of such tuition claims less expenditures
not applicable to the regular K-12 program, less offsetting
revenues from State sources except those from the common
school fund, less offsetting revenues from federal sources
except those from federal impaction aid, less student and
community service revenues, plus a depreciation allowance;
and dividing such total by the average daily attendance for
the year.
Annually on or before June 30 the superintendent of the
district upon forms prepared by the State Superintendent of
Education shall certify to the regional superintendent the
following:
1. The name of the home and of the organization or
association maintaining it; or the legal description of
the real estate upon which the house, housing units, or
housing accommodations are located and that no taxes or
service charges or other payments authorized by law to be
made in lieu of taxes were collected therefrom or on
account thereof during either of the calendar years
included in the school year for which claim is being
made;
2. The number of children from the home or living
in such houses, housing units or housing accommodations
and attending the schools of the district;
3. The total number of children attending the
schools of the district;
4. The per capita tuition charge of the district;
and
5. The computed amount of the tuition payment
claimed as due.
Whenever the persons in charge of such home for orphans,
dependent, abandoned or maladjusted children have received
from the parent or guardian of any such child or by virtue of
an order of court a specific allowance for educating such
child, such persons shall pay to the school board in the
district where the child attends school such amount of the
allowance as is necessary to pay the tuition required by such
district for the education of the child. If the allowance is
insufficient to pay the tuition in full the State
Superintendent of Education shall direct the Comptroller to
pay to the district the difference between the total tuition
charged and the amount of the allowance.
Whenever the facilities of a school district in which
such house, housing units or housing accommodations are
located, are limited, pupils may be assigned by that district
to the schools of any adjacent district to the limit of the
facilities of the adjacent district to properly educate such
pupils as shall be determined by the school board of the
adjacent district, and the State Superintendent of Education
shall direct the Comptroller to pay a specified amount
sufficient to pay the annual tuition of the children so
assigned to and attending public schools in the adjacent
districts and the Comptroller shall draw his warrant upon the
State Treasurer for the payment of such amount for the
benefit of the adjacent school districts in the same manner
as for districts in which the houses, housing units or
housing accommodations are located.
The school district shall certify to the State
Superintendent of Education the report of claims due for such
tuition payments on or before July 31. Failure on the part of
the school board to certify its claim on July 31 shall
constitute a forfeiture by the district of its right to the
payment of any such tuition claim for the school year. The
State Superintendent of Education shall direct the
Comptroller to pay to the district, on or before August 15,
the amount due the district for the school year in accordance
with the calculation of the claim as set forth in this
Section.
Claims for tuition for children from any home for orphans
or dependent, abandoned, or maladjusted children beginning
with the 1993-1994 school year shall be paid on a current
year basis. On September 30, December 31, and March 31, the
State Board of Education shall voucher payments for districts
with those students based on an estimated cost calculated
from the prior year's claim. Final claims for those students
for the regular school term and summer term must be received
at the State Board of Education by July 31 following the end
of the regular school year. Final claims for those students
shall be vouchered by August 15. During fiscal year 1994
both the 1992-1993 school year and the 1993-1994 school year
shall be paid in order to change the cycle of payment from a
reimbursement basis to a current year funding basis of
payment. However, notwithstanding any other provisions of
this Section or the School Code, beginning with fiscal year
1994 and each fiscal year thereafter through fiscal year
2002, if the amount appropriated for any fiscal year is less
than the amount required for purposes of this Section, the
amount required to eliminate any insufficient reimbursement
for each district claim under this Section shall be
reimbursed on August 30 of the next fiscal year, and the.
payments required to eliminate any insufficiency for prior
fiscal year claims shall be made before any claims are paid
for the current fiscal year. Notwithstanding any other
provision of this Section or this Code, beginning with fiscal
year 2003, total reimbursement under this Section in any
fiscal year is limited to the amount appropriated for that
purpose for that fiscal year, and if the amount appropriated
for any fiscal year is less than the amount required for
purposes of this Section, the insufficiency shall be
apportioned pro rata among the school districts seeking
reimbursement.
If a school district makes a claim for reimbursement
under Section 18-4 or 14-7.03 it shall not include in any
claim filed under this Section children residing on the
property of State institutions included in its claim under
Section 18-4 or 14-7.03.
Any child who is not a resident of Illinois who is placed
in a child welfare institution, private facility, State
operated program, orphanage or children's home shall have the
payment for his educational tuition and any related services
assured by the placing agent.
In order to provide services appropriate to allow a
student under the legal guardianship or custodianship of the
State to participate in local school district educational
programs, costs may be incurred in appropriate cases by the
district that are in excess of 1.2 times the district per
capita tuition charge allowed under the provisions of this
Section. In the event such excess costs are incurred, they
must be documented in accordance with cost rules established
under the authority of this Section and may then be claimed
for reimbursement under this Section.
Planned services for students eligible for this funding
must be a collaborative effort between the appropriate State
agency or the student's group home or institution and the
local school district.
(Source: P.A. 91-764, eff. 6-9-00; 92-94, eff. 1-1-02.)
Section 50. The State Aid Continuing Appropriation Law
is amended by changing Sections 15-10, 15-15, and 15-25 as
follows:
(105 ILCS 235/15-10)
(Section scheduled to be repealed on June 30, 2002)
Sec. 15-10. Annual budget; recommendation. The Governor
shall include a Common School Fund recommendation to the
State Board of Education in the fiscal year 1999 through 2003
2002 annual Budgets sufficient to fund (i) the General State
Aid Formula set forth in subsection (E) (Computation of
General State Aid) and subsection (H) (Supplemental General
State Aid) of Section 18-8.05 of the School Code and (ii) the
supplementary payments for school districts set forth in
subsection (J) (Supplementary Grants in Aid) of Section
18-8.05 of the School Code.
(Source: P.A. 92-7, eff. 6-29-01.)
