Illinois General Assembly - Bill Status for SB 558

Replaces everything after the enacting clause. Provides that the Act may be referred to as the Illinois Health Care and Human Service Reform Act. Contains findings. Creates the Community Health Worker Certification and Reimbursement Act. Requires community health workers to be provided with multi-tiered academic and community-based training opportunities that lead to the mastery of community health worker core competencies. Creates the Illinois Community Health Worker Certification Board to serve as the regulatory body that develops and has oversight of initial community health workers certification and certification renewals for both individuals and academic and community-based training programs. Provides that community health worker services shall be covered under the medical assistance program for persons who are otherwise eligible for medical assistance. Contains other provisions. Amends the University of Illinois Hospital Act and the Hospital Licensing Act. Requires hospitals to require an intern, resident, or physician who provides medical services at the hospital to have proper credentials and any required certificates for ongoing training at the time the intern, resident, or physician renews his or her license. Amends the Hospital Report Card Act. Requires hospitals to include in their quarterly reports the number of female patients who have died within the reporting period, the number of female patients who have died of a preventable cause within the reporting period and the number of those preventable deaths that the hospital has otherwise reported within the reporting period, and the number of physicians who were required by the hospital to undergo any amount or type of retraining during the reporting period. Amends the Hospital Licensing Act. Requires hospitals that receive a property tax exemption under a provision of the Property Tax Code concerning exemptions related to access to hospital and health care services by low-income and underserved individuals to post the hospital's charity care policy and the contact information of a financial counselor in a reasonably viewable area in the hospital's emergency room. Amends the University of Illinois Hospital Act and the Hospital Licensing Act. Requires hospitals organized or licensed under the Acts to provide N95 masks to all physicians licensed under the Medical Practice Act of 1987 and registered nurses and advanced practice registered nurses licensed under the Nurse Licensing Act if the physician, registered nurse, or advanced practice registered nurse is employed by or providing services for another employer at the hospital. Amends the University of Illinois Hospital Act and the Hospital Licensing Act. Requires hospitals organized or licensed under the Acts to report to the Department of Public Health the demographic data of individuals who have symptoms of COVID-19 and are released from, not admitted to, the hospital. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that the inpatient, per diem rate to be paid to all community safety-net hospitals for inpatient psychiatric services on and after January 1, 2021 shall be at least $630. In provisions amending the Medical Practice Act of 1987, the Nurse Practice Act, and the Physician Assistant Practice Act of 1987, provides that the rules adopted by the Department of Financial and Professional Regulation concerning continuing education shall require that, on and after January 1, 2022, all continuing education courses for persons licensed under the Acts contain curriculum that includes the understanding of implicit bias in the practice of medicine. Provides that a continuing education course dedicated solely to research or other issues that does not include a direct patient care component is not required to contain curriculum that includes implicit bias in the practice of medicine. Specifies requirements that continuing education courses must satisfy. Amends the Illinois Controlled Substances Act and the Methamphetamine Control and Community Protection Act. Provides that a person who, in good faith, seeks or obtains emergency medical assistance for someone experiencing an overdose or who is experiencing an overdose shall not be arrested, charged, or prosecuted for controlled substance manufacture, delivery, or possession with intent to manufacture or deliver or a possession violation of the Illinois Controlled Substances Act, a drug paraphernalia violation, a methamphetamine delivery or possession violation, a drug-induced homicide violation, or an aggravated battery violation based on unlawfully delivering a controlled substance to another person and any user experiences great bodily harm or permanent disability as a result of the injection, inhalation, or ingestion of any amount of the controlled substance. Provides that these violations must not serve as the sole basis of a violation of parole, mandatory supervised release, probation or conditional discharge, a Department of Children and Family Services investigation, or any seizure of property under any State law authorizing civil forfeiture so long as the evidence for the violation was acquired as a result of the person seeking or obtaining emergency medical assistance in the event of an overdose. Provides that the limited immunity as relates to methamphetamine only applies to possession of less than 3 grams. Provides that nothing in these provisions are intended to interfere with or prevent the investigation, arrest, or prosecution of any person for the delivery or distribution of cannabis, methamphetamine, or other controlled substances, drug-induced homicide, or any other crime if the evidence of the violation is not acquired as a result of the person seeking or obtaining emergency medical assistance in the event of an overdose. Deletes provisions that the limited immunity only applies to Class 4 felony possession of a controlled, counterfeit, or look-alike substance or a controlled substance analog. Amends the Illinois Controlled Substances Act. Provides that the requirements for transmitting information to the central repository under the Prescription Monitoring Program also apply to opioid treatment programs that prescribe Schedule II, III, IV, or V controlled substances for the treatment of opioid use disorder. Amends the Adult Protective Services Act. Requires the Department on Aging to develop and implement a dementia training program that must include instruction on the identification of people with dementia, risks such as wandering, communication impairments, elder abuse, and the best practices for interacting with people with dementia. Provides