Illinois General Assembly - Full Text of SB1851
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Full Text of SB1851  100th General Assembly

SB1851ham002 100TH GENERAL ASSEMBLY

Rep. Gregory Harris

Filed: 5/28/2018

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1851

2    AMENDMENT NO. ______. Amend Senate Bill 1851, AS AMENDED,
3by replacing everything after the enacting clause with the
4following:
 
5    "Section 1. Findings; intent. According to the
6Congressional Research Service reporting, approximately 35% to
760% of children placed in foster care have at least one chronic
8or acute physical health condition that requires treatment,
9including growth failure, asthma, obesity, vision impairment,
10hearing loss, neurological problems, and complex chronic
11illnesses; as many as 50% to 75% show behavioral or social
12competency issues that may warrant mental health services; many
13of these physical and mental health care issues persist and,
14relative to their peers in the general population, children who
15leave foster care for adoption and those who age out of care
16continue to have greater health needs.
17    Federal child welfare policy requires states to develop

 

 

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1strategies to address the health care needs of each child in
2foster care and mandates coordination of state child welfare
3and Medicaid agencies to ensure that the health care needs of
4children in foster care are properly identified and treated.
5    The Department of Children and Family Services is
6responsible for ensuring safety, family permanence, and
7well-being for the children placed in its custody and
8protecting these children from further trauma by ensuring
9timely access to appropriate placements and services,
10especially those children with complex emotional and
11behavioral needs who are at much greater risk for not achieving
12the fundamental child welfare goals of safety, permanence, and
13well-being.
14    The Department remains under federal court oversight
15pursuant to the B.H. Consent Decree, in part, for failure to
16provide constitutionally sufficient services and placements
17for children with psychological, behavioral, or emotional
18challenges; the 2015 court-appointed Expert Panel found too
19many children in the class experience multiple disruptions of
20placement, services, and relationships; these children and
21their families endure indeterminate waits, month upon month,
22for services the child and family need, without a concrete plan
23or timeframe; these disruptions and delays and the inaction of
24Department officials exacerbate children's already serious and
25chronic mental health problems; the Department's approach to
26treatment and its system of practice have been shaped by

 

 

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1crises, practitioner preferences, tradition, and system
2expediency.
3    The American Academy of Pediatrics cautions that the
4effects of managed care on children's access to services and
5actual health outcomes are not yet clear; it outlines design
6and implementation principles if managed care is to be
7implemented for children.
8    It is the intent of the General Assembly to ensure that
9children are provided a system of health care with full and
10inclusive access to physical and behavioral health services
11necessary for them to thrive.
12    The General Assembly finds it necessary to protect youth in
13care by requiring the Department to plan the use of managed
14care services transparently, collaboratively, and deliberately
15to ensure quality outcomes and accountable oversight.
 
16    Section 5. The Open Meetings Act is amended by changing
17Section 2 as follows:
 
18    (5 ILCS 120/2)  (from Ch. 102, par. 42)
19    Sec. 2. Open meetings.
20    (a) Openness required. All meetings of public bodies shall
21be open to the public unless excepted in subsection (c) and
22closed in accordance with Section 2a.
23    (b) Construction of exceptions. The exceptions contained
24in subsection (c) are in derogation of the requirement that

 

 

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1public bodies meet in the open, and therefore, the exceptions
2are to be strictly construed, extending only to subjects
3clearly within their scope. The exceptions authorize but do not
4require the holding of a closed meeting to discuss a subject
5included within an enumerated exception.
6    (c) Exceptions. A public body may hold closed meetings to
7consider the following subjects:
8        (1) The appointment, employment, compensation,
9    discipline, performance, or dismissal of specific
10    employees of the public body or legal counsel for the
11    public body, including hearing testimony on a complaint
12    lodged against an employee of the public body or against
13    legal counsel for the public body to determine its
14    validity. However, a meeting to consider an increase in
15    compensation to a specific employee of a public body that
16    is subject to the Local Government Wage Increase
17    Transparency Act may not be closed and shall be open to the
18    public and posted and held in accordance with this Act.
19        (2) Collective negotiating matters between the public
20    body and its employees or their representatives, or
21    deliberations concerning salary schedules for one or more
22    classes of employees.
23        (3) The selection of a person to fill a public office,
24    as defined in this Act, including a vacancy in a public
25    office, when the public body is given power to appoint
26    under law or ordinance, or the discipline, performance or

 

 

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1    removal of the occupant of a public office, when the public
2    body is given power to remove the occupant under law or
3    ordinance.
4        (4) Evidence or testimony presented in open hearing, or
5    in closed hearing where specifically authorized by law, to
6    a quasi-adjudicative body, as defined in this Act, provided
7    that the body prepares and makes available for public
8    inspection a written decision setting forth its
9    determinative reasoning.
10        (5) The purchase or lease of real property for the use
11    of the public body, including meetings held for the purpose
12    of discussing whether a particular parcel should be
13    acquired.
14        (6) The setting of a price for sale or lease of
15    property owned by the public body.
16        (7) The sale or purchase of securities, investments, or
17    investment contracts. This exception shall not apply to the
18    investment of assets or income of funds deposited into the
19    Illinois Prepaid Tuition Trust Fund.
20        (8) Security procedures, school building safety and
21    security, and the use of personnel and equipment to respond
22    to an actual, a threatened, or a reasonably potential
23    danger to the safety of employees, students, staff, the
24    public, or public property.
25        (9) Student disciplinary cases.
26        (10) The placement of individual students in special

 

 

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1    education programs and other matters relating to
2    individual students.
3        (11) Litigation, when an action against, affecting or
4    on behalf of the particular public body has been filed and
5    is pending before a court or administrative tribunal, or
6    when the public body finds that an action is probable or
7    imminent, in which case the basis for the finding shall be
8    recorded and entered into the minutes of the closed
9    meeting.
10        (12) The establishment of reserves or settlement of
11    claims as provided in the Local Governmental and
12    Governmental Employees Tort Immunity Act, if otherwise the
13    disposition of a claim or potential claim might be
14    prejudiced, or the review or discussion of claims, loss or
15    risk management information, records, data, advice or
16    communications from or with respect to any insurer of the
17    public body or any intergovernmental risk management
18    association or self insurance pool of which the public body
19    is a member.
20        (13) Conciliation of complaints of discrimination in
21    the sale or rental of housing, when closed meetings are
22    authorized by the law or ordinance prescribing fair housing
23    practices and creating a commission or administrative
24    agency for their enforcement.
25        (14) Informant sources, the hiring or assignment of
26    undercover personnel or equipment, or ongoing, prior or

 

 

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1    future criminal investigations, when discussed by a public
2    body with criminal investigatory responsibilities.
3        (15) Professional ethics or performance when
4    considered by an advisory body appointed to advise a
5    licensing or regulatory agency on matters germane to the
6    advisory body's field of competence.
7        (16) Self evaluation, practices and procedures or
8    professional ethics, when meeting with a representative of
9    a statewide association of which the public body is a
10    member.
11        (17) The recruitment, credentialing, discipline or
12    formal peer review of physicians or other health care
13    professionals, or for the discussion of matters protected
14    under the federal Patient Safety and Quality Improvement
15    Act of 2005, and the regulations promulgated thereunder,
16    including 42 C.F.R. Part 3 (73 FR 70732), or the federal
17    Health Insurance Portability and Accountability Act of
18    1996, and the regulations promulgated thereunder,
19    including 45 C.F.R. Parts 160, 162, and 164, by a hospital,
20    or other institution providing medical care, that is
21    operated by the public body.
22        (18) Deliberations for decisions of the Prisoner
23    Review Board.
24        (19) Review or discussion of applications received
25    under the Experimental Organ Transplantation Procedures
26    Act.

 

 

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1        (20) The classification and discussion of matters
2    classified as confidential or continued confidential by
3    the State Government Suggestion Award Board.
4        (21) Discussion of minutes of meetings lawfully closed
5    under this Act, whether for purposes of approval by the
6    body of the minutes or semi-annual review of the minutes as
7    mandated by Section 2.06.
8        (22) Deliberations for decisions of the State
9    Emergency Medical Services Disciplinary Review Board.
10        (23) The operation by a municipality of a municipal
11    utility or the operation of a municipal power agency or
12    municipal natural gas agency when the discussion involves
13    (i) contracts relating to the purchase, sale, or delivery
14    of electricity or natural gas or (ii) the results or
15    conclusions of load forecast studies.
16        (24) Meetings of a residential health care facility
17    resident sexual assault and death review team or the
18    Executive Council under the Abuse Prevention Review Team
19    Act.
20        (25) Meetings of an independent team of experts under
21    Brian's Law.
22        (26) Meetings of a mortality review team appointed
23    under the Department of Juvenile Justice Mortality Review
24    Team Act.
25        (27) (Blank).
26        (28) Correspondence and records (i) that may not be

 

 

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1    disclosed under Section 11-9 of the Illinois Public Aid
2    Code or (ii) that pertain to appeals under Section 11-8 of
3    the Illinois Public Aid Code.
4        (29) Meetings between internal or external auditors
5    and governmental audit committees, finance committees, and
6    their equivalents, when the discussion involves internal
7    control weaknesses, identification of potential fraud risk
8    areas, known or suspected frauds, and fraud interviews
9    conducted in accordance with generally accepted auditing
10    standards of the United States of America.
11        (30) Those meetings or portions of meetings of a
12    fatality review team or the Illinois Fatality Review Team
13    Advisory Council during which a review of the death of an
14    eligible adult in which abuse or neglect is suspected,
15    alleged, or substantiated is conducted pursuant to Section
16    15 of the Adult Protective Services Act.
17        (31) Meetings and deliberations for decisions of the
18    Concealed Carry Licensing Review Board under the Firearm
19    Concealed Carry Act.
20        (32) Meetings between the Regional Transportation
21    Authority Board and its Service Boards when the discussion
22    involves review by the Regional Transportation Authority
23    Board of employment contracts under Section 28d of the
24    Metropolitan Transit Authority Act and Sections 3A.18 and
25    3B.26 of the Regional Transportation Authority Act.
26        (33) Those meetings or portions of meetings of the