(105 ILCS 235/15-15)
(Section scheduled to be repealed on June 30, 2002)
Sec. 15-15. State Aid Formula; Funding. The General
Assembly shall annually make Common School Fund
appropriations to the State Board of Education in fiscal
years 1999 through 2003 2002 sufficient to fund (i) the
General State Aid Formula set forth in subsection (E)
(Computation of General State Aid) and subsection (H)
(Supplemental General State Aid) of Section 18-8.05 of the
School Code and (ii) the supplementary payments for school
districts set forth in subsection (J) (Supplementary Grants
in Aid) of Section 18-8.05 of the School Code.
(Source: P.A. 92-7, eff. 6-29-01.)
(105 ILCS 235/15-25)
(Section scheduled to be repealed on June 30, 2002)
Sec. 15-25. Repeal. This Article is repealed June 30,
2003. Section 15-20 of this Article is repealed June 30,
2002.
(Source: P.A. 92-7, eff. 6-29-01.)
Section 55. The Public Community College Act is amended
by adding Section 2-16.07 as follows:
(110 ILCS 805/2-16.07 new)
Sec. 2-16.07. Career and Technical Education Fund. The
Career and Technical Education Fund is created as a special
fund in the State treasury. The Comptroller shall order
transferred and the State Treasurer shall transfer from the
Federal Department of Education Fund into the Career and
Technical Education Fund such amounts as may be directed in
writing by the State Board of Education. All moneys so
deposited into the Career and Technical Education Fund may be
used, subject to appropriation, by the State Board for
operational expenses associated with the administration of
Career and Technical Education, for payment of Career and
Technical Education grants to colleges, and for payment of
costs relating to State leadership activities, as provided by
the United States Department of Education.
Section 60. The Higher Education Student Assistance
Act is amended by adding Sections 65.56 and 77 as
follows:
(110 ILCS 947/65.56 new)
Sec. 65.56. Illinois Teachers and Child Care Providers
Loan Repayment Program.
(a) In order to encourage academically talented Illinois
students to enter and continue teaching in Illinois schools
in low-income areas and to encourage students to enter the
early child care profession and serve low-income areas, the
Commission shall, each year, receive and consider
applications for loan repayment assistance under this
Section. This program shall be known as the Illinois Teachers
and Child Care Providers Loan Repayment Program. The
Commission shall administer the program and shall make all
necessary and proper rules not inconsistent with this Section
for the program's effective implementation. The Commission
may use up to 5% of the appropriation for this program for
administration and promotion of teacher incentive programs.
(b) Beginning January 1, 2003, subject to a separate
appropriation made for such purposes, the Commission shall
award a grant to each qualified applicant in an amount equal
to the amount of educational loans forgiven on behalf of the
qualified applicant pursuant to Sections 424 and 425 of Title
IV of the Higher Education Amendments of 1998 (20 U.S.C.
1078-10 and 1078-11), up to a maximum of $5,000. The
Commission shall encourage the recipient of a grant under
this Section to use the grant amount awarded to pay off his
or her educational loans.
(c) A person is a qualified applicant under this Section
if he or she meets all of the following qualifications:
(1) The person is a United States citizen or
eligible noncitizen.
(2) The person is a resident of this State.
(3) The person is a borrower who has had an amount
of his or her educational loans forgiven pursuant to
Sections 424 and 425 of Title IV of the Higher Education
Amendments of 1998.
(4) The person has fulfilled the obligations set
forth by Sections 424 and 425 of Title IV of the Higher
Education Amendments of 1998 in this State.
(d) All applications for grant assistance under this
Section shall be made to the Commission. The form of
application and the information required to be set forth in
the application shall be determined by the Commission, and
the Commission shall require applicants to submit with their
applications such supporting documents as the Commission
deems necessary.
(e) A qualified applicant must apply for a grant under
this Section within 6 months after receiving notification of
loan forgiveness pursuant to Sections 424 and 425 of Title IV
of the Higher Education Amendments of 1998.
(110 ILCS 947/77 new)
Sec. 77. Illinois Student Assistance Commission
Contracts and Grants Fund.
(a) The Illinois Student Assistance Commission Contracts
and Grants Fund is created as a special fund in the State
treasury. All gifts, grants, or donations of money received
by the Commission must be deposited into this Fund.
(b) Moneys in the Fund may be used by the Commission,
subject to appropriation, for support of the Commission's
student assistance outreach activities.
(110 ILCS 947/65.57 rep.)
Section 65. The Higher Education Student Assistance Act
is amended by repealing Section 65.57.
Section 70. The Comprehensive Health Insurance Plan Act
is amended by changing Section 3 as follows:
(215 ILCS 105/3) (from Ch. 73, par. 1303)
Sec. 3. Operation of the Plan.
a. There is hereby created an Illinois Comprehensive
Health Insurance Plan.
b. The Plan shall operate subject to the supervision and
control of the board. The board is created as a political
subdivision and body politic and corporate and, as such, is
not a State agency. The board shall consist of 10 public
members, appointed by the Governor with the advice and
consent of the Senate.
Initial members shall be appointed to the Board by the
Governor as follows: 2 members to serve until July 1, 1988,
and until their successors are appointed and qualified; 2
members to serve until July 1, 1989, and until their
successors are appointed and qualified; 3 members to serve
until July 1, 1990, and until their successors are appointed
and qualified; and 3 members to serve until July 1, 1991, and
until their successors are appointed and qualified. As terms
of initial members expire, their successors shall be
appointed for terms to expire the first day in July 3 years
thereafter, and until their successors are appointed and
qualified.
Any vacancy in the Board occurring for any reason other
than the expiration of a term shall be filled for the
unexpired term in the same manner as the original
appointment.
Any member of the Board may be removed by the Governor
for neglect of duty, misfeasance, malfeasance, or nonfeasance
in office.