that initial training of 4 hours shall be completed at the start of employment with the Adult Protective Services division and shall cover several subjects, including: (i) dementia, psychiatric, and behavioral symptoms; (ii) communication issues, including how to communicate respectfully and effectively; and (iii) protocols for connecting people living with dementia to local care resources and professionals who are skilled in dementia care to encourage cross-referral and reporting regarding incidents of abuse. Provides that annual continuing education shall include 2 hours of dementia training covering the same subjects discussed during initial training. Grants rulemaking authority. Amends the Use Tax Act, the Service Use Tax Act, the Service Occupation Tax Act, and the Retailers' Occupation Tax Act. Provides that all blood sugar testing materials are subject to the 1% reduced rate of tax (rather than urine testing materials for human use only). Amends the Illinois Public Aid Code. In provisions concerning the Department of Human Services' Child Care Assistance Program, requires the Department to update the Child Care Assistance Program Eligibility Calculator posted on the Department's website to include a question on whether a family is applying for child care assistance for the first time or is applying for a redetermination of eligibility. Amends the Employee Sick Leave Act. Provides that personal care of a parent, mother-in-law, father-in-law, grandparent, or stepparent is a permissible use of personal sick leave benefits. Amends the Nursing Home Care Act and the Hospital Licensing Act. Requires licensed long-term care facilities and hospitals to prove upon inspection that they provided testing for Legionnaires' disease and to provide the results of that testing. Creates the Child Trauma Counseling Act. Provides that: (1) a day care center shall provide the services of a trauma counselor to a child, from birth through the fifth grade, enrolled and attending the day care center who has been identified as needing trauma counseling; and (2) a school shall provide the services of a trauma counselor to a child who is enrolled and attending kindergarten through the fifth grade at that school and has been identified as needing trauma counseling. Provides that there shall be no cost for such trauma counseling to the parents or guardians of the child. Provides that a child is identified as needing trauma counseling if the child reports trauma to a day care center or a school or a parent or guardian of a child or employee of a day care center or a school reports that the child has experienced trauma. Provides for the adoption of rules to implement the Act and rules related to qualifications of trauma counselors working with children under the Act. Amends the State Mandates Act to require implementation without reimbursement. Creates the Special Commission on Gynecologic Cancer Act. Creates the Special Commission on Gynecologic Cancers to study specified issues regarding gynecologic cancers in Illinois and submit its final report to the General Assembly no later than December 31, 2021. Amends the Hospital Provider Funding Article of the Illinois Public Aid Code. Provides that, in order to address the escalating infant mortality rates among minority communities in Illinois, the State shall, subject to appropriation, create a pool of funding of at least $50,000,000 annually to be dispersed among community safety-net hospitals who maintain perinatal designation from the Department of Public Health, and that he funding shall be used to preserve or enhance OB/GYN services or other specialty services at the receiving hospital. Creates the Racial Impact Note Act. Provides that every bill which has or could have a disparate impact on racial and ethnic minorities, upon the request of any member, shall have prepared for it, before second reading in the house of introduction, a brief explanatory statement or note that shall include a reliable estimate of the anticipated impact on those racial and ethnic minorities likely to be impacted by the bill. Specifies the contents and provides for the preparation of each racial impact note. Provides that no comment or opinion shall be included in the racial impact note with regard to the merits of the measure for which the racial impact note is prepared. Provides that the fact that a racial impact note is prepared for any bill shall not preclude or restrict the appearance before any committee of the General Assembly of any official or authorized employee of the responding agency or agencies, or any other impacted State agency, who desires to be heard in support of or in opposition to the measure. Amends the Department of Healthcare and Family Services Law. Requires the Department of Healthcare and Family Services, on or before December 31, 2021, to develop: (1) a program to increase the presence of Federally Qualified Health Centers (FQHCs) in hospitals with the goal of increasing care coordination, managing chronic diseases, and addressing the social determinants of health and (2) a payment methodology to allow for care coordination services in FQHCs. Amends the Departments of State Government Law of the Civil Administrative Code of Illinois. Provides that it shall be the duty of the State Board of Health, among other duties, to deliver to the Governor for presentation to the General Assembly a State Health Assessment and a State Health Improvement Plan (currently, only a State Health Improvement Plan required). Provides further requirements concerning the State Health Assessment and the State Health Improvement Plan. Creates the Health and Human Services Task Force and Study Act establishing the Health and Human Services Task Force to undertake a systematic review of health and human service departments and programs with the goal of improving health and human service outcomes for Illinois residents. Creates the Anti-Racism Commission Act establishing the Anti-Racism Commission to identify and propose statewide policies to eliminate systemic racism and advance equitable solutions for Black and Brown people in Illinois. Creates the Sickle Cell Prevention, Care, and Treatment Program Act. Requires the Department of Healthcare and Family Services to establish a grant program for the purpose of providing for the prevention, care, and treatment of sickle cell disease and for educational programs concerning the disease. Requires the Department to: (1) develop application criteria and standards of eligibility for groups or organizations that apply for funds under the program; and (2) make available grants to groups and organizations who meet the eligibility