HB5417 103RD GENERAL ASSEMBLY

LRB103 39489 CES 69685 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5417

Introduced 2/9/2024, by Rep. Kelly M. Cassidy

SYNOPSIS AS INTRODUCED:

See Index

Amends the Department of Public Health Act. Establishes the role of HIV Treatment Innovation Coordinator to be housed within the Department. Provides that the Department shall create and fill the Coordinator role within 6 months after the effective date of the amendatory Act. Requires the Coordinator to develop and execute a comprehensive strategy to adopt a Rapid Start model for HIV treatment as the standard of care. Requires compensation and benefits for the Coordinator be at the Program Director level. Describes the specific job responsibilities of the Coordinator. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2025 shall provide coverage for home test kits for sexually transmitted infections, including any laboratory costs of processing the home test kit, that are deemed medically necessary or appropriate and ordered directly by a clinician or furnished through a standing order for patient use based on clinical guidelines and individual patient health needs. Makes a conforming change to the Illinois Public Aid Code regarding coverage for home test kits for sexually transmitted infections. Amends the AIDS Confidentiality Act. Creates the Illinois AIDS Drug Assistance Program. Provides that Illinois AIDS Drug Assistance Program applications shall be processed within 72 hours after the time of submission. Provides for conditional approval of Illinois AIDS Drug Assistance Program applications within 24 hours after time of submission. Requires Illinois AIDS Drug Assistance Program applicants to document residency within the State of Illinois. Provides for 8 Rapid Start for HIV Treatment pilot sites established by the Department of Public Health. Provides that the Department shall publish a report on the operation of the pilot program 15 months after the pilot sites have launched. Establishes requirements for the report, requires that the report be shared with the General Assembly, the Governor's Office, and requires that the report be made available on the Department's Internet website. Amends the County Jail Act. Creates new annual adult correctional facility public inspection report requirements on the topics of HIV and AIDS.

A BILL FOR

AN ACT concerning health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Department of Public Health Act is amended by adding Section 6.5 as follows:

(20 ILCS 2305/6.5 new)

Sec. 6.5. HIV Treatment Innovation Coordinator.

(a) Within 6 months after the effective date of this amendatory Act of the 103rd General Assembly, the Department of Public Health shall create and fill the position of "HIV Treatment Innovation Coordinator" within the HIV Section and shall employ a full-time person to serve in this position. The HIV Treatment Innovation Coordinator shall develop and execute a comprehensive strategy to adopt a Rapid Start model for HIV treatment as the standard of care, aligning with industry standards informed by the most current guidance of the Centers for Disease Control and Prevention on HIV care and treatment.

(b) The HIV Treatment Innovation Coordinator employed by the Department shall be compensated at a rate that is comparable to the rate of compensation for a Program Director and shall be provided benefits similar to those of a Program Director. The HIV Treatment Innovation Coordinator shall also be provided similar means and resources as those supplied to a Program Director. The Department shall not modify any current position to meet these requirements. The position of HIV Treatment Innovation Coordinator shall be created and filled anew, as set forth in this Section.

(c) The HIV Treatment Innovation Coordinator shall have the following responsibilities:

(1) The Coordinator shall develop and execute a comprehensive strategy for the adoption of the Rapid Start model for HIV treatment, aligning with public health objectives outlined in the Getting to Zero Illinois Plan, including the process and qualifications for choosing the 8 rapid start pilots.

(2) The Coordinator shall support the launch of 8 rapid start pilots within 12 months after the effective date of this amendatory Act of the 103rd General Assembly.

(3) The Coordinator shall establish coordination efforts between pilot sites and health care providers, community organizations, and stakeholders for the successful implementation of the Rapid Start for HIV treatment model.

(4) The Coordinator shall provide educational resources, technical assistance, and training to healthcare professionals at pilot sites to ensure a thorough understanding and effective implementation of Rapid Start for HIV treatment protocols.

(5) The Coordinator shall facilitate regular data collection from Rapid Start for HIV treatment pilot sites to optimize service delivery and monitor equitable access to communities disproportionately impacted by HIV/AIDS.

(6) The Coordinator shall be responsible for the management and allocation of resources dedicated to the implementation of the Rapid Start for HIV treatment model, including technical assistance, capacity building, and grant management.