In addition, a representative of the Bureau of the Budget
Illinois Health Care Cost Containment Council, a
representative of the Office of the Attorney General and the
Director or the Director's designated representative shall be
members of the board. Four members of the General Assembly,
one each appointed by the President and Minority Leader of
the Senate and by the Speaker and Minority Leader of the
House of Representatives, shall serve as nonvoting members of
the board. At least 2 of the public members shall be
individuals reasonably expected to qualify for coverage under
the Plan, the parent or spouse of such an individual, or a
surviving family member of an individual who could have
qualified for the plan during his lifetime. The Director or
Director's representative shall be the chairperson of the
board. Members of the board shall receive no compensation,
but shall be reimbursed for reasonable expenses incurred in
the necessary performance of their duties.
c. The board shall make an annual report in September
and shall file the report with the Secretary of the Senate
and the Clerk of the House of Representatives. The report
shall summarize the activities of the Plan in the preceding
calendar year, including net written and earned premiums, the
expense of administration, the paid and incurred losses for
the year and other information as may be requested by the
General Assembly. The report shall also include analysis and
recommendations regarding utilization review, quality
assurance and access to cost effective quality health care.
d. In its plan of operation the board shall:
(1) Establish procedures for selecting a plan
administrator in accordance with Section 5 of this Act.
(2) Establish procedures for the operation of the
board.
(3) Create a Plan fund, under management of the
board, to fund administrative, claim, and other expenses
of the Plan.
(4) Establish procedures for the handling and
accounting of assets and monies of the Plan.
(5) Develop and implement a program to publicize
the existence of the Plan, the eligibility requirements
and procedures for enrollment and to maintain public
awareness of the Plan.
(6) Establish procedures under which applicants and
participants may have grievances reviewed by a grievance
committee appointed by the board. The grievances shall
be reported to the board immediately after completion of
the review. The Department and the board shall retain
all written complaints regarding the Plan for at least 3
years. Oral complaints shall be reduced to written form
and maintained for at least 3 years.
(7) Provide for other matters as may be necessary
and proper for the execution of its powers, duties and
obligations under the Plan.
e. No later than 5 years after the Plan is operative the
board and the Department shall conduct cooperatively a study
of the Plan and the persons insured by the Plan to determine:
(1) claims experience including a breakdown of medical
conditions for which claims were paid; (2) whether
availability of the Plan affected employment opportunities
for participants; (3) whether availability of the Plan
affected the receipt of medical assistance benefits by Plan
participants; (4) whether a change occurred in the number of
personal bankruptcies due to medical or other health related
costs; (5) data regarding all complaints received about the
Plan including its operation and services; (6) and any other
significant observations regarding utilization of the Plan.
The study shall culminate in a written report to be presented
to the Governor, the President of the Senate, the Speaker of
the House and the chairpersons of the House and Senate
Insurance Committees. The report shall be filed with the
Secretary of the Senate and the Clerk of the House of
Representatives. The report shall also be available to
members of the general public upon request.
f. The board may:
(1) Prepare and distribute certificate of
eligibility forms and enrollment instruction forms to
insurance producers and to the general public in this
State.
(2) Provide for reinsurance of risks incurred by
the Plan and enter into reinsurance agreements with
insurers to establish a reinsurance plan for risks of
coverage described in the Plan, or obtain commercial
reinsurance to reduce the risk of loss through the Plan.
(3) Issue additional types of health insurance
policies to provide optional coverages as are otherwise
permitted by this Act including a Medicare supplement
policy designed to supplement Medicare.
(4) Provide for and employ cost containment
measures and requirements including, but not limited to,
preadmission certification, second surgical opinion,
concurrent utilization review programs, and individual
case management for the purpose of making the pool more
cost effective.
(5) Design, utilize, contract, or otherwise arrange
for the delivery of cost effective health care services,
including establishing or contracting with preferred
provider organizations, health maintenance organizations,
and other limited network provider arrangements.
(6) Adopt bylaws, rules, regulations, policies and
procedures as may be necessary or convenient for the
implementation of the Act and the operation of the Plan.
(7) Administer separate pools, separate accounts,
or other plans or arrangements as required by this Act to
separate federally eligible individuals or groups of
federally eligible individuals who qualify for plan
coverage under Section 15 of this Act from eligible
persons or groups of eligible persons who qualify for
plan coverage under Section 7 of this Act and apportion
the costs of the administration among such separate
pools, separate accounts, or other plans or arrangements.
g. The Director may, by rule, establish additional
powers and duties of the board and may adopt rules for any
other purposes, including the operation of the Plan, as are
necessary or proper to implement this Act.
h. The board is not liable for any obligation of the
Plan. There is no liability on the part of any member or
employee of the board or the Department, and no cause of
action of any nature may arise against them, for any action
taken or omission made by them in the performance of their
powers and duties under this Act, unless the action or
omission constitutes willful or wanton misconduct. The board
may provide in its bylaws or rules for indemnification of,
and legal representation for, its members and employees.
i. There is no liability on the part of any insurance
producer for the failure of any applicant to be accepted by
the Plan unless the failure of the applicant to be accepted
by the Plan is due to an act or omission by the insurance
producer which constitutes willful or wanton misconduct.
(Source: P.A. 90-30, eff. 7-1-97.)
Section 75. The Children's Health Insurance Program Act
is amended by changing Sections 20, 40, and 97 as follows:
(215 ILCS 106/20)
(Section scheduled to be repealed on July 1, 2002)
Sec. 20. Eligibility.