standards set by the Department. Provides that the highest priority for grants shall be accorded to established sickle cell disease community-based organizations, and priority shall be given to ensuring the establishment of sickle cell disease centers in underserved areas that have a higher population of sickle cell disease patients. Requires the Department to determine the maximum amount available for each grant; determine policies for the expiration and renewal of grants; require that all grant funds be used for the purpose of prevention, care, and treatment of sickle cell disease or for educational programs concerning the disease; and develop a sickle cell disease educational outreach program that includes the dissemination of educational materials to specified persons and institutions. Permits the Department to contract with an entity to implement the sickle cell disease educational outreach program. Requires the Department to adopt rules. Requires the Department to conduct a study to determine the prevalence, impact, and needs of individuals with sickle cell disease and the sickle cell trait in Illinois. Provides that implementation of the Act is subject to appropriation. Amends the State Finance Act. Creates the Sickle Cell Chronic Disease Fund. Amends the Chicago School District Article of the School Code. Requires the Chicago Board of Education to establish a school nurse pilot program. Provides that under the program, the Board shall require the top 20% of the lowest performing schools in the school district, as determined by the Board, to employ a school nurse in conformance with certain provisions of the Code concerning school nurses. Requires the Board to implement this program beginning with the 2019-2020 school year. Amends the Illinois Health Facilities Planning Act. Adds 2 members to the Health Facilities and Services Review Board. Provides that, due to the COVID-19 pandemic, the State shall institute a moratorium on the closure of hospitals until December 31, 2023, and no hospital shall close or reduce capacity below the hospital's capacity as of January 1, 2020 before the end of the moratorium. Provides that, upon the completion of an application to close a health care facility or discontinue a category of service, the Health Facilities and Services Review Board shall conduct a racial equity impact assessment to determine the effect of the closure or discontinuation of service on racial and ethnic minorities, and the results of the racial equity impact assessment shall be made available to the public. Amends the Medical Assistance Article of the Illinois Public Aid Code. Requires managed care organizations (MCOs) to publish, at least quarterly for the preceding quarter, on their websites: (1) the total number of claims received by the MCO; (2) the number and monetary amount of claims payments made to a service provider; (3) the dates of services rendered for the claims payments made under item (2); (4) the dates the claims were received by the MCO for the claims payments made under item (2); and (5) the dates on which claims payments under item (2) were released. Requires the Department of Healthcare and Family Services to require MCOs to: (i) ensure that any provider under contract with an MCO on the date of service is paid for any medically necessary service rendered to any of the MCO's enrollees, regardless of inclusion on the MCO's published and publicly available roster of available providers; and (ii) ensure that all contracted providers are listed on an updated roster within 7 days of entering into a contract with the MCO and that such roster is readily accessible to all medical assistance enrollees for purposes of selecting an approved healthcare provider. Makes other changes regarding discharge notification and facility placement of individuals and other provisions regarding MCOs. Creates the Medicaid Managed Care Oversight Commission within the Department of Healthcare and Family Services to evaluate the effectiveness of Illinois' managed care program. Amends the State Finance Act. Creates the Managed Care Oversight Fund to be used by the Department of Healthcare and Family Services to support emergency procurement and sole source contracting with women and minority-owned businesses. Provides that the Department shall not renew, re-enter, renegotiate, change orders, or amend any contract or agreement it entered with a managed care organization that was solicited under the State of Illinois Medicaid Managed Care Organization Request for Proposals. Requires any health care plan administered by a managed care organization that entered a contract with the Department under the State of Illinois Medicaid Managed Care Organization Request for Proposals shall be transitioned to the State's fee-for-service medical assistance program upon the expiration of the managed care organization's contract with the Department until such time the Department enters a new contract in accordance specified provisions of the Code. Contains other provisions. Provides that the Department shall require each managed care organization participating in the medical assistance program to satisfy any minority-owned or women-owned business subcontracting requirements to which the managed care organization is subject under the contract. Provides that the Department shall terminate its contract with any managed care organization that does not meet the minority-owned or women-owned business subcontracting requirements under its contract with the State. Provides that the Department shall reassign to another managed care plan any Medicaid recipient who will lose healthcare coverage as a result of the Department's decision to terminate its contract with the managed care organization. Provides that the Department shall terminate the contract no later than 60 days after receiving a contractually required report indicating that the managed care organization has not met the subcontracting goals. Amends the Illinois Public Aid Code. Provides that specified doula services and evidence-based home visiting services shall be covered under the medical assistance program for persons who are otherwise eligible for medical assistance. Provides that the Department of Healthcare and Family Services shall adopt rules, periodically assess the rates of reimbursement for perinatal doula and home visiting services, adjust rates accordingly, seek State plan amendments or waivers necessary to implement the new provisions, and secure federal financial participation for expenditures made in accordance with the new provisions. Provides for the repeal of certain provisions. Makes other changes. Effective immediately.