 

 

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1    advisory committee and peer review subcommittee created
2    under Section 320 of the Illinois Controlled Substances Act
3    during which specific controlled substance prescriber,
4    dispenser, or patient information is discussed.
5        (34) Meetings of the Tax Increment Financing Reform
6    Task Force under Section 2505-800 of the Department of
7    Revenue Law of the Civil Administrative Code of Illinois.
8        (35) Meetings of the group established to discuss
9    Medicaid capitation rates under Section 5-30.8 of the
10    Illinois Public Aid Code.
11    (d) Definitions. For purposes of this Section:
12    "Employee" means a person employed by a public body whose
13relationship with the public body constitutes an
14employer-employee relationship under the usual common law
15rules, and who is not an independent contractor.
16    "Public office" means a position created by or under the
17Constitution or laws of this State, the occupant of which is
18charged with the exercise of some portion of the sovereign
19power of this State. The term "public office" shall include
20members of the public body, but it shall not include
21organizational positions filled by members thereof, whether
22established by law or by a public body itself, that exist to
23assist the body in the conduct of its business.
24    "Quasi-adjudicative body" means an administrative body
25charged by law or ordinance with the responsibility to conduct
26hearings, receive evidence or testimony and make

 

 

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1determinations based thereon, but does not include local
2electoral boards when such bodies are considering petition
3challenges.
4    (e) Final action. No final action may be taken at a closed
5meeting. Final action shall be preceded by a public recital of
6the nature of the matter being considered and other information
7that will inform the public of the business being conducted.
8(Source: P.A. 99-78, eff. 7-20-15; 99-235, eff. 1-1-16; 99-480,
9eff. 9-9-15; 99-642, eff. 7-28-16; 99-646, eff. 7-28-16;
1099-687, eff. 1-1-17; 100-201, eff. 8-18-17; 100-465, eff.
118-31-17.)
 
12    Section 10. The Freedom of Information Act is amended by
13changing Section 7.5 as follows:
 
14    (5 ILCS 140/7.5)
15    (Text of Section before amendment by P.A. 100-512 and
16100-517)
17    Sec. 7.5. Statutory exemptions. To the extent provided for
18by the statutes referenced below, the following shall be exempt
19from inspection and copying:
20        (a) All information determined to be confidential
21    under Section 4002 of the Technology Advancement and
22    Development Act.
23        (b) Library circulation and order records identifying
24    library users with specific materials under the Library

 

 

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1    Records Confidentiality Act.
2        (c) Applications, related documents, and medical
3    records received by the Experimental Organ Transplantation
4    Procedures Board and any and all documents or other records
5    prepared by the Experimental Organ Transplantation
6    Procedures Board or its staff relating to applications it
7    has received.
8        (d) Information and records held by the Department of
9    Public Health and its authorized representatives relating
10    to known or suspected cases of sexually transmissible
11    disease or any information the disclosure of which is
12    restricted under the Illinois Sexually Transmissible
13    Disease Control Act.
14        (e) Information the disclosure of which is exempted
15    under Section 30 of the Radon Industry Licensing Act.
16        (f) Firm performance evaluations under Section 55 of
17    the Architectural, Engineering, and Land Surveying
18    Qualifications Based Selection Act.
19        (g) Information the disclosure of which is restricted
20    and exempted under Section 50 of the Illinois Prepaid
21    Tuition Act.
22        (h) Information the disclosure of which is exempted
23    under the State Officials and Employees Ethics Act, and
24    records of any lawfully created State or local inspector
25    general's office that would be exempt if created or
26    obtained by an Executive Inspector General's office under

 

 

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1    that Act.
2        (i) Information contained in a local emergency energy
3    plan submitted to a municipality in accordance with a local
4    emergency energy plan ordinance that is adopted under
5    Section 11-21.5-5 of the Illinois Municipal Code.
6        (j) Information and data concerning the distribution
7    of surcharge moneys collected and remitted by carriers
8    under the Emergency Telephone System Act.
9        (k) Law enforcement officer identification information
10    or driver identification information compiled by a law
11    enforcement agency or the Department of Transportation
12    under Section 11-212 of the Illinois Vehicle Code.
13        (l) Records and information provided to a residential
14    health care facility resident sexual assault and death
15    review team or the Executive Council under the Abuse
16    Prevention Review Team Act.
17        (m) Information provided to the predatory lending
18    database created pursuant to Article 3 of the Residential
19    Real Property Disclosure Act, except to the extent
20    authorized under that Article.
21        (n) Defense budgets and petitions for certification of
22    compensation and expenses for court appointed trial
23    counsel as provided under Sections 10 and 15 of the Capital
24    Crimes Litigation Act. This subsection (n) shall apply
25    until the conclusion of the trial of the case, even if the
26    prosecution chooses not to pursue the death penalty prior

 

 

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1    to trial or sentencing.
2        (o) Information that is prohibited from being
3    disclosed under Section 4 of the Illinois Health and
4    Hazardous Substances Registry Act.
5        (p) Security portions of system safety program plans,
6    investigation reports, surveys, schedules, lists, data, or
7    information compiled, collected, or prepared by or for the
8    Regional Transportation Authority under Section 2.11 of
9    the Regional Transportation Authority Act or the St. Clair
10    County Transit District under the Bi-State Transit Safety
11    Act.
12        (q) Information prohibited from being disclosed by the
13    Personnel Records Review Act.
14        (r) Information prohibited from being disclosed by the
15    Illinois School Student Records Act.
16        (s) Information the disclosure of which is restricted
17    under Section 5-108 of the Public Utilities Act.
18        (t) All identified or deidentified health information
19    in the form of health data or medical records contained in,
20    stored in, submitted to, transferred by, or released from
21    the Illinois Health Information Exchange, and identified
22    or deidentified health information in the form of health
23    data and medical records of the Illinois Health Information
24    Exchange in the possession of the Illinois Health
25    Information Exchange Authority due to its administration
26    of the Illinois Health Information Exchange. The terms

 

 

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1    "identified" and "deidentified" shall be given the same
2    meaning as in the Health Insurance Portability and
3    Accountability Act of 1996, Public Law 104-191, or any
4    subsequent amendments thereto, and any regulations
5    promulgated thereunder.
6        (u) Records and information provided to an independent
7    team of experts under Brian's Law.
8        (v) Names and information of people who have applied
9    for or received Firearm Owner's Identification Cards under
10    the Firearm Owners Identification Card Act or applied for
11    or received a concealed carry license under the Firearm
12    Concealed Carry Act, unless otherwise authorized by the
13    Firearm Concealed Carry Act; and databases under the
14    Firearm Concealed Carry Act, records of the Concealed Carry
15    Licensing Review Board under the Firearm Concealed Carry
16    Act, and law enforcement agency objections under the
17    Firearm Concealed Carry Act.
18        (w) Personally identifiable information which is
19    exempted from disclosure under subsection (g) of Section
20    19.1 of the Toll Highway Act.
21        (x) Information which is exempted from disclosure
22    under Section 5-1014.3 of the Counties Code or Section
23    8-11-21 of the Illinois Municipal Code.
24        (y) Confidential information under the Adult
25    Protective Services Act and its predecessor enabling
26    statute, the Elder Abuse and Neglect Act, including

 

 

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1    information about the identity and administrative finding
2    against any caregiver of a verified and substantiated
3    decision of abuse, neglect, or financial exploitation of an
4    eligible adult maintained in the Registry established
5    under Section 7.5 of the Adult Protective Services Act.
6        (z) Records and information provided to a fatality
7    review team or the Illinois Fatality Review Team Advisory
8    Council under Section 15 of the Adult Protective Services
9    Act.
10        (aa) Information which is exempted from disclosure
11    under Section 2.37 of the Wildlife Code.
12        (bb) Information which is or was prohibited from
13    disclosure by the Juvenile Court Act of 1987.
14        (cc) Recordings made under the Law Enforcement
15    Officer-Worn Body Camera Act, except to the extent
16    authorized under that Act.
17        (dd) Information that is prohibited from being
18    disclosed under Section 45 of the Condominium and Common
19    Interest Community Ombudsperson Act.
20        (ee) Information that is exempted from disclosure
21    under Section 30.1 of the Pharmacy Practice Act.
22        (ff) Information that is exempted from disclosure
23    under the Revised Uniform Unclaimed Property Act.
24        (gg) (ff) Information that is prohibited from being
25    disclosed under Section 7-603.5 of the Illinois Vehicle
26    Code.

 

 

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1        (hh) (ff) Records that are exempt from disclosure under
2    Section 1A-16.7 of the Election Code.
3        (ii) (ff) Information which is exempted from
4    disclosure under Section 2505-800 of the Department of
5    Revenue Law of the Civil Administrative Code of Illinois.
6        (ll) Information the disclosure of which is restricted
7    and exempted under Section 5-30.8 of the Illinois Public
8    Aid Code.
9(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
10eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
1199-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
12100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
138-28-17; 100-465, eff. 8-31-17; revised 11-2-17.)
 