(7) The Coordinator shall be responsible for creating and disseminating the report on the operation of the pilot program 15 months after the pilot sites have launched as required under the AIDS Confidentiality Act. The report shall include:

(i) the number of enrolled participants; and

(ii) the length of time from initial diagnosis or referral to the start of HIV treatment, and, when available, the length of time during which participants were able to achieve an undetectable viral load.

Data shall also include demographic data on the racial, ethnic, age, sex, disability status, sexual orientation, gender identity, and primary or preferred language of program participants in accordance with the Data Governance and Organization to Support Equity and Racial Justice Act. The report shall include the Department's recommendations concerning the continued operation of the Rapid Start for HIV treatment pilot program and its expansion or progress towards becoming the standard of care for HIV treatment. The contents of the report shall be in accordance with the AIDS Confidentiality Act. The Coordinator shall share the report with the Illinois General Assembly, the Governor's Office and shall make it publicly available on the Department of Public Health's Internet website.

Implementation of this Section is subject to appropriations made to the Illinois Department of Public Health for this purpose.

Section 10. The Illinois Insurance Code is amended by adding Section 356z.71 as follows:

(215 ILCS 5/356z.71 new)

Sec. 356z.71. Coverage for home test kits for sexually transmitted infections (STIs).

(a) As used in this Section, "home test kit" means a product used for a test recommended by the federal Centers for Disease Control and Prevention guidelines or the United States Preventive Services Task Force that has received a certificate of waiver under the Clinical Laboratory Improvement Amendments to the federal Public Health Services Act, has been cleared or approved by the United States Food and Drug Administration, or has been developed by a laboratory in accordance with established regulations and quality standards, to allow individuals to self-collect specimens for STIs, including HIV, remotely at a location outside of a clinical setting.

(b) An individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State after January 1, 2025 shall provide coverage for home test kits for sexually transmitted infections, including any laboratory costs of processing the kit, that are deemed medically necessary or appropriate and ordered directly by a clinician or furnished through a standing order for patient use based on clinical guidelines and individual patient health needs.

(1) A commercial health care plan is required to cover the services outlined in this subsection when ordered for an enrollee by an in-network provider.

(2) Except as otherwise provided in this subsection, a policy subject to this subsection shall not impose a deductible, coinsurance, copayment, or any other cost-sharing requirement on the coverage provided. The provisions of this subsection do not apply to coverage of procedures to the extent such coverage would disqualify a high-deductible health plan from eligibility for a health savings account pursuant to the federal Internal Revenue Code, 26 U.S.C. 223.

(3) Except as otherwise authorized under this Section, a policy shall not impose any restrictions or delays on the coverage required under this Section.

(4) If a plan or issuer uses a network of providers, nothing in this Section shall be construed to require coverage or to prohibit the plan or issuer from imposing cost-sharing for items or services described in this Section that are provided or delivered by an out-of-network provider, unless the plan or issuer does not have in its network a provider who is able to or is willing to provide the applicable items or services.

Section 15. The Illinois Public Aid Code is amended by changing Section 5-16.8 as follows:

(305 ILCS 5/5-16.8)

Sec. 5-16.8. Required health benefits. The medical assistance program shall (i) provide the post-mastectomy care benefits required to be covered by a policy of accident and health insurance under Section 356t and the coverage required under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6, 356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46, 356z.47, 356z.51, 356z.53, 356z.56, 356z.59, 356z.60, and 356z.61, 356z.64, 356z.67, and 356z.71 of the Illinois Insurance Code, (ii) be subject to the provisions of Sections 356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the Illinois Insurance Code, and (iii) be subject to the provisions of subsection (d-5) of Section 10 of the Network Adequacy and Transparency Act.

The Department, by rule, shall adopt a model similar to the requirements of Section 356z.39 of the Illinois Insurance Code.

On and after July 1, 2012, the Department shall reduce any rate of reimbursement for services or other payments or alter any methodologies authorized by this Code to reduce any rate of reimbursement for services or other payments in accordance with Section 5-5e.