Date	Chamber	Action
1/13/2021	Senate	Session Sine Die

Date	Chamber	Action
1/31/2019	Senate	Filed with Secretary by Sen. John J. Cullerton
1/31/2019	Senate	First Reading
1/31/2019	Senate	Referred to Assignments
2/20/2019	Senate	Assigned to Executive
3/6/2019	Senate	Do Pass Executive; 016-000-000
3/6/2019	Senate	Placed on Calendar Order of 2nd Reading March 7, 2019
3/7/2019	Senate	Second Reading
3/7/2019	Senate	Placed on Calendar Order of 3rd Reading March 12, 2019
4/12/2019	Senate	Rule 3-9(a) / Re-referred to Assignments
10/21/2019	Senate	Chief Sponsor Changed to Sen. Linda Holmes
10/28/2019	Senate	Rule 2-10 Third Reading Deadline Established As November 14, 2019
10/28/2019	Senate	Approved for Consideration Assignments
10/28/2019	Senate	Placed on Calendar Order of 3rd Reading October 29, 2019
10/28/2019	Senate	Senate Floor Amendment No. 1 Filed with Secretary by Sen. Linda Holmes
10/28/2019	Senate	Senate Floor Amendment No. 1 Referred to Assignments
10/28/2019	Senate	Senate Floor Amendment No. 1 Assignments Refers to Licensed Activities
10/29/2019	Senate	Senate Floor Amendment No. 1 Recommend Do Adopt Licensed Activities; 006-000-000
10/29/2019	Senate	Recalled to Second Reading
10/29/2019	Senate	Senate Floor Amendment No. 1 Adopted; Holmes
10/29/2019	Senate	Placed on Calendar Order of 3rd Reading
10/29/2019	Senate	3/5 Vote Required
10/29/2019	Senate	Third Reading - Passed; 056-000-000
10/29/2019	House	Arrived in House
10/29/2019	House	Chief House Sponsor Rep. Diane Pappas
10/29/2019	House	Alternate Chief Sponsor Changed to Rep. Jonathan Carroll
10/29/2019	House	First Reading
10/29/2019	House	Referred to Rules Committee
11/6/2019	House	Assigned to Labor & Commerce Committee
11/14/2019	House	House Committee Amendment No. 1 Filed with Clerk by Rep. Jonathan Carroll
11/14/2019	House	House Committee Amendment No. 1 Referred to Rules Committee
12/16/2019	House	Rule 19(b) / Re-referred to Rules Committee
1/2/2021	House	Assigned to Health Care Availability & Accessibility Committee
1/8/2021	House	House Committee Amendment No. 2 Filed with Clerk by Rep. Camille Y. Lilly
1/8/2021	House	House Committee Amendment No. 2 Referred to Rules Committee
1/8/2021	House	Alternate Chief Sponsor Changed to Rep. Camille Y. Lilly
1/9/2021	House	House Committee Amendment No. 2 Rules Refers to Health Care Availability & Accessibility Committee
1/9/2021	House	House Committee Amendment No. 2 Adopted in Health Care Availability & Accessibility Committee; by Voice Vote
1/9/2021	House	Do Pass as Amended / Short Debate Health Care Availability & Accessibility Committee; 005-003-000
1/9/2021	House	Placed on Calendar 2nd Reading - Short Debate
1/9/2021	House	Second Reading - Short Debate
1/9/2021	House	Held on Calendar Order of Second Reading - Short Debate
1/10/2021	House	House Floor Amendment No. 3 Filed with Clerk by Rep. Camille Y. Lilly
1/10/2021	House	House Floor Amendment No. 3 Referred to Rules Committee
1/10/2021	House	House Floor Amendment No. 3 Rules Refers to Executive Committee