14    (Text of Section after amendment by P.A. 100-517 but before
15amendment by P.A. 100-512)
16    Sec. 7.5. Statutory exemptions. To the extent provided for
17by the statutes referenced below, the following shall be exempt
18from inspection and copying:
19        (a) All information determined to be confidential
20    under Section 4002 of the Technology Advancement and
21    Development Act.
22        (b) Library circulation and order records identifying
23    library users with specific materials under the Library
24    Records Confidentiality Act.
25        (c) Applications, related documents, and medical

 

 

10000SB1851ham002- 18 -LRB100 10394 KTG 41023 a

1    records received by the Experimental Organ Transplantation
2    Procedures Board and any and all documents or other records
3    prepared by the Experimental Organ Transplantation
4    Procedures Board or its staff relating to applications it
5    has received.
6        (d) Information and records held by the Department of
7    Public Health and its authorized representatives relating
8    to known or suspected cases of sexually transmissible
9    disease or any information the disclosure of which is
10    restricted under the Illinois Sexually Transmissible
11    Disease Control Act.
12        (e) Information the disclosure of which is exempted
13    under Section 30 of the Radon Industry Licensing Act.
14        (f) Firm performance evaluations under Section 55 of
15    the Architectural, Engineering, and Land Surveying
16    Qualifications Based Selection Act.
17        (g) Information the disclosure of which is restricted
18    and exempted under Section 50 of the Illinois Prepaid
19    Tuition Act.
20        (h) Information the disclosure of which is exempted
21    under the State Officials and Employees Ethics Act, and
22    records of any lawfully created State or local inspector
23    general's office that would be exempt if created or
24    obtained by an Executive Inspector General's office under
25    that Act.
26        (i) Information contained in a local emergency energy

 

 

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1    plan submitted to a municipality in accordance with a local
2    emergency energy plan ordinance that is adopted under
3    Section 11-21.5-5 of the Illinois Municipal Code.
4        (j) Information and data concerning the distribution
5    of surcharge moneys collected and remitted by carriers
6    under the Emergency Telephone System Act.
7        (k) Law enforcement officer identification information
8    or driver identification information compiled by a law
9    enforcement agency or the Department of Transportation
10    under Section 11-212 of the Illinois Vehicle Code.
11        (l) Records and information provided to a residential
12    health care facility resident sexual assault and death
13    review team or the Executive Council under the Abuse
14    Prevention Review Team Act.
15        (m) Information provided to the predatory lending
16    database created pursuant to Article 3 of the Residential
17    Real Property Disclosure Act, except to the extent
18    authorized under that Article.
19        (n) Defense budgets and petitions for certification of
20    compensation and expenses for court appointed trial
21    counsel as provided under Sections 10 and 15 of the Capital
22    Crimes Litigation Act. This subsection (n) shall apply
23    until the conclusion of the trial of the case, even if the
24    prosecution chooses not to pursue the death penalty prior
25    to trial or sentencing.
26        (o) Information that is prohibited from being

 

 

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1    disclosed under Section 4 of the Illinois Health and
2    Hazardous Substances Registry Act.
3        (p) Security portions of system safety program plans,
4    investigation reports, surveys, schedules, lists, data, or
5    information compiled, collected, or prepared by or for the
6    Regional Transportation Authority under Section 2.11 of
7    the Regional Transportation Authority Act or the St. Clair
8    County Transit District under the Bi-State Transit Safety
9    Act.
10        (q) Information prohibited from being disclosed by the
11    Personnel Records Review Act.
12        (r) Information prohibited from being disclosed by the
13    Illinois School Student Records Act.
14        (s) Information the disclosure of which is restricted
15    under Section 5-108 of the Public Utilities Act.
16        (t) All identified or deidentified health information
17    in the form of health data or medical records contained in,
18    stored in, submitted to, transferred by, or released from
19    the Illinois Health Information Exchange, and identified
20    or deidentified health information in the form of health
21    data and medical records of the Illinois Health Information
22    Exchange in the possession of the Illinois Health
23    Information Exchange Authority due to its administration
24    of the Illinois Health Information Exchange. The terms
25    "identified" and "deidentified" shall be given the same
26    meaning as in the Health Insurance Portability and

 

 

10000SB1851ham002- 21 -LRB100 10394 KTG 41023 a

1    Accountability Act of 1996, Public Law 104-191, or any
2    subsequent amendments thereto, and any regulations
3    promulgated thereunder.
4        (u) Records and information provided to an independent
5    team of experts under Brian's Law.
6        (v) Names and information of people who have applied
7    for or received Firearm Owner's Identification Cards under
8    the Firearm Owners Identification Card Act or applied for
9    or received a concealed carry license under the Firearm
10    Concealed Carry Act, unless otherwise authorized by the
11    Firearm Concealed Carry Act; and databases under the
12    Firearm Concealed Carry Act, records of the Concealed Carry
13    Licensing Review Board under the Firearm Concealed Carry
14    Act, and law enforcement agency objections under the
15    Firearm Concealed Carry Act.
16        (w) Personally identifiable information which is
17    exempted from disclosure under subsection (g) of Section
18    19.1 of the Toll Highway Act.
19        (x) Information which is exempted from disclosure
20    under Section 5-1014.3 of the Counties Code or Section
21    8-11-21 of the Illinois Municipal Code.
22        (y) Confidential information under the Adult
23    Protective Services Act and its predecessor enabling
24    statute, the Elder Abuse and Neglect Act, including
25    information about the identity and administrative finding
26    against any caregiver of a verified and substantiated

 

 

10000SB1851ham002- 22 -LRB100 10394 KTG 41023 a

1    decision of abuse, neglect, or financial exploitation of an
2    eligible adult maintained in the Registry established
3    under Section 7.5 of the Adult Protective Services Act.
4        (z) Records and information provided to a fatality
5    review team or the Illinois Fatality Review Team Advisory
6    Council under Section 15 of the Adult Protective Services
7    Act.
8        (aa) Information which is exempted from disclosure
9    under Section 2.37 of the Wildlife Code.
10        (bb) Information which is or was prohibited from
11    disclosure by the Juvenile Court Act of 1987.
12        (cc) Recordings made under the Law Enforcement
13    Officer-Worn Body Camera Act, except to the extent
14    authorized under that Act.
15        (dd) Information that is prohibited from being
16    disclosed under Section 45 of the Condominium and Common
17    Interest Community Ombudsperson Act.
18        (ee) Information that is exempted from disclosure
19    under Section 30.1 of the Pharmacy Practice Act.
20        (ff) Information that is exempted from disclosure
21    under the Revised Uniform Unclaimed Property Act.
22        (gg) (ff) Information that is prohibited from being
23    disclosed under Section 7-603.5 of the Illinois Vehicle
24    Code.
25        (hh) (ff) Records that are exempt from disclosure under
26    Section 1A-16.7 of the Election Code.

 

 

10000SB1851ham002- 23 -LRB100 10394 KTG 41023 a

1        (ii) (ff) Information which is exempted from
2    disclosure under Section 2505-800 of the Department of
3    Revenue Law of the Civil Administrative Code of Illinois.
4        (jj) (ff) Information and reports that are required to
5    be submitted to the Department of Labor by registering day
6    and temporary labor service agencies but are exempt from
7    disclosure under subsection (a-1) of Section 45 of the Day
8    and Temporary Labor Services Act.
9        (ll) Information the disclosure of which is restricted
10    and exempted under Section 5-30.8 of the Illinois Public
11    Aid Code.
12(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
13eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
1499-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
15100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
168-28-17; 100-465, eff. 8-31-17; 100-517, eff. 6-1-18; revised
1711-2-17.)
 
18    (Text of Section after amendment by P.A. 100-512)
19    Sec. 7.5. Statutory exemptions. To the extent provided for
20by the statutes referenced below, the following shall be exempt
21from inspection and copying:
22        (a) All information determined to be confidential
23    under Section 4002 of the Technology Advancement and
24    Development Act.
25        (b) Library circulation and order records identifying

 

 

10000SB1851ham002- 24 -LRB100 10394 KTG 41023 a

1    library users with specific materials under the Library
2    Records Confidentiality Act.
3        (c) Applications, related documents, and medical
4    records received by the Experimental Organ Transplantation
5    Procedures Board and any and all documents or other records
6    prepared by the Experimental Organ Transplantation
7    Procedures Board or its staff relating to applications it
8    has received.
9        (d) Information and records held by the Department of
10    Public Health and its authorized representatives relating
11    to known or suspected cases of sexually transmissible
12    disease or any information the disclosure of which is
13    restricted under the Illinois Sexually Transmissible
14    Disease Control Act.
15        (e) Information the disclosure of which is exempted
16    under Section 30 of the Radon Industry Licensing Act.
17        (f) Firm performance evaluations under Section 55 of
18    the Architectural, Engineering, and Land Surveying
19    Qualifications Based Selection Act.
20        (g) Information the disclosure of which is restricted
21    and exempted under Section 50 of the Illinois Prepaid
22    Tuition Act.
23        (h) Information the disclosure of which is exempted
24    under the State Officials and Employees Ethics Act, and
25    records of any lawfully created State or local inspector
26    general's office that would be exempt if created or

 

 

10000SB1851ham002- 25 -LRB100 10394 KTG 41023 a

1    obtained by an Executive Inspector General's office under
2    that Act.
3        (i) Information contained in a local emergency energy
4    plan submitted to a municipality in accordance with a local
5    emergency energy plan ordinance that is adopted under
6    Section 11-21.5-5 of the Illinois Municipal Code.
7        (j) Information and data concerning the distribution
8    of surcharge moneys collected and remitted by carriers
9    under the Emergency Telephone System Act.
10        (k) Law enforcement officer identification information
11    or driver identification information compiled by a law
12    enforcement agency or the Department of Transportation
13    under Section 11-212 of the Illinois Vehicle Code.
14        (l) Records and information provided to a residential
15    health care facility resident sexual assault and death
16    review team or the Executive Council under the Abuse
17    Prevention Review Team Act.
18        (m) Information provided to the predatory lending
19    database created pursuant to Article 3 of the Residential
20    Real Property Disclosure Act, except to the extent
21    authorized under that Article.
22        (n) Defense budgets and petitions for certification of
23    compensation and expenses for court appointed trial
24    counsel as provided under Sections 10 and 15 of the Capital
25    Crimes Litigation Act. This subsection (n) shall apply
26    until the conclusion of the trial of the case, even if the

 

 

10000SB1851ham002- 26 -LRB100 10394 KTG 41023 a

1    prosecution chooses not to pursue the death penalty prior
2    to trial or sentencing.
3        (o) Information that is prohibited from being
4    disclosed under Section 4 of the Illinois Health and
5    Hazardous Substances Registry Act.
6        (p) Security portions of system safety program plans,
7    investigation reports, surveys, schedules, lists, data, or
8    information compiled, collected, or prepared by or for the
9    Regional Transportation Authority under Section 2.11 of
10    the Regional Transportation Authority Act or the St. Clair
11    County Transit District under the Bi-State Transit Safety
12    Act.
13        (q) Information prohibited from being disclosed by the
14    Personnel Records Review Act.
15        (r) Information prohibited from being disclosed by the
16    Illinois School Student Records Act.
17        (s) Information the disclosure of which is restricted
18    under Section 5-108 of the Public Utilities Act.
19        (t) All identified or deidentified health information
20    in the form of health data or medical records contained in,
21    stored in, submitted to, transferred by, or released from
22    the Illinois Health Information Exchange, and identified
23    or deidentified health information in the form of health
24    data and medical records of the Illinois Health Information
25    Exchange in the possession of the Illinois Health
26    Information Exchange Authority due to its administration