(a) To be eligible for this Program, a person must be a
person who has a child eligible under this Act and who is
eligible under a waiver of federal requirements pursuant to
an application made pursuant to subdivision (a)(1) of Section
40 of this Act or who is a child who:
(1) is a child who is not eligible for medical
assistance;
(2) is a child whose annual household income, as
determined by the Department, is above 133% of the
federal poverty level and at or below 185% of the federal
poverty level;
(3) is a resident of the State of Illinois; and
(4) is a child who is either a United States
citizen or included in one of the following categories of
non-citizens:
(A) unmarried dependent children of either a
United States Veteran honorably discharged or a
person on active military duty;
(B) refugees under Section 207 of the
Immigration and Nationality Act;
(C) asylees under Section 208 of the
Immigration and Nationality Act;
(D) persons for whom deportation has been
withheld under Section 243(h) of the Immigration
and Nationality Act;
(E) persons granted conditional entry under
Section 203(a)(7) of the Immigration and Nationality
Act as in effect prior to April 1, 1980;
(F) persons lawfully admitted for permanent
residence under the Immigration and Nationality Act;
and
(G) parolees, for at least one year, under
Section 212(d)(5) of the Immigration and Nationality
Act.
Those children who are in the categories set forth in
subdivisions (4)(F) and (4)(G) of this subsection, who enter
the United States on or after August 22, 1996, shall not be
eligible for 5 years beginning on the date the child entered
the United States.
(b) A child who is determined to be eligible for
assistance may shall remain eligible for 12 months, provided
the child maintains his or her residence in the State, has
not yet attained 19 years of age, and is not excluded
pursuant to subsection (c). A child who has been determined
to be eligible for assistance must reapply or otherwise
establish eligibility Eligibility shall be re-determined by
the Department at least annually. An eligible child shall be
required, as determined by the Department by rule, to report
promptly those changes in income and other circumstances that
affect eligibility. The eligibility of a child may be
redetermined based on the information reported or may be
terminated based on the failure to report or failure to
report accurately. A child's responsible relative or
caretaker may also be held liable to the Department for any
payments made by the Department on such child's behalf that
were inappropriate. An applicant shall be provided with
notice of these obligations.
(c) A child shall not be eligible for coverage under
this Program if:
(1) the premium required pursuant to Section 30 of
this Act has not been paid. If the required premiums are
not paid the liability of the Program shall be limited to
benefits incurred under the Program for the time period
for which premiums had been paid. If the required
monthly premium is not paid, the child shall be
ineligible for re-enrollment for a minimum period of 3
months. Re-enrollment shall be completed prior to the
next covered medical visit and the first month's required
premium shall be paid in advance of the next covered
medical visit. The Department shall promulgate rules
regarding grace periods, notice requirements, and hearing
procedures pursuant to this subsection;
(2) the child is an inmate of a public institution
or a patient in an institution for mental diseases; or
(3) the child is a member of a family that is
eligible for health benefits covered under the State of
Illinois health benefits plan on the basis of a member's
employment with a public agency.
(Source: P.A. 90-736, eff. 8-12-98.)
(215 ILCS 106/40)
(Section scheduled to be repealed on July 1, 2002)
Sec. 40. Waivers.
(a) The Department shall request any necessary waivers
of federal requirements in order to allow receipt of federal
funding for:
(1) the coverage of families with eligible children
under this Act; and
(2) for the coverage of children who would
otherwise be eligible under this Act, but who have health
insurance.
(b) The failure of the responsible federal agency to
approve a waiver for children who would otherwise be eligible
under this Act but who have health insurance shall not
prevent the implementation of any Section of this Act
provided that there are sufficient appropriated funds.
(c) Eligibility of a person under an approved waiver due
to the relationship with a child pursuant to Article V of the
Illinois Public Aid Code or this Act shall be limited to such
a person whose countable income is determined by the
Department to be at or below 65% of the federal poverty
level. Such persons who are determined to be eligible must
reapply, or otherwise establish eligibility, at least
annually. An eligible person shall be required, as
determined by the Department by rule, to report promptly
those changes in income and other circumstances that affect
eligibility. The eligibility of a person may be redetermined
based on the information reported or may be terminated based
on the failure to report or failure to report accurately. A
person may also be held liable to the Department for any
payments made by the Department on such person's behalf that
were inappropriate. An applicant shall be provided with
notice of these obligations.
(Source: P.A. 90-736, eff. 8-12-98.)
(215 ILCS 106/97)
(Section scheduled to be repealed on July 1, 2002)
Sec. 97. Repealer. This Act is repealed on July 1, 2003
2002.
(Source: P.A. 90-736, eff. 8-12-98; 91-712, eff. 7-1-00.)
Section 80. The Illinois Public Aid Code is amended by
changing Sections 5-2, 5-4.1, 5-5.4, 5-5.12, 11-16, 12-3,
12-4.34, 12-10.5, and 12-13.05 as follows:
(305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
Sec. 5-2. Classes of Persons Eligible. Medical
assistance under this Article shall be available to any of
the following classes of persons in respect to whom a plan
for coverage has been submitted to the Governor by the
Illinois Department and approved by him:
1. Recipients of basic maintenance grants under Articles
III and IV.
2. Persons otherwise eligible for basic maintenance
under Articles III and IV but who fail to qualify thereunder
on the basis of need, and who have insufficient income and
resources to meet the costs of necessary medical care,
including but not limited to the following:
(a) All persons otherwise eligible for basic
maintenance under Article III but who fail to qualify
under that Article on the basis of need and who meet
either of the following requirements:
(i) their income, as determined by the
Illinois Department in accordance with any federal
requirements, is equal to or less than 70% in fiscal
year 2001, equal to or less than 85% in fiscal year
2002 and until a date to be determined by the
Department by rule, and equal to or less than 100%
beginning on the date determined by the Department
by rule, in fiscal year 2003 and thereafter of the
nonfarm income official poverty line, as defined by
the federal Office of Management and Budget and
revised annually in accordance with Section 673(2)
of the Omnibus Budget Reconciliation Act of 1981,
applicable to families of the same size; or
(ii) their income, after the deduction of
costs incurred for medical care and for other types
of remedial care, is equal to or less than 70% in
fiscal year 2001, equal to or less than 85% in
fiscal year 2002 and until a date to be determined
by the Department by rule, and equal to or less than
100% beginning on the date determined by the
Department by rule, in fiscal year 2003 and
thereafter of the nonfarm income official poverty
line, as defined in item (i) of this subparagraph
(a).