To ensure full access to the benefits set forth in this Section, on and after January 1, 2016, the Department shall ensure that provider and hospital reimbursement for post-mastectomy care benefits required under this Section are no lower than the Medicare reimbursement rate.

(Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22; 102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff. 1-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420, eff. 1-1-24; revised 12-15-23.)

Section 20. The AIDS Confidentiality Act is amended by adding Section 5.6 as follows:

(410 ILCS 305/5.6 new)

Sec. 5.6. Illinois AIDS Drug Assistance Program.

(a) The purpose of this Section is to expand and assist with implementation of the Rapid Start for HIV treatment model. The pilot sites will allow the development of a coordinated system of health care services to provide timely and quality HIV treatment. This will occur by increasing the capacity of the Department of Public Health and build toward establishing the Rapid Start model as the standard of care for HIV treatment. This program shall be known as the Illinois AIDS Drug Assistance Program or Illinois ADAP.

(b) In this Section:

"Conditional approval" means Illinois ADAP approval within 24 hours and allows for attestation of eligibility requirements. An applicant seeking conditional approval must document residency in the State of Illinois.

"Rapid Start for HIV Treatment" means initiating antiretroviral therapy within 7 days after initial diagnosis or within 7 days after referral to HIV medical care as defined by the Centers for Disease Control and Prevention recommendations for HIV treatment.

(c) Once a complete Illinois AIDS Drug Assistance Program application is submitted with all necessary supporting documents, processing of the application shall occur within 72 hours after the time of submission.

(d) Illinois ADAP shall establish a pathway for conditional approval of Illinois ADAP enrollment, with the requirement that applicants then submit a full Illinois ADAP application within 30 days after receiving conditional approval.

(e) The Department of Public Health shall establish 8 Rapid Start for HIV Treatment pilot sites. Upon referral from an HIV testing site, the program shall provide funding for and coordination of health care services to support treatment goals. The program shall provide ancillary services, pharmaceutical drug assistance, and case management services to participants while the appropriate transition is made for continuity of care within the Rapid Start for HIV treatment model timeline. The Department may adopt rules to implement this pilot program in accordance with industry standards informed by the most current Centers for Disease Control and Prevention guidance on HIV care and treatment.

(f) The Pilot sites shall abide by the following principles:

(1) Nothing About Us Without Us: Pilot site programs and services shall be formulated with transparency, community involvement, and direct ongoing input by people living with and vulnerable to HIV.

(2) Equity: Pilot site programs and services shall provide equitable support, services, and resources to all participants and ensure accessibility to the greatest extent possible. They shall also be established in underserved communities.

(3) Self-Determination: Pilot site programs and services shall prioritize individual dignity and autonomy in decision-making while encouraging people to connect with additional services that promote health and well-being.

(4) Reduce Stigma: Pilot site programs and services shall affirm the humanity and dignity of people living with or vulnerable to HIV and shall operate in a way that is welcoming to reduce stigma and build trust.

(5) Safe Spaces: Pilot site programs and services shall prioritize relationship-building and trust among partners, staff, and participants to create safe spaces.

(g) The Department, in cooperation with the lead agency designated under subsection (c), shall publish a report on the operation of the pilot program 15 months after the pilot sites have launched. The Department shall share the report with the General Assembly and the Governor's Office and shall make it publicly available on its Internet website. The report shall include:

(1) the number offers made for enrollment;

(2) the number of enrolled participants;

(3) the number and reasons of patients declined for service; and

(4) the length of time from initial diagnosis or referral to the start of HIV treatment, and, when available, the length of time participants were able to achieve an undetectable viral load.

Data shall also include demographic data on the racial, ethnic, age, sex, disability status, sexual orientation, gender identity, and primary or preferred language of program participants in accordance with the Data Governance and Organization to Support Equity and Racial Justice Act. The report shall include the Department's recommendations concerning the continued operation of the Rapid Start for HIV treatment pilot program and its expansion or progress towards becoming the standard of care for HIV treatment. The contents of the report shall be in accordance with the AIDS Confidentiality Act.

Implementation of this Section is subject to appropriations made to the Illinois Department of Public Health for this purpose.

Section 25. The County Jail Act is amended by changing Section 17.10 as follows:

(730 ILCS 125/17.10)

Sec. 17.10. Requirements in connection with HIV/AIDS.