 

 

10000SB1851ham002- 27 -LRB100 10394 KTG 41023 a

1    of the Illinois Health Information Exchange. The terms
2    "identified" and "deidentified" shall be given the same
3    meaning as in the Health Insurance Portability and
4    Accountability Act of 1996, Public Law 104-191, or any
5    subsequent amendments thereto, and any regulations
6    promulgated thereunder.
7        (u) Records and information provided to an independent
8    team of experts under Brian's Law.
9        (v) Names and information of people who have applied
10    for or received Firearm Owner's Identification Cards under
11    the Firearm Owners Identification Card Act or applied for
12    or received a concealed carry license under the Firearm
13    Concealed Carry Act, unless otherwise authorized by the
14    Firearm Concealed Carry Act; and databases under the
15    Firearm Concealed Carry Act, records of the Concealed Carry
16    Licensing Review Board under the Firearm Concealed Carry
17    Act, and law enforcement agency objections under the
18    Firearm Concealed Carry Act.
19        (w) Personally identifiable information which is
20    exempted from disclosure under subsection (g) of Section
21    19.1 of the Toll Highway Act.
22        (x) Information which is exempted from disclosure
23    under Section 5-1014.3 of the Counties Code or Section
24    8-11-21 of the Illinois Municipal Code.
25        (y) Confidential information under the Adult
26    Protective Services Act and its predecessor enabling

 

 

10000SB1851ham002- 28 -LRB100 10394 KTG 41023 a

1    statute, the Elder Abuse and Neglect Act, including
2    information about the identity and administrative finding
3    against any caregiver of a verified and substantiated
4    decision of abuse, neglect, or financial exploitation of an
5    eligible adult maintained in the Registry established
6    under Section 7.5 of the Adult Protective Services Act.
7        (z) Records and information provided to a fatality
8    review team or the Illinois Fatality Review Team Advisory
9    Council under Section 15 of the Adult Protective Services
10    Act.
11        (aa) Information which is exempted from disclosure
12    under Section 2.37 of the Wildlife Code.
13        (bb) Information which is or was prohibited from
14    disclosure by the Juvenile Court Act of 1987.
15        (cc) Recordings made under the Law Enforcement
16    Officer-Worn Body Camera Act, except to the extent
17    authorized under that Act.
18        (dd) Information that is prohibited from being
19    disclosed under Section 45 of the Condominium and Common
20    Interest Community Ombudsperson Act.
21        (ee) Information that is exempted from disclosure
22    under Section 30.1 of the Pharmacy Practice Act.
23        (ff) Information that is exempted from disclosure
24    under the Revised Uniform Unclaimed Property Act.
25        (gg) (ff) Information that is prohibited from being
26    disclosed under Section 7-603.5 of the Illinois Vehicle

 

 

10000SB1851ham002- 29 -LRB100 10394 KTG 41023 a

1    Code.
2        (hh) (ff) Records that are exempt from disclosure under
3    Section 1A-16.7 of the Election Code.
4        (ii) (ff) Information which is exempted from
5    disclosure under Section 2505-800 of the Department of
6    Revenue Law of the Civil Administrative Code of Illinois.
7        (jj) (ff) Information and reports that are required to
8    be submitted to the Department of Labor by registering day
9    and temporary labor service agencies but are exempt from
10    disclosure under subsection (a-1) of Section 45 of the Day
11    and Temporary Labor Services Act.
12        (kk) (ff) Information prohibited from disclosure under
13    the Seizure and Forfeiture Reporting Act.
14        (ll) Information the disclosure of which is restricted
15    and exempted under Section 5-30.8 of the Illinois Public
16    Aid Code.
17(Source: P.A. 99-78, eff. 7-20-15; 99-298, eff. 8-6-15; 99-352,
18eff. 1-1-16; 99-642, eff. 7-28-16; 99-776, eff. 8-12-16;
1999-863, eff. 8-19-16; 100-20, eff. 7-1-17; 100-22, eff. 1-1-18;
20100-201, eff. 8-18-17; 100-373, eff. 1-1-18; 100-464, eff.
218-28-17; 100-465, eff. 8-31-17; 100-512, eff. 7-1-18; 100-517,
22eff. 6-1-18; revised 11-2-17.)
 
23    Section 15. The Children and Family Services Act is amended
24by adding Section 5.45 as follows:
 

 

 

10000SB1851ham002- 30 -LRB100 10394 KTG 41023 a

1    (20 ILCS 505/5.45 new)
2    Sec. 5.45. Managed care plan services.
3    (a) As used in this Section:
4    "Caregiver" means an individual or entity directly
5providing the day-to-day care of a child ensuring the child's
6safety and well-being.
7    "Child" means a child placed in the care of the Department
8pursuant to the Juvenile Court Act of 1987.
9    "Department" means the Department of Children and Family
10Services, or any successor State agency.
11    "Director" means the Director of Children and Family
12Services.
13    "Managed care organization" has the meaning ascribed to
14that term in Section 5-30.1 of the Illinois Public Aid Code.
15    "Medicaid managed care plan" means a health care plan
16operated by a managed care organization under the Medical
17Assistance Program established in Article V of the Illinois
18Public Aid Code.
19    "Workgroup" means the Child Welfare Medicaid Managed Care
20Implementation Advisory Workgroup.
21    (b) Every child who is in the care of the Department
22pursuant to the Juvenile Court Act of 1987 shall receive the
23necessary services required by this Act and the Juvenile Court
24Act of 1987, including any child enrolled in a Medicaid managed
25care plan.
26    (c) The Department shall not relinquish its authority or

 

 

10000SB1851ham002- 31 -LRB100 10394 KTG 41023 a

1diminish its responsibility to determine and provide necessary
2services that are in the best interest of a child even if those
3services are directly or indirectly:
4        (1) provided by a managed care organization, another
5    State agency, or other third parties;
6        (2) coordinated through a managed care organization,
7    another State agency, or other third parties; or
8        (3) paid for by a managed care organization, another
9    State agency, or other third parties.
10    (d) The Department shall:
11        (1) implement and enforce measures to ensure that a
12    child's enrollment in Medicaid managed care supports
13    continuity of treatment and does not hinder service
14    delivery;
15        (2) establish a single point of contact for health care
16    coverage inquiries and dispute resolution systemwide
17    without transferring this responsibility to a third party
18    such as a managed care coordinator;
19        (3) not require any child to participate in Medicaid
20    managed care if the child would otherwise be exempt from
21    enrolling in a Medicaid managed care plan under any rule or
22    statute of this State; and
23        (4) make recommendations regarding managed care
24    contract measures, quality assurance activities, and
25    performance delivery evaluations in consultation with the
26    Workgroup; and

 

 

10000SB1851ham002- 32 -LRB100 10394 KTG 41023 a

1        (5) post on its website:
2            (A) a link to any rule adopted or procedures
3        changed to address the provisions of this Section, if
4        applicable;
5            (B) each managed care organization's contract,
6        enrollee handbook, and directory;
7            (C) the notification process and timeframe
8        requirements used to inform managed care plan
9        enrollees, enrollees' caregivers, and enrollees' legal
10        representation of any changes in health care coverage
11        or change in a child's managed care provider;
12            (D) defined prior authorization requirements for
13        prescriptions, goods, and services in emergency and
14        non-emergency situations;
15            (E) the State's current Health Care Oversight and
16        Coordination Plan developed in accordance with federal
17        requirements; and
18            (F) the transition plan required under subsection
19        (f), including:
20                (i) the public comments submitted to the
21            Department, the Department of Healthcare and
22            Family Services, and the Workgroup for
23            consideration in development of the transition
24            plan;
25                (ii) a list and summary of recommendations of
26            the Workgroup that the Director or Director of

 

 

10000SB1851ham002- 33 -LRB100 10394 KTG 41023 a

1            Healthcare and Family Services declined to adopt
2            or implement; and
3                (iii) the Department's attestation that the
4            transition plan will not impede the Department's
5            ability to timely identify the service needs of
6            youth in care and the timely and appropriate
7            provision of services to address those identified
8            needs.
9    (e) The Child Welfare Medicaid Managed Care Implementation
10Advisory Workgroup is established to advise the Department on
11the transition and implementation of managed care for children.
12The Director of Children and Family Services and the Director
13of Healthcare and Family Services shall serve as
14co-chairpersons of the Workgroup. The Directors shall jointly
15appoint members to the Workgroup who are stakeholders from the
16child welfare community, including:
17        (1) employees of the Department of Children and Family
18    Services who have responsibility in the areas of (i)
19    managed care services, (ii) performance monitoring and
20    oversight, (iii) placement operations, and (iv) budget
21    revenue maximization;
22        (2) employees of the Department of Healthcare and
23    Family Services who have responsibility in the areas of (i)
24    managed care contracting, (ii) performance monitoring and
25    oversight, (iii) children's behavioral health, and (iv)
26    budget revenue maximization;

 

 

10000SB1851ham002- 34 -LRB100 10394 KTG 41023 a

1        (3) 2 representatives of youth in care;
2        (4) one representative of managed care organizations
3    serving youth in care;
4        (5) 4 representatives of child welfare providers;
5        (6) one representative of parents of children in
6    out-of-home care;
7        (7) one representative of universities or research
8    institutions;
9        (8) one representative of pediatric physicians;
10        (9) one representative of the juvenile court;
11        (10) one representative of caregivers of youth in care;
12        (11) one practitioner with expertise in child and
13    adolescent psychiatry;
14        (12) one representative of substance abuse and mental
15    health providers with expertise in serving children
16    involved in child welfare and their families;
17        (13) at least one member of the Medicaid Advisory
18    Committee;
19        (14) one representative of a statewide organization
20    representing hospitals;
21        (15) one representative of a statewide organization
22    representing child welfare providers;
23        (16) one representative of a statewide organization
24    representing substance abuse and mental health providers;
25    and
26        (17) other child advocates as deemed appropriate by the