(b) All persons who would be determined eligible
for such basic maintenance under Article IV by
disregarding the maximum earned income permitted by
federal law.
3. Persons who would otherwise qualify for Aid to the
Medically Indigent under Article VII.
4. Persons not eligible under any of the preceding
paragraphs who fall sick, are injured, or die, not having
sufficient money, property or other resources to meet the
costs of necessary medical care or funeral and burial
expenses.
5. (a) Women during pregnancy, after the fact of
pregnancy has been determined by medical diagnosis, and
during the 60-day period beginning on the last day of the
pregnancy, together with their infants and children born
after September 30, 1983, whose income and resources are
insufficient to meet the costs of necessary medical care
to the maximum extent possible under Title XIX of the
Federal Social Security Act.
(b) The Illinois Department and the Governor shall
provide a plan for coverage of the persons eligible under
paragraph 5(a) by April 1, 1990. Such plan shall provide
ambulatory prenatal care to pregnant women during a
presumptive eligibility period and establish an income
eligibility standard that is equal to 133% of the nonfarm
income official poverty line, as defined by the federal
Office of Management and Budget and revised annually in
accordance with Section 673(2) of the Omnibus Budget
Reconciliation Act of 1981, applicable to families of the
same size, provided that costs incurred for medical care
are not taken into account in determining such income
eligibility.
(c) The Illinois Department may conduct a
demonstration in at least one county that will provide
medical assistance to pregnant women, together with their
infants and children up to one year of age, where the
income eligibility standard is set up to 185% of the
nonfarm income official poverty line, as defined by the
federal Office of Management and Budget. The Illinois
Department shall seek and obtain necessary authorization
provided under federal law to implement such a
demonstration. Such demonstration may establish resource
standards that are not more restrictive than those
established under Article IV of this Code.
6. Persons under the age of 18 who fail to qualify as
dependent under Article IV and who have insufficient income
and resources to meet the costs of necessary medical care to
the maximum extent permitted under Title XIX of the Federal
Social Security Act.
7. Persons who are 18 years of age or younger and would
qualify as disabled as defined under the Federal Supplemental
Security Income Program, provided medical service for such
persons would be eligible for Federal Financial
Participation, and provided the Illinois Department
determines that:
(a) the person requires a level of care provided by
a hospital, skilled nursing facility, or intermediate
care facility, as determined by a physician licensed to
practice medicine in all its branches;
(b) it is appropriate to provide such care outside
of an institution, as determined by a physician licensed
to practice medicine in all its branches;
(c) the estimated amount which would be expended
for care outside the institution is not greater than the
estimated amount which would be expended in an
institution.
8. Persons who become ineligible for basic maintenance
assistance under Article IV of this Code in programs
administered by the Illinois Department due to employment
earnings and persons in assistance units comprised of adults
and children who become ineligible for basic maintenance
assistance under Article VI of this Code due to employment
earnings. The plan for coverage for this class of persons
shall:
(a) extend the medical assistance coverage for up
to 12 months following termination of basic maintenance
assistance; and
(b) offer persons who have initially received 6
months of the coverage provided in paragraph (a) above,
the option of receiving an additional 6 months of
coverage, subject to the following:
(i) such coverage shall be pursuant to
provisions of the federal Social Security Act;
(ii) such coverage shall include all services
covered while the person was eligible for basic
maintenance assistance;
(iii) no premium shall be charged for such
coverage; and
(iv) such coverage shall be suspended in the
event of a person's failure without good cause to
file in a timely fashion reports required for this
coverage under the Social Security Act and coverage
shall be reinstated upon the filing of such reports
if the person remains otherwise eligible.
9. Persons with acquired immunodeficiency syndrome
(AIDS) or with AIDS-related conditions with respect to whom
there has been a determination that but for home or
community-based services such individuals would require the
level of care provided in an inpatient hospital, skilled
nursing facility or intermediate care facility the cost of
which is reimbursed under this Article. Assistance shall be
provided to such persons to the maximum extent permitted
under Title XIX of the Federal Social Security Act.
10. Participants in the long-term care insurance
partnership program established under the Partnership for
Long-Term Care Act who meet the qualifications for protection
of resources described in Section 25 of that Act.
11. Persons with disabilities who are employed and
eligible for Medicaid, pursuant to Section
1902(a)(10)(A)(ii)(xv) of the Social Security Act, as
provided by the Illinois Department by rule.
12. Subject to federal approval, persons who are
eligible for medical assistance coverage under applicable
provisions of the federal Social Security Act and the federal
Breast and Cervical Cancer Prevention and Treatment Act of
2000. Those eligible persons are defined to include, but not
be limited to, the following persons:
(1) persons who have been screened for breast or
cervical cancer under the U.S. Centers for Disease
Control and Prevention Breast and Cervical Cancer Program
established under Title XV of the federal Public Health
Services Act in accordance with the requirements of
Section 1504 of that Act as administered by the Illinois
Department of Public Health; and
(2) persons whose screenings under the above
program were funded in whole or in part by funds
appropriated to the Illinois Department of Public Health
for breast or cervical cancer screening.
"Medical assistance" under this paragraph 12 shall be
identical to the benefits provided under the State's approved
plan under Title XIX of the Social Security Act. The
Department must request federal approval of the coverage
under this paragraph 12 within 30 days after the effective
date of this amendatory Act of the 92nd General Assembly.
The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7
as soon as possible after July 1, 1984.