(a) In each county other than Cook, during the medical admissions exam, the warden of the jail, a correctional officer at the jail, or a member of the jail medical staff must provide the prisoner with appropriate written information concerning human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The Department of Public Health and community-based organizations certified to provide HIV/AIDS testing must provide these informational materials to the warden at no cost to the county. The warden, a correctional officer, or a member of the jail medical staff must inform the prisoner of the option of being tested for infection with HIV by a certified local community-based agency or other available medical provider at no charge to the prisoner.

(b) In Cook County, during the medical admissions exam, an employee of the Cook County Health & Hospitals System must provide the prisoner with appropriate information in writing, verbally or by video or other electronic means concerning human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and must also provide the prisoner with option of testing for infection with HIV or any other identified causative agent of AIDS, as well as counseling in connection with such testing. The Cook County Health & Hospitals System may provide the inmate with opt-out human immunodeficiency virus (HIV) testing, as defined in Section 4 of the AIDS Confidentiality Act, unless the inmate refuses. If opt-out HIV testing is conducted, the Cook County Health & Hospitals System shall place signs in English, Spanish, and other languages as needed in multiple, highly visible locations in the area where HIV testing is conducted informing inmates that they will be tested for HIV unless they refuse, and refusal or acceptance of testing shall be documented in the inmate's medical record. Pre-test information shall be provided to the inmate and informed consent obtained from the inmate as required in subsection (q) of Section 3 and Section 5 of the AIDS Confidentiality Act. The Cook County Health & Hospitals System shall follow procedures established by the Department of Public Health to conduct HIV testing and testing to confirm positive HIV test results. All aspects of HIV testing shall comply with the requirements of the AIDS Confidentiality Act, including delivery of test results, as determined by the Cook County Health & Hospitals System in consultation with the Illinois Department of Public Health. Nothing in this Section shall require the Cook County Health & Hospitals System to offer HIV testing to inmates who are known to be infected with HIV. The Department of Public Health and community-based organizations certified to provide HIV/AIDS testing may provide these informational materials to the Bureau at no cost to the county. The testing provided under this subsection (b) shall consist of a test approved by the Illinois Department of Public Health to determine the presence of HIV infection, based upon recommendations of the United States Centers for Disease Control and Prevention. If the test result is positive, a reliable supplemental test based upon recommendations of the United States Centers for Disease Control and Prevention shall be administered.

(b-5) The Department of Corrections shall include the following information in the annual adult correctional facility public inspection report for each county:

(1) whether the warden of the jail, a correctional officer at the jail, or a member of the jail medical staff provide the prisoner with appropriate written information concerning HIV and AIDS during the medical admissions exam;

(2) whether the warden, a correctional officer, or a member of the jail medical staff informs the prisoner of the option of being tested for infection with HIV by a certified local community-based agency or other available medical provider at no charge to the prisoner;

(3) whether the warden of the jail makes appropriate written information or visual aids concerning HIV/AIDS available to every visitor to the jail;

(4) whether the warden of the jail has contacted the Department of Public Health or community-based organizations certified to provide HIV/AIDS testing to obtain informational materials within the past year;

(5) for Cook County, whether an employee of the Cook County Health and Hospitals System provides the prisoner with appropriate information in writing, verbally, or by video or other electronic means concerning HIV and AIDS during the medical admissions exam; and

(6) for Cook County, whether an employee of the Cook County Health and Hospitals System provides the prisoner with the option of testing for infection with HIV or any other identified causative agent of AIDS, as well as counseling in connection with such testing;

The Department of Public Health and community-based organizations certified to provide HIV/AIDS testing shall provide these informational materials to the warden at no cost to the office of the county sheriff.

(c) In each county, the warden of the jail must make appropriate written information concerning HIV/AIDS available to every visitor to the jail. This information must include information concerning persons or entities to contact for local counseling and testing. The Department of Public Health and community-based organizations certified to provide HIV/AIDS testing must provide these informational materials to the warden at no cost to the office of the county sheriff.

(d) Implementation of this Section is subject to appropriation.

(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11; 97-813, eff. 7-13-12; 98-1046, eff. 1-1-15.)