 

 

10000SB1851ham002- 35 -LRB100 10394 KTG 41023 a

1    Directors.
2    To the greatest extent possible, the co-chairpersons shall
3appoint members who reflect the geographic diversity of the
4State and include members who represent rural service areas.
5Members shall serve 2-year terms or until the Workgroup
6dissolves. If a vacancy occurs in the Workgroup membership, the
7vacancy shall be filled in the same manner as the original
8appointment for the remainder of the unexpired term. The
9Workgroup shall hold meetings, as it deems appropriate, in the
10northern, central, and southern regions of the State to solicit
11public comments to develop its recommendations. To ensure the
12Department of Children and Family Services and the Department
13of Healthcare and Family Services are provided time to confer
14and determine their use of pertinent Workgroup recommendations
15in the transition plan required under subsection (f), the
16co-chairpersons shall convene at least 3 meetings. The
17Department of Children and Family Services and the Department
18of Healthcare and Family Services shall provide administrative
19support to the Workgroup. Workgroup members shall serve without
20compensation. The Workgroup shall dissolve 5 years after the
21Department of Children and Family Services' implementation of
22managed care.
23    (f) Prior to transitioning any child to managed care, the
24Department of Children and Family Services and the Department
25of Healthcare and Family Services, in consultation with the
26Workgroup, must develop and post publicly, a transition plan

 

 

10000SB1851ham002- 36 -LRB100 10394 KTG 41023 a

1for the provision of health care services to children enrolled
2in Medicaid managed care plans. Interim transition plans must
3be posted to the Department's website by July 15, 2018. The
4transition plan shall be posted at least 28 days before the
5Department's implementation of managed care. The transition
6plan shall address, but is not limited to, the following:
7        (1) an assessment of existing network adequacy, plans
8    to address gaps in network, and ongoing network evaluation;
9        (2) a framework for preparing and training
10    organizations, caregivers, frontline staff, and managed
11    care organizations;
12        (3) the identification of administrative changes
13    necessary for successful transition to managed care, and
14    the timeframes to make changes;
15        (4) defined roles, responsibilities, and lines of
16    authority for care coordination, placement providers,
17    service providers, and each State agency involved in
18    management and oversight of managed care services;
19        (5) data used to establish baseline performance and
20    quality of care, which shall be utilized to assess quality
21    outcomes and identify ongoing areas for improvement;
22        (6) a process for stakeholder input into managed care
23    planning and implementation;
24        (7) a dispute resolution process, including the rights
25    of enrollees and representatives of enrollees under the
26    dispute process and timeframes for dispute resolution

 

 

10000SB1851ham002- 37 -LRB100 10394 KTG 41023 a

1    determinations and remedies;
2        (8) the process for health care transition for youth
3    exiting the Department's care through emancipation or
4    achieving permanency; and
5        (9) protections to ensure the continued provision of
6    health care services if a child's residence or legal
7    guardian changes.
8    (g) Reports.
9        (1) On or before February 1, 2019, and on or before
10    each February 1 thereafter, the Department shall submit a
11    report to the House and Senate Human Services Committees,
12    or to any successor committees, on measures of access to
13    and the quality of health care services for children
14    enrolled in Medicaid managed care plans, including, but not
15    limited to, data showing whether:
16            (A) children enrolled in Medicaid managed care
17        plans have continuity of care across placement types,
18        geographic regions, and specialty service needs;
19            (B) each child is receiving the early periodic
20        screening, diagnosis, and treatment services as
21        required by federal law, including, but not limited to,
22        regular preventative care and timely specialty care;
23            (C) children are assigned to health homes;
24            (D) each child has a health care oversight and
25        coordination plan as required by federal law;
26            (E) there exist complaints and grievances

 

 

10000SB1851ham002- 38 -LRB100 10394 KTG 41023 a

1        indicating gaps or barriers in service delivery; and
2            (F) the Workgroup and other stakeholders have and
3        continue to be engaged in quality improvement
4        initiatives.
5        The report shall be prepared in consultation with the
6    Workgroup and other agencies, organizations, or
7    individuals the Director deems appropriate in order to
8    obtain comprehensive and objective information about the
9    managed care plan operation.
10        (2) During each legislative session, the House and
11    Senate Human Services Committees shall hold hearings to
12    take public testimony about managed care implementation
13    for children in the care of, adopted from, or placed in
14    guardianship by the Department. The Department shall
15    present testimony, including information provided in the
16    report required under paragraph (1), the Department's
17    compliance with the provisions of this Section, and any
18    recommendations for statutory changes to improve health
19    care for children in the Department's care.
20    (h) If any provision of this Section or its application to
21any person or circumstance is held invalid, the invalidity of
22that provision or application does not affect other provisions
23or applications of this Section that can be given effect
24without the invalid provision or application.
 
25    Section 16. The Nursing Home Care Act is amended by

 

 

10000SB1851ham002- 39 -LRB100 10394 KTG 41023 a

1changing Section 2-217 as follows:
 
2    (210 ILCS 45/2-217)
3    Sec. 2-217. Order for transportation of resident by an
4ambulance service provider. If a facility orders medi-car,
5service car, or ground ambulance transportation of a resident
6of the facility by an ambulance service provider, the facility
7must maintain a written record that shows (i) the name of the
8person who placed the order for that transportation and (ii)
9the medical reason for that transportation. Additionally, the
10facility must provide the ambulance service provider with a
11Physician Certification Statement on a form prescribed by the
12Department of Healthcare and Family Services in accordance with
13subsection (g) of Section 5-4.2 of the Illinois Public Aid
14Code. The facility shall provide a copy of the Physician
15Certification Statement to the ambulance service provider
16prior to or at the time of transport. The Physician
17Certification Statement is not required prior to the transport
18if a delay in transport can be expected to negatively affect
19the patient outcome; however, the facility shall provide a copy
20of the Physician Certification Statement to the ambulance
21service provider at no charge within 10 days after the request.
22A facility shall, upon request, furnish assistance to the
23transportation provider in the completion of the form if the
24Physician Certification Statement is incomplete. The facility
25must maintain the record for a period of at least 3 years after

 

 

10000SB1851ham002- 40 -LRB100 10394 KTG 41023 a

1the date of the order for transportation by ambulance.
2(Source: P.A. 94-1063, eff. 1-31-07.)
 
3    Section 17. The Specialized Mental Health Rehabilitation
4Act of 2013 is amended by adding Section 5-104 as follows:
 
5    (210 ILCS 49/5-104 new)
6    Sec. 5-104. Therapeutic visit rates. For a facility
7licensed under this Act by June 1, 2018 or provisionally
8licensed under this Act by June 1, 2018, a payment shall be
9made for therapeutic visits that have been indicated by an
10interdisciplinary team as therapeutically beneficial. Payment
11under this Section shall be at a rate of 75% of the facility's
12rate on the effective date of this amendatory Act of the 100th
13General Assembly and may not exceed 20 days in a fiscal year
14and shall not exceed 10 days consecutively.
 
15    Section 18. The Hospital Licensing Act is amended by
16changing Section 6.22 as follows:
 
17    (210 ILCS 85/6.22)
18    Sec. 6.22. Arrangement for transportation of patient by an
19ambulance service provider.
20    (a) In this Section:
21        "Ambulance service provider" means a Vehicle Service
22    Provider as defined in the Emergency Medical Services (EMS)

 

 

10000SB1851ham002- 41 -LRB100 10394 KTG 41023 a

1    Systems Act who provides non-emergency transportation
2    services by ambulance.
3        "Patient" means a person who is transported by an
4    ambulance service provider.
5    (b) If a hospital arranges for medi-car, service car, or
6ground ambulance transportation of a patient of the hospital by
7ambulance, the hospital must provide the ambulance service
8provider, at or prior to transport, a Physician Certification
9Statement formatted and completed in compliance with federal
10regulations or an equivalent form developed by the hospital.
11Each hospital shall develop a policy requiring a physician or
12the physician's designee to complete the Physician
13Certification Statement. The Physician Certification Statement
14shall be maintained as part of the patient's medical record. A
15hospital shall, upon request, furnish assistance to the
16ambulance service provider in the completion of the form if the
17Physician Certification Statement is incomplete. The Physician
18Certification Statement or equivalent form is not required
19prior to transport if a delay in transport can be expected to
20negatively affect the patient outcome; however, a hospital
21shall provide a copy of the Physician Certification Statement
22to the ambulance service provider at no charge within 10 days
23after the request.
24    (c) If a hospital is unable to provide a Physician
25Certification Statement or equivalent form, then the hospital
26shall provide to the patient a written notice and a verbal

 

 

10000SB1851ham002- 42 -LRB100 10394 KTG 41023 a

1explanation of the written notice, which notice must meet all
2of the following requirements:
3        (1) The following caption must appear at the beginning
4    of the notice in at least 14-point type: Notice to Patient
5    Regarding Non-Emergency Ambulance Services.
6        (2) The notice must contain each of the following
7    statements in at least 14-point type:
8            (A) The purpose of this notice is to help you make
9        an informed choice about whether you want to be
10        transported by ambulance because your medical
11        condition does not meet medical necessity for
12        transportation by an ambulance.
13            (B) Your insurance may not cover the charges for
14        ambulance transportation.
15            (C) You may be responsible for the cost of
16        ambulance transportation.
17            (D) The estimated cost of ambulance transportation
18        is $(amount).
19        (3) The notice must be signed by the patient or by the
20    patient's authorized representative. A copy shall be given
21    to the patient and the hospital shall retain a copy.
22    (d) The notice set forth in subsection (c) of this Section
23shall not be required if a delay in transport can be expected
24to negatively affect the patient outcome.
25    (e) If a patient is physically or mentally unable to sign
26the notice described in subsection (c) of this Section and no

 

 

10000SB1851ham002- 43 -LRB100 10394 KTG 41023 a

1authorized representative of the patient is available to sign
2the notice on the patient's behalf, the hospital must be able
3to provide documentation of the patient's inability to sign the
4notice and the unavailability of an authorized representative.
5In any case described in this subsection (e), the hospital
6shall be considered to have met the requirements of subsection
7(c) of this Section.
8(Source: P.A. 94-1063, eff. 1-31-07.)
 