1/11/2021	House	House Floor Amendment No. 3 Recommends Be Adopted Executive Committee; 008-005-000
1/11/2021	House	House Floor Amendment No. 3 Fiscal Note Requested as Amended by Rep. Tom Demmer
1/11/2021	House	Added Alternate Co-Sponsor Rep. Debbie Meyers-Martin
1/11/2021	House	Added Alternate Co-Sponsor Rep. Lamont J. Robinson, Jr.
1/11/2021	House	Added Alternate Co-Sponsor Rep. Justin Slaughter
1/11/2021	House	Added Alternate Co-Sponsor Rep. Nicholas K. Smith
1/11/2021	House	Added Alternate Co-Sponsor Rep. Curtis J. Tarver, II
1/11/2021	House	Added Alternate Co-Sponsor Rep. André Thapedi
1/11/2021	House	Added Alternate Co-Sponsor Rep. Emanuel Chris Welch
1/11/2021	House	Added Alternate Co-Sponsor Rep. Maurice A. West, II
1/11/2021	House	Added Alternate Co-Sponsor Rep. Jawaharial Williams
1/12/2021	House	House Floor Amendment No. 4 Filed with Clerk by Rep. Camille Y. Lilly
1/12/2021	House	House Floor Amendment No. 4 Referred to Rules Committee
1/12/2021	House	Added Alternate Chief Co-Sponsor Rep. William Davis
1/12/2021	House	Added Alternate Chief Co-Sponsor Rep. Mary E. Flowers
1/12/2021	House	Added Alternate Chief Co-Sponsor Rep. LaToya Greenwood
1/12/2021	House	Added Alternate Chief Co-Sponsor Rep. Rita Mayfield
1/12/2021	House	House Floor Amendment No. 3 Fiscal Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Recommends Be Adopted Rules Committee; 003-002-000
1/12/2021	House	House Floor Amendment No. 4 Fiscal Note Requested as Amended by Rep. Tom Demmer
1/12/2021	House	House Floor Amendment No. 4 Housing Affordability Impact Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Pension Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Judicial Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Land Conveyance Appraisal Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 State Debt Impact Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Correctional Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Balanced Budget Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Fiscal Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 State Mandates Fiscal Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Home Rule Note Filed as Amended
1/12/2021	House	House Floor Amendment No. 4 Fiscal Note Filed as Amended
1/13/2021	House	House Floor Amendment No. 5 Filed with Clerk by Rep. Camille Y. Lilly
1/13/2021	House	House Floor Amendment No. 5 Referred to Rules Committee
1/13/2021	House	House Floor Amendment No. 5 Recommends Be Adopted Rules Committee; 003-001-000
1/13/2021	House	House Floor Amendment No. 3 Adopted
1/13/2021	House	House Floor Amendment No. 4 Adopted
1/13/2021	House	House Floor Amendment No. 5 Adopted
1/13/2021	House	Placed on Calendar Order of 3rd Reading - Short Debate
1/13/2021	House	Third Reading - Short Debate - Passed 066-041-000
1/13/2021	Senate	Secretary's Desk - Concurrence House Amendment(s) 2, 3, 4, 5
1/13/2021	Senate	Placed on Calendar Order of Concurrence House Amendment(s) 2, 3, 4, 5 - January 13, 2021
1/13/2021	Senate	Session Sine Die