The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any
grant under the Senior Citizens and Disabled Persons Property
Tax Relief and Pharmaceutical Assistance Act or any
distributions or items of income described under subparagraph
(X) of paragraph (2) of subsection (a) of Section 203 of the
Illinois Income Tax Act. The Department shall by rule
establish the amounts of assets to be disregarded in
determining eligibility for medical assistance, which shall
at a minimum equal the amounts to be disregarded under the
Federal Supplemental Security Income Program. The amount of
assets of a single person to be disregarded shall not be less
than $2,000, and the amount of assets of a married couple to
be disregarded shall not be less than $3,000.
To the extent permitted under federal law, any person
found guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
The eligibility of any person for medical assistance
under this Article shall not be affected by the receipt by
the person of donations or benefits from fundraisers held for
the person in cases of serious illness, as long as neither
the person nor members of the person's family have actual
control over the donations or benefits or the disbursement of
the donations or benefits.
(Source: P.A. 91-676, eff. 12-23-99; 91-699, eff. 7-1-00;
91-712, eff. 7-1-00; 92-16, eff. 6-28-01; 92-47, eff.
7-3-01.)
(305 ILCS 5/5-4.1) (from Ch. 23, par. 5-4.1)
Sec. 5-4.1. Co-payments. The Department may by rule
provide that recipients under any Article of this Code (other
than group care recipients) shall pay a fee as a co-payment
for services. Co-payments may not exceed $3 for brand name
drugs, $1 one dollar for other pharmacy services, and $2 for
physicians services, dental services, optical services and
supplies, chiropractic services, podiatry services, and
encounter rate clinic services. Co-payments may not exceed
$3 three dollars for hospital outpatient and clinic services.
Provided, however, that any such rule must provide that no
co-payment requirement can exist for renal dialysis,
radiation therapy, cancer chemotherapy, or insulin, and other
products necessary on a recurring basis, the absence of which
would be life threatening, or where co-payment expenditures
for required services and/or medications for chronic diseases
that the Illinois Department shall by rule designate shall
cause an extensive financial burden on the recipient, and
provided no co-payment shall exist for emergency room
encounters which are for medical emergencies.
(Source: P.A. 82-664.)
(305 ILCS 5/5-5.4) (from Ch. 23, par. 5-5.4)
Sec. 5-5.4. Standards of Payment - Department of Public
Aid. The Department of Public Aid shall develop standards of
payment of skilled nursing and intermediate care services in
facilities providing such services under this Article which:
(1) Provide Provides for the determination of a
facility's payment for skilled nursing and intermediate care
services on a prospective basis. The amount of the payment
rate for all nursing facilities certified under the medical
assistance program shall be prospectively established
annually on the basis of historical, financial, and
statistical data reflecting actual costs from prior years,
which shall be applied to the current rate year and updated
for inflation, except that the capital cost element for newly
constructed facilities shall be based upon projected budgets.
The annually established payment rate shall take effect on
July 1 in 1984 and subsequent years. Rate increases shall be
provided annually thereafter on July 1 in 1984 and on each
subsequent July 1 in the following years, except that no rate
increase and no update for inflation shall be provided on or
after July 1, 1994 and before July 1, 2003 2002, unless
specifically provided for in this Section.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 1998 shall include an increase of 3%. For facilities
licensed by the Department of Public Health under the Nursing
Home Care Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking effect on July 1, 1998
shall include an increase of 3% plus $1.10 per resident-day,
as defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 1999 shall include an increase of 1.6% plus $3.00 per
resident-day, as defined by the Department. For facilities
licensed by the Department of Public Health under the Nursing
Home Care Act as Skilled Nursing facilities or Intermediate
Care facilities, the rates taking effect on July 1, 1999
shall include an increase of 1.6% and, for services provided
on or after October 1, 1999, shall be increased by $4.00 per
resident-day, as defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on July
1, 2000 shall include an increase of 2.5% per resident-day,
as defined by the Department. For facilities licensed by the
Department of Public Health under the Nursing Home Care Act
as Skilled Nursing facilities or Intermediate Care
facilities, the rates taking effect on July 1, 2000 shall
include an increase of 2.5% per resident-day, as defined by
the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on March
1, 2001 shall include a statewide increase of 7.85%, as
defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as Intermediate Care
for the Developmentally Disabled facilities or Long Term Care
for Under Age 22 facilities, the rates taking effect on April
1, 2002 shall include a statewide increase of 2.0%, as
defined by the Department. This increase terminates on July
1, 2002; beginning July 1, 2002 these rates are reduced to
the level of the rates in effect on March 31, 2002, as
defined by the Department.
For facilities licensed by the Department of Public
Health under the Nursing Home Care Act as skilled nursing
facilities or intermediate care facilities, the rates taking
effect on July 1, 2001, and each subsequent year thereafter,
shall be computed using the most recent cost reports on file
with the Department of Public Aid no later than April 1,
2000, updated for inflation to January 1, 2001. For rates
effective July 1, 2001 only, rates shall be the greater of
the rate computed for July 1, 2001 or the rate effective on
June 30, 2001.
Notwithstanding any other provision of this Section, for
facilities licensed by the Department of Public Health under
the Nursing Home Care Act as skilled nursing facilities or
intermediate care facilities, the Illinois Department shall
determine by rule the rates taking effect on July 1, 2002,
which shall be 5.9% less than the rates in effect on June 30,
2002.
Rates established effective each July 1 shall govern
payment for services rendered throughout that fiscal year,
except that rates established on July 1, 1996 shall be
increased by 6.8% for services provided on or after January
1, 1997. Such rates will be based upon the rates calculated
for the year beginning July 1, 1990, and for subsequent years
thereafter until June 30, 2001 shall be based on the facility
cost reports for the facility fiscal year ending at any point
in time during the previous calendar year, updated to the
midpoint of the rate year. The cost report shall be on file
with the Department no later than April 1 of the current rate
year. Should the cost report not be on file by April 1, the
Department shall base the rate on the latest cost report
filed by each skilled care facility and intermediate care
facility, updated to the midpoint of the current rate year.