9    Section 20. The Illinois Public Aid Code is amended by
10changing Sections 5-4.2, 5-5.4h, and 5A-16 and by adding
11Sections 5-5.07 and 5-30.8 as follows:
 
12    (305 ILCS 5/5-4.2)  (from Ch. 23, par. 5-4.2)
13    Sec. 5-4.2. Ambulance services payments.
14    (a) For ambulance services provided to a recipient of aid
15under this Article on or after January 1, 1993, the Illinois
16Department shall reimburse ambulance service providers at
17rates calculated in accordance with this Section. It is the
18intent of the General Assembly to provide adequate
19reimbursement for ambulance services so as to ensure adequate
20access to services for recipients of aid under this Article and
21to provide appropriate incentives to ambulance service
22providers to provide services in an efficient and
23cost-effective manner. Thus, it is the intent of the General
24Assembly that the Illinois Department implement a

 

 

10000SB1851ham002- 44 -LRB100 10394 KTG 41023 a

1reimbursement system for ambulance services that, to the extent
2practicable and subject to the availability of funds
3appropriated by the General Assembly for this purpose, is
4consistent with the payment principles of Medicare. To ensure
5uniformity between the payment principles of Medicare and
6Medicaid, the Illinois Department shall follow, to the extent
7necessary and practicable and subject to the availability of
8funds appropriated by the General Assembly for this purpose,
9the statutes, laws, regulations, policies, procedures,
10principles, definitions, guidelines, and manuals used to
11determine the amounts paid to ambulance service providers under
12Title XVIII of the Social Security Act (Medicare).
13    (b) For ambulance services provided to a recipient of aid
14under this Article on or after January 1, 1996, the Illinois
15Department shall reimburse ambulance service providers based
16upon the actual distance traveled if a natural disaster,
17weather conditions, road repairs, or traffic congestion
18necessitates the use of a route other than the most direct
19route.
20    (c) For purposes of this Section, "ambulance services"
21includes medical transportation services provided by means of
22an ambulance, medi-car, service car, or taxi.
23    (c-1) For purposes of this Section, "ground ambulance
24service" means medical transportation services that are
25described as ground ambulance services by the Centers for
26Medicare and Medicaid Services and provided in a vehicle that

 

 

10000SB1851ham002- 45 -LRB100 10394 KTG 41023 a

1is licensed as an ambulance by the Illinois Department of
2Public Health pursuant to the Emergency Medical Services (EMS)
3Systems Act.
4    (c-2) For purposes of this Section, "ground ambulance
5service provider" means a vehicle service provider as described
6in the Emergency Medical Services (EMS) Systems Act that
7operates licensed ambulances for the purpose of providing
8emergency ambulance services, or non-emergency ambulance
9services, or both. For purposes of this Section, this includes
10both ambulance providers and ambulance suppliers as described
11by the Centers for Medicare and Medicaid Services.
12    (c-3) For purposes of this Section, "medi-car" means
13transportation services provided to a patient who is confined
14to a wheelchair and requires the use of a hydraulic or electric
15lift or ramp and wheelchair lockdown when the patient's
16condition does not require medical observation, medical
17supervision, medical equipment, the administration of
18medications, or the administration of oxygen.
19    (c-4) For purposes of this Section, "service car" means
20transportation services provided to a patient by a passenger
21vehicle where that patient does not require the specialized
22modes described in subsection (c-1) or (c-3).
23    (d) This Section does not prohibit separate billing by
24ambulance service providers for oxygen furnished while
25providing advanced life support services.
26    (e) Beginning with services rendered on or after July 1,

 

 

10000SB1851ham002- 46 -LRB100 10394 KTG 41023 a

12008, all providers of non-emergency medi-car and service car
2transportation must certify that the driver and employee
3attendant, as applicable, have completed a safety program
4approved by the Department to protect both the patient and the
5driver, prior to transporting a patient. The provider must
6maintain this certification in its records. The provider shall
7produce such documentation upon demand by the Department or its
8representative. Failure to produce documentation of such
9training shall result in recovery of any payments made by the
10Department for services rendered by a non-certified driver or
11employee attendant. Medi-car and service car providers must
12maintain legible documentation in their records of the driver
13and, as applicable, employee attendant that actually
14transported the patient. Providers must recertify all drivers
15and employee attendants every 3 years.
16    Notwithstanding the requirements above, any public
17transportation provider of medi-car and service car
18transportation that receives federal funding under 49 U.S.C.
195307 and 5311 need not certify its drivers and employee
20attendants under this Section, since safety training is already
21federally mandated.
22    (f) With respect to any policy or program administered by
23the Department or its agent regarding approval of non-emergency
24medical transportation by ground ambulance service providers,
25including, but not limited to, the Non-Emergency
26Transportation Services Prior Approval Program (NETSPAP), the

 

 

10000SB1851ham002- 47 -LRB100 10394 KTG 41023 a

1Department shall establish by rule a process by which ground
2ambulance service providers of non-emergency medical
3transportation may appeal any decision by the Department or its
4agent for which no denial was received prior to the time of
5transport that either (i) denies a request for approval for
6payment of non-emergency transportation by means of ground
7ambulance service or (ii) grants a request for approval of
8non-emergency transportation by means of ground ambulance
9service at a level of service that entitles the ground
10ambulance service provider to a lower level of compensation
11from the Department than the ground ambulance service provider
12would have received as compensation for the level of service
13requested. The rule shall be filed by December 15, 2012 and
14shall provide that, for any decision rendered by the Department
15or its agent on or after the date the rule takes effect, the
16ground ambulance service provider shall have 60 days from the
17date the decision is received to file an appeal. The rule
18established by the Department shall be, insofar as is
19practical, consistent with the Illinois Administrative
20Procedure Act. The Director's decision on an appeal under this
21Section shall be a final administrative decision subject to
22review under the Administrative Review Law.
23    (f-5) Beginning 90 days after July 20, 2012 (the effective
24date of Public Act 97-842), (i) no denial of a request for
25approval for payment of non-emergency transportation by means
26of ground ambulance service, and (ii) no approval of

 

 

10000SB1851ham002- 48 -LRB100 10394 KTG 41023 a

1non-emergency transportation by means of ground ambulance
2service at a level of service that entitles the ground
3ambulance service provider to a lower level of compensation
4from the Department than would have been received at the level
5of service submitted by the ground ambulance service provider,
6may be issued by the Department or its agent unless the
7Department has submitted the criteria for determining the
8appropriateness of the transport for first notice publication
9in the Illinois Register pursuant to Section 5-40 of the
10Illinois Administrative Procedure Act.
11    (g) Whenever a patient covered by a medical assistance
12program under this Code or by another medical program
13administered by the Department, including a patient covered
14under the State's Medicaid managed care program, is being
15transported discharged from a facility and requires
16non-emergency transportation including ground ambulance,
17medi-car, or service car transportation, a Physician
18Certification Statement , a physician discharge order as
19described in this Section shall be required for each patient
20whose discharge requires medically supervised ground ambulance
21services. Facilities shall develop procedures for a licensed
22medical professional physician with medical staff privileges
23to provide a written and signed Physician Certification
24Statement physician discharge order. The Physician
25Certification Statement physician discharge order shall
26specify the level of transportation ground ambulance services

 

 

10000SB1851ham002- 49 -LRB100 10394 KTG 41023 a

1needed and complete a medical certification establishing the
2criteria for approval of non-emergency ambulance
3transportation, as published by the Department of Healthcare
4and Family Services, that is met by the patient. This order and
5the medical certification shall be completed prior to ordering
6the transportation an ambulance service and prior to patient
7discharge. The Physician Certification Statement is not
8required prior to transport if a delay in transport can be
9expected to negatively affect the patient outcome. discharge.
10    The medical certification specifying the level and type of
11non-emergency transportation needed shall be in the form of the
12Physician Certification Statement on a standardized form
13prescribed by the Department of Healthcare and Family Services.
14Within 75 days after the effective date of this amendatory Act
15of the 100th General Assembly, the Department of Healthcare and
16Family Services shall develop a standardized form of the
17Physician Certification Statement specifying the level and
18type of transportation services needed in consultation with the
19Department of Public Health, Medicaid managed care
20organizations, a statewide association representing ambulance
21providers, a statewide association representing hospitals, 3
22statewide associations representing nursing homes, and other
23stakeholders. The Physician Certification Statement shall
24include, but is not limited to, the criteria necessary to
25demonstrate medical necessity for the level of transport needed
26as required by (i) the Department of Healthcare and Family

 

 

10000SB1851ham002- 50 -LRB100 10394 KTG 41023 a

1Services and (ii) the federal Centers for Medicare and Medicaid
2Services as outlined in the Centers for Medicare and Medicaid
3Services' Medicare Benefit Policy Manual, Pub. 100-02, Chap.
410, Sec. 10.2.1, et seq. The use of the Physician Certification
5Statement shall satisfy the obligations of hospitals under
6Section 6.22 of the Hospital Licensing Act and nursing homes
7under Section 2-217 of the Nursing Home Care Act.
8Implementation and acceptance of the Physician Certification
9Statement shall take place no later than 90 days after the
10issuance of the Physician Certification Statement by the
11Department of Healthcare and Family Services.
12    Pursuant to subsection (E) of Section 12-4.25 of this Code,
13the Department is entitled to recover overpayments paid to a
14provider or vendor, including, but not limited to, from the
15discharging physician, the discharging facility, and the
16ground ambulance service provider, in instances where a
17non-emergency ground ambulance service is rendered as the
18result of improper or false certification.
19    Beginning October 1, 2018, the Department of Healthcare and
20Family Services shall collect data from Medicaid managed care
21organizations and transportation brokers, including the
22Department's NETSPAP broker, regarding denials and appeals
23related to the missing or incomplete Physician Certification
24Statement forms and overall compliance with this subsection.
25The Department of Healthcare and Family Services shall publish
26quarterly results on its website within 15 days following the

 

 

10000SB1851ham002- 51 -LRB100 10394 KTG 41023 a

1end of each quarter.
2    (h) On and after July 1, 2012, the Department shall reduce
3any rate of reimbursement for services or other payments or
4alter any methodologies authorized by this Code to reduce any
5rate of reimbursement for services or other payments in
6accordance with Section 5-5e.
7(Source: P.A. 97-584, eff. 8-26-11; 97-689, eff. 6-14-12;
897-842, eff. 7-20-12; 98-463, eff. 8-16-13.)
 