	Adds reference to:
	405 ILCS 20/0.1	from Ch. 91 1/2, par. 300.1

	Fiscal Note, House Floor Amendment No. 3 (Dept. of Human Services)
	The trauma counseling services are to be provided free of charge. This Act creates an unfunded mandate for day care centers and schools. The number of children in need of trauma counseling between birth and fifth grade are unknown and the estimate cost to day care centers and schools is unknown. The other impacts to IDHS included in SB 588 House Amendment 3 have minimal fiscal impact to implement

	Housing Affordability Impact Note, House Floor Amendment No. 4 (Housing Development Authority)
	This bill will have no effect on the cost of constructing, purchasing, owning, or selling a single-family residence.

	Pension Note, House Floor Amendment No. 4 (Government Forecasting & Accountability)
	SB 558, as amended by HA 4, will not impact any public pension fund or retirement system in the State of Illinois.

	Judicial Note, House Floor Amendment No. 4 (Admin Office of the Illinois Courts)
	Based on a review of the bill, it has been determined that the proposed legislation would neither increase nor decrease the number of judges needed in the state of Illinois.

	Land Conveyance Appraisal Note, House Floor Amendment No. 4 (Dept. of Transportation)
	No land conveyances are included in Senate Bill 558 House Amendment #4; therefore, there are no appraisals to be filed.

	State Debt Impact Note, House Floor Amendment No. 4 (Government Forecasting & Accountability)
	SB 0558, as amended by House Amendment 4, would not change the amount of authorization for any type of State-issued or State-supported bond, and, therefore, would not affect the level of State indebtedness.

	Correctional Note, House Floor Amendment No. 4 (Dept of Corrections)
	This amendment has no fiscal impact or population impact on the deparbnent.

	Balanced Budget Note, House Floor Amendment No. 4 (Office of Management and Budget)
	Please be advised that the Balanced Budget Note Act does not apply to Senate Bill 558, as amended by House Amendment 4 as it is not a supplemental appropriation that increases or decreases appropriations. Under the Act, a balanced budget note must be prepared only for bills that change a general funds appropriation for the fiscal year in which the new bill is enacted.

	Fiscal Note, House Floor Amendment No. 4 (Dept. of Healthcare & Family Services)
	SB 558 (H-AM 4) has the following fiscal impact: (1) $50 million for new category of safety-net perinatal hospitals; (2) $40 million for home visiting; (3) $15 million for doulas; (4) $7.2 million for hospital psychiatric services; (5) $960 million - $2.88 billion towards Community Health Workers; (6) Undetermined administrative costs to support Managed Care Oversight Commission.

	Deletes reference to:
	410 ILCS 620/17.2

	State Mandates Fiscal Note, House Floor Amendment No. 4 (Dept. of Commerce & Economic Opportunity)
	This bill does not create a State mandate.

	Home Rule Note, House Floor Amendment No. 4 (Dept. of Commerce & Economic Opportunity)
	This bill does not pre-empt home rule authority.

	Fiscal Note, House Floor Amendment No. 4 (Dept. of Human Services)
	This Act creates an unfunded mandate for day care centers and schools.The number of children in need of trauma counseling between birth and fifth grade are unknown and the estimate cost to day care centers and schools is unknown.The other impacts to IDHS included in SB 558 House Amendment 4 have minimal fiscal impact to implement.