In determining rates for services rendered on and after July
1, 1985, fixed time shall not be computed at less than zero.
The Department shall not make any alterations of regulations
which would reduce any component of the Medicaid rate to a
level below what that component would have been utilizing in
the rate effective on July 1, 1984.
(2) Shall take into account the actual costs incurred by
facilities in providing services for recipients of skilled
nursing and intermediate care services under the medical
assistance program.
(3) Shall take into account the medical and
psycho-social characteristics and needs of the patients.
(4) Shall take into account the actual costs incurred by
facilities in meeting licensing and certification standards
imposed and prescribed by the State of Illinois, any of its
political subdivisions or municipalities and by the U.S.
Department of Health and Human Services pursuant to Title XIX
of the Social Security Act.
The Department of Public Aid shall develop precise
standards for payments to reimburse nursing facilities for
any utilization of appropriate rehabilitative personnel for
the provision of rehabilitative services which is authorized
by federal regulations, including reimbursement for services
provided by qualified therapists or qualified assistants, and
which is in accordance with accepted professional practices.
Reimbursement also may be made for utilization of other
supportive personnel under appropriate supervision.
(Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
eff. 6-11-01; 92-31, eff. 6-28-01; revised 12-13-01.)
(305 ILCS 5/5-5.12) (from Ch. 23, par. 5-5.12)
Sec. 5-5.12. Pharmacy payments.
(a) Every request submitted by a pharmacy for
reimbursement under this Article for prescription drugs
provided to a recipient of aid under this Article shall
include the name of the prescriber or an acceptable
identification number as established by the Department.
(b) Pharmacies providing prescription drugs under this
Article shall be reimbursed at a rate which shall include a
professional dispensing fee as determined by the Illinois
Department, plus the current acquisition cost of the
prescription drug dispensed. The Illinois Department shall
update its information on the acquisition costs of all
prescription drugs no less frequently than every 30 days.
However, the Illinois Department may set the rate of
reimbursement for the acquisition cost, by rule, at a
percentage of the current average wholesale acquisition cost.
(c) Reimbursement under this Article for prescription
drugs shall be limited to reimbursement for 4 brand-name
prescription drugs per patient per month. This subsection
applies only if (i) the brand-name drug was not prescribed
for an acute or urgent condition, (ii) the brand-name drug
was not prescribed for Alzheimer's disease, arthritis,
diabetes, HIV/AIDS, a mental health condition, or respiratory
disease, and (iii) a therapeutically equivalent generic
medication has been approved by the federal Food and Drug
Administration.
(Source: P.A. 88-554, eff. 7-26-94; 89-673, eff. 8-14-96.)
(305 ILCS 5/11-16) (from Ch. 23, par. 11-16)
Sec. 11-16. Changes in grants; cancellations,
revocations, suspensions.
(a) All grants of financial aid under this Code shall be
considered as frequently as may be required by the rules of
the Illinois Department. The Department of Public Aid shall
consider grants of financial aid to children who are eligible
under Article V of this Code at least annually and shall take
into account those reports filed, or required to be filed,
pursuant to Sections 11-18 and 11-19. After such
investigation as may be necessary, the amount and manner of
giving aid may be changed or the aid may be entirely
withdrawn if the County Department, local governmental unit,
or Illinois Department finds that the recipient's
circumstances have altered sufficiently to warrant such
action. Financial aid may at any time be canceled or revoked
for cause or suspended for such period as may be proper.
(b) Whenever any such grant of financial aid is
cancelled, revoked, reduced, or terminated because of the
failure of the recipient to cooperate with the Department,
including but not limited to the failure to keep an
appointment, attend a meeting, or produce proof or
verification of eligibility or need, the grant shall be
reinstated in full, retroactive to the date of the change in
or termination of the grant, provided that within 10 working
days after the first day the financial aid would have been
available, the recipient cooperates with the Department and
is not otherwise ineligible for benefits for the period in
question. This subsection (b) does not apply to sanctions
imposed for the failure of any recipient to participate as
required in the child support enforcement program or in any
educational, training, or employment program under this Code
or any other sanction under Section 4-21, nor does this
subsection (b) apply to any cancellation, revocation,
reduction, termination, or sanction imposed for the failure
of any recipient to cooperate in the monthly reporting
process or the quarterly reporting process.
(Source: P.A. 90-17, eff. 7-1-97; 91-357, eff. 7-29-99.)
(305 ILCS 5/12-3) (from Ch. 23, par. 12-3)
Sec. 12-3. Local governmental units. As provided in
Article VI, local governmental units shall provide funds for
and administer the programs provided in that Article subject,
where so provided, to the supervision of the Illinois
Department. Local governmental units shall also provide the
social services and utilize the rehabilitative facilities
authorized in Article IX for persons served through Article
VI, and shall discharge such other duties as may be required
by this Code or other laws of this State.
In counties not under township organization, the county
shall provide funds for and administer such programs.
In counties under township organization (including any
such counties in which the governing authority is a board of
commissioners) the various towns other than those towns lying
entirely within the corporate limits of any city, village or
incorporated town having a population of more than 500,000
inhabitants shall provide funds for and administer such
programs.
Cities, villages, and incorporated towns having a
population of more than 500,000 inhabitants shall provide
funds for public aid purposes under Article VI but the
Department of Human Services shall administer the program for
such municipality. For the fiscal year beginning July 1,
2003, however, the municipality shall decrease by $5,000,000
the amount of funds it provides for public aid purposes under
Article VI. For each fiscal year thereafter, the
municipality shall decrease the amount of funds it provides
for public aid purposes under Article VI in that fiscal year
by an additional amount equal to (i) $5,000,000 or (ii) the
amount provided by the municipality in the preceding fiscal
year, whichever is less, until the municipality does not
provide any funds for public aid purposes under Article VI.