9    (305 ILCS 5/5-5.4h)
10    Sec. 5-5.4h. Medicaid reimbursement for medically complex
11for the developmentally disabled facilities licensed under the
12MC/DD Act long-term care facilities for persons under 22 years
13of age.
14    (a) Facilities licensed as medically complex for the
15developmentally disabled facilities long-term care facilities
16for persons under 22 years of age that serve severely and
17chronically ill pediatric patients shall have a specific
18reimbursement system designed to recognize the characteristics
19and needs of the patients they serve.
20    (b) For dates of services starting July 1, 2013 and until a
21new reimbursement system is designed, medically complex for the
22developmentally disabled facilities long-term care facilities
23for persons under 22 years of age that meet the following
24criteria:
25        (1) serve exceptional care patients; and

 

 

10000SB1851ham002- 52 -LRB100 10394 KTG 41023 a

1        (2) have 30% or more of their patients receiving
2    ventilator care;
3shall receive Medicaid reimbursement on a 30-day expedited
4schedule.
5    (c) Subject to federal approval of changes to the Title XIX
6State Plan, for dates of services starting July 1, 2014 through
7March 31, 2019, medically complex for the developmentally
8disabled facilities and until a new reimbursement system is
9designed, long-term care facilities for persons under 22 years
10of age which meet the criteria in subsection (b) of this
11Section shall receive a per diem rate for clinically complex
12residents of $304. Clinically complex residents on a ventilator
13shall receive a per diem rate of $669. Subject to federal
14approval of changes to the Title XIX State Plan, for dates of
15services starting April 1, 2019, medically complex for the
16developmentally disabled facilities must be reimbursed an
17exceptional care per diem rate, instead of the base rate, for
18services to residents with complex or extensive medical needs.
19Exceptional care per diem rates must be paid for the conditions
20or services specified under subsection (f) at the following per
21diem rates: Tier 1 $326, Tier 2 $546, and Tier 3 $735.
22    (d) For To qualify for the per diem rate of $669 for
23clinically complex residents on a ventilator pursuant to
24subsection (c) or subsection (f), facilities shall have a
25policy documenting their method of routine assessment of a
26resident's weaning potential with interventions implemented

 

 

10000SB1851ham002- 53 -LRB100 10394 KTG 41023 a

1noted in the resident's medical record.
2    (e) For services provided prior to April 1, 2019 and for
3For the purposes of this Section, a resident is considered
4clinically complex if the resident requires at least one of the
5following medical services:
6        (1) Tracheostomy care with dependence on mechanical
7    ventilation for a minimum of 6 hours each day.
8        (2) Tracheostomy care requiring suctioning at least
9    every 6 hours, room air mist or oxygen as needed, and
10    dependence on one of the treatment procedures listed under
11    paragraph (4) excluding the procedure listed in
12    subparagraph (A) of paragraph (4).
13        (3) Total parenteral nutrition or other intravenous
14    nutritional support and one of the treatment procedures
15    listed under paragraph (4).
16        (4) The following treatment procedures apply to the
17    conditions in paragraphs (2) and (3) of this subsection:
18            (A) Intermittent suctioning at least every 8 hours
19        and room air mist or oxygen as needed.
20            (B) Continuous intravenous therapy including
21        administration of therapeutic agents necessary for
22        hydration or of intravenous pharmaceuticals; or
23        intravenous pharmaceutical administration of more than
24        one agent via a peripheral or central line, without
25        continuous infusion.
26            (C) Peritoneal dialysis treatments requiring at

 

 

10000SB1851ham002- 54 -LRB100 10394 KTG 41023 a

1        least 4 exchanges every 24 hours.
2            (D) Tube feeding via nasogastric or gastrostomy
3        tube.
4            (E) Other medical technologies required
5        continuously, which in the opinion of the attending
6        physician require the services of a professional
7        nurse.
8    (f) Complex or extensive medical needs for exceptional care
9reimbursement. The conditions and services used for the
10purposes of this Section have the same meanings as ascribed to
11those conditions and services under the Minimum Data Set (MDS)
12Resident Assessment Instrument (RAI) and specified in the most
13recent manual. Instead of submitting minimum data set
14assessments to the Department, medically complex for the
15developmentally disabled facilities must document within each
16resident's medical record the conditions or services using the
17minimum data set documentation standards and requirements to
18qualify for exceptional care reimbursement.
19        (1) Tier 1 reimbursement is for residents who are
20    receiving at least 51% of their caloric intake via a
21    feeding tube.
22        (2) Tier 2 reimbursement is for residents who are
23    receiving tracheostomy care without a ventilator.
24        (3) Tier 3 reimbursement is for residents who are
25    receiving tracheostomy care and ventilator care.
26    (g) For dates of services starting April 1, 2019,

 

 

10000SB1851ham002- 55 -LRB100 10394 KTG 41023 a

1reimbursement calculations and direct payment for services
2provided by medically complex for the developmentally disabled
3facilities are the responsibility of the Department of
4Healthcare and Family Services instead of the Department of
5Human Services. Appropriations for medically complex for the
6developmentally disabled facilities must be shifted from the
7Department of Human Services to the Department of Healthcare
8and Family Services. Nothing in this Section prohibits the
9Department of Healthcare and Family Services from paying more
10than the rates specified in this Section. The rates in this
11Section must be interpreted as a minimum amount. Any
12reimbursement increases applied to providers licensed under
13the ID/DD Community Care Act must also be applied in an
14equivalent manner to medically complex for the developmentally
15disabled facilities.
16    (h) The Department of Healthcare and Family Services shall
17pay the rates in effect on March 31, 2019 until the changes
18made to this Section by this amendatory Act of the 100th
19General Assembly have been approved by the Centers for Medicare
20and Medicaid Services of the U.S. Department of Health and
21Human Services.
22    (i) The Department of Healthcare and Family Services may
23adopt rules as allowed by the Illinois Administrative Procedure
24Act to implement this Section; however, the requirements of
25this Section must be implemented by the Department of
26Healthcare and Family Services even if the Department of

 

 

10000SB1851ham002- 56 -LRB100 10394 KTG 41023 a

1Healthcare and Family Services has not adopted rules by the
2implementation date of April 1, 2019.
3(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14.)
 
4    (305 ILCS 5/5-5.07 new)
5    Sec. 5-5.07. Inpatient psychiatric stay; DCFS per diem
6rate. The Department of Children and Family Services shall pay
7the DCFS per diem rate for inpatient psychiatric stay at a
8free-standing psychiatric hospital effective the 11th day when
9a child is in the hospital beyond medical necessity, and the
10parent or caregiver has denied the child access to the home and
11has refused or failed to make provisions for another living
12arrangement for the child or the child's discharge is being
13delayed due to a pending inquiry or investigation by the
14Department of Children and Family Services. This Section is
15repealed 6 months after the effective date of this amendatory
16Act of the 100th General Assembly.
 
17    (305 ILCS 5/5-30.8 new)
18    Sec. 5-30.8. Managed care organization rate transparency.
19    (a) For the establishment of Managed care organization
20(MCO) capitated base rate payments from the State, including,
21but not limited to: (i) hospital fee schedule reforms and
22updates, (ii) rates related to a single State-mandated
23preferred drug list, (iii) rate updates related to the State's
24preferred drug list, (iv) inclusion of coverage for children

 

 

10000SB1851ham002- 57 -LRB100 10394 KTG 41023 a

1with special needs, (v) inclusion of coverage for children
2within the child welfare system, (vi) annual MCO capitated
3rates, and (vii) any retroactive provider fee schedule
4adjustments or other changes required by legislation or other
5actions, the Department of Healthcare and Family Services shall
6implement a capitation base rate setting process beginning on
7the effective date of this amendatory Act of the 100th General
8Assembly which shall include all of the following elements of
9transparency:
10        (1) The Department shall include participating MCOs
11    and a statewide trade association representing a majority
12    of participating MCOs in meetings to discuss the impact to
13    base capitation rates as a result of any new or updated
14    hospital fee schedules or other provider fee schedules.
15    Additionally, the Department shall share any data or
16    reports used to develop MCO capitation rates with
17    participating MCOs. This data shall be comprehensive
18    enough for MCO actuaries to recreate and verify the
19    accuracy of the capitation base rate build-up.
20        (2) The Department shall not limit the number of
21    experts that each MCO is allowed to bring to the draft
22    capitation base rate meeting or the final capitation base
23    rate review meeting. Draft and final capitation base rate
24    review meetings shall be held in at least 2 locations.
25        (3) The Department and its contracted actuary shall
26    meet with all participating MCOs simultaneously and

 

 

10000SB1851ham002- 58 -LRB100 10394 KTG 41023 a

1    together along with consulting actuaries contracted with
2    statewide trade association representing a majority of
3    Medicaid health plans at the request of the plans.
4    Participating MCOs shall additionally, at their request,
5    be granted individual capitation rate development meetings
6    with the Department.
7        (4) Any quality incentive or other incentive
8    withholding of any portion of the actuarially certified
9    capitation rates must be budget-neutral. The entirety of
10    any aggregate withheld amounts must be returned to the MCOs
11    in proportion to their performance on the relevant
12    performance metric. No amounts shall be returned to the
13    Department if all performance measures are not achieved to
14    the extent allowable by federal law and regulations.
15        (5) Upon request, the Department shall provide written
16    responses to questions regarding MCO capitation base
17    rates, the capitation base development methodology, and
18    MCO capitation rate data, and all other requests regarding
19    capitation rates from MCOs. Upon request, the Department
20    shall also provide to the MCOs materials used in
21    incorporating provider fee schedules into base capitation
22    rates.
23    (b) For the development of capitation base rates for new
24capitation rate years:
25        (1) The Department shall take into account emerging
26    experience in the development of the annual MCO capitation

 

 

10000SB1851ham002- 59 -LRB100 10394 KTG 41023 a

1    base rates, including, but not limited to, current-year
2    cost and utilization trends observed by MCOs in an
3    actuarially sound manner and in accordance with federal law
4    and regulations.
5        (2) No later than January 1 of each year, the
6    Department shall release an agreed upon annual calendar
7    that outlines dates for capitation rate setting meetings
8    for that year. The calendar shall include at least the
9    following meetings and deadlines:
10            (A) An initial meeting for the Department to review
11        MCO data and draft rate assumptions to be used in the
12        development of capitation base rates for the following
13        year.
14            (B) A draft rate meeting after the Department
15        provides the MCOs with the draft capitated base rates
16        to discuss, review, and seek feedback regarding the
17        draft capitation base rates.
18        (3) Prior to the submission of final capitation rates
19    to the federal Centers for Medicare and Medicaid Services,
20    the Department shall provide the MCOs with a final
21    actuarial report including the final capitation base rates
22    for the following year and subsequently conduct a final
23    capitation base review meeting. Final capitation rates
24    shall be marked final.
25    (c) For the development of capitation base rates reflecting
26policy changes:

 

 

10000SB1851ham002- 60 -LRB100 10394 KTG 41023 a

1        (1) Unless contrary to federal law and regulation, the
2    Department must provide notice to MCOs of any significant
3    operational policy change no later than 60 days prior to
4    the effective date of an operational policy change in order
5    to give MCOs time to prepare for and implement the
6    operational policy change and to ensure that the quality
7    and delivery of enrollee health care is not disrupted.
8    "Operational policy change" means a change to operational
9    requirements such as reporting formats, encounter
10    submission definitional changes, or required provider
11    interfaces made at the sole discretion of the Department
12    and not required by legislation with a retroactive
13    effective date. Nothing in this Section shall be construed
14    as a requirement to delay or prohibit implementation of
15    policy changes that impact enrollee benefits as determined
16    in the sole discretion of the Department.
17        (2) No later than 60 days after the effective date of
18    the policy change or program implementation, the
19    Department shall meet with the MCOs regarding the initial
20    data collection needed to establish capitation base rates
21    for the policy change. Additionally, the Department shall
22    share with the participating MCOs what other data is needed
23    to estimate the change and the processes for collection of
24    that data that shall be utilized to develop capitation base
25    rates.
26        (3) No later than 60 days after the effective date of

 

 

10000SB1851ham002- 61 -LRB100 10394 KTG 41023 a

1    the policy change or program implementation, the
2    Department shall meet with MCOs to review data and the
3    Department's written draft assumptions to be used in
4    development of capitation base rates for the policy change,
5    and shall provide opportunities for questions to be asked
6    and answered.
7        (4) No later than 60 days after the effective date of
8    the policy change or program implementation, the
9    Department shall provide the MCOs with draft capitation
10    base rates and shall also conduct a draft capitation base
11    rate meeting with MCOs to discuss, review, and seek
12    feedback regarding the draft capitation base rates.
13    (d) For the development of capitation base rates for
14retroactive policy or fee schedule changes:
15        (1) The Department shall meet with the MCOs regarding
16    the initial data collection needed to establish capitation
17    base rates for the policy change. Additionally, the
18    Department shall share with the participating MCOs what
19    other data is needed to estimate the change and the
20    processes for collection of the data that shall be utilized
21    to develop capitation base rates.
22        (2) The Department shall meet with MCOs to review data
23    and the Department's written draft assumptions to be used
24    in development of capitation base rates for the policy
25    change. The Department shall provide opportunities for
26    questions to be asked and answered.

 

 

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1        (3) The Department shall provide the MCOs with draft
2    capitated rates and shall also conduct a draft rate meeting
3    with MCOs to discuss, review, and seek feedback regarding
4    the draft capitation base rates.
5        (4) The Department shall inform MCOs no less than
6    quarterly of upcoming benefit and policy changes to the
7    Medicaid program.
8    (e) Meetings of the group established to discuss Medicaid
9capitation rates under this Section shall be closed to the
10public and shall not be subject to the Open Meetings Act.
11Records and information produced by the group established to
12discuss Medicaid capitation rates under this Section shall be
13confidential and not subject to the Freedom of Information Act.
 
14    (305 ILCS 5/5A-16)
15    Sec. 5A-16. State fiscal year 2019 implementation
16protection.
17    (a) To preserve access to hospital services and to ensure
18continuity of payments and stability of access to hospital
19services, it is the intent of the General Assembly that there
20not be a gap in payments to hospitals while the changes
21authorized under Public Act 100-581 this amendatory Act of the
22100th General Assembly are being reviewed by the federal
23Centers for Medicare and Medicaid Services and implemented by
24the Department. Therefore, pending the review and approval of
25the changes to the assessment and hospital reimbursement

 

 

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1methodologies authorized under Public Act 100-581 this
2amendatory Act of the 100th General Assembly by the federal
3Centers for Medicare and Medicaid Services and the final
4implementation of such program by the Department, the
5Department shall take all actions necessary to continue the
6reimbursement methodologies and payments to hospitals that are
7changed under Public Act 100-581 this amendatory Act of the
8100th General Assembly, as they are in effect on June 30, 2018,
9until the first day of the second month after the new and
10revised methodologies and payments authorized under Public Act
11100-581 this amendatory Act of the 100th General Assembly are
12effective and implemented by the Department. Such actions by
13the Department shall include, but not be limited to, requesting
14prior to June 15, 2018 the extension of any federal approval of
15the currently approved payment methodologies contained in
16Illinois' Medicaid State Plan while the federal Centers for
17Medicare and Medicaid Services reviews the proposed changes
18authorized under Public Act 100-581 this amendatory Act of the
19100th General Assembly.
20    (b) Notwithstanding any other provision of this Code, if
21the federal Centers for Medicare and Medicaid Services should
22approve the continuation of the reimbursement methodologies
23and payments to hospitals under Sections 5A-12.2, 5A-12.4,
245A-12.5 and , and Section 14-12, as they are in effect on June
2530, 2018, until the new and revised methodologies and payments
26authorized under Sections 5A-12.6 and Section 14-12 of this

 

 

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1Code amendatory Act of the 100th General Assembly are federally
2approved, then the reimbursement methodologies and payments to
3hospitals under Sections 5A-12.2, 5A-12.4, 5A-12.5, and 14-12,
4and the assessments imposed under Section 5A-2, as they are in
5effect on June 30, 2018, shall continue until the effective
6date of the new and revised methodologies and payments, which
7shall be the first day of the second month following the date
8of approval by the federal Centers for Medicare and Medicaid
9Services.
10    (c) Notwithstanding any other provision of this Code, if by
11July 11, 2018 the federal Centers for Medicare and Medicaid
12Services has neither approved the changes authorized under
13Public Act 100-581 nor has formally approved an extension of
14the reimbursement methodologies and payments to hospitals
15under Sections 5A-12.5 and 14-12 as they are in effect on June
1630, 2018, then the following shall apply:
17        (1) all reimbursement methodologies and payments for
18    hospital services authorized under Sections 5A-12.2,
19    5A-12.4, and 5A-12.5 in effect on June 30, 2018 shall
20    continue subject to the availability of federal matching
21    funds for such expenditures and subject to the provisions
22    of subsection (c) of Section 5A-15; and
23        (2) all supplemental payments to hospitals authorized
24    in Illinois' Medicaid State Plan in effect on June 30,
25    2018, which are scheduled to terminate under Illinois'
26    Medicaid State Plan on June 30, 2018, shall continue

 

 

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1    subject to the availability of federal matching funds for
2    such expenditures; and
3        (3) all assessments imposed under Section 5A-2, as they
4    are in effect on June 30, 2018, shall continue.
5    Notwithstanding any other provision in this subsection,
6the Department shall make monthly advance payments to any
7safety-net hospital or critical access hospital requesting
8such advance payments in an amount, as requested by the
9hospital, provided that the total monthly payments to the
10hospital under this subsection shall not exceed 1/12th of the
11payments the hospital would have received under Sections
125A-12.2, 5A-12.4, and 5A-12.5 and subsections (d) and (f) of
13Section 14-12.
14    Notwithstanding any other provision in this subsection,
15the Department may make monthly advance payments to a hospital
16requesting such advance payments in an amount, as requested by
17the hospital, provided that the total monthly payments to the
18hospital under this subsection shall not exceed 1/12th of the
19payments the hospital would have received under Sections
205A-12.2, 5A-12.4, and 5A-12.5 and subsections (d) and (f) of
21Section 14-12.
22    Payments under this subsection shall be made regardless of
23federal approval for federal financial participation under
24Title XIX or XXI of the federal Social Security Act.
25    As used in this subsection, "safety-net hospital" means a
26hospital as defined in Section 5-5e.1 for Rate Year 2017 or an

 

 

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1Illinois hospital that meets the criteria in paragraphs (2) and
2(3) of subsection (a) of Section 5-5e.1 for Rate Year 2017.
3    As used in this subsection, "critical access hospital"
4means a hospital that has such status as of June 30, 2018.
5    The changes authorized under this subsection shall
6continue, on the same time schedule as otherwise authorized
7under this Article, until the effective date of the new and
8revised methodologies and payments under Public Act 100-581,
9which shall be the first day of the second month following the
10date of approval by the federal Centers for Medicare and
11Medicaid Services.
12(Source: P.A. 100-581, eff. 3-12-18.)
 
13    Section 95. No acceleration or delay. Where this Act makes
14changes in a statute that is represented in this Act by text
15that is not yet or no longer in effect (for example, a Section
16represented by multiple versions), the use of that text does
17not accelerate or delay the taking effect of (i) the changes
18made by this Act or (ii) provisions derived from any other
19Public Act.
 
20    Section 999. Effective date. This Act takes effect upon
21becoming law.".