Incorporated towns which have superseded civil townships
shall provide funds for and administer the public aid program
provided by Article VI.
In counties of less than 3 million population having a
County Veterans Assistance Commission in which there has been
levied a tax as authorized by Section 5-2006 of the Counties
Code for the purpose of providing assistance to military
veterans and their families, the County Veterans Assistance
Commission shall administer the programs provided by Article
VI for such military veterans and their families as seek aid
through the County Veterans Assistance Commission.
(Source: P.A. 92-111, eff. 1-1-02.)
(305 ILCS 5/12-4.34)
(Section scheduled to be repealed on August 31, 2002)
Sec. 12-4.34. Services to noncitizens.
(a) Subject to specific appropriation for this purpose
and notwithstanding Sections 1-11 and 3-1 of this Code, the
Department of Human Services is authorized to provide
services to legal immigrants, including but not limited to
naturalization and nutrition services and financial
assistance. The nature of these services, payment levels,
and eligibility conditions shall be determined by rule.
(b) The Illinois Department is authorized to lower the
payment levels established under this subsection or take such
other actions during the fiscal year as are necessary to
ensure that payments under this subsection do not exceed the
amounts appropriated for this purpose. These changes may be
accomplished by emergency rule under Section 5-45 of the
Illinois Administrative Procedure Act, except that the
limitation on the number of emergency rules that may be
adopted in a 24-month period shall not apply.
(c) This Section is repealed on August 31, 2002.
(Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10,
eff. 6-11-01.)
(305 ILCS 5/12-10.5)
Sec. 12-10.5. Medical Special Purposes Trust Fund.
(a) The Medical Special Purposes Trust Fund ("the Fund")
is created. Any grant, gift, donation, or legacy of money or
securities that the Department of Public Aid is authorized to
receive under Section 12-4.18 or Section 12-4.19, and that is
dedicated for functions connected with the administration of
any medical program administered by the Department, shall be
deposited into the Fund. All federal moneys received by the
Department as reimbursement for disbursements authorized to
be made from the Fund shall also be deposited into the Fund.
In addition, federal moneys received on account of State
expenditures made in connection with obtaining compliance
with the federal Health Insurance Portability and
Accountability Act (HIPAA) shall be deposited into the Fund.
(b) No moneys received from a service provider or a
governmental or private entity that is enrolled with the
Department as a provider of medical services shall be
deposited into the Fund.
(c) Disbursements may be made from the Fund for the
purposes connected with the grants, gifts, donations, or
legacies deposited into the Fund, including, but not limited
to, medical quality assessment projects, eligibility
population studies, medical information systems evaluations,
and other administrative functions that assist the Department
in fulfilling its health care mission under the Illinois
Public Aid Code and the Children's Health Insurance Program
Act.
(Source: P.A. 92-37, eff. 7-1-01.)
(305 ILCS 5/12-13.05)
Sec. 12-13.05. Rules for Temporary Assistance for Needy
Families. All rules regulating the Temporary Assistance for
Needy Families program and all other rules regulating the
amendatory changes to this Code made by this amendatory Act
of 1997 shall be promulgated pursuant to this Section. All
rules regulating the Temporary Assistance for Needy Families
program and all other rules regulating the amendatory changes
to this Code made by this amendatory Act of 1997 are repealed
on July 1 2006 January 1, 2003. On and after July 1, 2006
January 1, 2003, the Illinois Department may not promulgate
any rules regulating the Temporary Assistance for Needy
Families program or regulating the amendatory changes to this
Code made by this amendatory Act of 1997.
(Source: P.A. 91-5, eff. 5-27-99; 92-111, eff. 1-1-02.)
Section 85. The Senior Citizens and Disabled Persons
Property Tax Relief and Pharmaceutical Assistance Act is
amended by changing Section 3.16 as follows:
(320 ILCS 25/3.16) (from Ch. 67 1/2, par. 403.16)
Sec. 3.16. "Reasonable cost" means Average Wholesale
Price (AWP) minus 10% for products provided by authorized
pharmacies plus a professional dispensing fee determined by
the Department in accordance with its findings in a survey of
professional pharmacy dispensing fees conducted at least
every 12 months. For the purpose of this Act, AWP shall be
determined from the latest publication of the Blue Book, a
universally subscribed pharmacist reference guide annually
published by the Hearst Corporation. AWP may also be derived
electronically from the drug pricing database synonymous with
the latest publication of the Blue Book and furnished in the
National Drug Data File (NDDF) by First Data Bank (FDB), a
service of the Hearst Corporation. The elements of such fees
and methodology of such survey shall be promulgated as an
administrative rule. Effective July 1, 1986, the
professional dispensing fee shall be $3.60 per prescription
and such amount shall be adjusted on July 1st of each year
thereafter in accordance with a survey of professional
pharmacy dispensing fees. The Department may establish
maximum acquisition costs from time to time based upon
information as to the cost at which covered products may be
readily acquired by authorized pharmacies. In no case shall
the reasonable cost of any given pharmacy exceed the price
normally charged to the general public by that pharmacy. In
the event that generic equivalents for covered prescription
drugs are available at lower cost, the Department shall
establish the maximum acquisition costs for such covered
prescription drugs at the lower generic cost unless, pursuant
to the conditions described in subsection (f) of Section 4, a
non-generic drug may be substituted.
Effective July 1, 2002, the rates paid for products
provided by authorized pharmacies and a professional
dispensing fee shall be determined by the Department by rule.
(Source: P.A. 91-699, eff. 1-1-01.)
Section 99. Effective date. This Act takes effect upon
becoming law, except that Sections 25, 26, 45, 60, and 65
take effect on July 1, 2002.
Passed in the General Assembly June 02, 2002.
Approved June 28, 2002.
Effective June 28, 2002.
Effective July 01, 2002.
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